Laparoscopic versus open distal pancreatectomy with or without splenectomy: A propensity score analysis in Japan.

Background: Although the laparoscopic approach has been applied to distal pancreatectomy, its benefits with regard to the short-term outcomes of distal pancreatectomy remain unclear.

Materials And Methods: Using a Japanese nationwide inpatient database, we identified patients who underwent laparoscopic (n = 6647) and open (n = 21,843) distal pancreatectomy between July 2012 and March 2020. We conducted a 1:2 propensity score-matched analysis with adjustment for background characteristics (e.

Cost-effectiveness analysis of trastuzumab monotherapy versus adjuvant chemotherapy plus trastuzumab in elderly patients with HER2-positive early breast cancer.

Background: In elderly patients with human epidermal growth factor 2-positive breast cancer, adjuvant chemotherapy was associated with decreased quality of life, with relatively small benefits for prognosis. We examined the cost-effectiveness of trastuzumab monotherapy versus adjuvant chemotherapy plus trastuzumab in elderly patients with human epidermal growth factor 2-positive breast cancer.

Methods: A Markov model was developed to evaluate the costs and benefits of trastuzumab monotherapy over adjuvant chemotherapy plus trastuzumab for elderly patients with human epidermal growth factor 2-positive breast cancer.

cGAS-STING signaling encourages immune cell overcoming of fibroblast barricades in pancreatic cancer.

Immune checkpoint blockade (ICB) treatment improves the prognosis of several types of solid tumors, however, responsiveness to ICB therapy remains low in pancreatic ductal adenocarcinoma (PDACs), which has a rich tumor microenvironment (TME). The TME is composed of various stromal cells, including cancer-associated fibroblasts (CAFs), which contribute to the establishment of an immunosuppressive microenvironment. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway is an innate immune pathway that results in the upregulation of immune cell recruiting-cytokines and anti-tumor efficacy.

Successful endoscopic full-thickness resection of an exophytic subepithelial lesion with double scope traction technique.

Video 1Video demonstrating the endoscopic full-thickness resection of an exophytic subepithelial lesion with "double scope traction" technique.

An International Retrospective Observational Study of Liver Functional Deterioration after Repeat Liver Resection for Patients with Hepatocellular Carcinoma.

Whether albumin and bilirubin levels, platelet counts, ALBI, and ALPlat scores could be useful for the assessment of permanent liver functional deterioration after repeat liver resection was examined, and the deterioration after laparoscopic procedure was evaluated. For 657 patients with liver resection of segment or less in whom results of plasma albumin and bilirubin levels and platelet counts before and 3 months after surgery could be retrieved, liver functional indicators were compared before and after surgery. There were 268 patients who underwent open repeat after previous open liver resection, and 224 patients who underwent laparoscopic repeat after laparoscopic liver resection.

Association between body mass index and incidence of breast cancer in premenopausal women: a Japanese nationwide database study.

Purpose: The association between body mass index (BMI) and the incidence of premenopausal breast cancer in the Asian population remains unclear. We investigated this association using data from a Japanese nationwide administrative database.

Methods: We retrospectively identified 785,703 females aged < 45 years with available health checkup data on BMI from January 2005 and April 2020 from a Japanese nationwide database.

A nationwide certification system to increase the safety of highly advanced hepatobiliary-pancreatic surgery.

Background: To ensure that highly advanced hepatobiliary-pancreatic surgery (HBPS) is performed safely, the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons established a safety committee to monitor surgical safety.

Methods: We investigated postoperative mortality rates based on summary reports of numbers and outcomes of highly advanced HBPS submitted annually by the board-certified training institutions from 2012 to 2019. We also analyzed summary reports on mortality cases submitted by institutions with high 90-day post-HBPS mortality rates and recommended site visits and surveys as necessary.

Systemic capillary leak syndrome requiring fasciotomy for limb compartment syndrome: A case report and literature review.

Background: Limb compartment syndrome (LCS), a rare but serious complication of systemic capillary leak syndrome (SCLS)-related systemic edema, warrants prompt decompressive fasciotomy. We report a case of SCLS complicated by LCS of four extremities requiring emergent fasciotomies; furthermore, we reviewed existing published reports on SCLS with LCS.

Case Presentation: A 36-year-old man was diagnosed with SCLS based on profound vascular permeability with no other underlying conditions.

A convenient and reliable method for endoscopic mapping biopsy of cholangiocarcinoma using a double-lumen cytology device.

Video 1A convenient and reliable method for endoscopic mapping biopsy using a double-lumen cytology device. We developed a method using the external sheath of the CytomaxII double-lumen biliary cytology brush (Cook Medical, Bloomington, Ind, USA). In this method, the sheath is stabilized by the guidewire, allowing for convenient and reliable biopsy.

