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Article: Is damage control surgery useful in the treatment of colorectal perforation? A single-center case-control study.

Kunitatsu, Kosei / Ueda, Kentaro / Nasu, Toru / Kawashima, Shuji / Okishio, Yuko / Kato, Seiya

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 4, Page(s) 645–649

Abstract: Colorectal perforation with systemic peritonitis requires prompt surgical attention, and damage control surgery (DCS) is performed in patients with severe injuries. This study aimed to retrospectively investigate the efficacy of DCS in patients with ... ...

Abstract	Colorectal perforation with systemic peritonitis requires prompt surgical attention, and damage control surgery (DCS) is performed in patients with severe injuries. This study aimed to retrospectively investigate the efficacy of DCS in patients with colonic perforation. Materials and methods: From January 2013 to December 2019, 131 patients with colorectal perforation underwent emergency surgery at our hospital. Among these, 95 patients required postoperative intensive care unit management and were included in this study; of these patients, 29 (31%) underwent DCS, and 66 (69%) underwent primary abdominal closure (PC). Results: Patients who underwent DCS had significantly higher Acute Physiology and Chronic Health Evaluation II (23.9 [19.5-29.5] vs. 17.6 [13.7-22]; Conclusions: The results suggest that DCS is useful in the management of acute generalized peritonitis caused by colorectal perforation.
Language	English
Publishing date	2023-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000000334
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Article: Life-threatening gastrointestinal bleeding from splenic artery pseudoaneurysm due to gastric ulcer penetration treated by surgical hemostasis with resuscitative endovascular balloon occlusion of the aorta: A case report.

Nakata, Tomonori / Okishio, Yuko / Ueda, Kentaro / Nasu, Toru / Kawashima, Shuji / Kunitatsu, Kosei / Kato, Seiya

Clinical case reports

2022 Volume 10, Issue 3, Page(s) e05561

Abstract: We report the case of a patient for whom surgical hemostasis of gastrointestinal bleeding due to a splenic artery pseudoaneurysm, which developed due to gastric ulcer penetration, was achieved with resuscitative endovascular balloon occlusion of the ... ...

Abstract	We report the case of a patient for whom surgical hemostasis of gastrointestinal bleeding due to a splenic artery pseudoaneurysm, which developed due to gastric ulcer penetration, was achieved with resuscitative endovascular balloon occlusion of the aorta without ischemia of organs including the spleen.
Language	English
Publishing date	2022-03-10
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.5561
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Article ; Online: Novel Peritoneal Sclerosis Rat Model Developed by Administration of Bleomycin and Lansoprazole.

Kunitatsu, Kosei / Yamamoto, Yuta / Nasu, Shota / Taniji, Akira / Kawashima, Shuji / Yamagishi, Naoko / Ito, Takao / Inoue, Shigeaki / Kanai, Yoshimitsu

International journal of molecular sciences

2023 Volume 24, Issue 22

Abstract: In our preliminary experiment, peritoneal sclerosis likely induced by peritoneal dialysis was unexpectedly observed in the livers of rats given bleomycin and lansoprazole. We examined whether this peritoneal thickening around the liver was time- ... ...

Abstract	In our preliminary experiment, peritoneal sclerosis likely induced by peritoneal dialysis was unexpectedly observed in the livers of rats given bleomycin and lansoprazole. We examined whether this peritoneal thickening around the liver was time-dependently induced by administration of both drugs. Male Wistar rats were injected with bleomycin and/or lansoprazole for 2 or 4 weeks. The 3YB-1 cell line derived from rat fibroblasts was treated by bleomycin and/or lansoprazole for 24 h. The administration of both drugs together, but not individually, thickened the peritoneal tissue around the liver. There was accumulation of collagen fibers, macrophages, and eosinophils under mesothelial cells. Expressions of
MeSH term(s)	Rats ; Male ; Animals ; Peritoneal Fibrosis/chemically induced ; Peritoneal Fibrosis/genetics ; Bleomycin/adverse effects ; Rats, Wistar ; Lansoprazole/adverse effects ; Lansoprazole/metabolism ; Epithelial Cells/metabolism ; Peritoneum/pathology
Chemical Substances	Bleomycin (11056-06-7) ; Lansoprazole (0K5C5T2QPG)
Language	English
Publishing date	2023-11-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242216108
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Article ; Online: Intraoperative techniques to prevent deep incisional or organ-space surgical site infection after emergency surgery for nonappendiceal perforation peritonitis: a prospective two-center observational study.

