Prospective Survey of Postoperative Pain in Japan: A Multicenter, Observational Study.

: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of analgesia for early recovery.

[A Case of Pathological Complete Response after Nivolumab Therapy in Unresectable Advanced Gastric Cancer].

A 70-year-old man was admitted to a local hospital with epigastric pain and diagnosed with type-2 gastric cancer. Contrast-enhanced CT scan showed metastases in S3 and S8 of the liver, and the tumor was classified as type cT4aN2H1, cStage ⅣB. Nivolumab monotherapy was initiated after failure of treatment with S-1 plus oxaliplatin and ramucirumab.

The safety and feasibility of robotic pancreaticoduodenectomy: A multicenter retrospective assessment of 425 patients in Japan.

Background/purpose: The Japanese public health insurance system has recently covered robotic pancreaticoduodenectomy (RPD). This study aimed to review the results of RPD during the introductory period and elucidate its safety and feasibility in Japan.

Methods: Consecutive data of 425 patients who underwent RPD were retrospectively collected from 10 high-volume centers in Japan between April 2020 and September 2022.

Short- and long-term outcomes of liver resection with hepatic vein reconstruction for liver tumors: A nationwide multicenter survey.

Background/purpose: This study clarifies the short- and long-term outcomes of liver resection with hepatic vein (HV) reconstruction for liver tumors and identifies the risk factors for poor outcome.

Methods: We contacted 263 specialized centers in Japan and collected data on this surgical procedure. Patient characteristics, surgical procedures, and outcomes were then analyzed.

Giant splenic artery aneurysm rupture into the stomach that was successfully managed with emergency distal pancreatectomy.

Background: Splenic artery aneurysms usually rupture into the free peritoneal space and rarely into the gastrointestinal tract. We report the case of a patient with a giant splenic artery aneurysm that ruptured in to the stomach with hemorrhagic shock and was successfully treated with emergency surgery.

Case Presentation: A 59-year-old man presented to the emergency department with chest pain and syncope.

Metachronous skeletal muscle metastasis without any other organ metastases after curative gastrectomy: a case report.

Background: Skeletal muscle metastasis from gastric cancer is extremely rare and often accompanied with synchronous metastasis to any other organs. We herein report a case of rapidly developing multiple skeletal metastases from gastric cancer without any other organ metastases.

Case Presentation: A 47-year-old man underwent distal gastrectomy for advanced gastric cancer.

Questionnaire survey on work motivations of gastrointestinal and hepatobiliary pancreatic surgeons enrolled in a Japanese national interdisciplinary program.

Background: Among young residents, there seems to be a decreasing desire to become surgeons, resulting in a decrease in the number of surgeons. There is concern regarding a shortage of hepatobiliary pancreatic (HBP) surgery residents in Japan. A questionnaire survey was designed to assess the work motivations of Japanese gastrointestinal (GI) and HBP surgeons.

Parenchyma-Sparing Hepatectomy with Vascular Reconstruction Techniques for Resection of Colorectal Liver Metastases with Major Vascular Invasion.

Background: Resectability of colorectal liver metastasis (CRLM) depends on major vascular involvement and is affected by chemotherapy-induced liver injury. Parenchyma-sparing with combined resection and reconstruction of involved vessels may expand the indications and safety of hepatectomy.

Methods: Of 92 patients who underwent hepatectomy for CRLM, 15 underwent major vascular resection and reconstruction.

Retrocaval liver lifting maneuver and modifications of total hepatic vascular exclusion for liver tumor resection.

Aim: To evaluate the efficacy of technical modifications of total hepatic vascular exclusion (THVE) for hepatectomy involving inferior vena cava (IVC).

Methods: Of 301 patients who underwent hepatectomy during the immediate previous 5-year period, 8 (2.7%) required THVE or modified methods of IVC cross-clamping for resection of liver tumors with massive involvement of the IVC.

von Willebrand Factor-Rich Platelet Thrombi in the Liver Cause Sinusoidal Obstruction Syndrome following Oxaliplatin-Based Chemotherapy.

Oxaliplatin-based chemotherapy is widely used to treat advanced colorectal cancer (CRC). Sinusoidal obstruction syndrome (SOS) due to oxaliplatin is a serious type of chemotherapy-associated liver injury (CALI) in CRC patients. SOS is thought to be caused by the sinusoidal endothelial cell damage, which results in the release of unusually-large von Willebrand factor multimers (UL-VWFMs) from endothelial cells.

Relevance of ADAMTS13 to liver transplantation and surgery.

A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS13) specifically cleaves unusually-large von Willebrand factor (VWF) multimers under high shear stress, and down-regulates VWF function to form platelet thrombi. Deficiency of plasma ADAMTS13 activity induces a life-threatening systemic disease, termed thrombotic microangiopathy (TMA) including thrombotic thrombocytopenic purpura (TTP). Children with advanced biliary cirrhosis due to congenital biliary atresia sometimes showed pathological features of TMA, with a concomitant decrease of plasma ADAMTS13 activity.

