Publications by authors named "URAKAWA N"
Background: Gastrectomy for gastric cancer with duodenal invasion poses an oncologic (high positive rate of resection line infiltration) and a surgical (high risk of duodenal fistula) challenge. This study aimed to validate the safety of gastrectomy for gastric cancer with duodenal invasion.
Methods: A total of 82 patients with distal gastric cancer who underwent gastrectomy and reconstruction via the Billroth II or Roux-en-Y procedure at Kobe University Hospital between 2011 and 2021 were retrospectively reviewed.
Background/aim: Squamous cell carcinoma antigen (SCC) is widely used as a tumor marker for esophageal cancer. In this study, we investigated the relationship between SCC and long-term outcomes in patients with esophageal squamous cell carcinoma after neoadjuvant chemotherapy (NAC) followed by minimally invasive esophagectomy (MIE).
Patients And Methods: Between 2010 and 2018, 124 patients with ESCC who underwent MIE after NAC (cisplatin plus 5-fluorouracil) were included.
Background: Esophagectomy with lymphadenectomy is the primary treatment for esophageal squamous cell carcinoma (ESCC). However, intensive dissection of lymph nodes (LNs) along the recurrent laryngeal nerve (RLN) is associated with RLN palsy and pulmonary complications leading to poor survival. Therefore, this study aimed identify the risk factors for LNs metastasis along the RLN in patients with ESCC.
View Article and Find Full Text PDFDevelopmental cyst is occasionally seen in children but are less common in adults. Complete removal of developmental cyst is necessary because there are risk of infection, squamous cell carcinoma, and recurrence due to incomplete resection. The best approach for resection of developmental cyst is still controversial.
View Article and Find Full Text PDFArticle Synopsis
- After esophagectomy, patients often experience anastomotic strictures that complicate food passage and increase the risk of aspiration pneumonia, potentially affecting quality of life and nutrition.
- A study of 188 patients who underwent minimally invasive esophagectomy identified that 23% developed strictures, with a significantly higher occurrence among those who had neoadjuvant chemotherapy.
- Early intervention—specifically within 69 days post-surgery—was found to be a crucial risk factor for requiring more than five balloon dilatations to treat strictures, indicating a need for careful treatment planning.
Article Synopsis
- The study compares two surgical methods for treating low rectal cancer: traditional abdominoperineal resection (APR) and the newer transperineal total mesorectal excision (TpTME).
- Results showed that the TpTME method had a significantly shorter operative time and less blood loss and transfusion rates compared to conventional APR.
- Both methods had similar long-term cancer survival rates, but patients in the TpTME group experienced a shorter hospital stay post-surgery.
Article Synopsis
- A study compared two surgical techniques, Triangular Anastomosis (TA) and Totally Mechanical Collard Anastomosis (TMCA), for cervical esophagogastric anastomosis during minimally invasive esophagectomy.
- The research involved 117 patients, with outcomes such as pneumonia, recurrent laryngeal nerve palsy, anastomotic leakage, and stricture being analyzed between the two methods.
- Results showed no significant difference in major complications but highlighted that TMCA had a significantly lower rate of anastomotic stricture (2.5%) compared to TA (27.5%).
Article Synopsis
- The study investigates the importance of reinforcing the duodenal stump to prevent leakage after radical gastrectomy in gastric cancer patients, as the effectiveness of different reinforcement methods was not well understood.
- Conducted across 57 medical centers in Japan, the research analyzed data from over 16,000 patients from 2012 to 2021 and found that 0.93% experienced duodenal stump leakage, with lower incidence rates linked to reinforcement methods like seromuscular sutures and reinforced staplers.
- Results highlighted that duodenal stump reinforcement is crucial, as leakage rates were lower in higher-volume hospitals and specific patient demographics were identified as risk factors for leakage-related mortality.
Article Synopsis
- * Researchers analyzed 62 patients who had surgery after NACRT, determining a significant cutoff reduction rate of 61.5% for predicting prognosis.
- * Results showed that patients with higher SUVmax reduction rates had better pathologic responses and improved survival rates, suggesting that SUVmax reduction could be a valuable prognostic indicator.
Article Synopsis
- A case of advanced gastric antrum cancer in an 80-year-old male patient was successfully treated with laparoscopic distal gastrectomy after initial preoperative chemotherapy, despite the cancer having spread to multiple organs.
- The patient, who had a poor general condition (performance status score of 3), underwent three cycles of chemotherapy, improving his health to a score of 1 and achieving a partial response.
- Post-surgery, histopathological analysis showed no signs of remaining cancer, indicating a complete cure.
Article Synopsis
- The study investigates the safety and feasibility of using the open left diaphragm method during transhiatal surgery for esophagogastric junction adenocarcinoma, despite this approach not yet being standard due to reconstruction challenges.
- A retrospective analysis was conducted comparing outcomes for patients who had surgery with and without the open left diaphragm method, focusing on complications and operative time.
- Results indicated that the open left diaphragm method led to significantly fewer respiratory complications (17% vs. 46%) and was deemed safe for patients with esophageal invasion lengths of 3-4 cm.
Article Synopsis
- * Key findings revealed that different cut-off values for resected LN counts varied by anatomical areas (upper, middle, lower mediastinal, and abdominal) and patient types (upper/middle thoracic and lower thoracic ESCC).
