80 results match your criteria: "Saga Medical Center KOSEIKAN[Affiliation]"

Laparoscopic procedure for rectal prolapse has extend throughout the world as a minimally invasive treatment. Various techniques have been reported regarding the use of mesh, fixation, and rectal mobilization. However, a standard technique has not been established yet.

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Robotic liver resection (RLR) faces challenges in parenchymal dissection due to device limitations, necessitating the development of a safe, efficient, and versatile method for its widespread use. We introduce our six-port RLR approach utilizing the double bipolar clamp-crush method with saline drops to overcome these device limitations. This method, combined with robotic bipolar forceps, maximizes the advantages of RLR by leveraging its multi-joint functionality and facilitates the dissection of strong, fibrotic liver tissue through the use of bipolar energy.

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Introduction: Fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) improve overall survival (OS) and progression-free survival (PFS) in patients with pancreatic cancer, compared with gemcitabine (GEM). However, whether PFS is a surrogate marker of OS in pancreatic cancer chemotherapy focusing on FOLFIRINOX or GEM plus nab-paclitaxel remains unknown. We aimed to verify whether PFS can be a surrogate marker of OS in prognosis prediction.

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Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022. Recently, the European Society of Cardiology (ESC) published the guidelines for the management of acute coronary syndrome in 2023.

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Article Synopsis
  • - This study compared the effectiveness of second-line treatments for patients with unresectable pancreatic cancer who previously received gemcitabine plus nab-paclitaxel (GnP), analyzing 318 patients treated with nanoliposomal irinotecan plus 5-fluorouracil/folinic acid (NFF), S-1, or FOLFIRINOX.
  • - Results showed that the median overall survival (OS) for the NFF group was significantly better at 9.08 months compared to 4.90 months for S-1, while FOLFIRINOX had an OS of 4.77 months with no significant difference from NFF.
  • - Factors like serum levels and duration
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Orthognathic surgery has a high incidence of postoperative nausea (PON) and vomiting (POV), delaying mobility initiation and postoperative recovery. Bleeding is another risk associated with this surgical procedure. We aimed to compare total intravenous anesthesia (TIVA) and volatile anesthesia in patients undergoing orthognathic surgery in terms of postoperative nausea and vomiting (PONV) incidence and hemodynamic changes.

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Background: Distal pancreatectomy (DP) with lymph node (LN) dissection is the standard procedure for pancreatic ductal adenocarcinoma of the tail (Pt-PDAC). However, the optimal surgery including extent of LN dissection is still being debated. The present study investigated the incidence and prognostic impact of LN metastasis on patients suffering from Pt-PDAC.

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Nanoliposomal irinotecan with fluorouracil and folinic acid (NFF) is a standard regimen after gemcitabine-based therapy for patients with unresectable or recurrent pancreatic cancer. However, there are limited clinical data on its efficacy and safety in the real-world. We therefore initiated a retrospective and prospective observational study (NAPOLEON-2).

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A woman in her 70s was hospitalized and was diagnosed with liver abscess and managed with antibiotics in a previous hospital. However, she experienced altered consciousness and neck stiffness during treatment. She was then referred to our hospital.

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First-line chemotherapy for patients with metastatic pancreatic cancer (MPC) includes gemcitabine plus nab-paclitaxel (GnP) and FOLFIRINOX (FFX). However, the efficacy of second-line chemotherapy and the role of combination chemotherapy in clinical practice is still unknown. Data was gathered from 14 hospitals in the Kyushu area of Japan from December 2013 to March 2017.

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A prospective pilot study was conducted on 11 patients with rectal cancer to investigate fecal calprotectin (FC) as a diagnostic tool for detecting anastomotic leakage (AL) after low anterior resection. Among the 11 patients, 1 patient (9.1%) experienced AL (Clavien-Dindo Grade IIIa).

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Article Synopsis
  • The study focused on the genomic features of HER2-positive and negative gastric cancer to understand their impact on tumor growth and treatment response.
  • Researchers analyzed 80 samples from a clinical trial, employing a 435-gene panel to evaluate mutations and other genomic changes.
  • Findings revealed that HER2-negative patients had more mutations, particularly with the ARID1A gene, and may benefit from immune therapies, while HER2-positive cases showed more gene amplifications, indicating potential resistance to certain treatments.
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  • Patients with metastatic pancreatic cancer who do not respond to first-line chemotherapy have limited treatment options, and it's uncertain which patients benefit from second-line chemotherapy.
  • A study involving 233 patients analyzed the effectiveness of second-line chemotherapy compared to best supportive care, using a scoring system based on specific prognostic factors like serum albumin and CA19-9 levels.
  • Results showed that patients with scores of 0 and 1 had a significant survival benefit from second-line chemotherapy, while those with score 2 did not experience similar advantages.
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  • Recent advances in chemotherapy for unresectable pancreatic cancer (uPC) offer the possibility of conversion surgery (CS), but its effectiveness with specific treatments like FOLFIRINOX (FFX) and gemcitabine plus nab-paclitaxel (GnP) is still being evaluated.
  • A study reviewed 318 uPC patients treated with FFX or GnP and found that CS was achieved in only 4.3% of cases, with a higher success in locally advanced pancreatic cancer (LAPC) compared to metastatic cases (MPC).
  • Factors linked to a higher chance of CS include having LAPC, absence of liver metastasis, lower CA19-9 levels, and a good response to chemotherapy; overall
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CD133, also called prominin-1, is widely known as a cancer stem cell marker, and its high expression correlates with a poor prognosis in many cancers. CD133 was originally discovered as a plasma membranous protein in stem/progenitor cells. It is now known that Src family kinases phosphorylate the C-terminal of CD133.

