Risk Factors and Risk Scores for Predicting Early Recurrence After Curative Gastrectomy in Patients with Stage III Gastric Cancer
AbstractBackgroundWe revealed patients with pathological stage (pStage) III gastric cancer (GC) who had early recurrence within 12  months after curative surgery. We identified risk factors for predicting early recurrence in patients with pStage III GC who underwent curative gastrectomy.MethodsBetween January 2007 and December 2016, 758 patients underwent gastrectomy in our institution. This retrospective study included 96 patients with pStage III who were divided into two groups: early recurrence within 12  months (ERec) and non-ERec (nERec). We investigated clinicopathological differences between ERec and nERec...
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Efficacy of Neoadjuvant Chemotherapy in Distal Pancreatectomy with En Bloc Celiac Axis Resection (DP-CAR) for Locally Advanced Pancreatic Cancer
This study retrospectively reviewed 20 consecutive patients who underwent DP-CAR at a single institution.ResultsEleven of 20 patients (55.0%) received NAC. Their first regimens were gemcitabine (GEM) plus nab-PTX (n = 7, 63.6%), GEM plus S-1 (n = 3, 27.3%), and GEM (n = 1, 9.1%). Although two patients converted to a second regimen, none abandoned NAC due to adverse effects or could not undergo a planned procedure for disease progression. There were no significant differences in intraoperative variables, morbidity, including pancreatic fistula and delayed gas tric emptying, and mort...
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

The Learning Curve of Linear-Shaped Gastroduodenostomy Associated with Totally Laparoscopic Distal Gastrectomy
AbstractBackgroundLinear-shaped gastroduodenostomy (LSGD) is a new method of intracorporeal reconstruction that is simpler to perform and associated with a lower rate of bile reflux than delta-shaped anastomosis. Here, we analyzed the learning curve of LSGD in totally laparoscopic distal gastrectomy.MethodsThe cumulative sum method was used to retrospectively analyze consecutive gastric cancer patients undergoing intracorporeal gastroduodenostomy after distal gastrectomy between January 2009 and May 2016. The duration of surgery, postoperative complications, hospital stay, and endoscopic findings in the postoperative perio...
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Clinical Outcomes After Staged and Primary Laparotomy Soave Procedure for Total Colonic Aganglionosis: a Single-Center Experience from 2007 to 2017
ConclusionPLSP and SLSP had equivalent clinical outcomes, but enterocolitis and perianal excoriation after the Soave procedure need to be managed carefully. PLSP is a feasible option for older TCA patients after conservative treatment. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Impact of Surgeon Volume on Outcomes and Expenditure Among Medicare Beneficiaries Undergoing Liver Resection: the Effect of Minimally Invasive Surgery
ConclusionAnnual surgeon volume was an  important predictor of outcomes following LR. MILR had comparable results to open LR among both the low- and high-volume surgeons. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Early Versus Late Oral Refeeding After Pancreaticoduodenectomy for Malignancy: a Comparative Belgian-French Study in Two Tertiary Centers
AbstractBackgroundIn the era of fast-track surgery, because pancreaticoduodenectomy (PD) carries a significant morbidity, surgeons hesitate to begin early oral feeding and achieve early discharge. We compared the outcome of two different approaches to the postoperative management of PD in two tertiary centers.MethodsOf patients having undergone PD for malignancy from 2008 to 2017, 100 patients who received early postoperative oral feeding (group A) were compared to 100 patients from another center who received early enteral feeding and a delayed oral diet (group B). Surgical indication and approach and type of pancreatic a...
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Escherichia coli Bacterobilia Is Associated with Severe Postoperative Pancreatic Fistula After Pancreaticoduodenectomy
ConclusionMajor surgical complications following pancreaticoduodenectomy, including severe pancreatic fistula, are associated with bacterobilia after EBS. The indication for bile duct stenting should be evaluated in a multidisciplinary setting. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Extensive NSAID-Induced Small Bowel ‘Diaphragm Disease’
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 19, 2019 Category: Surgery Source Type: research