Okishio, Yuko / Ueda, Kentaro / Nasu, Toru / Kawashima, Shuji / Kunitatsu, Kosei / Masuda, Mitsuru / Ichimiya, Masato / Uyama, Shiro / Kato, Seiya

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2023 Volume 49, Issue 5, Page(s) 2215–2224

Abstract: Purpose: The rate of surgical site infection (SSI) after surgery for secondary peritonitis is very high. This study investigated the relationship between intraoperative procedures of emergency surgery for nonappendiceal perforation peritonitis and deep ... ...

Abstract	Purpose: The rate of surgical site infection (SSI) after surgery for secondary peritonitis is very high. This study investigated the relationship between intraoperative procedures of emergency surgery for nonappendiceal perforation peritonitis and deep incisional or organ-space SSI. Methods: This prospective, two-center observational study included patients aged ≥ 20 years who underwent emergency surgery for perforation peritonitis between April 2017 and March 2020. We compared patients with deep incisional or organ-space SSI (Group S) to patients without SSIs or with superficial incisional SSIs (Group C). Thereafter, we evaluated the association between intraoperative technical variables and deep incisional or organ-space SSI using a multivariate logistic regression model. All multivariate analyses were adjusted for potentially relevant risk factors (e.g., age, body mass index, diabetes, smoking habit, and National Nosocomial Infection Surveillance risk index). Results: Of the 75 participants, 14 were in Group S and 61 were in Group C. The use of a wound protector device was significantly associated with decreased odds of deep incisional or organ-space SSI (adjusted odds ratios [AOR], 0.017; 95% confidence intervals [CI] 0.0014-0.19, p = 0.0011). A 1000 ml increase in intra-abdominal lavage with normal saline was significantly associated with increased odds of deep incisional or organ-space SSI (AOR: 1.28, 95% CI 1.02-1.61, p = 0.033). Conclusion: Wound protector devices should be used in emergency surgery for nonappendiceal perforation peritonitis. Excessive intra-abdominal lavage with normal saline for peritonitis may have unsatisfactory benefits and increases the incidence of deep incisional or organ-space SSI.
MeSH term(s)	Humans ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Surgical Wound Infection/etiology ; Prospective Studies ; Saline Solution ; Risk Factors ; Incidence ; Peritonitis/prevention & control ; Peritonitis/surgery ; Retrospective Studies
Chemical Substances	Saline Solution
Language	English
Publishing date	2023-06-10
Publishing country	Germany
Document type	Observational Study ; Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-023-02301-0
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Article ; Online: Is open abdominal management useful in nontrauma emergency surgery for older adults? A single-center retrospective study.

Okishio, Yuko / Ueda, Kentaro / Nasu, Toru / Kawashima, Shuji / Kunitatsu, Kosei / Kato, Seiya

Surgery today

2021 Volume 51, Issue 8, Page(s) 1285–1291

Abstract: Purpose: Open abdominal management (OAM) is being adopted increasingly frequently in nontrauma patients. This study assessed the effectiveness of OAM in nontrauma older adults.: Methods: We retrospectively reviewed all adults who underwent nontrauma ... ...

Abstract	Purpose: Open abdominal management (OAM) is being adopted increasingly frequently in nontrauma patients. This study assessed the effectiveness of OAM in nontrauma older adults. Methods: We retrospectively reviewed all adults who underwent nontrauma emergency laparotomy requiring postoperative intensive care unit (ICU) management between September 2012 and August 2017 at our hospital. Patients ≥ 80 years old, who underwent OAM, were compared with those < 80 years old. The primary outcome was the 90-day mortality. Secondary outcomes were the 30-day mortality, unplanned relaparotomy, and the ICU length of stay (LOS). Results: The OAM group comprised 58 patients, including 27 who were ≥ 80 years old. The patients ≥ 80 years old in the OAM group had a significantly higher 90-day mortality rate (33% vs. 10%; p = 0.027) than those < 80 years old. There were no significant differences in the 30-day mortality rate, patients' unplanned relaparotomy rate, or ICU LOS between the patients ≥ 80 years old and those < 80 in the OAM group. Conclusions: Older adults who underwent OAM had a significantly higher mortality rate than younger patients. However, the OAM strategy for older nontrauma patients may still be useful and reasonable considering the severe condition of these patients.
MeSH term(s)	Abdomen/surgery ; Age Factors ; Aged ; Aged, 80 and over ; Emergencies ; Emergency Medical Services ; Humans ; Intensive Care Units ; Laparotomy/mortality ; Length of Stay ; Postoperative Care ; Reoperation ; Retrospective Studies ; Severity of Illness Index ; Time Factors
Language	English
Publishing date	2021-01-09
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-020-02214-0
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Article ; Online: Prediction of early acute kidney injury after trauma using prehospital systolic blood pressure and lactate levels: A prospective validation study.

