Annual report on National Clinical Database 2021 for gastroenterological surgery in Japan.

Aim: The Japanese National Clinical Database, which covers more than 95% of the surgeries performed in Japan, is the largest nationwide database. This is the 2021 annual report of the Gastroenterological Section of the National Clinical Database, which aims to present the short-term outcomes of cases registered in 2021 and discuss significant changes and insights into gastroenterological surgeries observed over the decade.

Methods: We reviewed the data of patients registered in the National Clinical Database between 2012 and 2021.

Essential updates 2022/2023: Recent advances in perioperative management of esophagectomy to improve operative outcomes.

In the era of minimally invasive surgery, esophagectomy remains a highly invasive procedure with a high rate of postoperative complications. Preoperative risk assessment is essential for planning esophagectomy in patients with esophageal cancer, and it is crucial to implement evidence-based perioperative management to mitigate these risks. Perioperative support from multidisciplinary teams has recently been reported to improve the perioperative nutritional status and long-term survival of patients undergoing esophagectomy.

Preoperative geniohyoid muscle mass in esophageal cancer patients is associated with swallowing function after esophagectomy.

Aim: Dysphagia often develops after esophagectomy. The geniohyoid muscle is involved in swallowing movements, but its significance in esophagectomy patients remains unclear. We investigated the relationship of preoperative geniohyoid muscle mass with post-esophagectomy swallowing function.

Japanese primary care physicians' postpartum mental health care: A cross-sectional study.

Background: Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care.

Mid-term outcomes of delivery catheter-based and stylet-based right ventricular septal pacing: Follow-up results from a multicenter, prospective, randomized study.

Background: The Mt FUJI study was a multicenter, prospective, randomized, single-blind, controlled trial comparing delivery catheter-based and stylet-based right ventricular (RV) lead placement at the RV septum. This study extended the follow-up duration to 1 year after implantation.

Methods: Seventy patients with pacemaker indications for atrioventricular block were randomly assigned to the delivery catheter and stylet groups.

Mental health status of children who use foreign languages at home in Japan.

Aim: Little is known about the mental health status of children in Japan whose roots are in foreign countries. The differences in language that are used every day may be a factor that makes adaptation difficult for these children. The aim of the present study, therefore, was to examine the mental health status of children who use foreign languages at home via a cross-sectional survey in a large cohort.

Relationship of Mild to Moderate Impairment of Left Ventricular Ejection Fraction With Fatal Ventricular Arrhythmic Events in Cardiac Sarcoidosis.

Background: Current guidelines recommend placing an implantable cardiac defibrillator for patients with cardiac sarcoidosis and a severely impaired left ventricular ejection fraction (LVEF) of ≤35%. In this study, we determined the association between mild or moderate LVEF impairment and fatal ventricular arrhythmic event (FVAE).

Methods And Results: We retrospectively analyzed 401 patients with cardiac sarcoidosis without sustained ventricular arrhythmia at diagnosis.

Robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using the novel surgical robot platform, hinotori: Initial experience with two cases.

Introduction: A newly developed surgical robot system, hinotori, with various unique advantages has been in clinical use in Japan; however, there have not been any studies of robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori.

Case Presentation: We describe two male patients aged 67 and 76 years old with right renal cell carcinoma and a level II and I inferior vena cava tumor thrombus, respectively, undergoing robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori. Both operations were successfully completed with a purely robotic procedure without any major perioperative complications, resulting in the following findings: time using robotic system, 158 and 156 min; total operative time, 228 and 214 min; estimated blood loss, 535 and 200 mL, respectively.

Evaluation and comparison of impedance and amplitude changes in lesion index-guided pulmonary vein isolation.

Background: The lesion index (LSI) has been used to estimate lesion formation after radiofrequency catheter ablation. However, the impedance drop and decrease in bipolar amplitude of intracardiac electrograms, which are parameters that are traditionally used to predict effective ablation lesions, are not used to calculate LSI. Therefore, we aimed to investigate the association between LSI and traditional parameters.

Tenascin C in pancreatic cancer-associated fibroblasts enhances epithelial mesenchymal transition and is associated with resistance to immune checkpoint inhibitor.

Tenascin C (TNC) is an extracellular matrix glycoprotein that is highly expressed in cancer stroma and is associated with tumor progression in pancreatic adenocarcinoma (PAAD). In this study, we aimed to investigate the potential involvement of TNC in the response to immune checkpoint inhibitors (ICI) among PAAD patients. Transcriptomic profiles were obtained from public databases and analyzed to compare mRNA levels between tumor and normal tissues.

