Multiple gastric cancers can be a risk factor in Lynch syndrome. Intensive surveillance might be recommended for Japanese individuals with LS associated with MLH1 or MSH2 variants. Abstract Aim Lynch syndrome (LS) is a dominantly inherited syndrome characterized by an increased risk for LS associated tumors such as colorectal cancer (CRC) and gastric cancer (GC). However, the clinical benefit of surveillance for GC remains unclear while it has already been recommended for CRC. This study aimed to elucidate the clinical features of GC in Japanese individuals with LS, and the risk of developin ..read more

Patients who underwent pancreatoduodenectomy showed relatively high blood culture positivity rates. It may be possible to distinguish pancreatic fistula-related and -unrelated febrile events. Abstract Aim The aim of this study was to clarify the significance of blood culture testing in the postoperative period of pancreatoduodectomy (PD), a highly invasive surgery. Methods Rates of blood culture sampling and positivity were investigated for febrile episodes (FEs) in patients who underwent PD (2016–2021). FEs were defined as body temperature of 38.0°C or higher occurring on or after the 4th p ..read more

Laparoscopic Heller myotomy (LHM) is the gold standard treatment for achalasia, and peroral endoscopic myotomy (POEM) is performed extensively; however, the selection of the intervention method remains debatable to date. Recent studies have analyzed the long-term outcomes over 5 y of LHM and POEM. In this review, we draw on previous reports to discuss the long-term outcomes and future status of LHM and POEM for achalasia. Abstract Achalasia is a rare esophageal motility disorder characterized by nonrelaxation of the lower esophageal sphincter. Laparoscopic Heller myotomy (LHM) is the gold st ..read more

Biliary anatomical factors were shown in this study to influence biliary complications after central liver resection. Importantly, the supraportal with right hepatic duct type is the most common anatomy and can be hazardous if it is >10 mm in length. Abstract Aim Central liver resections are considered to be high-risk procedures due to postoperative biliary complications. However, anatomical aspect-related causes are underreported. Focusing upon right anterior sectionectomy (H58) and central bisectionectomy (H458), we assessed risk factors for postoperative biliary complications. Methods ..read more

We evaluated the morbidity and mortality associated with liver surgery and developed a risk model for liver resection by using information from the National Clinical Database. Abstract Aim We evaluated the morbidity and mortality associated with liver surgery in Japan and developed a risk model for liver resection using information from a national database. Methods We retrospectively reviewed 73 861 Japanese patients who underwent hepatectomy between 2014 and 2019, using information from the National Clinical Database (NCD) registrations. The primary endpoints were 30 days and in-hospital mo ..read more

Preoperative cachexia index (CXI), which consists of skeletal muscle, inflammation, and nutritional status, has been associated with prognosis in patients with hepatocellular carcinoma (HCC). We found that postoperative CXI and dynamic changes in CXI from before to after hepatic resection were significantly associated with overall survival in patients with HCC. Interestingly, intraoperative blood loss in the preoperative high CXI group and age in the preoperative low CXI group were associated with low postoperative CXI. Abstract Background The cachexia index (CXI), which consists of skeletal ..read more

The COVID-19 pandemic had few negative effects on outcomes after surgery for gastroduodenal perforation. These findings suggest that the emergency system for gastroduodenal perforation in Japan was generally maintained during the pandemic. Abstract Aim To examine the potential negative effects of the COVID-19 pandemic on short-term postoperative outcomes of emergency surgery for gastroduodenal perforation in Japan. Methods A total of 7973 cases of gastroduodenal perforation from 2019 to 2021 were retrieved from the National Clinical Database (NCD), which includes >95% of surgical cases in ..read more

The perioperative administration of enoxaparin in hepatobiliary-pancreatic malignancies is feasible and safe. However, further case accumulation and investigation are necessary to assess its potential in reducing the occurrence of VTE. Abstract Purpose Postoperative venous thromboembolism (VTE) risk is pronounced after abdominal cancer surgery. Enoxaparin shows promise in preventing VTE in gastrointestinal, gynecological, and urological cancers, but its application after surgery for hepatobiliary-pancreatic malignancy has been under-evaluated due to bleeding concerns. We confirmed the safety ..read more

We investigated whether TO can be used to predict outcomes after curative resection for esophageal squamous cell carcinoma in elderly patients. The patients in non-TO group had significantly shorter overall survival than those in TO group. TO can be used to predict outcomes after curative esophagectomy in elderly patients with ESCC. Abstract Purpose Textbook outcome (TO) is a composite quality measurement of outcomes for evaluating surgical procedures. We investigated whether TO can be used to predict outcomes after curative resection for esophageal squamous cell carcinoma (ESCC) in elderly ..read more

We surveyed the impacts of the COVID-19 pandemic on the incidence of complications and mortality following pancreaticoduodenectomy for pancreatic cancer by using the Japanese National Clinical Database. This study revealed the increasing trend in the number of pancreaticoduodenectomies and favorable short-term outcomes even in the COVID-19 pandemic and suggests the medical care for pancreatic cancer in Japan functioned well even during the pandemic. Abstract Aim The coronavirus disease 2019 (COVID-19) pandemic greatly impacted medical resources such as cancer screening, diagnosis, and treatm ..read more