Publications by authors named "Tomonori Nakanoko"
Introduction: This study aimed to evaluate the clinical impact of skeletal muscle mass and nutritional status in gastric cancer patients treated with nivolumab monotherapy as late-line treatment.
Methods: We conducted a multi-institutional retrospective study of 90 gastric cancer patients who previously received anti-PD-1 therapy (nivolumab). On computed tomography images captured before nivolumab induction, the skeletal muscle index (SMI, cm2/m2) was defined as the erector muscle area (cm2) divided by the height (m) squared.
Introduction: This study aimed to clarify the validity of laparoscopic surgery for lower gastrointestinal perforation by comparing the clinical outcomes of laparoscopic and open emergency surgery.
Methods: We reviewed the data of patients who underwent surgery for lower gastrointestinal perforation. Patients were categorized into two groups: the laparoscopic group who underwent laparoscopic surgery, and the open group who underwent laparotomy.
Article Synopsis
- Colorectal perforation leads to high risks of complications and death post-surgery, prompting an investigation into patient features and risk factors.
- A study of 147 patients revealed that complications like wound infections and abscesses were most common, with certain clinical indicators (like time to surgery and nutritional status) linked to these issues.
- Key findings suggest that delays in surgery and specific blood test results (PNI, NLR, PLR) can predict severe complications and increased mortality rates following surgery for colorectal perforation.
Background/aim: Recent research has demonstrated that laparoscopic multivisceral resection (MVR) for advanced colorectal cancer is safe, practicable, and yields satisfactory oncological results, which is in line with the growing usage of laparoscopic surgery. The effectiveness of laparoscopic MVR is still debatable, though. The goal of this study was to compare the short- and long-term results of patients with advanced colorectal cancer treated with open MVR with laparoscopic procedures.
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- - This study investigated the importance of very high preoperative carbohydrate antigen 19-9 (CA19-9) levels in patients with early-stage colorectal cancer, analyzing data from 971 patients treated between 2004 and 2022.
- - Results showed that only 2.0% of patients had very high CA19-9 levels, and they experienced significantly worse overall survival compared to those with normal levels, highlighting a correlation between high CA19-9 levels and poor outcomes.
- - The study concludes that high preoperative CA19-9 levels indicate worse survival rates, suggesting that these patients should receive careful monitoring and follow-up post-surgery.
Background: Laparoscopic gastrectomy is widely used as a curative treatment for gastric cancer. Although delta-shaped anastomosis is commonly used for Billroth I anastomosis after totally laparoscopic distal gastrectomy (TLDG), it has some drawbacks. The book-binding technique (BBT) was developed as an alternative, and this study aimed to examine its short-term results in 188 consecutive cases.
View Article and Find Full Text PDFObjective: To clarify the surgical outcomes of esophagectomy in Japan and comprehensively evaluate trends over time. It is important to analyze data from a large number of consecutive patients from a single institution.
Methods: We evaluated the treatment outcomes, complications, and prognosis of 1500 consecutive patients who underwent esophagectomy during 5 periods: group A (n = 284), 1964-1984; group B (n = 345), 1985-1993; group C (n = 253), 1994-2002; group D (n = 297), 2003-2012; and group E (n = 321), 2013-March 2020.
Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by frequent esophageal involvement. However, there are few reports on esophagectomy for esophageal strictures associated with SSc. Herein, we present a case of successful treatment of an esophageal stricture associated with SSc through subtotal esophagectomy.
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- Telementoring in robotic surgery is affected by teaching methods, especially since surgery involves complex 3D structures.
- A study with 20 medical students using 3D drawing annotations showed better performance compared to voice and 2D annotations, including shorter operation times and fewer retries.
- The 3D annotation group scored higher on surgical skill assessments, suggesting it enhances comprehension and efficiency in surgical procedures.
Article Synopsis
- - This study aimed to assess the effectiveness of haptic feedback during telesurgery to enhance safety in robotic surgery practices.
- - Experiments involved a surgeon operating from two separate locations, and while no significant impact on task accuracy was found, the remote operations resulted in longer completion times and lower usability ratings.
- - Haptic feedback allowed surgeons to use lighter grasping forces, particularly benefiting experienced surgeons, highlighting its potential as a crucial tool for safe and effective telerobotic surgery.
Primary adenocarcinoma of the duodenum is a rare neoplasm that is often microsatellite instability-high (MSI-H). Pembrolizumab, a monoclonal antibody, has been recently approved in Japan for treatment of MSI-H solid tumors. Lynch syndrome is a frequent hereditary cancer predisposition syndrome.
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- The study focuses on improving left recurrent nerve lymph node (LRLN) dissection during robot-assisted thoracoscopic subtotal esophagectomy (RATE) by addressing the interference caused by the robotic arm.
- Researchers analyzed 102 cases from a specific time period, emphasizing a technique that uses natural organ movement to create space for dissection.
- Results showed a reasonable surgery time, a sufficient number of LRLNs dissected, and a low percentage of postoperative complications, indicating the method's safety and effectiveness.
Article Synopsis
- A 72-year-old woman with esophageal cancer experienced perforation of a gastric metastasis, which is typically linked to a poor prognosis.
- Due to complications from chemotherapy, she underwent a palliative resection instead of a complete removal, but the tumor grew afterwards.
- After beginning treatment with an immune checkpoint inhibitor, nivolumab, her tumor significantly shrank, leading to improved quality of life and long-term survival.
