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  1. Article ; Online: Impact of Frailty and Sarcopenia on Short- and Long-Term Outcomes in Elderly Patients Undergoing Radical Gastrectomy for Gastric Cancer.

    Osaki, Tomohiro / Tatebe, Shigeru / Orihara, Junpei / Uchinaka, Ei / Ashida, Keigo / Hirooka, Yasuaki / Fujiwara, Yoshiyuki

    World journal of surgery

    2023  Volume 47, Issue 12, Page(s) 3250–3261

    Abstract: Background: The impact of frailty and sarcopenia in patients with gastric cancer is unclear. This study aimed to comprehensively examine the impact of frailty and sarcopenia on the short- and long-term outcomes in elderly patients undergoing radical ... ...

    Abstract Background: The impact of frailty and sarcopenia in patients with gastric cancer is unclear. This study aimed to comprehensively examine the impact of frailty and sarcopenia on the short- and long-term outcomes in elderly patients undergoing radical gastrectomy for gastric cancer.
    Methods: We retrospectively assessed 246 patients aged ≥ 65 years who underwent radical gastrectomy. Frailty and sarcopenia were assessed using the modified frailty index (mFI) and psoas muscle mass index (PMI), respectively.
    Results: There were 30 (12.2%) and 60 (24.4%) patients with High-mFI and Low-PMI, respectively. As the age increased, both sexes showed significant correlations with PMI and mFI (r = - 0.238, 0.322, P = 0.003 and 0.002, respectively). High-mFI and Low-PMI did not affect the short-term outcomes. However, High-mFI was an independent risk factor for non-home discharge (P = 0.004) and was a significant predictor of 3- and 5-year overall survival (OS) (HR = 2.76 and 2.26; P = 0.002 and 0.005, respectively) and 1-, 3- and 5-year non-cancer-specific survival (non-CSS) (HR = 4.88, 8.05, and 4.01; P = 0.017, < 0.001, < 0.001, respectively). Low-PMI was a significant predictor of only 5-year OS (HR = 2.03, P = 0.003) and non-CSS (HR = 2.10, P = 0.020).
    Conclusions: Frailty is significant predictor of non-home discharge and 1-, 3-, 5-year OS and 3- and 5-year non-CSS. Sarcopenia is a significant predictor of 5-year OS and non-CSS. Preoperative assessment of both frailty and sarcopenia can help surgeons to select adequate treatment strategies for the elderly population.
    MeSH term(s) Male ; Female ; Humans ; Aged ; Sarcopenia/complications ; Sarcopenia/diagnosis ; Sarcopenia/epidemiology ; Frailty/complications ; Frailty/diagnosis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/complications ; Stomach Neoplasms/surgery ; Gastrectomy/adverse effects
    Language English
    Publishing date 2023-09-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-023-07200-4
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  2. Article: Post-colostomy internal hernia of the stomach treated with laparoscopic gastropexy: a case report.

    Tada, Yoichiro / Orihara, Junpei / Wada, Yamato / Uchinaka, Ei / Osaki, Tomohiro / Ashida, Keigo / Tatebe, Shigeru / Kuroda, Seika / Hirooka, Yasuaki

    Surgical case reports

    2022  Volume 8, Issue 1, Page(s) 105

    Abstract: Background: Internal hernias are formed by the protrusion of internal organs through an aperture formed congenitally or postoperatively. Internal hernias are most commonly associated with the small intestine. Only two cases of a post-sigmoid colostomy ... ...

    Abstract Background: Internal hernias are formed by the protrusion of internal organs through an aperture formed congenitally or postoperatively. Internal hernias are most commonly associated with the small intestine. Only two cases of a post-sigmoid colostomy internal hernia of the stomach have been reported. This hernia arises from the space between the lifted sigmoid colon and the left abdominal wall. In the two aforementioned cases, treatment comprised suturing of the sigmoid colon to the lateral abdominal wall and changing of the intraperitoneal route to an extraperitoneal one. Herein, we present a very rare case who underwent laparoscopic gastropexy for a post-sigmoid colostomy internal hernia of the stomach.
    Case presentation: Our patient, a 67-year-old woman, was undergoing chemoradiation for rectal cancer and planned to undergo abdominoperineal resection. However, tumor perforation resulted in a high fever and a right gluteal abscess; therefore, a sigmoid colostomy was performed through the intraperitoneal route in the left lower abdomen. One month after the surgery, the patient presented to our emergency room with vomiting, abdominal pain, and abdominal distension. Computed tomography revealed a markedly distended stomach caused by the obstruction of the pylorus secondary to the colostomy; laparoscopic gastropexy was performed subsequently and the postoperative course was uneventful.
    Conclusions: This is the first report on the laparoscopic gastropexy treatment of a post-sigmoid colostomy internal hernia of the stomach; our findings may help physicians manage such hernias.
    Language English
    Publishing date 2022-05-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2809613-7
    ISSN 2198-7793
    ISSN 2198-7793
    DOI 10.1186/s40792-022-01455-0
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  3. Article ; Online: Impact of gastrectomy on body composition within 1 month in patients with gastric cancer.