Minimally Invasive Ivor Lewis Esophagectomy with Linear Stapled Anastomosis Associated with Low Leak and Stricture Rates
ConclusionsIvor Lewis MIE with a 6-cm linear stapled anastomosis can be completed with a high technical success rate, and low rates of anastomotic leak and stricture. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

Laparoscopic Versus Open Surgery for Gastric Gastrointestinal Stromal Tumors: a Propensity Score Matching Analysis
This study evaluated the efficacy of laparoscopic resection and open surgery in gastric GISTs using the propensity score matching (PSM) method.MethodsBetween January 2005 and December 2017, 1027 patients were diagnosed with primary GIST at our institution. Among them, 548 patients were enrolled in this study. Standard demographic and clinicopathological data were collected from our database. Selection bias was eliminated using the PSM methods.ResultsAfter PSM, 256 cases involved in the comparison (128 laparoscopic (LAP) vs. 128 open surgery (OPEN)) were randomly matched (1:1) by age, sex, body mass index, hypertension, dia...
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

Synergistic Effect of Lymphatic Invasion and Venous Invasion on the Risk of Lymph Node Metastasis in Patients with Non-Curative Endoscopic Resection of Early Gastric Cancer
ConclusionsBoth LI and VI were significant predictors of LN metastasis. The risk of LN metastasis was augmented when both LI and VI were positive. Therefore, LI and VI should be evaluated separately in patients with non-curative endoscopic resection. Additive surgery should be recommended for patients with LI and/or VI. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

Laparoscopic Repeat Hepatic Resection for the Management of Liver Tumors
AbstractBackgroundLaparoscopic hepatic resection has been developed as a minimally invasive surgery; however, laparoscopic repeat minor hepatic resection (LRH) carries a higher risk of damage to other organs because of postoperative changes to and losses of anatomical landmarks. The current standard approach at many facilities has been to perform open repeat minor hepatic resection (ORH). This paper describes the surgical outcomes, procedure safety, and utility of ORH versus LRH, as well as the laparoscopic techniques used in LRH.MethodsBetween February 2010 and May 2018, the data of 142 patients who underwent LRH or ORH a...
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

A Tailored Strategy for Recipient Hepatectomy: Left Portal Flow Preserving High Hilar Dissection
ConclusionLFP-HHD is a novel simple technique for recipient hepatectomy that can be tailored for certain clinical conditions. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

Colorectal Cancer Metastases to Brain or Bone and the Relationship to Primary Tumor Location: a Population-Based Study
ConclusionsPrimary tumor location impacts incidence proportions of bone metastasis and survival of both brain and bone mCRC patients. Primary tumor location should be taken into consideration in clinical practice and prognostic assessment. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 16, 2019 Category: Surgery Source Type: research

Comparison Between Redo Endoscopic Treatment and Surgery in Patients with Locally Recurrent Gastric Neoplasms
ConclusionsEndoscopic treatment could be an effective and safe alternative to surgery for selected patients with gastric neoplasms recurring at the scar of previous ESD. Especially, patients having small lesions located in the distal part of the stomach could be a good candidate for redo ESD. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 15, 2019 Category: Surgery Source Type: research

Comparison of Postoperative Nutritional Status after Distal Gastrectomy for Gastric Cancer Using Three Reconstructive Methods: a Multicenter Study of over 1300 Patients
ConclusionDuring the first year after gastric cancer surgery, postoperative nutritional status differed according to the reconstruction type; BI resulted in the least weight and nutritional loss, RY yielded results comparable with BI in the nutritional indexes, and BII resulted in the greatest nutritional loss. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 15, 2019 Category: Surgery Source Type: research

Treatment Utilization and Socioeconomic Disparities in the Surgical Management of Gastroparesis
AbstractBackgroundGastroparesis is an end-organ sequela of diabetes. We evaluated the roles of race and socioeconomic status in hospitalization rates and utilization of surgical treatments in these patients.MethodsData was extracted from the National Inpatient Sample (NIS) between the years 2012 and 2014, and any discharge diagnosis of gastroparesis (536.3) was included. Gastrostomy, jejunostomy, and total parenteral nutrition were considered nutritional support procedures, and procedures aimed at improving motility were considered definitive disease-specific procedures: pyloroplasty, endoscopic pyloric dilation, gastric p...
Source: Journal of Gastrointestinal Surgery - July 10, 2019 Category: Surgery Source Type: research

