In my initial letter to you, with the first quarterly issue 96(1), I indicated that journals are making constant improvements to disseminate the latest research and development findings. An investigation is presently under way to adopt the best technologies and services available to reinvigorate International Surgery. In this process, we are seeking advice and input from several knowledgeable and experienced persons, whose years of great experience with scientific and medical journals will serve us well. We are doing this with emphasis on peer-reviewed original scientific articles covering important clinical observations, surgical techniques, experimental surgery, research, and cultural and

Abstract

Laparoscopic antireflux surgery is very successful in patients with short-segment Barrett's esophagus (BE), but in patients with long-segment BE, the results remain in discussion. In these patients, during the open era of surgery, we performed acid suppression + duodenal diversion procedures added to the antireflux procedure (fundoplication + vagotomy + antrectomy + Roux-en-Y gastrojejunostomy) to obtain better results at long-term follow-up. The aim of this prospective study is to present the results of 3 to 5 years' follow-up in patients with short-segment and long-segment or complicated BE (ulcer or stricture) who underwent fundoplication or the acid suppression–duodenal diversion technique, both performed by a laparoscopic approach. One hundred eight patients with histologically confirmed BE were included: 58 patients with short-segment BE, and 50 with long-segment BE, 28 of whom had complications associated with severe erosive esophagitis, ulcer, or stricture. After surgery, among patients treated with fundoplication with cardia calibration, endoscopic erosive esophagitis was observed in 6.9% of patients with short-segment BE, while 50% of patients with long-segment BE presented with positive acid reflux, persistence of endoscopic esophagitis with intestinal metaplasia, and progression to dysplasia (in 5% of cases; P = 0.000). On the contrary, after acid suppression–duodenal diversion surgery in patients with long-segment BE, more than 95.6% presented with successful results regarding recurrent symptoms and endoscopic regression of esophagitis. Regression of intestinal metaplasia to the cardiac mucosa was observed in 56.9% of patients with short-segment BE who underwent fundoplication and in 61% of those with long-segment BE treated with the acid suppression–duodenal diversion procedure. Patients with long-segment BE who experienced fundoplication alone presented no regression of intestinal metaplasia; on the contrary, progression to dysplasia was observed in 1 case (P = 0.049). Patients with short-segment BE can be successfully treated with fundoplication, but for patients with long-segment BE, we suggest performance of fundoplication plus an acid suppression–duodenal diversion procedure.

Abstract

To evaluate the usefulness of laparoscopic assistance for curative distal gastrectomy by minilaparotomy, 19 patients (body mass index ≤25.0 kg/m²) with T1N0-1 gastric cancer who underwent distal gastrectomy with a minilaparotomy (skin incision ≤7 cm) with laparoscopic assistance (LA (+) group) were compared with 19 historic controls who underwent equivalent surgery by minilaparotomy without laparoscopic assistance (LA (−) group). The percentage of patients with blood loss more than 300 mL tended to be lower in the LA (+) group (5.3% versus 31.6%, P = 0.09). The first flatus passage was earlier (P = 0.04), serum C-reactive protein levels on postoperative day 1 were lower (P = 0.04), and white blood cell counts on postoperative day 1 tended to be lower (P = 0.07) in the LA (+) group. Minilaparotomy with laparoscopic assistance seems to be less invasive compared with pure minilaparotomy. This procedure is considered to be a simple alternative to standard laparoscopic-assisted distal gastrectomy in selected patients with T1N0-1 gastric cancer.

Abstract

This single-institution experience retrospectively reviewed the outcomes in 21 patients with primary duodenal adenocarcinoma. Twelve patients underwent curative surgery, and 9 patients underwent palliative surgery at the Chiba University Hospital. The maximum follow-up period was 8650 days. All pathologic specimens from endoscopic biopsy and surgical specimens were reviewed and categorized. Twelve (57.1%) patients underwent curative surgery (R0): 4 pancreaticoduodenectomies (PD), 4 pylorus-preserving PDs (PpPD), 2 local resections of the duodenum and 2 endoscopic mucosal resections (EMR). Palliative surgery was performed for 9 patients (42.9%) following gastro-intestinal bypass. The median cause-specific survival times were 1784 days (range 160–8650 days) in the curative surgery group and 261 days (range 27–857 days) in the palliative surgery group (P = 0.0003, log-rank test). The resectability of primary duodenal adenocarcinoma was associated with a smaller tumor size, a lower degree of tumor depth invasiveness, and less spread to the lymph nodes and distant organs.

To the Editor:

We read with great interest this single-blind randomized controlled trial done by Karakayali et al.1 They aimed at evaluating the effects of prophylactic neurectomies on the incidence of chronic groin pain following Lichtenstein's tension-free hernia repair. The authors tried to identify an important solution to this most common and significant complication following inguinal hernia repair, recruiting 240 patients under 4 groups.

The authors concluded that there is a significant difference between the neurectomies group and the preservation group, with pain being much less in the former group at 1-year follow-up (5.7% versus 23.3%;

The Importance of Peer Review and Constant Improvement

Laparoscopic Surgical Treatment for Patients With Short- and Long-Segment Barrett's Esophagus: Which Technique in Which Patient?

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Experience of Distal Gastrectomy By Minilaparotomy With Laparoscopic-Assistance for Nonoverweight Patients With T1N0-1 Gastric Cancer

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Survival Predictors of Patients With Primary Duodenal Adenocarcinoma

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Torquated Giant Appendix Epiploica Mimicking Intraperitoneal Liposarcoma: Report of a Case

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Surgical Treatment for Colorectal Cancer

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Oncologic Outcome of Stages II/III Colon Cancer Treated via Minilaparotomy

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Skin Metastasis From Sigmoid Colon Cancer

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A Case of Marked Response to Preoperative Chemoradiotherapy for Rectal Cancer With Para-Aortic Lymph Node Metastasis

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Sacrococcygeal Pilonidal Disease

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Severance of a Ventriculoperitoneal Shunt Catheter Implanted Between the Cerebral Ventricle and Peritoneal Cavity, Resulting in Protrusion From the Anus

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Mixed Ductal-Endocrine Carcinoma of the Pancreas Occurring as a Double Cancer: Report of a Case

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Free Colonic Perforation in a Patient With Crohn's Disease and Loop Ileostomy: Report of a Case

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Effectiveness of Multiple Neurectomies to Prevent Chronic Groin Pain After Tension-Free Hernia Repair

Effect of Phaleria Macrocarpa Supplementation on Apoptosis and Tumor Growth of C3H Mice With Breast Cancer Under Treatment With Adriamycin–Cyclophosphamide

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Pleural Lavage Cytology Immediately After Thoracotomy in Patients With Completely Resected Non–Small Cell Lung Cancer

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A Case of Lung Squamous Cell Carcinoma With Metastases to the Duodenum and Small Intestine

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Papillary Muscle Sandwich Plasty for the Treatment of Functional Mitral Valve Regurgitation

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Inadequacy of anterior-only fixation for reducible three-column injury of the subaxial cervical spine: case report

Lasers for Pulmonary Resections

miR-135a promotes tumor invasion by targeting BACH1 and GATA3 in gastric cancer

Treatment of Intertrochanteric Fractures in the Elderly with Minimally Invasive DAA for Hip Arthroplasty

Comparison of clinical outcomes between percutaneous transhepatic biliary drainage with local lithotripsy and ERCP alone for treating intrahepatic bile duct stones