Comparison between percutaneous radiofrequency ablation and surgical hepatectomy focusing on local disease control rate for colorectal liver metastases.

Background/aims: Therapeutic efficacy of radiofrequency ablation (RFA) for colorectal liver metastases (CRLM) was compared with hepatic resection (HR), focusing on local disease control rate as well as risk factors of recurrence and patients survival.

Methodology: From April 2002 to March 2012, 32 patients underwent RFA and 60 patients underwent HR for CRLM. The rate of local recurrence along the ablated or resected margin was evaluated in these patients.

Kugel patch method prevents the development of a femoral hernia after inguinal herniorrhaphy.

Purpose: A femoral hernia is a relatively rare condition, and no standard surgical methods have so far been established. In this study, we investigated the development of a femoral hernia after inguinal herniorrhaphy.

Methods: A total of 1,969 patients who underwent surgery for an inguinal hernia from April 1992 to March 2012 were enrolled in this study.

[Solitary metastasis to the pancreas of renal cell carcinoma : a case report].

A 62-year-old man had undergone retroperitoneoscopic radical nephrectomy for left renal cell carcinoma at the age of 57 years. The histopathological diagnosis was clear cell carcinoma of the kidney (G2, pT2a, INF β). Five years postoperatively, enhanced computed tomography demonstrated strongly enhanced tumors on the pancreatic head and body.

[A case of AFP-producing gastric cancer with peritoneal metastasis treated effectively with chemotherapy, mainly using S-1 and trastuzumab].

A 71-year-old man, diagnosed with advanced gastric cancer and severe pyloric stenosis, was introducted to our hospital. Para-aortic lymph nodes metastasis and pancreas invasion were seen with enhanced CT scan. Serum AFP showed a high price (1,465.

Determination of ADAMTS13 and Its Clinical Significance for ADAMTS13 Supplementation Therapy to Improve the Survival of Patients with Decompensated Liver Cirrhosis.

The liver plays a central role in hemostasis by synthesizing clotting factors, coagulation inhibitors, and fibrinolytic proteins. Liver cirrhosis (LC), therefore, impacts on both primary and secondary hemostatic mechanisms. ADAMTS13 is a metalloproteinase, produced exclusively in hepatic stellate cells, and specifically cleaves unusually large von Willebrand factor multimers (UL-VWFM).

Salvage living donor liver transplantation after percutaneous transluminal angioplasty for recurrent Budd-Chiari syndrome: a case report.

Introduction: Budd-Chiari syndrome is a very rare pathological entity that ultimately leads to liver failure. Several therapeutic modalities, including percutaneous transluminal angioplasty, have been attempted to save the life of patients with Budd-Chiari syndrome. Few reports have described a salvage living donor liver transplantation performed after percutaneous transluminal angioplasty in a patient with acute Budd-Chiari syndrome.

[Roles of hepatectomy for colorectal liver metastases with necrotic foci caused by prior anti-cancer therapies].

Recent advances in chemotherapy for colorectal cancer prolonged survival. Tumor necrosis may develop as a side effect of chemotherapeutic agents. Recently, radiofrequency ablation sometimes indicated to patients with colorectal liver metastasis, when hepatectomy cannot be performed due to impaired hepatic functional reserve or general condition.

ADAMTS13 activity decreases after hepatectomy, reflecting a postoperative liver dysfunction.

Background/aims: The precise mechanism and prophylactic strategy of deteriorated hepatic function after liver surgery have not been fully understood. The substrate of ADAMTS13, unusually large von Willebrand factor multimers, is produced in vascular endothelial cells at liver injury, leading to platelet aggregation. The decrease of plasma ADAMTS13 activity may involve not only the formation of platelet thrombi in the liver, but also subsequent progression of liver dysfunction through a microcirculatory disturbance.

Pivotal role of ADAMTS13 function in liver diseases.

The liver is a major source of clotting and fibrinolytic proteins, and plays a central role in thrombo-regulation. Patients with advanced liver diseases tend to bleed because of reduced plasma levels of several clotting factors and thrombocytopenia, but they do also exhibit thrombotic complications. ADAMTS13 is a metalloproteinase, produced exclusively in hepatic stellate cells, and specifically cleaves highly multimeric von Willebrand factor (VWF).

Survival of microencapsulated islets at 400 days posttransplantation in the omental pouch of NOD mice.

The long-term durability of agarose microencapsulated islets against autoimmunity was evaluated in NOD mice. Islets were isolated from 6-8-week-old prediabetic male NOD mice and microencapsulated in 5% agarose hydrogel. Microencapsulated or nonencapsulated islets were transplanted into the omental pouch of spontaneously diabetic NOD mice.

Primary leiomyoma of the liver: report of a case.

We report a case of primary leiomyoma of the liver. A 71-year-old man was admitted for investigation of a mass lesion in his liver, detected on ultrasonography. Computed tomography (CT) showed a solid tumor, 3 cm in diameter, in the caudate lobe of the liver.