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Purpose: Therapeutic efficacy of ustekinumab in the real-world data is limited in patients with refractory Crohn's disease (CD). In addition, factors predictive of better therapeutic efficacy of ustekinumab remains unsolved in CD. We aimed to evaluate therapeutic efficacy of ustekinumab in patients with refractory CD and to identify the factors associated with the efficacy of ustekinumab.

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Background/purpose: We evaluated the difficulty score of laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) proposed in the Tokyo guidelines 2018 (TG18) and analyzed the most appropriate scoring method.

Methods: We reviewed 127 patients who underwent LC for AC from January 2018 to March 2022. According to TG18, surgical difficulty was scored for five categories consisting of 25 intraoperative findings.

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Intussusception of the cecum due to the acute appendicitis: A case report.

Int J Surg Case Rep

November 2022

Department of Surgery, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga 840-8571, Japan.

Introduction And Importance: Intussusception of the cecum due to acute appendicitis is rare condition.

Presentation Of Case: A 17-year-old male patient presented to our hospital with a chief complaint of right lower abdominal pain, which had lasted for two days. Computed tomography (CT) revealed a "target sign" from the cecum to the ascending colon, leading to a diagnosis of cecocolic intussusception.

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Article Synopsis
  • The study compares the efficacy and toxicity of the original FOLFIRINOX (oFFX) and a modified version (mFFX) for treating metastatic pancreatic cancer (mPC) in a Japanese patient population.
  • A multicenter analysis of 318 patients revealed no significant difference in overall survival and progression-free survival between oFFX and mFFX, although oFFX had higher rates of thromobocytopenia and liver dysfunction.
  • The findings suggest that mFFX is as effective as oFFX while causing fewer side effects, making it a safer option in clinical practice.
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Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study.

Gastrointest Endosc

January 2023

Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan; Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address:

Article Synopsis
  • The study aimed to find the best timing for colonoscopy in patients with acute lower GI bleeding and to identify factors that could help them.
  • Researchers analyzed data from over 6,200 patients who had colonoscopy within 120 hours of bleeding, comparing outcomes based on early (≤24 hours), elective (24-48 hours), and late (48-120 hours) procedures.
  • Early colonoscopy led to better identification of recent bleeding and shorter hospital stays but also had a higher rebleeding rate, without affecting mortality or the need for additional interventions; it was especially beneficial for patients with a higher shock index or poor performance status.
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Purpose: Incisional hernia (IH) is a frequent complication following laparoscopic colorectal surgery. The present study investigated the risk factors for IH after laparoscopic surgery for colorectal cancer.

Methods: A retrospective study was conducted on 202 patients who underwent laparoscopic surgery for colorectal cancer.

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Article Synopsis
  • Coronary artery bifurcation lesions are challenging and often lead to complicated procedures and poorer outcomes compared to non-bifurcation lesions during cardiac catheterization.
  • *A thorough anatomical and physiological assessment of these lesions is crucial before, during, and after intervention to understand their impact on blood flow and to make informed treatment decisions.
  • *This consensus document from Korean, Japanese, and European experts outlines the importance of a physiological approach, offering guidance, potential challenges, and future strategies for treating coronary bifurcation lesions.*
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Background: The jailing strut configuration with link-free and distal guidewire recrossing (LFD) at the side branch orifice (SBO) reduces incomplete stent apposition (ISA) after kissing balloon technique (KBT) in crossover stenting of coronary bifurcation lesions (CBLs). However, data regarding vascular healing after KBT are lacking. We investigated vascular healing 9 months after crossover stenting followed by KBT with optical coherence tomography (OCT) guidance in a prospective multicenter registry.

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Purpose: The present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer.

Methods: A retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined.

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CD133 is a transmembrane protein that mainly localizes to the plasma membrane in hematopoietic/neural stem cells and cancer stem cells. Although CD133 also localizes to the cytoplasm and is degraded through autophagy, the precise mechanisms responsible for the autophagic degradation of endosomal CD133 currently remain unknown. We demonstrated that endosomal CD133 has unique properties for cell homeostasis.

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