Nasu, Toru / Ueda, Kentaro / Kawashima, Shuji / Okishio, Yuko / Kunitatsu, Kosei / Iwasaki, Yasuhiro / Kato, Seiya

Injury

2021 Volume 53, Issue 1, Page(s) 81–85

Abstract: Background: Acute kidney injury (AKI) after trauma is a major complication independently associated with a prolonged hospital stay and increased mortality. We previously reported that the prehospital systolic blood pressure (SBP) and early hospital ... ...

Abstract	Background: Acute kidney injury (AKI) after trauma is a major complication independently associated with a prolonged hospital stay and increased mortality. We previously reported that the prehospital systolic blood pressure (SBP) and early hospital arterial lactate level, along with specific cut-off values, show good performance in the early prediction of AKI using AUC-ROC [1]. The purpose of this study was to prospectively validate whether or not these parameters are predictive of newly occurring AKI after trauma. Methods: This was a prospective review of trauma patients who were admitted to a single trauma center from January to December 2019. Patients who were <16 years old, who had burns, and who had chronic kidney disease were excluded. AKI was defined according to the Risk, Injury, Failure, Loss of the kidney function, and End-stage kidney disease (RIFLE) classification based on serum creatinine alone. Patients with a low prehospital SBP (≤126 mmHg) and high lactate levels (≥2.5 mmol/L) were defined as the high-risk group, and other patients were defined as the low-risk group. Results: A total of 489 trauma patients were admitted to our center, of whom 403 were eligible for the study. The high-risk group consisted of 38 patients, and the low-risk group consisted of 365 patients. The incidence of severe AKI in Stage Injury and Failure was significantly higher in the high-risk group (5 patients, 13.2%) than in the low-risk group (7 patients, 1.9%), with an odds ratio of 7.75 and 95% confidence interval of 2.33-25.77. Conclusions: These predictors showed good performance in the early prediction of severe AKI after trauma. Early prediction of the high-risk groups for severe AKI after trauma prompting early treatment may help improve the prognosis of trauma patients.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Adolescent ; Blood Pressure ; Emergency Medical Services ; Humans ; Lactates ; Retrospective Studies ; Risk Factors
Chemical Substances	Lactates
Language	English
Publishing date	2021-10-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2021.09.039
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Article ; Online: Prehospital Blood Pressure and Lactate are Early Predictors of Acute Kidney Injury After Trauma.

Nasu, Toru / Ueda, Kentaro / Kawashima, Shuji / Okishio, Yuko / Kunitatsu, Kosei / Iwasaki, Yasuhiro / Kato, Seiya

The Journal of surgical research

2021 Volume 265, Page(s) 180–186

Abstract: Background: The purpose of this study is to report the prevalence of acute kidney injury (AKI) after trauma in our center, describe the risk factors associated with AKI, and determine whether these risk factors help avoid AKI.: Materials and methods: ...

Abstract	Background: The purpose of this study is to report the prevalence of acute kidney injury (AKI) after trauma in our center, describe the risk factors associated with AKI, and determine whether these risk factors help avoid AKI. Materials and methods: We retrospectively analyzed the data which were prospectively collected from a single center trauma registry from January 2017 to December 2018. Patients who were <16 years of age, patients with burns, and patients with chronic kidney disease were excluded from the present study. AKI was defined according to the risk, injury, failure, loss of the kidney function, and end-stage kidney disease (RIFLE) classification from serum creatinine alone. A logistic regression analysis was performed to identify prehospital and early hospital risk factors for AKI. Results: There were 806 trauma patients recorded in the database. One hundred thirty cases were excluded based on the abovementioned exclusion criteria. Six hundred seventy-six patients were included in the analysis. The prevalence of AKI in the overall population was 14.5% including 10.5% of patients with stage R, 3.0% of patients with stage I and 1.0% with stage F. The incidence of AKI increased to 36.3%, 12.1% and 3.3% in the subgroup of patients with hemorrhagic shock. The multivariate analysis revealed that the minimum prehospital systolic blood pressure and arterial lactate level were independent predictors of AKI. The model showed good discrimination with an area under the receiver operating characteristic curve (AUC-ROC) of 0.867 and 0.852 in the prediction of AKI stage I or F. The cutoff values were ≤126 mmHg and ≥2.5 mmol/L, respectively. Conclusion: These parameters showed good performance in the early prediction of AKI after trauma. They are associated with the early onset of AKI after trauma and may be an early predictor of the effects of treatment to prevent AKI.
MeSH term(s)	Acute Kidney Injury/blood ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; Female ; Humans ; Japan/epidemiology ; Lactic Acid/blood ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Wounds and Injuries/complications
Chemical Substances	Lactic Acid (33X04XA5AT)
Language	English
Publishing date	2021-04-30
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2021.03.037
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Article ; Online: Activities of daily living and psychiatric symptoms after intensive care unit discharge among critically ill patients with or without tracheostomy: a single center longitudinal study.

