91 results match your criteria: "Saiseikai Nagasaki Hospital[Affiliation]"

Introduction: The number of female doctors is increasing worldwide, but the percentage of female general surgeons and gastrointestinal surgeons remains low, at only 6% in Japan. Furthermore, in rural areas, the number of doctors is small and training opportunities are limited, and training in surgical techniques is reportedly inadequate compared with urban areas. This study examined the current status and surgical outcomes of colorectal cancer surgery by surgeon sex using a multicenter database in a Japanese rural area.

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Background: The number of elderly people undergoing surgery for colorectal cancer has been increasing. We examine prognosis, including risks of surgery by age and cancer- and noncancer-related deaths.

Methods: This study retrospectively reviewed 1830 patients who underwent curative resection colorectal surgery.

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Background: Laparoscopic rectal surgery is often technically difficult. The Endoscopic Surgical Skill Qualification System (ESSQS) was established in Japan as an objective measure of skill for laparoscopic surgeons. However, the advantages of the ESSQS qualification for laparoscopic rectal surgery have been limited.

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Purpose: Postoperative management for colonic perforation is an important prognostic factor, but whether intensivists perform postoperative management varies between institutions.

Methods: We investigated 291 patients with colonic perforation between 2018 and 2022. Patients were divided into those managed by an intensivists (ICU group; n = 40) and those not managed by an intensivists (non-ICU group; n = 251).

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Article Synopsis
  • This study aimed to determine if there is a connection between anogenital distance (AGD) and vaginal pH levels in women with endometriosis.
  • A cohort of 107 women, both with and without endometriosis, was analyzed regarding AGD measurements and vaginal pH during surgical procedures from July 2021 to June 2022.
  • The results showed no significant difference in AGD across groups, but vaginal pH levels differed significantly, suggesting women with endometriosis are less likely to have an alkaline pH; however, AGD was not a reliable predictor for endometriosis.
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Introduction: The American Society of Anesthesiologists (ASA) classification is used to assess the fitness of a patient for surgery. Whether laparoscopic surgery is appropriate for colorectal cancer patients with poor ASA performance status (PS) remains unclear.

Methods: Among 4585 patients who underwent colorectal surgery between 2016 and 2023, this study retrospectively reviewed all 458 patients with ASA-PS ≥3.

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Background: Several methods are used for reconstruction in colon cancer surgery, including hand-sewn or stapled anastomosis. However, few reports have compared short-term outcomes among reconstruction methods. This study compared short-term outcomes between delta-shaped anastomosis (Delta) and functional end-to-end anastomosis (FEEA).

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Article Synopsis
  • A clinical pathway was implemented in Nagasaki hospitals for managing LDL cholesterol (LDL-C) after acute myocardial infarction (AMI) to improve patient outcomes.
  • The study found that the percentage of patients achieving the LDL-C target of <70 mg/dL increased from 37.2% to 54.6% after the pathway was introduced.
  • Overall, the implementation of this pathway significantly enhanced lipid-lowering therapy effectiveness in hospitals performing percutaneous coronary interventions (PCI).
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Purpose: The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel score that offers a good reflection of nutritional status, inflammatory response, and immune system status. The CALLY index is reported to correlate with the prognosis of various carcinomas. The purpose of the present study was to investigate the association between the CALLY index and the short-term prognosis of obstructive colorectal cancer managed with a colonic stent.

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Purpose: The prognostic value of the lymphocyte-to-monocyte (LMR) ratio has been reported for various cancers, including colorectal cancer (CRC). The insertion of colonic stents is considered effective for patients with surgically indicated obstructive CRC, but their LMR can vary depending on factors such as inflammation associated with stent dilation and improvement of obstructive colitis. However, the usefulness of the LMR in patients with obstructive CRC and colonic stents and the optimal timing for its measurement remain unclear.

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Purpose: Pulmonary complications (PC) are a serious condition with a 20% mortality rate. However, few reports have examined risk factors for PC after colorectal surgery. This study investigated the frequency, characteristics, and risk factors for PC after colorectal cancer surgery.

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Background And Objective: The identification of factors associated with long-term prognosis after community-onset pneumonia in elderly patients should be considered when initiating advance care planning (ACP). We aimed to identify these factors and develop a prediction score model.

Methods: Patients aged 65 years and older, who were hospitalized for pneumonia at nine collaborating institutions, were included.

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Background/aim: Colonic stents have been inserted as a bridge to surgery in patients with resectable colorectal cancer, allowing bowel decompression for systemic assessment and better preparation to avoid stoma construction. However, reports of short- and long-term prognoses for elderly patients remain limited.

Patients And Methods: This retrospective study reviewed 175 consecutive patients who underwent colonic stent insertion for bowel obstruction followed by curative colectomy.

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The role of innate and adaptive immunity in endometriosis.

J Reprod Immunol

June 2024

Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.