    Osaki, Tomohiro / Matsunaga, Tomoyuki / Makinoya, Masahiro / Shishido, Yuji / Miyatani, Kozo / Uchinaka, Ei / Tada, Yoichiro / Ashida, Keigo / Tatebe, Shigeru / Fujiwara, Yoshiyuki

    Surgery today

    2022  Volume 53, Issue 7, Page(s) 834–844

    Abstract: Purpose: The present study examined the changes in and risk factors for body composition (BC) during the first postoperative month when dynamic biological reactions occur.: Methods: We retrospectively assessed 202 patients who underwent gastrectomy. ... ...

    Abstract Purpose: The present study examined the changes in and risk factors for body composition (BC) during the first postoperative month when dynamic biological reactions occur.
    Methods: We retrospectively assessed 202 patients who underwent gastrectomy. The BC was assessed using a bioelectrical impedance analysis and evaluated within 1 month preoperatively, 1 week postoperatively, and 1 month postoperatively. Multiple regression analyses were performed to identify predictive factors for BC change.
    Results: The mean reduction rate in BC at 1 month postoperatively was - 6.0, - 10.5, - 5.6, - 1.1, - 10.1, and + 1.2% for body weight, body fat, skeletal muscle, bone mineral, extracellular water/total body water, and the whole-body phase angle, respectively. A multiple regression analysis revealed that independent risk factors for weight loss were complications, operative time, and type of gastrectomy (P = 0.004, 0.011, 0.015, respectively), and those for skeletal muscle loss were complications and gastrectomy type (P = 0.002, 0.010, respectively). A segmental lean mass analysis revealed that the lower limbs were markedly reduced at 1 week postoperatively (- 8.0%), and these independent risk factors were the female sex and Stage II/III disease (P = 0.008, 0.036, respectively).
    Conclusion: Detailed analyses of BC might help elucidate the mechanisms underlying postoperative physical changes, which might be useful for perioperative management.
    MeSH term(s) Humans ; Female ; Retrospective Studies ; Stomach Neoplasms/surgery ; Stomach Neoplasms/etiology ; Body Weight/physiology ; Body Composition/physiology ; Gastrectomy/adverse effects ; Postoperative Complications/etiology
    Language English
    Publishing date 2022-12-14
    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/s00595-022-02633-1
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  4. Article ; Online: What is necessary to shorten the operative time in initial introduction of robotic gastrectomy for gastric cancer?

    Osaki, Tomohiro / Tatebe, Shigeru / Nakamura, Noriaki / Takano, Takeshi / Uchinaka, Ei / Tada, Yoichiro / Endo, Kanenori / Ashida, Keigo / Hirooka, Yasuaki

    Asian journal of endoscopic surgery

    2022  Volume 15, Issue 3, Page(s) 495–504

    Abstract: Introduction: Robotic gastrectomy (RG) is a good alternative to laparoscopic gastrectomy, as it improves treatment outcomes and reduces the burden of technical difficulties; however, prolonged operative time may be a disadvantage. This study aimed to ... ...

