BACKGROUND/AIM:The usefulness of robot-assisted surgery for elderly colorectal cancer patients remains controversial. The aim of this study was to examine the impact of the surgical approach on short-term prognosis in patients aged ≥80 years. PATIENTS AND METHODS:A total of 1,115 colorectal cancer patients aged ≥80 years who underwent surgery at 6 hospitals between 2016 and 2024 were included in the study. Patients were divided into three groups according to surgical approach: robotic surgery (R group, n=55), laparoscopic surgery (L group, n=910), and open surgery (O group, n=150). Patient characteristics and surgical outcomes were compared among the three groups. RESULTS:The O group had higher proportions of patients with a body mass index (BMI) <25 kg/m2 (R vs. L vs. O: 72.7% vs. 80.8% vs. 87.3%, p=0.040), a performance status ≥3 (9.1% vs. 18.6% vs. 27.3%, p=0.006), an operation time <240 min (47.3% vs. 59.1% vs. 79.3%, p<0.001), and postoperative complications (9.1% vs. 23.0% vs. 27.3%, p=0.022). Multivariable analysis demonstrated that robotic surgery [odds ratio (OR)=0.243, 95% confidence interval (CI)=0.088-0.668, p=0.006] and BMI <25 kg/m2 (OR=0.626, 95% CI=0.419-0.936, p=0.032) were associated with a reduced risk of postoperative complications. CONCLUSION:Robotic-assisted colorectal surgery in elderly patients is safe, with relatively few complications.
Persistent low back and pelvic pain (pp-LBPP) is a common postpartum condition with important implications for maternal function and quality of life. However, its underlying mechanisms remain insufficiently understood. While reduced trunk muscle mass (TMM) has been associated with chronic low back pain in nonpregnant populations, its relevance in the postpartum period, characterized by unique physiological and biomechanical changes, has not been prospectively evaluated, highlighting a critical knowledge gap in postpartum musculoskeletal health. This study aimed to examine the association between early postpartum TMM and pp-LBPP and to identify independent risk factors. This prospective observational study enrolled pregnant women with LBPP at 35 weeks’ gestation. TMM was measured at four weeks postpartum using bioelectrical impedance analysis and indexed by height (TMM-I, kg/m²). Persistent pain was assessed at four months postpartum. Multivariable logistic regression analyses were performed to evaluate associations between pp-LBPP and maternal, obstetric, and behavioral variables. Among 209 participants, 48
BACKGROUND:Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are increasingly being recognized as important viral pathogens in adults, particularly in advanced age and high-risk populations. However, epidemiological and clinical data on RSV and hMPV pneumonia in Japan are limited. METHODS:We conducted a retrospective cohort study of adult patients diagnosed with RSV, hMPV, or influenza virus pneumonia at eight institutions in Nagasaki. Clinical information, including the Charlson Comorbidity Index (CCI), laboratory and radiological findings, were collected from medical records. Pneumonia severity was assessed using the A-DROP and Pneumonia Severity Index (PSI). RESULTS:A total of 301 patients were included: 215 with influenza, 34 with RSV, and 52 with hMPV pneumonia. The median ages were 75, 82, and 69 years, respectively. Female predominance was observed in RSV and hMPV cases compared with influenza. RSV cases were more frequently associated with residence in long-term care facilities, lower BMI, and higher prevalence of chronic cardiopulmonary disease. Lower respiratory tract symptoms, particularly cough and sputum production, were significantly more frequent in patients with RSV infections. hMPV cases exhibited lower CCI scores and milder severity profiles. The A-DROP and PSI scores did not differ significantly between RSV and influenza, and the in-hospital mortality was comparable across the groups. CONCLUSIONS:RSV and hMPV are clinically important causes of pneumonia in advanced aged Japanese population. RSV pneumonia is associated with prominent respiratory symptoms and radiological findings, with severity comparable to that of influenza. These findings underscore the need for increased awareness and large-scale, prospective studies.