What is the best reconstruction procedure after esophagectomy? A meta-analysis comparing posterior mediastinal and retrosternal approaches.

Thoracic esophagectomy is a particularly invasive and complicated surgical procedure, with a reconstruction of the gastrointestinal tract, such as the stomach, jejunum, or colon. The posterior mediastinal, retrosternal, and subcutaneous routes are the three possible esophageal reconstruction routes. Each route has advantages and disadvantages, and the optimal reconstruction route after esophagectomy remains controversial.

Additional oncological benefit of photodynamic diagnosis with blue light cystoscopy in transurethral resection for primary non-muscle-invasive bladder cancer: A comparative study from experienced institutes.

Objectives: The objective of this work is to evaluate the additional oncological benefit of photodynamic diagnosis (PDD) using blue-light cystoscopy in transurethral resection (TURBT) for primary non-muscle-invasive bladder cancer (NMIBC) based on the International Bladder Cancer Group (IBCG)-defined progression and the subsequent pathological pathways.

Patients And Methods: We reviewed 1578 consecutive primary NMIBC patients undergoing white-light TURBT (WL-TURBT) or PDD-TURBT during 2006-2020. One-to-one propensity score-matching was performed using multivariable logistic regression to obtain balanced groups.

Pharmaceutical Payments to Japanese Board-Certified Head and Neck Surgeons Between 2016 and 2019.

Objective: To evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese head and neck surgeons and pharmaceutical companies between 2016 and 2019.

Study Design: Cross-sectional analysis.

Setting: Japan.

Phenotyping of Elderly Patients With Heart Failure Focused on Noncardiac Conditions: A Latent Class Analysis From a Multicenter Registry of Patients Hospitalized With Heart Failure.

Background The burden of noncardiovascular conditions is becoming increasingly prevalent in patients with heart failure (HF). We aimed to identify novel phenogroups incorporating noncardiovascular conditions to facilitate understanding and risk stratification in elderly patients with HF. Methods and Results Data from a total of 1881 (61.

Defining conversion therapy for esophageal squamous cell carcinoma.

A multimodality treatment conference with experts from across East Asia was held to establish a consensus for conversion therapy. An agreement was reached that conversion therapy was defined as surgery or chemoradiotherapy (CRT) aiming at cure after initial treatment for tumors that were initially unresectable due to adjacent organ invasion or distant metastasis.

Perspectives of medical students on future work-life balance in Japan: A qualitative study using postlecture comments.

Background: Recently, work-life balance (WLB) has grown in popularity among medical professionals, and an increasing number of institutions are including WLB lectures into medical school curricula. In Japan, medical student lectures concerning WLB were given in at least 50% of universities. However, with these changes in social awareness, it is not fully clear how current medical students view WLB.

Rationale and Design of Rivaroxaban Estimation With Warfarin in Atrial Fibrillation Patients With Coronary Stent Implantation (REWRAPS).

Recent major randomized trials revealed the superiority of non-vitamin K antagonist oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) from 6 months to 2 years after percutaneous coronary intervention (PCI). However, whether NOAC monotherapy superiority over warfarin continues in real-world patients with a history of atrial fibrillation (AF), coronary stenting, and underlying chronic kidney disease (CKD) >1 year after PCI (e.g.

The Prognostic Value of B-Type Natriuretic Peptide in Patients With Cardiac Sarcoidosis Without Heart Failure: Insights From ILLUMINATE-CS.

Background The prognostic role of BNP (B-type natriuretic peptide) in patients with cardiac sarcoidosis without evident heart failure is unknown. Methods and Results This is a post hoc analysis of ILLUMINATE-CS (Illustration of the Management and Prognosis of Japanese Patients With Cardiac Sarcoidosis), a multicenter, retrospective, and observational study that evaluated the clinical characteristics and prognosis of cardiac sarcoidosis. We analyzed patients with cardiac sarcoidosis without evident heart failure at the time of diagnosis.

An autopsy case of ovarian mucinous cystic tumor complicated by ovarian abscess and a review of the English literature.

Ovarian tumors are rarely associated with abscesses. Herein, an autopsy case of an ovarian mucinous cystic tumor complicated by an abscess, along with a review of previous cases, suggests the necessity of considering ovarian abscess as a cause of inflammation in patients with the ovarian tumors.