- * Overall survival for patients with upper/middle thoracic ESCC was significantly influenced by resected LNs from the upper mediastinal area, while for lower thoracic cases, factors like tumor invasion depth and pulmonary complications were more critical
Article Synopsis
- In Japan, the standard treatment for locally advanced esophageal squamous cell carcinoma involves preoperative chemotherapy followed by surgery, but recurrence rates after surgery remain high.
- This study investigates the effectiveness and safety of using nivolumab, a targeted therapy, as a postoperative treatment for patients who have undergone preoperative chemotherapy with specific drugs and surgery.
- It is a Phase II trial involving 130 patients, assessing outcomes such as disease-free survival and any side effects from nivolumab treatment following their surgery.
Adenocarcinoma of the rectum and anal canal with inguinal lymph node metastasis(ILNM)is rare and the prognosis is generally poor. The aim of this study was to clarify the clinical significance of selective inguinal lymph node dissection and total mesorectal excision after preoperative therapy for adenocarcinoma of the rectum and anorectal canal with clinically suspected ILNM. Of the 15 patients, 11 received preoperative chemoradiotherapy, 3 received chemotherapy, and 1 received chemotherapy after chemoradiotherapy.
View Article and Find Full Text PDFAlthough a therapeutic response to neoadjuvant chemoradiotherapy(NACRT)is important to improve oncological outcomes after surgery in patients with locally advanced rectal cancer, there is no reliable predictor for this. The Wnt/β-catenin signal is known to be crucial for the tumorigenesis of colorectal cancer. This study aimed to investigate the association between Wnt/β-catenin signal activation and the response to NACRT in patients with locally advanced rectal cancer.
View Article and Find Full Text PDFBackground/aim: The relationship between gastric cancer and oral health has been reported in several studies. This study aimed to determine the relationship between the postoperative prognosis of gastric cancer and oral health using preoperative tooth loss as a simple index.
Patients And Methods: We conducted a single-center retrospective cohort study.
Background/aim: The albumin and derived neutrophil-to-lymphocyte ratio (Alb-dNLR) score, which combines an inflammation index with a nutritional index, has recently been reported as a useful prognostic marker in various cancers. However, evaluation of the usefulness of Alb-dNLR score in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (NACRT) has not been reported yet.
Patients And Methods: This retrospective study included 69 patients with LARC undergoing NACRT followed by surgery between November 2005 and July 2020.
Background: Large tumor size is a prognostic factor in esophageal squamous cell carcinoma (ESCC). However, the effect of tumor size on outcomes following neoadjuvant chemotherapy (NAC) has not been evaluated. This study aimed to assess the influence of tumor size on prognosis of patients undergoing esophagectomy after NAC.
View Article and Find Full Text PDFPurpose: Esophageal cancer is a lethal tumor typically treated by neoadjuvant chemotherapy and surgery. For patients undergoing esophagectomy, postoperative enteral nutrition is important in preventing complications. Sarcopenia is associated with poor postoperative outcomes in esophageal cancer.
View Article and Find Full Text PDFBackground/aim: Elderly patients with pathological stage II/III gastric cancer struggle to complete adjuvant chemotherapy. Neoadjuvant chemotherapy (NAC) for treating locally advanced gastric cancer (LAGC) has drawn attention; however, its indication for elderly patients who are vulnerable to chemotherapy is unclear. This study aimed to investigate the feasibility and efficacy of NAC for elderly patients with gastric cancer.
View Article and Find Full Text PDFThere has been no reliable marker for predicting oncological outcomes in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (NACRT). We retrospectively analyzed 73 patients with LARC who underwent curative surgery after NACRT. The modified Glasgow prognostic score (mGPS) was assessed after NACRT, and clinical outcomes were compared between the high (mGPS = 1 or 2; n = 23) and low (mGPS = 0; n = 50) groups.
View Article and Find Full Text PDFBackground/aim: In pathology, the digitization of tissue slide images and the development of image analysis by deep learning have dramatically increased the amount of information obtainable from tissue slides. This advancement is anticipated to not only aid in pathological diagnosis, but also to enhance patient management. Deep learning-based image cytometry (DL-IC) is a technique that plays a pivotal role in this process, enabling cell identification and counting with precision.
View Article and Find Full Text PDFPurpose: Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. In recent years, the proportion of patients diagnosed with CRC at younger ages has increased. The clinicopathological features and oncological outcomes in younger patients with CRC remain controversial.
View Article and Find Full Text PDFBackground/aim: There are several concerns about oncological contamination and technical difficulty in the laparoscopic approach for locally advanced gastric cancer. We aimed to determine the safety and usefulness of laparoscopic gastrectomy for patients with advanced gastric cancer with tumor depth greater than serosal invasion.
Patients And Methods: Sixty-two laparoscopic and 82 laparotomy gastric cancer cases surgically diagnosed as serosal or other organ invasions intraoperatively between 2011 and 2021 were included.
Background: Retrosternal reconstruction has lower risks for severe postoperative morbidities, such as gastro-tracheal fistula or esophageal hiatal hernia. We have previously reported the laparoscopic retrosternal route creation (LRRC) method, but its safety and efficacy remain unclear.
Methods: In total, 374 patients with esophageal carcinoma who underwent minimally invasive McKeown esophagectomy in the prone position between 2010 and 2021 were retrospectively reviewed.