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Article ; Online: Prognostic Impact of Lymphocyte-to-C-Reactive Protein Ratio in Patients Who Underwent Surgical Resection for Pancreatic Cancer.

Iseda, Norifumi / Iguchi, Tomohiro / Hirose, Kosuke / Itoh, Shinji / Honboh, Takuya / Sadanaga, Noriaki / Matsuura, Hiroshi

The American surgeon

2022 Volume 89, Issue 11, Page(s) 4452–4458

Abstract: Background: Increasing evidence indicates that increased systemic inflammation is correlated with poorer cancer-specific survival in various cancer types. This study aimed to evaluate the prognostic value of various combinations of inflammatory factors ... ...

Abstract	Background: Increasing evidence indicates that increased systemic inflammation is correlated with poorer cancer-specific survival in various cancer types. This study aimed to evaluate the prognostic value of various combinations of inflammatory factors in patients who underwent surgical resection for pancreatic cancer (PC). Methods: We retrospectively analyzed 97 consecutive patients with PC who underwent pancreatectomy. We assessed the predictive impact for recurrence using a combination of 5 inflammatory markers and focused on the lymphocyte-C-reactive protein ratio (LCR) to elucidate its prognostic and predictive value for recurrence-free survival (RFS) and overall survival (OS) in univariate and multivariate analyses using the Cox proportional hazards model. Results: Low preoperative LCR was correlated with low serum hemoglobin, low serum albumin concentration, high frequency of microscopic vascular invasion, and high frequency of microscopic perineural invasion. The low LCR group had significantly worse RFS and OS. Lower preoperative LCR was an independent predictor of shorter RFS and OS in this cohort. Discussion: Preoperative LCR is a novel and convenient prognostic marker for patients with PC. Patients with low LCR may require more favorable intensive therapy.
MeSH term(s)	Humans ; Prognosis ; C-Reactive Protein/metabolism ; Retrospective Studies ; Pancreatic Neoplasms ; Lymphocytes/metabolism ; Pancreatic Neoplasms
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2022-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221117034
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Article ; Online: Textbook outcome in the laparoscopic cholecystectomy of acute cholecystitis.

Iseda, Norifumi / Iguchi, Tomohiro / Itoh, Shinji / Sasaki, Shun / Honboh, Takuya / Yoshizumi, Tomoharu / Sadanaga, Noriaki / Matsuura, Hiroshi

Asian journal of endoscopic surgery

2023 Volume 16, Issue 4, Page(s) 741–746

Abstract: Purpose: Textbook outcome (TO) is a novel composite measure of clinical outcomes that can be used to measure the quality of surgical outcomes. The aim of this cohort study was to propose TO criteria for laparoscopic cholecystectomy for acute ... ...

Abstract	Purpose: Textbook outcome (TO) is a novel composite measure of clinical outcomes that can be used to measure the quality of surgical outcomes. The aim of this cohort study was to propose TO criteria for laparoscopic cholecystectomy for acute cholecystitis and to identify reasons for TO failure and individual patient factors that predispose to failure. Methods: We retrospectively analyzed data for 189 patients with acute cholecystitis who underwent laparoscopic cholecystectomy. TO was defined as laparoscopic cholecystectomy without conversion to open cholecystectomy, intraoperative complications, postoperative complications (Clavien-Dindo classification ≥2), prolonged length of stay (≥10 days), readmission within 30 days, or mortality. Results: TO was achieved in 154 of 189 patients who underwent laparoscopic cholecystectomy for acute cholecystitis. Medical costs were lower in the TO-achieved group than in the TO-failure group. Factors associated with TO failure on multivariate analysis were age > 70 years, hemoglobin <11.9 g/dL, and white blood cells >18 000 / μL (all P < .05). Conclusions: Applying TO to patients with acute cholecystitis allowed us to evaluate the overall quality of care related to hospitalization. TO may provide better assessment of the quality of care and help determine the treatment choice and reduce costs.
MeSH term(s)	Humans ; Aged ; Cholecystectomy, Laparoscopic ; Retrospective Studies ; Cohort Studies ; Cholecystitis, Acute/surgery ; Cholecystectomy ; Length of Stay ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Treatment Outcome
Language	English
Publishing date	2023-08-01
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2503256-2
ISSN	1758-5910 ; 1758-5902
ISSN (online)	1758-5910
ISSN	1758-5902
DOI	10.1111/ases.13238
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Article: [A 30-Month Survival Case of Undifferentiated Carcinoma of the Duodenum Treated by Pancreaticoduodenectomy].