Article Synopsis
- This study introduces a double-surgeon cockpit system for telesurgery, marking a significant step in developing a clinically applicable telesurgical technique.
- It involved non-specialized surgeons performing surgeries on pigs with remote assistance and evaluated the effect of internet security measures on communication during procedures.
- Results showed promising outcomes, with non-specialized surgeons performing safely and effectively, indicating the feasibility of this system as a foundation for future clinical telesurgery.
Background/aim: Surgery for elderly patients with gastric cancer is becoming more common. However, the risk factors of the laparoscopic surgery for these patients are unknown, and thus it is difficult to determine appropriate treatments for such patients. The aim of this retrospective study was to clarify the risk factors for the treatment outcomes after laparoscopic gastrectomy in elderly patients.
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- - A study developed an AI model to predict the recurrence of colorectal cancer after surgery by analyzing digitized pathological slides from 471 patients.
- - The model showed a strong ability to classify patients' risk for recurrence with an area under the curve of 0.7245, indicating it can differentiate between better and worse survival outcomes.
- - High scores from the model were significantly linked to a worse chance of recurrence, independent of other factors, suggesting it could assist in treatment decisions like the need for adjuvant chemotherapy.
Objective: To establish the prognostic value of mean corpuscular volume (MCV) in patients with esophageal squamous cell carcinoma (ESCC) who have undergone esophagectomy.
Background: The MCV increases in patients with high alcohol and tobacco consumption. Such a lifestyle can be a risk factor for malnutrition, comorbidities related to those habits, and multiple primary malignancies, which may be associated with frequent postoperative morbidity and poor prognosis.
Article Synopsis
- - The study aimed to compare the effects of triple-layered and double-layered circular staplers on anastomotic leakage in rectal cancer surgeries, through both a porcine model and a clinical analysis of patient outcomes.
- - Results showed that the triple-layered stapler had a significantly higher bursting pressure and a lower rate of anastomotic leakage in patients compared to the double-layered stapler (0.0% vs 5.8%).
- - Factors like the use of the triple-layered stapler and female sex were associated with a reduced risk of leakage, suggesting its potential benefits for surgical outcomes in rectal cancer surgery.
Background: Compared with open standard gastrectomy (OG), laparoscopic gastrectomy (LG) did not result in inferior disease-free survival for early-stage and locally advanced gastric cancer (AGC). However, whether LG for AGC in elderly patients is more beneficial than OG is unclear.
Methods: This study examined 458 patients with AGC.
Background: No post-treatment follow-up methods have been established yet for patients with esophageal carcinoma who undergo radical esophagectomy (Surg) or who show complete response to definitive chemoradiotherapy (dCRT-CR). The purpose of this study was to investigate the current status of follow-up of the Surg and dCRT-CR patients in Japan, and understand the current reality and problems to establish an optimal follow-up method.
Methods: A questionnaire on the follow-up method adopted was sent by e-mail to 124 institutions approved by the Japan Esophageal Society as training institutions for board-certified esophageal surgeons; responses were received from 89 institutions.
Background: Intraductal papillary mucinous neoplasm (IPMN) can lead, via the adenoma-carcinoma sequence, to invasive adenocarcinoma, which has a poor prognosis. Most IPMNs do not meet the indications for surgery and instead are monitored regularly, but no biomarkers of malignant transformation during surveillance have been established.
Patients And Methods: A total of 50 patients with IPMN who underwent pancreatectomy were evaluated retrospectively.
Background: Ectopic variceal bleeding is a rare but life-threatening complication of portal hypertension (PH). Oxaliplatin-based chemotherapy for colorectal cancer (CRC) is associated with sinusoidal obstruction syndrome of the liver, which can lead to PH.
Case Presentation: Here, we report a successful hybrid surgery that included intraoperative obliteration of ileal conduit stomal varices (ICSVs) for a 66-year-old woman with CRC and liver metastasis that had been treated multimodally during the previous 4 years, including 17 courses of oxaliplatin-based chemotherapy.
Esophageal bypass surgery is an effective treatment strategy for esophageal cancer with esophago-tracheobronchial fistula. We herein report an esophageal cancer patient with esophago-pulmonary fistula who achieved a long-term survival but died suddenly because of cardiac tamponade. A 70-year-old male patient with esophago-pulmonary fistula due to esophageal tumor invasion underwent definitive chemoradiotherapy as the initial treatment.
View Article and Find Full Text PDFBackground/aim: The safety and efficacy of laparoscopic total gastrectomy (LTG) for remnant gastric cancer (RGC) remains unclear. The purpose of this study was to compare the clinical outcomes of LTG with open total gastrectomy (OTG) for RGC.
Patients And Methods: Twenty-two patients who underwent total gastrectomy for RGC were enrolled in this study.
Objective: The aim of this study is to identify biomarkers that predict efficacy of preoperative therapy and survival for esophageal squamous cell carcinoma (ESCC).
Background: It is essential to improve the accuracy of preoperative molecular diagnostics to identify specific patients who will benefit from the treatment; thus, this issue should be resolved with a large-cohort, retrospective observational study.
Methods: A total of 656 patients with ESCC who received surgery after preoperative CDDP + 5-FU therapy, docetaxel + CDDP + 5-FU therapy or chemoradiotherapy (CRT) were enrolled.