Shibata, Mami / Miyamoto, Kyohei / Shima, Nozomu / Nakashima, Tsuyoshi / Kunitatsu, Kosei / Yonemitsu, Takafumi / Kawabata, Atsumi / Kishi, Yutsuki / Kato, Seiya

Acute medicine & surgery

2022 Volume 9, Issue 1, Page(s) e753

Abstract: Aim: Tracheostomy is widely performed in critically ill patients who require prolonged mechanical ventilation. Long-term morbidity (post-intensive care syndrome) in tracheostomized patients is not widely reported, however, so we evaluate it here.: ... ...

Abstract	Aim: Tracheostomy is widely performed in critically ill patients who require prolonged mechanical ventilation. Long-term morbidity (post-intensive care syndrome) in tracheostomized patients is not widely reported, however, so we evaluate it here. Methods: This is a sub-analysis of a single center prospective longitudinal study, which assessed activities of daily living (ADL) and psychiatric symptoms in adult patients emergently admitted to the intensive care unit (ICU). We evaluated association between these symptoms and tracheostomy by posting questionnaires at 3 and 12 months after ICU discharge. Results: We analyzed 107 patients (15 patients with tracheostomy) at 3 months and 74 patients (13 patients with tracheostomy) at 12 months after ICU discharge. ADL tended to be lower in patients with tracheostomy than in those without tracheostomy at 3 months after ICU discharge (65 [10-100] versus 95 [59-100]; Conclusion: Activities of daily living disability and psychiatric symptoms were not significantly worse in patients with tracheostomy at 3 and 12 months from ICU discharge compared with patients without tracheostomy. Despite the limited number in our cohort, our study may inform shared decision making concerning tracheostomy for critically ill patients and their families.
Language	English
Publishing date	2022-05-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2751184-4
ISSN	2052-8817 ; 2052-8817
ISSN (online)	2052-8817
ISSN	2052-8817
DOI	10.1002/ams2.753
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Article ; Online: Surgical intervention for blunt bowel and mesenteric injury: indications and time intervals.

Okishio, Yuko / Ueda, Kentaro / Nasu, Toru / Kawashima, Shuji / Kunitatsu, Kosei / Kato, Seiya

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2019 Volume 47, Issue 6, Page(s) 1739–1744

Abstract: Purpose: Decision making in management of blunt bowel and mesenteric injury (BBMI) is difficult. This study aimed to identify indicators for laparotomy and appropriate time intervals to surgery.: Methods: We retrospectively reviewed our hospital's ... ...

