Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：(NPO)日本食道学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J04260&link_issn=&doc_id=20250529320005&doc_link_id=10.1272%2Fmanms.21.67&url=https%3A%2F%2Fdoi.org%2F10.1272%2Fmanms.21.67&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(一社)日本外科学会  

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Language：Japanese   Publisher：(一社)日本外科学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J04260&link_issn=&doc_id=20250529320004&doc_link_id=10.1272%2Fmanms.21.61&url=https%3A%2F%2Fdoi.org%2F10.1272%2Fmanms.21.61&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：日本医科大学医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J04260&link_issn=&doc_id=20250529320003&doc_link_id=10.1272%2Fmanms.21.56&url=https%3A%2F%2Fdoi.org%2F10.1272%2Fmanms.21.56&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：日本外科系連合学会  

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Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Postoperative incisional hernia impairs patients' quality of life and may require surgical intervention. This study investigated the risk of incisional hernia following laparoscopic colorectal cancer surgery. METHODS: In total, 199 patients who underwent laparoscopic colorectal cancer surgery were enrolled in this retrospective single-center study. The patients were divided into the no incisional hernia group (n = 185) and the incisional hernia group (n = 9). Subcutaneous fat area (SFA) and visceral fat area (VFA) at the level of the umbilicus were measured using specialized computed tomography imaging software. Data from an additional 78 patients who underwent laparoscopic colorectal cancer surgery in another hospital were used as a validation cohort. RESULTS: Nine patients (4.6%) were diagnosed with incisional hernia. Body mass index, SFA, and VFA were significantly higher in the hernia group than in the non-hernia group (p = 0.04, 0.004, and 0.03, respectively). In the multivariate analysis, only SFA of ≥ 167.8 cm2 remained an independent risk factor (odds ratio: 7.73, 95% confidence interval: 1.31-45.8, p = 0.02). Subcutaneous fat thickness (SFT), which can be easily measured on routine computed tomography scans, showed a strong correlation with SFA (coefficient = 0.779, p < 0.001) and was also significantly associated with incisional hernia. This association was validated in an independent cohort. CONCLUSION: High SFA was an independent risk factor for incisional hernia following laparoscopic colorectal cancer surgery. SFT may serve as a practical surrogate for SFA.

DOI： 10.1111/ases.70190

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Postoperative infectious complications in colorectal cancer prolong hospital stays and increase the risk of recurrence. Given that risk factors may vary depending on the surgical procedure-namely, right-sided colon, left-sided colon, and rectal cancer-we aimed to identify both common and procedure-specific risk factors．. METHODS: This retrospective multicenter study included 2,636 patients who underwent elective colorectal cancer surgery between April 2015 and March 2023 at three affiliated institutions. The primary endpoint was the incidence of Clavien-Dindo grade ≥2 infectious complications by surgical site. Multivariate logistic regression analyses were performed to identify common and procedure-specific risk factors across the three anatomical groups．. RESULTS: Infectious complications occurred in 18.5% of patients. The incidence significantly differed by surgical site: 11.7% in right-sided colon, 14.6% in left-sided colon, and 22.0% in rectal cancer (P < 0.001). Operative time was the only risk factor common to all procedures. Right-sided colon cancer was associated with additional risks including advanced age, low BMI, male sex, and open surgery. Rectal cancer, in contrast, showed younger age and male sex as contributing factors. Both male sex and higher BMI correlated significantly with longer operative times in all groups．. CONCLUSIONS: Prolonged operative time appears to be a consistent and independent risk factor for postoperative infectious complications across various colorectal cancer procedures. In contrast, other factors such as age, body mass index, sex, and surgical approach showed associations that varied depending on the type of procedure．.

DOI： 10.23922/jarc.2025-046

PubMed

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：(一社)日本外科感染症学会  

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Language：Japanese   Publisher：日本臨床外科学会  

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Language：Japanese   Publisher：(NPO)日本高齢消化器病学会  

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：(NPO)日本食道学会  

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Language：Japanese   Publisher：(NPO)日本食道学会  

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：日本外科系連合学会  

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Language：Japanese   Publisher：日本外科系連合学会  