    Abstract Introduction: Robotic gastrectomy (RG) is a good alternative to laparoscopic gastrectomy, as it improves treatment outcomes and reduces the burden of technical difficulties; however, prolonged operative time may be a disadvantage. This study aimed to identify measures to shorten the operative time during the initial introduction of RG at an institution.
    Methods: We assessed 33 patients with gastric cancer who underwent radical distal gastrectomy with Billroth-I reconstruction and divided them into three groups: laparoscopic distal gastrectomy (LDG), robotic distal gastrectomy in the early phase (RDG-E), and in the late phase (RDG-L). Operative time, six technical steps, and junk time, including the roll-in/roll-out, docking/undocking, and instrument exchange times, were compared among the groups.
    Results: The median (range) overall operative times of LDG, RDG-E, and RDG-L were 248 (179-323), 304 (249-383), and 263 (220-367) min, respectively, but no significant differences were observed. For each surgical step of RG, RDG-L in suprapancreatic lymph node dissection was significantly shorter than that in RDG-E. The median (range) junk times of LDG, RDG-E, and RDG-L were 16.7 (12.7-26.4), 48.3 (38.6-67.7), and 42.0 (35.4-49.2) min, respectively. Junk time was significantly longer in RDG-L than in LDG (p = 0.003), but not significant between RDG-E and RDG-L. The learning curve effect of overall, console, and junk times were achieved in four cases of RDG.
    Conclusion: Junk time is a major factor in prolonging RDG operative time. However, to reduce the time after initial introduction, measures to promote robot-specific standardization and more effective use of robotic instruments are essential.
    MeSH term(s) Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Operative Time ; Retrospective Studies ; Robotic Surgical Procedures ; Robotics ; Stomach Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-02-02
    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.13037
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  5. Article: Encapsulated fat necrosis mimicking abdominal liposarcoma: A case report and literature review.

    Watanabe, Jun / Osaki, Tomohiro / Tatebe, Shigeru / Goto, Keisuke / Endo, Kanenori / Nakamura, Seiichi / Hirooka, Yasuaki

    Clinical case reports

    2020  Volume 8, Issue 11, Page(s) 2255–2258

    Abstract: We report a case of an encapsulated fat necrosis without significant medical history. To differentiate from liposarcoma, it should be recognized that a half of abdominal encapsulated fat necrosis cases have a history of inflammation and surgery. ...

    Abstract We report a case of an encapsulated fat necrosis without significant medical history. To differentiate from liposarcoma, it should be recognized that a half of abdominal encapsulated fat necrosis cases have a history of inflammation and surgery.
    Language English
    Publishing date 2020-07-12
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.3120
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  6. Article ; Online: The type of gastrectomy and modified frailty index as useful predictive indicators for 1-year readmission due to nutritional difficulty in patients who undergo gastrectomy for gastric cancer.

    Osaki, Tomohiro / Saito, Hiroaki / Miyauchi, Wataru / Shishido, Yuji / Miyatani, Kozo / Matsunaga, Tomoyuki / Tatebe, Shigeru / Fujiwara, Yoshiyuki

    BMC surgery

    2021  Volume 21, Issue 1, Page(s) 445

    Abstract: Background: Patients who undergo gastrectomy for gastric cancer (GC) are likely to have nutritional difficulty after surgery. Readmission due to nutritional difficulty is common in such patients. Thus, in this study, we aim to identify the predictive ... ...

    Abstract Background: Patients who undergo gastrectomy for gastric cancer (GC) are likely to have nutritional difficulty after surgery. Readmission due to nutritional difficulty is common in such patients. Thus, in this study, we aim to identify the predictive indicators for readmission due to nutritional difficulty in patients who underwent gastrectomy for GC.
    Methods: We retrospectively reviewed surgical outcomes in 516 consecutive patients who underwent gastrectomy for GC.
    Results: The readmission rate within 1 year was 13.8%. Readmission due to nutritional difficulty was observed in 20 patients (3.9%); it was determined as the second leading cause of readmission. Multivariate analysis revealed that the type of gastrectomy and the modified frailty index (mFI) were independent predictive indicators of readmission due to nutritional difficulty. Patients were assigned 1 point for each predictive indicator, and the total points were calculated (point 0, point 1, or point 2). The readmission rates due to nutritional difficulty were 1.2%, 4.7%, and 11.5% in patients with 0, 1, and 2 points, respectively (P = 0.0008).
    Conclusions: The readmission rate due to nutritional difficulty was noted to be high in patients who underwent total or proximal partial gastrectomy with high mFI. Intensive follow-up and nutritional support are needed to reduce readmissions due to nutritional difficulty. Reduced readmission rates can improve patient quality of life and reduce medical costs.
    MeSH term(s) Frailty ; Gastrectomy ; Humans ; Patient Readmission ; Postoperative Complications/epidemiology ; Quality of Life ; Retrospective Studies ; Stomach Neoplasms/surgery
    Language English
    Publishing date 2021-12-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-021-01450-6
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  7. Article ; Online: The Combination of Preoperative Skeletal Muscle Quantity and Quality is an Important Indicator of Survival in Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer.