Paraduodenal Hernia: a Rare Cause of Acute Abdominal Pain
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 10, 2019 Category: Surgery Source Type: research

Gastric Intrapleural Herniation Following Pericardio-Peritoneal Window
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 10, 2019 Category: Surgery Source Type: research

In-hospital Mortality Following Pancreatoduodenectomy: a Comprehensive Analysis
ConclusionPatient-level factors, such as advanced comorbidities, male sex, and increased age, contributed the most to increased risk of mortality after PD. Hospital volume was the only hospital-level factor contributing to risk of in-hospital mortality following PD. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 10, 2019 Category: Surgery Source Type: research

Appendiceal Carcinoid Tumors: Is There a Survival Advantage to Colectomy over Appendectomy?
ConclusionsSurvival in patients with carcinoid tumor of the appendix is primarily determined by tumor grade and stage. Our study found no survival advantage to colectomy over appendectomy in a large cohort of patients with the disease. Further investigation is necessary prior to recommending change of practice for patients with appendiceal carcinoid tumors. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Lymphovascular Invasion as the Major Prognostic Factor in Node-Negative Esophageal Cancer After Primary Esophagectomy
AbstractBackgroundStudies addressing both lymphovascular invasion (LVI) and perineural invasion (PNI) in patients with esophageal squamous cell carcinoma (ESCC) treated with or without neoadjuvant therapy are limited. We aimed to analyze the incidence and prognostic significance of LVI and PNI in patients with thoracic ESCC.MethodsThis retrospective study included 520 patients with ESCC: 174 patients after neoadjuvant treatment followed by surgery and 346 after primary esophagectomy, from two medical centers. The relationships between LVI, PNI, and other histological factors were evaluated. The Cox regression model was use...
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Single Nucleotide Polymorphisms and Post-operative Complications Following Major Gastrointestinal Surgery: a Systematic Review and Meta-analysis
ConclusionsWe found biologically plausible associations between SNPs involved in inflammation and post-operative infection, but the available data were too limited and of insufficient quality to reach definitive conclusions. Further work is needed, including genome-wide association studies (GWAS). (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Disparities in the Use of Chemotherapy in Patients with Resected Pancreatic Ductal Adenocarcinoma
AbstractBackgroundIntroduction of effective systemic therapies for pancreatic ductal adenocarcinoma (PDAC) has demonstrated survival benefit. However, chemotherapy remains underutilized in these patients. We sought to investigate the implications of disparities on the trends in utilization of chemotherapy.MethodsA retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database identified patients who underwent surgical resection for PDAC from 1998 to 2014. Clinicopathologic, demographic, racial, and geographical factors were analyzed to assess associations with receipt of chemotherapy and disease-...
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients: a Single-Institution Study
ConclusionsExcellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Obstructive Gastroparesis: Patient Selection and Effect of Laparoscopic Pyloroplasty
AbstractBackgroundFunctional obstructive gastroparesis is an understudied subtype of gastroparesis with normal 3 cycle per minute gastric myoelectrical activity that responds to botulinum toxin A injection and balloon dilation of the pylorus.AimsTo determine the effect of pyloroplasty on symptoms, weight, gastric emptying, and gastric myoelectrical activity in patients with gastroparesis and normal 3 cycle per minute gastric myoelectrical activity.MethodsTen patients (average age 36  years with gastroparesis and normal 3 cycle per minute gastric myoelectrical activity) who had at least two successful endoscopic pylori...
Source: Journal of Gastrointestinal Surgery - July 3, 2019 Category: Surgery Source Type: research

Robotic Pancreaticoduodenectomy Is Associated with Decreased Clinically Relevant Pancreatic Fistulas: a Propensity-Matched Analysis
AbstractBackgroundClinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD) is a major complication that adversely affects recovery. The robotic approach may decrease the incidence of this complication. This propensity-matched analysis evaluates the impact of robotic PD (RPD) on CR-POPF.MethodsPatients undergoing PD after the learning curve at a high-volume academic medical center were reviewed. CR-POPF outcomes after open PD (OPD) and RPD were compared. Logistic regression and propensity score matching (PSM) were used to define the independent effect of RPD on CR-POPF.ResultsOf 865 PD...
Source: Journal of Gastrointestinal Surgery - July 2, 2019 Category: Surgery Source Type: research

