Robot-Assisted Total Proctocolectomy for Familial Adenomatous Polyposis with Multiple Colorectal Cancers Using the Hugo RAS System

Yu Yoshida, et al.

INTRODUCTION: Experience with the Hugo RAS system in robot-assisted colorectal surgery is limited. This is particularly noticeable when focusing on complex procedures, such as total proctocolectomy (TPC). This study aimed to demonstrate the feasibility and safety of using the Hugo RAS system for TPC.

Successful Conversion Surgery for Locally Advanced Pancreatic Neuroendocrine Carcinoma: A Case Report

Yuuko Tohmatsu, et al.

INTRODUCTION: Pancreatic neuroendocrine carcinoma (panNEC) is a poorly differentiated, highly malignant neoplasm with an extremely poor prognosis. This tumor often presents as locally advanced or unresectable at the initial diagnosis.

Successful Surgical Repair of Adult Anomalous Origin of the Left Main Coronary Artery from the Pulmonary Artery Complicated by a Mass in the Left Atrial Appendage: A Case Report

Takashi Harada, et al.

INTRODUCTION: An anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA) is a rare congenital abnormality associated with high rates of early infant mortality and sudden death in adults.

A Robotic Pancreaticoduodenectomy Case Involving a Meandering Main Pancreatic Duct Coursing Posterior to a Replaced Common Hepatic Artery and in Front of the Portal Vein

Yui Sawa, et al.

INTRODUCTION: Anatomical anomalies, such as branches of the celiac artery and superior mesenteric artery (SMA), and pancreatic malformations, including the annular pancreas, are important during pancreaticoduodenectomy (PD). Here, we report a case of an anomaly of the artery and main pancreatic duct (MPD) in which the pancreatic parenchyma surrounded the replaced common hepatic artery (rCHA), and the meandering main pancreatic duct (MMPD) ran behind the rCHA.

Hilar Cholangiocarcinoma with Para-Aortic Lymph Node Metastasis Treated with Chemoimmunotherapy and Conversion Surgery: A Case Report

Yuma Yasui, et al.

INTRODUCTION: Cholangiocarcinoma (CC) has a poor prognosis and few treatment options. Conversion surgery for unresectable CC has been frequently reported; however, there are almost no reports of conversion surgery after durvalumab plus gemcitabine and cisplatin therapy. In this study, we report the case of a patient with unresectable hilar CC who received durvalumab plus gemcitabine and cisplatin therapy and achieved a pathological complete response after conversion surgery.

Efficacy of Arterial Embolization prior to Pancreaticoduodenectomy for Pancreatic Arteriovenous Malformation: A Case Report

Ryota Kiuchi, et al.

INTRODUCTION: Pancreatic arteriovenous malformation is a rare disease characterized by abnormal vascular connections between arteries and veins. Despite the risk of increased intraoperative blood loss due to abundant blood flow, surgical resection remains the only curative modality for pancreatic arteriovenous malformation. We present a case of pancreatic arteriovenous malformation in which subtotal stomach-preserving pancreaticoduodenectomy was successfully performed following selective arterial embolization to reduce intraoperative blood loss.

Robotic Segmentectomy in a Patient with a Displaced Left Upper Division Bronchus and Fused Fissure

Hironobu Wada, et al.

INTRODUCTION: In thoracic surgery, anatomical anomalies and a fused fissure can cause inaccurate intraoperative recognition of anatomy and lead to accidental injury of pulmonary vessels and bronchi that should be preserved. A displaced left upper division bronchus (B1+2+3), also known as a left eparterial bronchus, is a rare anomaly that can present in combination with abnormal pulmonary arteries positioning and lobulation. Herein, we report a case of lung cancer in S1+2 of the left fused lung that was successfully resected by robotic left upper division segmentectomy following a detailed preoperative simulation using 3-dimensional computed tomography.

Extracorporeal Membrane Oxygenation-Assisted Thoracic Surgery: A Series of 10 Cases

Yuzu Harata, et al.

INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a type of extracorporeal circulation used to divert blood from and deliver blood to peripheral blood vessels. Recently, the use of ECMO has been reported in various non-transplant surgeries. Particularly in tracheal surgeries, ECMO provides an unobstructed surgical field and enables safe induction of general anesthesia in difficult intubation cases. Here, we report on 10 cases of thoracic surgery in which ECMO was employed at our institution.

Giant Intra-Abdominal Desmoid Tumor in a Young Man: A Case Report and Literature Review

Yusuke Tanaka, et al.

INTRODUCTION: Desmoid tumors are rare soft-tissue tumors with a high recurrence rate; however, histologically, these tumors are benign. We describe a case in which a giant desmoid tumor was resected in a young man without any apparent causative factors.

Axillo-Femoral Bypass Followed by Pelvic Exenteration for Locally Advanced Sigmoid Colon Cancer Invading the Common Iliac Artery

Moe Enari, et al.

INTRODUCTION: Initially, unresectable locally advanced colorectal cancers are still not uncommon. Despite recently developed systemic treatment has extended the survival of patients with unresectable and recurrent disease, surgical resection offers the chance for a cure or long-term survival. Recently, with improvement in the safety of major vascular reconstruction, several reports have suggested that extended pelvic tumor resection with vascular reconstruction with curative intent can be performed safely; however, the indications for arterial vascular reconstruction remain controversial and are reported with a literature review.

Ileal Pouch Cancer Detected More than 30 Years after Restorative Proctocolectomy for Ulcerative Colitis

Tetsuhiro Urashima, et al.

INTRODUCTION: The standard surgical treatment for ulcerative colitis (UC) is proctocolectomy with hand-sewn ileoanal pouch anastomosis (hand-sewn IPAA) or stapled ileal pouch anastomosis (stapled IPAA). The occurrence of cancer in the ileal pouch after surgery for UC is rare, and a consensus on surveillance for ileal pouch cancer has not been reached. We report a case of ileal pouch cancer diagnosed by pouchoscopy 33 years after restorative proctocolectomy with IPAA for UC.

A Case of Hypoglycemia Diagnosed by Neuropsychiatric Symptoms after Distal Gastrectomy and Total Colectomy

Kota Okuno, et al.

INTRODUCTION: Hypoglycemia can lead to significant adverse effects, including cognitive impairment, fatigue, convulsions, and even loss of consciousness in severe cases. Recent reviews also associate hypoglycemia with severe outcomes, such as mortality, dementia, and cardiovascular events. In gastrointestinal surgery, postoperative hypoglycemia related to dumping syndrome is well documented after gastric procedures. However, hypoglycemia in patients who have undergone both gastrectomy and total colectomy is rare, and the underlying mechanisms and effective management strategies remain unclear.