Abstract	Purpose: Decision making in management of blunt bowel and mesenteric injury (BBMI) is difficult. This study aimed to identify indicators for laparotomy and appropriate time intervals to surgery. Methods: We retrospectively reviewed our hospital's trauma registry to identify patients with a diagnosis of BBMI from February 2011 to July 2017. Patients requiring therapeutic surgical treatment (OM group) were compared with those who did not (NOM group). Preoperative risk factors for surgery (with p < 0.1 by univariate analysis) were integrated in a multivariate logistic regression model. In the OM group, we identified relevant factors for time intervals to surgical interventions. Results: Among 2808 trauma patients admitted to our hospital, 83 (3.0%) had bowel and mesenteric injury; 6 patients with penetrating trauma, 2 lethal, untreated cases, and 2 patients who underwent exploratory laparotomy were excluded. Finally, 73 patients (47 males), with a mean Injury Severity Score (ISS) of 23, were included. Results from univariate analysis identified three relevant factors between the OM and NOM groups: ISS score (p = 0.036), hemodynamic instability (p = 0.041), and free air (p = 0.0018). Multivariate analysis revealed one relevant factor, free air (p = 0.0002). Short intervals between hospital admission and intervention were associated with 7-day mortality (p = 0.029), hemodynamic instability (p = 0.0009), focused assessment with sonography for trauma positive (p < 0.0001), and mesenteric extravasation (p = 0.012). Conclusions: Early surgical intervention is essential in cases of hemodynamically unstable BBMI and bowel perforation with free air; nevertheless, it is associated with high mortality. We suggest that prompt transport along with early intervention could significantly lessen mortality.
MeSH term(s)	Abdominal Injuries/diagnostic imaging ; Abdominal Injuries/surgery ; Humans ; Injury Severity Score ; Male ; Mesentery/diagnostic imaging ; Mesentery/injuries ; Mesentery/surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/surgery
Language	English
Publishing date	2019-07-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-019-01192-4
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Article ; Online: Do synbiotics really enhance beneficial synbiotics effect on defecation symptoms in healthy adults?: Randomized, double-blind, placebo-controlled trial.

Ito, Daisaku / Yamamoto, Yuta / Maekita, Takao / Yamagishi, Naoko / Kawashima, Shuji / Yoshikawa, Takanori / Tanioka, Kensuke / Yoshida, Takeichi / Iguchi, Mikitaka / Kunitatsu, Kosei / Kanai, Yoshimitsu / Kato, Seiya / Kitano, Masayuki

Medicine

2022 Volume 101, Issue 8, Page(s) e28858

Abstract: Goals: We examined whether synbiotics enhance improvement by probiotics.: Background: Probiotics, which are beneficial microbacteria, are a nutritional intervention for treatment of functional constipation or its tendency. Prebiotics, meanwhile, can ... ...

Abstract	Goals: We examined whether synbiotics enhance improvement by probiotics. Background: Probiotics, which are beneficial microbacteria, are a nutritional intervention for treatment of functional constipation or its tendency. Prebiotics, meanwhile, can promote the proliferation of probiotics in the gastrointestinal tract and enhance their beneficial effects. Synbiotics, a combination of probiotics and prebiotics, may be superior to probiotics in the treatment of defecation-related symptoms, but this requires elucidation. Study: This randomized, double-blind, placebo-controlled study enrolled 69 healthy adults with constipation tendency. Participants were allocated to either control, probiotics, or synbiotics groups and they recorded details of their defecations and their condition. The first 2 weeks were the observation period and the latter 2 weeks were the intervention period, in which participants took test foods. Probiotic foods included Bifidobacterium longum NT strain (1010 CFU/day), synbiotic foods included the NT strain (1010 CFU/day) and galactooligosaccharide (1 g/day). Placebo foods contained the vehicle only. Participants answered questionnaires (Patient Assessment on Constipation Symptoms [PAC-SYM], and one on dietary history) on the last day of each period. Results: Nine participants withdrew consent, and 2 of the remaining 60 had missing data. Age, body mass index, and sex were not significantly different between the 3 groups. Frequency of bowel movements in the fourth week, the primary endpoint, was not increased in the probiotics or synbiotics groups compared with the control group, and the frequency of bowel movements and days with defecation were not changed by probiotics or synbiotics during the intervention period. Probiotics and synbiotics did not improve stool conditions, although incomplete defecation was improved by probiotics but not by synbiotics compared with placebo. PAC-SYM indicated that stool condition and total scores were improved by probiotics but not by synbiotics during the intervention compared with placebo. Conclusion: The probiotic strain Bifidobacterium longum NT can improve constipation symptoms, especially stool condition, but it does not increase bowel movement frequency in healthy adults with constipation tendency. Synbiotics treatment seemed to diminish this improvement of constipation induced by probiotics. This study indicates the possibility of attenuation of beneficial effects from probiotics by the use of synbiotics, contrary to synbiotics theory.
MeSH term(s)	Adult ; Bifidobacterium longum ; Constipation/therapy ; Defecation/drug effects ; Double-Blind Method ; Female ; Healthy Volunteers ; Humans ; Male ; Prebiotics ; Probiotics/therapeutic use ; Synbiotics/administration & dosage ; Treatment Outcome
Chemical Substances	Prebiotics
Language	English
Publishing date	2022-01-25
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000028858
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