Long-Term Outcomes in Laparoscopic D2 Gastrectomy for Gastric Cancer: a Large Comprehensive Study Proposing Novel Hypotheses
ConclusionsIn this large institutional analysis, while LG for GC was associated with DSS and DFS similar to those for OG overall, non-inferior LG-associated survival especially DSS was observed in some subgroups rarely investigated in prospective or randomized settings. There could still be biases even after PSM due to confounders not accounted for in this observational study. However, these findings offer novel hypotheses for further validation. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2019 Category: Surgery Source Type: research

Preferences for Surveillance of Barrett ’s Oesophagus: a Discrete Choice Experiment
ConclusionTest sensitivity, test frequency and out-of-pocket cost were the key factors influencing surveillance uptake. Patients prefer a test with the highest sensitivity, offered frequently, that incurs no upfront costs. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2019 Category: Surgery Source Type: research

Oncological Outcomes of Patients with Locally Advanced Rectal Cancer and Lateral Pelvic Lymph Node Involvement
ConclusionsManagement of patients with advanced rectal cancer and radiologically positive lateral pelvic lymph nodes is challenging due to high local recurrence rates. Further studies are needed to develop care pathways for the optimal treatment processes. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2019 Category: Surgery Source Type: research

Ileal Endometriosis: a Rare Cause of Enterocutaneous Fistula
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2019 Category: Surgery Source Type: research

Effective and Safe Living Donor Hepatectomy Under Intermittent Inflow Occlusion and Outflow Pressure Control
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2019 Category: Surgery Source Type: research

A Systematic Review and Meta-analysis of Physical Exercise Prehabilitation in Major Abdominal Surgery (PROSPERO 2017 CRD42017080366)
ConclusionPrehabilitation including a physical exercise intervention may lead to a reduction of postoperative pulmonary complications as well as less overall morbidity compared with standard care in patients undergoing major abdominal surgery. Further, well-designed RCT are needed to evaluate these potential positive effects in more detail and to identify suitable target populations.Protocol RegistrationPROSPERO 2017 CRD42017080366 (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 21, 2019 Category: Surgery Source Type: research

Reduction in Cardiac Arrhythmias Within an Enhanced Recovery After Surgery Program in Colorectal Surgery
AbstractBackgroundEnhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to achieve early recovery by preserving preoperative organ function and minimizing the stress response following surgery. Few studies have assessed the association between ERAS and postoperative cardiac complications. The goal of this study is to evaluate the impact of ERAS on postoperative cardiac complications.Materials and MethodsA retrospective review of a prospectively maintained database of colorectal patients who underwent surgery at a tertiary colorectal cancer referral center was carried out. Preoperative, ...
Source: Journal of Gastrointestinal Surgery - June 21, 2019 Category: Surgery Source Type: research

Comparison Between Endoscopic Biliary Stenting Combined with Balloon Dilation and Balloon Dilation Alone for the Treatment of Benign Hepaticojejunostomy Anastomotic Stricture
This study retrospectively analyzed 176 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for HJAS between April 2008 and March 2016. The outcome of endoscopic biliary stenting combined with balloon dilation (EBS group) and balloon dilation alone (balloon group) was evaluated.ResultsThe scope was successfully inserted into the HJ site in 93.8% patients (165/176), and 139 patients underwent endoscopic treatment after HJAS was confirmed. Successful biliary drainage was achieved in 137 patients by using ERCP and rendezvous procedures. Among these, 103 patients were included in balloon group and 34 p...
Source: Journal of Gastrointestinal Surgery - June 21, 2019 Category: Surgery Source Type: research