Matsuda, Masakazu / Iguchi, Tomohiro / Iseda, Norifumi / Sasaki, Shun / Honbo, Takuya / Emi, Yasunori / Sadanaga, Noriaki / Naito, Yoshiki / Kato, Seiya / Matsuura, Hiroshi

Gan to kagaku ryoho. Cancer & chemotherapy

2023 Volume 50, Issue 9, Page(s) 1001–1004

Abstract: The patient was an elderly man in his early 80s who was admitted to our hospital due to anemia and tarry stools. An upper gastrointestinal endoscopy revealed a type 2 tumor in the second portion of the duodenum. An endoscopic biopsy revealed poorly ... ...

Abstract	The patient was an elderly man in his early 80s who was admitted to our hospital due to anemia and tarry stools. An upper gastrointestinal endoscopy revealed a type 2 tumor in the second portion of the duodenum. An endoscopic biopsy revealed poorly differentiated adenocarcinoma. We performed a pancreaticoduodenectomy because neither lymphadenopathy nor distant metastases were found. Macroscopic findings revealed that the lesion was mainly in the second portion of the duodenum, and there was no evidence of invasion of the main pancreatic duct, the bile duct, or the ampulla of Vater. Histologically, the tumor was composed of atypical cells with polymorphic or spindle-shaped nuclei proliferating in a scattered fashion, and immunohistological examinations showed weakly positive results for cytokeratin(CK)AE1/AE3 and CK20 and positive results for vimentin but negative results for CK7. The tumor was diagnosed as undifferentiated carcinoma of the duodenum(pT4N0M0, pStage ⅡB). The patient recovered enough to be discharged and was followed up without postoperative adjuvant chemotherapy. He maintained recurrence-free survival for 27 months, after which lymph node and lung metastases reoccurred. This is a rare case of undifferentiated carcinoma of the duodenum treated by curative resection with a relatively favorable prognosis.
MeSH term(s)	Humans ; Male ; Adenocarcinoma/surgery ; Ampulla of Vater/surgery ; Carcinoma/surgery ; Common Bile Duct Neoplasms/pathology ; Duodenum/pathology ; Pancreatectomy ; Pancreaticoduodenectomy ; Aged, 80 and over
Language	Japanese
Publishing date	2023-10-03
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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Article ; Online: Safety of laparoscopic cholecystectomy in patients with a cerebrospinal fluid shunt in the peritoneal cavity.

Inaba, Daichi / Iguchi, Tomohiro / Iseda, Norifumi / Sasaki, Shun / Honboh, Takuya / Okura, Akira / Sadanaga, Noriaki / Matsuura, Hiroshi

Asian journal of endoscopic surgery

2023 Volume 16, Issue 3, Page(s) 447–454

Abstract: Introduction: The management of patients with a cerebrospinal fluid (CSF) shunt located in the peritoneal cavity undergoing laparoscopic surgery is an issue that has not yet been settled. These patients are at risk of increased intracranial pressure ... ...

Abstract	Introduction: The management of patients with a cerebrospinal fluid (CSF) shunt located in the peritoneal cavity undergoing laparoscopic surgery is an issue that has not yet been settled. These patients are at risk of increased intracranial pressure caused by peritoneal insufflation, shunt dysfunction, and shunt infection/retrograde meningitis. This study aimed to determine the need for perioperative shunt intervention in CSF shunt patients undergoing laparoscopic cholecystectomy. Methods: We reviewed and analyzed five shunt patients who underwent laparoscopic cholecystectomy in our institution between 2012 and 2022, as well as 17 patients described in previous reports. Results: Among the 22 patients, shunt type was ventriculoperitoneal in 14 and lumboperitoneal in eight. The most common indication for CSF shunt was hydrocephalus caused by cerebral vascular accident (50.0%). Laparoscopic cholecystectomy was performed for cholecystolithiasis in 13 patients (59.1%), acute cholecystitis in eight (36.4%), and gallbladder polyp in one (4.5%). Shunt clamping or externalization was performed in six patients. Two patients in the group that did not undergo shunt clamping or externalization experienced complications (intra abdominal abscess and subcutaneous emphysema). However, the incidence of short-term complications (both overall and shunt-related) and median length of hospital stay did not significantly differ between the two groups. Conclusion: Routine shunt clamping, externalization, or removal might not be necessarily required in patients with a ventriculoperitoneal or lumboperitoneal shunt undergoing laparoscopic cholecystectomy.
MeSH term(s)	Humans ; Cerebrospinal Fluid Shunts/adverse effects ; Cholecystectomy, Laparoscopic/adverse effects ; Hydrocephalus/surgery ; Laparoscopy ; Peritoneal Cavity/surgery ; Ventriculoperitoneal Shunt/adverse effects
Language	English
Publishing date	2023-04-16
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2503256-2
ISSN	1758-5910 ; 1758-5902
ISSN (online)	1758-5910
ISSN	1758-5902
DOI	10.1111/ases.13190
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Article ; Online: Development of predictive score for postoperative dysphagia after emergency abdominal surgery in patients of advanced age.