The innate and adaptive immune systems are the two key branches that determine host protection at all mucosal surfaces in human body, including the female reproductive tract. The pattern recognition receptors within the host that recognize pathogen-associated molecular patterns are expressed on the cells of the innate immune system. Rapidly reactive, theinnate immune system, responds immediately to the presence of infectious or other non-self agents, thereby launching an inflammatory response to protect the host until the activation of slower adaptive immune system.

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Introduction: The impact of institutional volume on postoperative outcomes after laparoscopic colectomy is still being debated. This study aimed to investigate whether differences in postoperative outcomes of laparoscopic colon resection exist between high- and low-volume centers.

Methods: Data were reviewed for 1360 patients who underwent laparoscopic colectomy for colon cancer between 2016 and 2022.

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Article Synopsis
  • Intraperitoneal chemotherapy may reduce mortality in patients with advanced epithelial ovarian cancer but is not commonly used, prompting the iPocc trial to evaluate its effectiveness.
  • The trial involved 655 women with newly diagnosed cancer, comparing the effects of intravenous carboplatin alone to a combination of intravenous and intraperitoneal carboplatin along with paclitaxel.
  • Results showed that the group receiving intraperitoneal carboplatin had a longer progression-free survival (23.5 months) compared to the intravenous group (20.7 months), but faced higher rates of catheter-related adverse events.
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Neonatal uterine bleeding: Risk factors and its association with endometriosis-related symptoms later in life.

Eur J Obstet Gynecol Reprod Biol

February 2024

Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.

Objective: We examined the prevalence and risk factors in association with neonatal uterine bleeding (NUB) by retrospective search of contemporary and historical medical records and investigated the possible association between the history of NUB at birth and endometriosis-related symptoms later in life who are now young women.

Study Design: This was a retrospective case-controlled cohort study and prospective evaluation of web-based questionnaire survey on symptoms related to endometriosis among young women born with and without NUB. Multiple regression analysis was performed incorporating various confounding variables that may influence the occurrence of NUB or the reporting of endometriosis symptoms later in life.

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Purpose: Positive pathologic lymph nodes in colorectal cancer represent an important prognostic indicator. Whether lymph node distribution or the number of metastatic nodes is more strongly associated with survival prediction remains controversial.

Methods: Among 3449 colorectal cancer surgeries performed at Nagasaki University Hospital and five affiliated institutions from April 2016 to March 2022, we investigated 604 patients who underwent laparoscopic radical resection and were diagnosed with pathological stage III cancer.

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Background: The effect of laparoscopic surgery on short-term outcomes in colorectal cancer patients over 90 years old has remained unclear.

Methods: We reviewed 87 colorectal cancer patients aged over 90 years who underwent surgery between 2016 and 2022. Patients were divided into an open surgery group (n = 22) and a laparoscopic surgery group (n = 65).

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Introduction: Thirty-day reoperation rate reflects short-term surgical outcomes following surgery. Laparoscopic surgery for colorectal cancer reportedly has positive effects on postoperative complications. This retrospective study investigated risk factors for 30-day reoperation rate among patients after laparoscopic colorectal cancer surgery using a multicenter database.

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Background: Current microbiological tests fail to identify the causative microorganism in more than half of all pneumonia cases. We explored biomarkers that could be used for differentiating between bacterial and viral pneumonia in patients with community-acquired pneumonia (CAP).

Methods: In this prospective cohort study conducted in Japan, data obtained from adult patients with bacterial pneumonia, including bacterial and viral coinfections (bacterial pneumonia [BP] group), and purely viral pneumonia (VP group) at diagnosis were analyzed using multivariate logistic regression analysis to identify predictors of bacterial pneumonia.

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Purpose: Laparoscopic colectomy for transverse colon cancer (TCC) can be technically demanding due to the anatomical complexity of the region. In Japan, the Endoscopic Surgical Skill Qualification System (ESSQS) was established to improve the skill of laparoscopic surgeons and further develop surgical teams. We examined the safety and feasibility of laparoscopic colectomy for TCC and evaluated the effects of the Japanese ESSQS in facilitating this approach.

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Instruction: In colon cancer, the incidence of postoperative ileus is reportedly higher for the right-side than for the left-side colon, but those studies included small numbers of subjects and contained several biases. Furthermore, risk factors for postoperative ileus remain unclear.

Methods: This multicenter study reviewed 1986 patients who underwent laparoscopic colectomy between 2016 and 2021 for right-side (n = 907) and left-side (n = 1079) colon cancer.

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Is neonatal uterine bleeding responsible for early-onset endometriosis?

Reprod Biol Endocrinol

June 2023

Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Article Synopsis
  • This study investigates the connection between neonatal uterine blood (NUB) and the development of early-onset endometriosis, hypothesizing that endometrial mesenchymal stem cells (eMSCs) could play a role.
  • Researchers analyzed neonatal endometria and NUB samples to assess various biological markers, focusing on hormone receptors, cell proliferation, and immune cell presence.
  • The results showed differences in immunoexpression between neonatal and adult endometria, but no evidence of eMSCs in NUB, challenging the proposed link between NUB and early-onset endometriosis.
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