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Language：Japanese   Publisher：日本外科系連合学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Laparoscopic surgery is performed worldwide and has clear economic and social benefits in terms of patient recovery time. It is used for most gastrointestinal surgical procedures, but laparoscopic surgery for more complex procedures in the esophageal, hepatobiliary, and pancreatic regions remains challenging. Minimally invasive surgery that results in accurate tumor dissection is vital in surgical oncology, and development of surgical systems and instruments plays a key role in assisting surgeons to achieve this. A notable advance in the latter half of the 1990s was the da Vinci Surgical System, which involves master-slave surgical support robots. Featuring high-resolution three-dimensional (3D) imaging with magnification capabilities and forceps with multi-joint function, anti-shake function, and motion scaling, the system compensates for the drawbacks of conventional laparoscopic surgery. It is expected to be particularly useful in the field of hepato-biliary-pancreatic surgery, which requires delicate reconstruction involving complex liver anatomy with diverse vascular and biliary systems and anastomosis of the biliary tract, pancreas, and intestines. The learning curve is said to be short, and it is hoped that robotic surgery will be standardized in the near future. There is also a need for a standardized robotic surgery training system for young surgeons that can later be adapted to a wider range of surgeries. This systematic review describes trends and future prospects for robotic surgery in the hepatobiliary-pancreatic region.

DOI： 10.1272/jnms.JNMS.2024_91-109

PubMed

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Language：Japanese   Publisher：(一財)日本消化器病学会  

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Language：Japanese   Publisher：日本手術医学会  

(緒言)外科医は,多職種との関わりも多いが,主戦場は手術室とも言える。特に器械出し看護師(Scrub nurse:SN)は,戦友と言っても過言ではない。これまでの自分の経験と私見を交え,匠のSNについて述べる。(本文)SNとは,手術中に外科医と共に,命を掛けて手術に臨んでいる患者の近くにいる存在で,手術を成功させるために不可欠であり,患者生命の一端を握る責任のある存在である。自分の海外施設見学の経験から,見学者の自分よりも前のめりで術野を観察し,的確に外科医の指示に従うSNを見てきた。確かに"Skillful"なSNではあったが,国ごとの地域差を感じた。自分の考える匠のSNとは,同じく"匠"を目指す外科医と共に,お互いにリスペクトし合い,協力しながら,成長していく過程の延長に存在する。現在,手術に必要な手作り器具の作成,手術シミュレーション,研究会発表などを共に行いながら,互いに"匠"を目指し,奮闘中である。(結語)匠のSNとは,理想であり,目標でもある。それは,外科医が多職種と協力し合って共に育てるものかもしれない。お互いのレベル・モチベーションのアップやコミュニケーションの強化などが必須であり,その点においても本学会の役割は大きいものと考える。(著者抄録)

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s12328-023-01911-w

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Other Link： https://link.springer.com/article/10.1007/s12328-023-01911-w/fulltext.html

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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Language：Japanese   Publisher：(一社)日本外科感染症学会  

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Language：Japanese   Publisher：日本臨床外科学会  

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Language：Japanese   Publisher：日本臨床外科学会  

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Language：Japanese   Publisher：(一社)日本大腸肛門病学会  

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Publishing type：Research paper (scientific journal)   Publisher：Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.jnms.2023_90-404

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：日本外科系連合学会  

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

Esophageal cancer patients require enteral nutritional support after esophagectomy. Conventional feeding enterostomy to the jejunum (FJ) is occasionally associated with small bowel obstruction because the jejunum is fixed to the abdominal wall. Feeding through an enteral feeding tube inserted through the reconstructed gastric tube (FG) or the duodenum (FD) using the round ligament of the liver have been suggested as alternatives. This meta-analysis aimed to compare short-term outcomes between FG/FD and FJ. Studies published prior to May 2022 that compared FG or FD with FJ in cancer patients who underwent esophagectomy were identified via electronic literature search. Meta-analysis was performed using the Mantel–Haenszel random-effects model to calculate Odds Ratios (ORs) with 95% confidence intervals (CIs). Five studies met inclusion criteria to yield a total of 1687 patients. Compared with the FJ group, the odds of small bowel obstruction (OR 0.09; 95% CI, 0.02–0.33), catheter site infection (OR 0.18; 95% CI, 0.06–0.51) and anastomotic leakage (OR 0.53; 95% CI, 0.32–0.89) were lower for the FG/FD group. Odds of pneumonia, recurrent laryngeal nerve palsy, chylothorax and hospital mortality did not significantly differ between the groups. The length of hospital stay was shorter for the FG/FD group (median difference, −10.83; 95% CI, −18.55 to −3.11). FG and FD using the round ligament of the liver were associated with lower odds of small bowel obstruction, catheter site infection and anastomotic leakage than FJ in esophageal cancer patients who underwent esophagectomy.

DOI： 10.1093/dote/doac105

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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Language：Japanese   Publisher：日本臨床外科学会  

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Language：Japanese   Publisher：(一社)日本消化器外科学会  

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