Iguchi, Tomohiro / Mita, Junya / Iseda, Norifumi / Sasaki, Shun / Harada, Noboru / Ninomiya, Mizuki / Sugimachi, Keishi / Honboh, Takuya / Sadanaga, Noriaki / Matsuura, Hiroshi

Annals of gastroenterological surgery

2023 Volume 8, Issue 1, Page(s) 172–181

Abstract: Aim: Postoperative dysphagia after emergency abdominal surgery (EAS) in patients of advanced age has become problematic, and appropriate dysphagia management is needed. This study was performed to identify predictive factors of dysphagia after EAS and ... ...

Abstract	Aim: Postoperative dysphagia after emergency abdominal surgery (EAS) in patients of advanced age has become problematic, and appropriate dysphagia management is needed. This study was performed to identify predictive factors of dysphagia after EAS and to explore the usefulness of swallowing screening tools (SSTs). Methods: This retrospective study included 267 patients of advanced age who underwent EAS from 2012 to 2022. They were assigned to a dysphagia group and non-dysphagia group using the Food Intake Level Scale (FILS) (dysphagia was defined as a FILS level of <7 on postoperative day 10). From 2018, original SSTs including a modified water swallowing test were performed by nurses. Results: The incidence of postoperative dysphagia was 22.8% (61/267). Patients were significantly older in the dysphagia than non-dysphagia group. The proportions of patients who had poor nutrition, cerebrovascular disorder, Parkinson's disease, dementia, nursing-care service, high intramuscular adipose tissue content (IMAC), and postoperative ventilator management were much higher in the dysphagia than non-dysphagia group. Using logistic regression analysis, high IMAC, postoperative ventilator management, cerebrovascular disorder, and dementia were correlated with postoperative dysphagia and were assigned 10, 4, 3, and 3 points, respectively, according to each odds ratio. The optimal cut-off value was 7 according to a receiver operating characteristics curve. Using 1:1 propensity score matching for high-risk patients, the incidence of postoperative dysphagia was reduced by SSTs. Conclusions: The new prediction score obtained from this study can identify older patients at high risk for dysphagia after EAS, and SSTs may improve these patients' short-term outcomes.
Language	English
Publishing date	2023-07-15
Publishing country	Japan
Document type	Journal Article
ISSN	2475-0328
ISSN (online)	2475-0328
DOI	10.1002/ags3.12716
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Article ; Online: An Adult Case of Multiple Extralobar Pulmonary Sequestrations in the Thoracic and Abdominal Cavities.

Ryujin, Keiichiro / Akamine, Takaki / Miura, Naoko / Yoshida, Rintaro / Shikada, Yasunori / Kato, Seiya / Sadanaga, Noriaki

The Annals of thoracic surgery

2021 Volume 113, Issue 1, Page(s) e17–e20

Abstract: Extralobar pulmonary sequestration is generally located in the left thoracic cavity and is often identified prenatally or in infants. We identified a rare case of multiple extralobar pulmonary sequestrations in the thoracic and abdominal cavities, ... ...

Abstract	Extralobar pulmonary sequestration is generally located in the left thoracic cavity and is often identified prenatally or in infants. We identified a rare case of multiple extralobar pulmonary sequestrations in the thoracic and abdominal cavities, incidentally detected in a 60-year-old woman by cancer screening. The patient underwent surgery by thoracoscopic and laparoscopic approaches simultaneously, and extralobar sequestration was histologically confirmed in each lesion. Preoperative diagnosis was difficult because of unusual multiple localization and an undetectable aberrant artery on imaging examinations.
MeSH term(s)	Abdominal Cavity ; Bronchopulmonary Sequestration/diagnostic imaging ; Bronchopulmonary Sequestration/surgery ; Female ; Humans ; Incidental Findings ; Middle Aged ; Thoracic Cavity
Language	English
Publishing date	2021-04-08
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.03.083
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Article: Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report.