Is Surgery Necessary? Endoscopic Management of Post-transplant Biliary Complications in the Modern Era
ConclusionsEndoscopic management of post-transplant biliary complications resulted in long-term resolution without increased morbidity, mortality, or graft failure. Successful endoscopic treatment requires collaboration with a skilled endoscopist. Moreover, multidisciplinary transplant teams must develop treatment protocols based on the local availability and expertise at their center. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 21, 2019 Category: Surgery Source Type: research

Effects of Sarcopenia on Prognosis After Resection of Gallbladder Cancer
This study aimed to determine the prognostic significance of radiographic sarcopenia (RS) in patients with gallbladder cancer (GBC).MethodsFrom March 2001 to December 2013, 158 GBC patients who underwent curative intent surgery were included. The presence of RS was determined by skeletal muscle mass index using abdominal computed tomography.ResultsThe 1-, 3-, and 5-year overall survival (OS) rates were 63.6%, 41.9%, and 36.4%, respectively, for patients with RS (n = 88), and 84.3%, 62.6%, and 54.3%, respectively, for those without RS (n = 70) (P = 0.006). Multivariate analysis show...
Source: Journal of Gastrointestinal Surgery - June 21, 2019 Category: Surgery Source Type: research

Tumor Size Drives the Prognosis After Hepatic Resection of Solitary Hepatocellular Carcinoma Without Vascular Invasion
AbstractPurposeWe assessed the association of tumor size with patient survival following diagnosis of solitary hepatocellular carcinoma without vascular invasion.MethodsThe overall population comprised 638 patients who initially underwent hepatic resection with curative intent for a solitary hepatocellular carcinoma without macroscopic vascular invasion (487 had no microscopic vascular invasion). We set 5  cm as the tumor cutoff size for a solitary tumor based on the Milan criteria, and we used a multivariate Cox proportional hazards model and propensity score matching to evaluate the impact of tumor size on survival....
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Surgical Outcomes After Pancreatic Resection of Screening-Detected Lesions in Individuals at High Risk for Developing Pancreatic Cancer
ConclusionsScreening HRI can detect PDAC with a high resectability rate. Surgical treatment is associated with a relatively short length of stay and low readmission rate, acceptable morbidity, zero 90-day mortality, and significant long-term survival.Clinical Trial Registration NumberNCT2000089 (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Omentoplasty Decreases Leak Rate After Esophagectomy: a Meta-analysis
AbstractObjectiveTo compare the efficacy of omentoplasty with non-omentoplasty in the prevention of postoperative anastomotic leakage, and to investigate the safety of omentoplasty.MethodsLiterature searches were performed of the Medline, EMBASE, and Cochrane Library databases. Studies that compared the efficacy of omentoplasty and non-omentoplasty after esophagectomy were selected. A meta-analysis was performed on anastomotic leakage, anastomotic stenosis, hospital mortality, and length of hospital stay. Results were reported as odds ratio (OR), weighted mean difference (WMD), or relative risk (RR), with 95% confidence in...
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Endoscopic Ultrasound for Routine Assessment in Idiopathic Acute Pancreatitis
AbstractBackgroundAcute pancreatitis (AP) is one of the most common general acute surgical presentations. Current recommendations are that idiopathic acute pancreatitis (IAP) should account for no more than 20% of AP cases. Some studies suggest gallbladder microlithiasis is the aetiology in up to 75% of IAP patients. Endoscopic ultrasound (EUS) has been reported to be effective in the detection of microlithiasis and choledocholithiasis as well as pancreatic parenchymal, ductal and ampullary disorders. The aims of this study were to evaluate the usefulness of EUS in establishing aetiology in IAP patients and to assess if th...
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Minimally Invasive Approach in the Setting of ALPPS Procedure: a Systematic Review of the Literature
ConclusionsMIS-ALPPS appears to be safe, with potentially lower morbidities and mortalities relative to open patients. The present results should be considered with caution. A limited number of articles exist on this topic. Furthermore, selection biases exist when comparing open versus MIS-ALPPS data. Registry studies are needed to better define the outcomes of patients undergoing MIS-ALPPS. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Clinical Efficacy of Single-Channel Gastroscopy, Double-Channel Gastroscopy, and Double Gastroscopy for Submucosal Tumors in the Cardia and Gastric Fundus
