Surgery today
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To reveal the patterns of the mediastinal course of the bronchial arteries (BAs). ⋯ The classification of the mediastinal course of the BAs determined by the spatial relationships to the tracheobronchus and the esophagus may be clinically useful, because each category of this classification can be determined during esophagectomy and indicates whether the BA is a right or left BA.
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Multicenter Study
Safety and efficacy of an "enhanced recovery after surgery" protocol for patients undergoing colon cancer surgery: a multi-institutional controlled study.
The aim of this multi-institutional study was to prospectively evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) protocol for colonic surgery. ⋯ This multi-institutional controlled study clearly demonstrated that an ERAS protocol was efficient, without increasing the complication risk.
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To evaluate the safety and feasibility of laparoscopic complete mesocolic excision via combined medial and cranial approaches with three-dimensional visualization around the gastrocolic trunk and middle colic vessels for transverse colon cancer. ⋯ Our procedure for laparoscopic complete mesocolic excision via combined medial and cranial approaches is safe and feasible for transverse colon cancer.
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Postoperative pancreatic fistula (POPF) is the most frequent and serious complication after distal pancreatectomy (DP) and often leads to other postoperative complications. Numerous studies have been conducted to clarify the risk factors for POPF after DP, and to also determine effective prophylactic treatments. In this article, we review the current evidence on the risk factors for POPF after DP, and also provide new evidence to support the currently implemented prophylactic measures against POPF after DP. ⋯ Various methods, such as stapler closure, procedures that may be performed in addition to stapler closure, pancreatoenteric anastomosis, pancreatic transection devices, laparoscopic surgery, pancreatic stenting, stump coverage, and somatostatin analogs, have been tested and in comparison with conventional procedures in case-control studies and randomized, controlled trials. Although some studies have shown the superiority of these methods to the conventional procedures, a consensus on precautionary measures that can be taken against POPF remains to be established. Further investigation is necessary to develop a reliable strategy for preventing POPF and to improve the outcomes of patients after DP.
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Preoperative chemoradiotherapy (CRT) is a novel, emerging treatment strategy for pancreatic ductal adenocarcinoma (PDAC), but it remains unclear whether post-surgery adjuvant chemotherapy is feasible following preoperative CRT. This retrospective study evaluates the feasibility of adjuvant therapy after preoperative CRT. ⋯ Preoperative CRT was demonstrated to be safe and did not compromise the feasibility of adjuvant chemotherapy.