Yoshida, Yurie / Iguchi, Tomohiro / Iseda, Norifumi / Hirose, Kosuke / Honboh, Takuya / Iwasaki, Noriko / Kato, Seiya / Sadanaga, Noriaki / Matsuura, Hiroshi

Surgical case reports

2022 Volume 8, Issue 1, Page(s) 134

Abstract: Background: Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of ... ...

Abstract	Background: Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of emergent surgeries changed to avoid contagion exposure among medical workers and poor postoperative outcomes. Case presentation: A 56-year-old man presented to our hospital with abdominal pain. Computed tomography revealed intraluminal membranes, an irregular or absent wall, and an abscess of the gallbladder, indicating acute gangrenous cholecystitis. Early laparoscopic cholecystectomy seemed to be indicated; however, a COVID-19 antigen test was positive despite no obvious pneumonia on chest computed tomography and no symptoms. After discussion among the multidisciplinary team, antibiotic therapy was started and percutaneous transhepatic gallbladder drainage (PTGBD) was planned for the following day because the patient's vital signs were stable and his abdominal pain was localized. Fortunately, the antibiotic therapy was very effective, and PTGBD was not needed. The cholecystitis improved and the patient was discharged from the hospital on day 10. One month later, laparoscopic delayed cholecystectomy was performed after confirming a negative COVID-19 polymerase chain reaction test result. The postoperative course was uneventful, and the patient was discharged on postoperative day 2 in satisfactory condition. Conclusion: We have reported a case of acute gangrenous cholecystitis in a patient with asymptomatic COVID-19 disease. This report can help to determine treatment strategies for patients with gangrenous cholecystitis during future pandemics.
Language	English
Publishing date	2022-07-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2809613-7
ISSN	2198-7793
ISSN	2198-7793
DOI	10.1186/s40792-022-01494-7
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Article: Refractory cutaneo-gastric conduit fistula after esophagectomy repaired by a pectoralis major muscle flap and split-thickness skin graft.

Yoshida, Rintaro / Sadanaga, Noriaki / Honboh, Takuya / Migita, Hisashi / Matsuura, Hiroshi

Surgical case reports

2019 Volume 5, Issue 1, Page(s) 113

Abstract: Background: Gastric conduit ulcer after esophagectomy is not uncommon. In cases where a gastric conduit ulcer penetrates the adjacent organs, it is difficult to select a suitable treatment strategy. The treatment depends on the adjacent organs ... ...

Abstract	Background: Gastric conduit ulcer after esophagectomy is not uncommon. In cases where a gastric conduit ulcer penetrates the adjacent organs, it is difficult to select a suitable treatment strategy. The treatment depends on the adjacent organs penetrated. Case presentation: We report a case in which a reconstructed gastric conduit ulcer penetrated the precordial skin in a patient who had undergone esophagectomy due to spontaneous esophageal rupture 28 years previously. To treat the cutaneo-gastric conduit fistula, we resected the fistula, covered the site of anastomosis with a major pectoralis muscle flap, and applied a split-thickness skin graft to the skin defect. Conclusions: In cases of gastric conduit trouble in patients treated via the antesternal route, a major pectoralis muscle flap is useful because of its rich blood supply and easy mobilization. In addition, a split-thickness skin graft should be applied to the skin defect.
Language	English
Publishing date	2019-07-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2809613-7
ISSN	2198-7793
ISSN	2198-7793
DOI	10.1186/s40792-019-0672-z
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Article: Successful laparoscopic cholecystectomy for gallbladder hemorrhage from a Dieulafoy lesion in a patient on hemodialysis: a case report.

Yano, Yuu-Ichi / Iguchi, Tomohiro / Sato, Shota / Iseda, Norifumi / Sasaki, Shun / Abe, Yasuhiro / Nakayama, Tomohiro / Honboh, Takuya / Kato, Seiya / Sadanaga, Noriaki / Matsuura, Hiroshi

Surgical case reports

2023 Volume 9, Issue 1, Page(s) 46

Abstract: Background: Patients on long-term dialysis are prone to hemorrhagic complications, particularly uremic bleeding, but gallbladder hemorrhage is rare, even in patients on dialysis. There have been occasional reports of a Dieulafoy lesion being a cause of ... ...