    Watanabe, Jun / Osaki, Tomihiro / Ueyama, Tadamasa / Koyama, Makoto / Iki, Masaru / Endo, Kanenori / Tatebe, Shigeru / Hirooka, Yasuaki

    World journal of surgery

    2021  Volume 45, Issue 9, Page(s) 2868–2877

    Abstract: Background: The diagnosis of sarcopenia emphasizes both, the quantity and quality of skeletal muscle. However, the impact of the combination of muscle quantity and quality on long-term survival remains unclear. This study aimed to assess the impact of ... ...

    Abstract Background: The diagnosis of sarcopenia emphasizes both, the quantity and quality of skeletal muscle. However, the impact of the combination of muscle quantity and quality on long-term survival remains unclear. This study aimed to assess the impact of the combination of skeletal muscle quantity and quality on long-term outcomes in patients with gastric cancer who underwent curative resection.
    Methods: We retrospectively assessed 242 patients aged ≥ 65 ears who underwent curative gastrectomy between 2006 and 2015. The psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) were measured on preoperative computed tomography as skeletal muscle quantity and quality, respectively. The sarcopenia stage was classified by the combination of preoperative skeletal muscle quantity and quality (non-sarcopenia, sarcopenia, and severe sarcopenia). Prognostic factors for the 5-year overall survival (OS), non-cancer-specific survival (non-CSS), and cancer-specific survival (CSS) were evaluated by multivariable Cox regression.
    Results: The median follow-up period was 63.2 months. The non-sarcopenia, sarcopenia, and severe sarcopenia groups comprised 88, 121, and 33 patients (36.4%, 50.0%, and 13.6%), respectively. The severe sarcopenia group was older, and had a greater depth of invasion, than the non-sarcopenia group. Multivariable analysis revealed severe sarcopenia as an independent predictive indicator of OS (hazard ratio [HR] 4.01; 95% confidence interval [CI] 1.75 to 9.22) and non-CSS (HR 3.27; 95% CI 1.61 to 6.67), but not CSS.
    Conclusions: The combination of preoperative skeletal muscle quantity and quality was useful for predicting survival, especially death from other diseases, in elderly patients who underwent gastrectomy for gastric cancer.
    MeSH term(s) Aged ; Gastrectomy ; Humans ; Psoas Muscles/diagnostic imaging ; Retrospective Studies ; Sarcopenia/complications ; Sarcopenia/diagnostic imaging ; Sarcopenia/pathology ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery
    Language English
    Publishing date 2021-07-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-021-06204-2
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  8. Article ; Online: Estimation of the physiologic ability and surgical stress scoring system as a useful predictor of postoperative recurrence in patients with stage II colorectal cancer: a multicenter study.

    Tanio, Akimitsu / Saito, Hiroaki / Hara, Kazushi / Sugezawa, Ken / Uejima, Chihiro / Kihara, Kyoichi / Tatebe, Shigeru / Kurisu, Yasuro / Shibata, Shunsuke / Yamamoto, Toshio / Nishie, Hiroshi / Shiota, Setsujo / Naka, Takuji / Sugamura, Kenji / Katano, Kuniyuki / Yamamoto, Manabu / Fujiwara, Yoshiyuki

    Surgery today

    2023  Volume 53, Issue 8, Page(s) 949–956

    Abstract: Purpose: We determined the usefulness of the estimation of physiologic ability and surgical stress (E-PASS), initially reported as a predictive factor for postoperative morbidity and mortality, as a prognostic indicator in stage II colorectal cancer ( ... ...

    Abstract Purpose: We determined the usefulness of the estimation of physiologic ability and surgical stress (E-PASS), initially reported as a predictive factor for postoperative morbidity and mortality, as a prognostic indicator in stage II colorectal cancer (CRC).
    Methods: Overall, 739 patients who underwent proctocolectomy for CRC at Tottori University Hospital and affiliated hospitals and histologically diagnosed with stage II CRC were included in the current study.
    Results: A receiver operating characteristic (ROC) analysis of the five-year recurrence-free survival indicated that the comprehensive risk score (CRS) of E-PASS predicted postoperative recurrence. A multivariate analysis revealed that the presence of preoperative perforation, T4, v ≥ 2, and CRS
    Conclusions: The CRS predicts postoperative recurrence in patients with stage II CRC.
    MeSH term(s) Humans ; Postoperative Complications/epidemiology ; Neoplasm Recurrence, Local/epidemiology ; Risk Factors ; Prognosis ; Colorectal Neoplasms/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-02-15
    Publishing country Japan
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1115435-4
    ISSN 1436-2813 ; 0941-1291
    ISSN (online) 1436-2813
    ISSN 0941-1291
    DOI 10.1007/s00595-023-02656-2
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  9. Article: Investigation of the Utility and Safety of Dynamic Computed Tomography with Vasodilators.

