Current status of endoscopic surgery in Japan: The 14th National Survey of Endoscopic Surgery by the Japan Society for Endoscopic Surgery

Ito, Masafumi; Shiroshita, Hidefumi; Uchida, Hajime; Bandoh, Toshio; Akira, Shigeo; Yamaguchi, Shigeki; Kurokawa, Yukinori; Seki, Yosuke; Eguchi, Susumu; Wada, Norihito; Takiguchi, Shuji; Ieiri, Satoshi; Endo, Shunsuke; Iwazaki, Masayuki; Satô, Yukio; Tamaki, Yasuhiro; Kitamura, Kenichiro; Tabata, Minoru; Kanayama, Hiro‐omi; Mimata, Hiromitsu; Hasegawa, Tomohiko; Takahashi, Hiroshi; Onishi, Kiyoshi; Uemura, Tetsuji; Hashizume, Makoto; Matsumoto, Sumio; Kitano, Seigo; Watanabe, Masahiko

doi:10.1111/ases.12768

Cited by 85 publications

(69 citation statements)

References 8 publications

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“…Laparoscopic colorectal surgery has become a standard procedure for treating colorectal cancer worldwide. As a result, the incidence of laparoscopic colorectal surgery in elderly patients has also been increasing in Japan recently [ 12 ]. However, the majority of the previous trials of laparoscopic colorectal surgery was conducted on patients younger than 80 years.…”

Section: Introductionmentioning

confidence: 99%

Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study

et al. 2020

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Background Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old. Methods Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups. Results The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p < .01 and 14% vs. 32%, p < .05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p < .01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p < .01), there was no difference in 5-year disease-specific survival between the groups. Conclusion Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.

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Section: Introductionmentioning

confidence: 99%

Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study

et al. 2020

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“…Minimal invasiveness is a very important point for the treatment of CP, which is a benign disease, even though the case is refractory to medical therapy. Benign pancreatic disease is a good indication for laparoscopic surgery [10]. We selected a laparoscopic approach before performing the Frey procedure, attaching great importance to the minimal invasiveness.…”

Section: Discussionmentioning

confidence: 99%

A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

Saito

Matsuo

Ueda

et al. 2020

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Background The treatment of chronic pancreatitis requires a surgical approach in patients refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Importantly, inadequate procedures lead to recurrent pancreatitis. We used a novel minimally invasive approach for patients with severe stenosis of the pancreatic duct. In this report, we aim to present the feasibility and outcomes of our approach. Methods We selected a laparoscopic approach for the distal pancreatectomy because these parts are relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for parts of the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We examined operative outcomes, postoperative complications and recurrence of pancreatitis. Results Our approach was performed in three patients from January 2018 to December 2018. No intraoperative complications occurred and the postoperative course was uneventful in all patients. There were no recurrence of pancreatitis and no postoperative pain in all patients in the over 18 months follow-up. Conclusion Our hybrid method focusing on complete ductal compression with safety and minimal invasiveness is the optimal approach for the surgical treatment of chronic pancreatitis which requires a pancreatectomy with the Frey procedure.

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“…Recently, endoscopic surgery has attracted significant attention, not only from the medical community, but also the general public, because of its minimal invasiveness [1]. In endoscopic surgery, the surgeon opens several small holes of about 1 cm in diameter in the abdominal cavity, chest cavity, or retroperitoneal cavity, inserts a rigid endoscope and surgical instruments into the body of the patient through the holes, and operates while observing a lesion or affected area under the endoscope.…”

Section: Introductionmentioning

confidence: 99%

Nerve Segmentation with Deep Learning from Label-Free Endoscopic Images Obtained Using Coherent Anti-Stokes Raman Scattering

et al. 2020

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Semantic segmentation with deep learning to extract nerves from label-free endoscopic images obtained using coherent anti-Stokes Raman scattering (CARS) for nerve-sparing surgery is described. We developed a CARS rigid endoscope in order to identify the exact location of peripheral nerves in surgery. Myelinated nerves are visualized with a CARS lipid signal in a label-free manner. Because the lipid distribution includes other tissues as well as nerves, nerve segmentation is required to achieve nerve-sparing surgery. We propose using U-Net with a VGG16 encoder as a deep learning model and pre-training with fluorescence images, which visualize the lipid distribution similar to CARS images, before fine-tuning with a small dataset of CARS endoscopy images. For nerve segmentation, we used 24 CARS and 1,818 fluorescence nerve images of three rabbit prostates. We achieved label-free nerve segmentation with a mean accuracy of 0.962 and an F 1 value of 0.860. Pre-training on fluorescence images significantly improved the performance of nerve segmentation in terms of the mean accuracy and F 1 value ( p < 0 . 05 ). Nerve segmentation of label-free endoscopic images will allow for safer endoscopic surgery, while reducing dysfunction and improving prognosis after surgery.

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Current status of endoscopic surgery in Japan: The 14th National Survey of Endoscopic Surgery by the Japan Society for Endoscopic Surgery

Cited by 85 publications

References 8 publications

Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study

Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study

A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

Nerve Segmentation with Deep Learning from Label-Free Endoscopic Images Obtained Using Coherent Anti-Stokes Raman Scattering

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