Validity of operative information in Japanese administrative data: a chart review-based analysis of 1221 cases at a single institution.

Purpose: To evaluate the validity of operative information recorded in the Diagnosis Procedure Combination (DPC) database, a national inpatient database including administrative claims data.

Methods: We reviewed the medical charts of 1221 patients who underwent one of six surgeries (breast, esophageal, gastric, thyroid cancer surgery, appendectomy, or inguinal hernia repair) at a surgery department of a university hospital from April 2016 to March 2019. We compared operative information (type, date, laterality of procedure; type of anesthesia; transfusion; and duration of anesthesia) recorded in the DPC database with the information recorded in the medical charts.

Transferability of an Artificial Intelligence Algorithm Predicting Rebubblings After Descemet Membrane Endothelial Keratoplasty.

Purpose: To develop an artificial intelligence (AI) algorithm enabling corneal surgeons to predict the probability of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) from images obtained using optical coherence tomography (OCT).

Methods: Anterior segment OCT data of patients undergoing DMEK by 2 different DMEK surgeons (C.C.

Pancreatic liposarcoma: a case report.

An 81-year-old woman who had undergone total thyroidectomy for papillary thyroid cancer 12 years earlier was found to have a tumor in the tail of the pancreas. Four years earlier, skin, lung, and mediastinal lymph node metastases had appeared. Computed tomography (CT) showed a mass 26 mm in diameter in the tail of the pancreas.

[Perioperative management of laparoscopic cholecystectomy in a patient with paroxysmal nocturnal haemoglobinuria undergoing ravulizumab treatment].

Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by hemolysis, thrombosis, and bone marrow failure. Infection, pregnancy, and surgical operation have the potential to evoke severe episodes of hemolysis and thrombosis. Therefore, the use of an antibody agent against complement component 5 (C5), eculizumab, one day before the operation is recommended.

The safety of rapid administration of enteral nutrition in acute stroke patients.

Background/aims: Early initiation of enteral nutrition (EN) is recommended for acute stroke patients, but it is time-consuming. Reducing EN administration time without increasing the frequency of complications is a worthwhile goal. We aimed to determine whether this goal was feasible.

Frequent HLA-DR loss on hematopoietic stem progenitor cells in patients with cyclosporine-dependent aplastic anemia carrying HLA-DR15.

To determine whether antigen presentation by HLA-DR on hematopoietic stem progenitor cells (HSPCs) is involved in the development of acquired aplastic anemia (AA), we studied the HLA-DR expression on CD45CD34CD38 cells in the peripheral blood of 61 AA patients including 23 patients possessing HLA-class I allele-lacking (HLA-class I[-]) leukocytes. HLA-DR-lacking (DR[-]) cells accounted for 13.0-57.

[Long-Term Survival after Surgical Resection for Small Cell Neuroendocrine Carcinoma of the Gallbladder].

A 60-year-old woman was not accompanied by any symptom. She had a gallstone which was identified 20 years prior. Ultrasonography performed by a local doctor revealed that the gallbladder was filled with small stones, and the patient was referred to our department for further examination and treatment for gallbladder stone.

Tumefactive eosinophil-rich non-granulomatous small vessel vasculitis in the cerebrum in a patient with idiopathic hypereosinophilic syndrome.

The definite diagnosis of central nervous system vasculitis requires pathological verification by biopsy or surgical resection of the lesion, which may not always be feasible. A 74-year-old woman with a history of allergic rhinitis, but not asthma, presented with slowly progressive left hemiparesis. Magnetic resonance imaging of the head revealed a heterogeneously enhancing mass involving the right internal capsule and corona radiata.

Clinical utility of comprehensive genomic profiling in Japan: Result of PROFILE-F study.

Introduction: Clinical sequencing has provided molecular and therapeutic insights into the field of clinical oncology. However, despite its significance, its clinical utility in Japanese patients remains unknown. Here, we examined the clinical utility of tissue-based clinical sequencing with FoundationOne® CDx and FoundationOne® Heme.

Two Cases of Angiosarcoma with Persistent Unilateral Eyelid Swelling.

Angiosarcoma is a widely known neoplasm with one of the poorest prognoses; however, such cases are rarely observed by the ophthalmologists in clinical practice. The tumor commonly develops on the face and scalp and may cause eyelid swelling. We present 2 such cases.

Portal vein embolization via the ipsilateral percutaneous transhepatic approach versus laparotomic transileocecal approach: complications, profile and changes in future liver remnant volume.

Objective: Major liver resection is an effective treatment option for patients with liver malignancy. The future liver remnant (FLR) volume and complications after portal vein embolization (PVE) were compared between the ipsilateral right portal vein (PTPE) and transileocolic (TIPE) approaches.

Methods: A total of 42 patients (TIPE, = 22; PTPE, = 20) underwent right lobectomy after PVE.