    Watanabe, Jun / Endo, Kanenori / Tanaka, Yasutaka / Goto, Keisuke / Urushibara, Shoichi / Osaki, Tomohiro / Tatebe, Shigeru / Nakamura, Seiichi / Hirooka, Yasuaki / Ikeguchi, Masahide

    Yonago acta medica

    2020  Volume 63, Issue 1, Page(s) 47–54

    Abstract: Background: Dynamic computed tomography (CT) angiography is useful for evaluating of hepatic vascularity. Although vasodilators increase hepatic blood flow, the utility of dynamic CT with vasodilators is unclear. Here we investigated the utility and ... ...

    Abstract Background: Dynamic computed tomography (CT) angiography is useful for evaluating of hepatic vascularity. Although vasodilators increase hepatic blood flow, the utility of dynamic CT with vasodilators is unclear. Here we investigated the utility and safety of dynamic CT with vasodilators.
    Methods: A prospective case-control radiographic evaluation using abdominal dynamic CT with and without vasodilator was performed at a single center between October 2015 and September 2016. We compared the CT values in Hounsfield units of the aorta; celiac artery; and common, right, and left hepatic arteries in the arterial phase and the main trunk; right and left branches of the portal vein; and right, middle, and left hepatic veins in the portal phase with and without vasodilators. The region of interest was set in each element of the liver vasculature. Four radiological technologists independently and visually compared the scores of the portal vein (P-score) and hepatic vein (V-score) on a 5-point scale with and without vasodilators.
    Results: The CT values of arteries and veins using vasodilators were significantly higher than those without vasodilators. With and without vasodilators, the
    Conclusion: Dynamic CT with vasodilators can provides better visualization of vascular structures.
    Language English
    Publishing date 2020-01-24
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 840719-8
    ISSN 1346-8049 ; 0513-5710
    ISSN (online) 1346-8049
    ISSN 0513-5710
    DOI 10.33160/yam.2020.02.007
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  10. Article ; Online: Modified Frailty Index is Useful in Predicting Non-home Discharge in Elderly Patients with Gastric Cancer Who Undergo Gastrectomy.

    Osaki, Tomohiro / Saito, Hiroaki / Shimizu, Shota / Murakami, Yuki / Miyatani, Kozo / Matsunaga, Tomoyuki / Tatebe, Shigeru / Ikeguchi, Masahide / Fujiwara, Yoshiyuki

    World journal of surgery

    2020  Volume 44, Issue 11, Page(s) 3837–3844

    Abstract: Background: Development of laparoscopic gastrectomy and the Enhanced Recovery After Surgery (ERAS) protocol enable early discharge to home of patients with gastric cancer (GC). However, a significant proportion of patients are still discharged to ... ...

    Abstract Background: Development of laparoscopic gastrectomy and the Enhanced Recovery After Surgery (ERAS) protocol enable early discharge to home of patients with gastric cancer (GC). However, a significant proportion of patients are still discharged to inpatient facilities after surgery. We aimed to identify predictive factors of non-home discharge in patients with GC who undergo gastrectomy.
    Methods: We enrolled 517 patients with histopathologically confirmed diagnosis of GC who underwent gastrectomy.
    Results: The number of patients with non-home discharge was 23 (4.4%), and non-home discharge was only observed in patients with GC aged ≥65 years. Patients were divided into the mFI
    Conclusions: The combination of mFI, postoperative complications, and surgical approach is useful for predicting non-home discharge in patients aged ≥65 years who underwent gastrectomy for GC.
    MeSH term(s) Aged ; Frailty ; Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Patient Discharge ; Postoperative Complications/epidemiology ; Retrospective Studies ; Stomach Neoplasms/surgery
    Language English
    Publishing date 2020-07-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05691-z
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