ConclusionSingle-channel gastroscopy, double-channel gastroscopy, and double gastroscopy present potential capability with distinctive advantages in the endoscopic treatment of submucosal tumors of the cardia and gastric fundus, and it also shows that appropriate operation methods should be selected based on the situation of an individual patient. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Survival Benefit of and Indications for Adjuvant Chemotherapy for Resected Colorectal Liver Metastases —a Japanese Nationwide Survey
ConclusionAdjuvant chemotherapy has a survival benefit for patients with resected CRLM. Synchronous CRLM is a favorable indication for AC, whereas in metachronous CRLM, the use of AC should be individualized according to each patient ’s risk factors. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Predictive Value of Intraoperative Indocyanine Green Clearance Measurement on Postoperative Liver Function After Anatomic Major Liver Resection
AbstractBackgroundThe aim of this study was to evaluate the predictive value of measuring indocyanine green (ICG) clearance during intraoperative partial occlusion of liver lobes to be resected on postoperative liver function following major anatomic liver resection.MethodsWe prospectively included 46 patients, and 35 patients ultimately underwent anatomic major liver resection. ICG clearance was measured preoperatively and intraoperatively. Intraoperative ICG clearance was measured immediately after selective occlusion of hepatic arterial, portal, and hepatic venous blood flow to the liver lobes to be resected. The albumi...
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Insurance Coverage Type Impacts Hospitalization Patterns Among Patients with Hepatopancreatic Malignancies
ConclusionInsurance status was strongly associated with the type of hospital in which patients underwent surgery for liver and pancreatic cancers. Addressing the reasons for inequitable access to different hospital settings relative to insurance status is essential to ensure that all patients undergoing pancreatic or liver surgery receive high-quality surgical care. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Preoperative Biliary Drainage for Patients with Perihilar Bile Duct Malignancy
This study sought to identify EBS-associated risk of recurrent biliary obstruction and postoperative SSI, with particular attention whether it was replaced with external drainage methods before surgery.MethodsFrom January 2005 to December 2014, 102 consecutive patients with perihilar biliary cancer who underwent PBD followed by hepatobiliary resection were analyzed.ResultsAmong the enrolled patients, 49 (48.0%) underwent total 76 re-interventions due to recurrent biliary obstruction with a median number of 1 (range, 1 to 6). Cholangitis occurred more frequently in patients with EBS (26.9%) than in other methods (P 
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Safety and Efficacy of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma (3 –5 cm): a Propensity Score Matching Cohort Study
ConclusionFor solitary hepatocellular carcinoma of 3 –4 cm in diameter, radiofrequency ablation could achieve a comparable prognosis with a low incidence of post-treatment complications and low hospitalization costs, while surgical resection is recommended for solitary hepatocellular carcinoma tumors of 4–5 cm in diameter when long-term prognosi s is considered. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Comparative Perioperative Outcomes by Esophagectomy Surgical Technique
We report on the perioperative outcomes based on esophagectomy surgical technique.MethodsA prospectively managed esophagectomy database was queried for patients undergoing esophagectomy from 1996 and 2016. Basic demographics, tumor characteristics, operative details, and post-operative outcomes were recorded and analyzed by comparison of transhiatal vs Ivor-lewis and minimally invasive (MIE) vs open procedures.ResultsWe identified 856 patients who underwent esophagectomy. Neoadjuvant therapy was administered in 543 patients (63.4%). There were 504 (58.8%) open esophagectomies and 302 (35.2%) MIE. There were 13 (1.5%) morta...
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research

Resection Versus Observation of Small Asymptomatic Nonfunctioning Pancreatic Neuroendocrine Tumors
AbstractBackgroundManagement of asymptomatic, nonfunctioning small pancreatic neuroendocrine tumors (PNETs) is controversial because of their overall good prognosis, and the morbidity and mortality associated with pancreatic surgery. Our aim was to compare the outcomes of resection with expectant management of patients with small asymptomatic PNETs.MethodsRetrospective review of patients with nonfunctioning asymptomatic PNETs
Source: Journal of Gastrointestinal Surgery - June 13, 2019 Category: Surgery Source Type: research