Abstract	Background: Patients on long-term dialysis are prone to hemorrhagic complications, particularly uremic bleeding, but gallbladder hemorrhage is rare, even in patients on dialysis. There have been occasional reports of a Dieulafoy lesion being a cause of gastrointestinal hemorrhage, but its occurrence within the gallbladder is quite rare. This report describes a case of gallbladder hemorrhage from a Dieulafoy lesion in a patient on hemodialysis that was diagnosed early and successfully treated by laparoscopic cholecystectomy. Case presentation: The patient was a 68-year-old woman on long-term hemodialysis with end-stage renal failure who presented with epigastralgia and back pain. There was no history of trauma or oral administration of antiplatelet or anticoagulant agents. There were no signs of an inflammatory reaction or hyperbilirubinemia. Contrast-enhanced computed tomography revealed a slightly hyperdense area in the distended gallbladder and extravasation within the gallbladder lumen but no gallstones. A severe atherosclerotic lesion was also found. She was diagnosed to have gallbladder hemorrhage and emergency laparoscopic cholecystectomy was performed. Although the postoperative course was complicated by drug fever, she was discharged on postoperative day 10 in a satisfactory condition. Histology revealed hemorrhagic ulceration with an exposed blood vessel accompanied by abnormal arteries in the submucosa. Arteriosclerosis with eccentric intimal hyperplasia in a small-sized artery was also seen. The diagnosis was gallbladder hemorrhage from a Dieulafoy lesion. Conclusions: A Dieulafoy lesion should be kept in mind as a cause of gallbladder hemorrhage in a patient with severe arteriosclerosis and a bleeding diathesis, particularly if on dialysis, and treated as early as possible.
Language	English
Publishing date	2023-03-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2809613-7
ISSN	2198-7793
ISSN	2198-7793
DOI	10.1186/s40792-023-01628-5
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Article ; Online: Prognostic Impact of the Preoperative Systemic Inflammation Score in Patients With Pancreatic Ductal Adenocarcinoma.

Iguchi, Tomohiro / Iseda, Norifumi / Hirose, Kosuke / Itoh, Shinji / Harada, Noboru / Ninomiya, Mizuki / Sugimachi, Keishi / Honboh, Takuya / Maeda, Takashi / Sadanaga, Noriaki / Matsuura, Hiroshi

The American surgeon

2022 Volume 89, Issue 6, Page(s) 2213–2219

Abstract: Backgroud: The systemic inflammation score (SIS), which is based on the preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin (Alb) level, is a prognostic indicator for several cancer types. However, the prognostic significance of the SIS in ...

Abstract	Backgroud: The systemic inflammation score (SIS), which is based on the preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin (Alb) level, is a prognostic indicator for several cancer types. However, the prognostic significance of the SIS in pancreatic ductal adenocarcinoma (PDAC) remains unknown. Methods: Seventy-eight patients who underwent radical surgery for PDAC were categorized as follows: SIS 0 (LMR ≥3.51 and Alb ≥4.0 g/dl), n = 26; SIS 1 (LMR <3.51 or Alb <4.0 g/dl), n = 29 and SIS 2 (LMR <3.51 and Alb <4.0 g/dl), n=23. Results: The tumour size sequentially increased in SIS 0, 1 and 2 groups. A higher SIS was associated with increased vascular invasion, perineural invasion and surgical margin positivity rate. Recurrence-free survival (RFS) rates between the SIS 1 and 2 groups showed no significant difference However, patients of the SIS 1 and 2 groups had poorer outcomes than those of the SIS 0 group for RFS. Overall survival (OS) rates between the SIS 1 and 2 groups also showed no significant difference. However, patients of the SIS 1 and 2 groups had poorer outcomes than those of the SIS 0 group for OS. The SIS was an independent prognostic factor for RFS and OS. Discussion: The SIS is a simplified prognostic factor for patients with PDAC.
MeSH term(s)	Humans ; Prognosis ; Pancreatic Neoplasms/pathology ; Carcinoma, Pancreatic Ductal/surgery ; Carcinoma, Pancreatic Ductal/pathology ; Inflammation ; Retrospective Studies ; Pancreatic Neoplasms
Language	English
Publishing date	2022-04-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221086782
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