Purpose: The review of the published reports was performed with the aim of systematic collection and integration of information related to "signs and symptoms" along with their changes among patients after upper gastroesophageal surgeries. Methods: The PubMed and the Japanese healthcare literature database were searched by the following keywords:"gastric cancer" "esopha∗ cancer" "surgery" and "symptom" As a result, 37 articles related to gastric or esophagus cancer were identified. The data were extracted according to each sign and symptom, and were evaluated and discussed. Results and Conclution: Standardized instruments for gastrointestinal symptoms included evaluations about dysphagia, difficulty in swallowing, reflux etc. The incidence of signs and symptoms, or postsurgical recovery processes are different among individual patients. Healthcare professionals should support patients continuously and systematically so that patients can take appropriate health maintenance behavior according to their signs and symptoms.

Purpose: This study aimed at identifying the nature of nursing for patients who have appearance changes due to cancer treatment. Methods: Nurses’ focus group interviews were conducted at two cancer hospitals. The data were analyzed qualitatively. This study was approved by the Research Ethics Committee at the study hospitals. Results: Six focus group interviews were conducted, including a total of 21 participants. The participants’ mean age was 39.2 (SD=6.0) years. Their mean years of professional experience was 16.3 (SD=5.8) years. The participants also included a total of 16 Certified Nurse Specialists and Certified Nurses. Interviews took an average of 42 minutes. Four core categories derived from interviews were: “providing information in advance that is necessary for those having the risk of appearance changes to predict and to prepare,” “providing support to enhance patients’ self-care according to the processes of appearance changes in their daily lives,” “advocating patients’ decision to improve their quality of life,” and “utilizing specialty of multi disciplines through care coordination and collaboration.” Conclusions: Further study will systematically analyze details of appearance changes and necessary care associated with different cancer treatment methods, organ sites, and treatment cycles.

Purpose: This study aimed at identifying difficulties among post thoracic esophagectomy cancer patients during outpatient follow-up. Methods: Patients who had radical esophagectomy at a cancer center hospital in Japan were prospectively observed and were interviewed by a certified nurse assigned at esophageal surgical outpatient division. Their responses were documented in medical records and were analyzed by content analysis method. This study was approved by the study hospital's research ethics committee. Results: The data from 66 patients were obtained. Content analysis yielded 221 extracts, 25 categories, and 65 codes of difficulties, including: concerns or signs/symptoms associated with dietary intake, physical activity, and anxiety. Implications: The majority of post-thoracoabdominal esophagectomy patients experienced multiple dysfunctions and symptoms after discharge. The results underscore the significance of nurses' role in assessing and instructing patients to address these issues.

Background: Patients having thoracic esophagectomy, a standardized treatment for esophageal cancer patients in Japan, are known to have various postsurgical signs and symptoms for a period of time. The current status of nursing interventions at outpatients need to be clarified. Purpose: This study aimed at identifying the nurses' interventions for cancer patients at the outpatient setting who previously had thoracic radical esophagectomy. Methods: Patients who had esophagectomy at a cancer center hospital in Japan were prospectively observed and interviewed by outpatient nurses between January 2009 and December 2010. Their documented responses in medical record were prospectively investigated and were qualitatively analyzed via content analysis method. This study was approved by the study hospital's research ethics committee. Results and discussion: The data analysis of nursing interventions for 66 patients yielded 372 extracts, 12 categories, and 74 codes. Nurses were assessing patients' signs and symptoms affected by postsurgical changes, and were utilizing patients' active self-monitoring skills. The results also showed the significance of facilitating postsurgical recovery in relation to nutritional intake and physical activity in patients' daily life. Implications: Based upon the study results, the development of a systematic program is underway, which facilitates esophageal cancer patients' postsurgical recovery.

Purpose: Quantitative elastography methods, such as ultrasound two-dimensional shear-wave elastography (2D-SWE) and magnetic resonance elastography (MRE), are used to diagnose liver fibrosis. The present study compared liver stiffness determined by 2D-SWE and MRE within individuals and analyzed the degree of agreement between the two techniques. Methods: In total, 888 patients who underwent 2D-SWE and MRE were analyzed. Bland-Altman analysis was performed after both types of measurements were log-transformed to a normal distribution and converted to a common set of units using linear regression analysis for differing scales. The expected limit of agreement (LoA) was defined as the square root of the sum of the squares of 2D-SWE and MRE precision. The percentage difference was expressed as (2D-SWEMRE)/ mean of the two methods×100. Results: A Bland-Altman plot showed that the bias and upper and lower LoAs (ULoA and LLoA) were 0.0002 (95% confidence interval [CI], -0.0057 to 0.0061), 0.1747 (95% CI, 0.1646 to 0.1847), and -0.1743 (95% CI, -0.1843 to -0.1642), respectively. In terms of percentage difference, the mean, ULoA, and LLoA were -0.5944%, 19.8950%, and -21.0838%, respectively. The calculated expected LoA was 17.1178% (95% CI, 16.6353% to 17.6002%), and 789 of 888 patients (88.9%) had a percentage difference within the expected LoA. The intraclass correlation coefficient of the two methods indicated an almost perfect correlation (0.8231; 95% CI, 0.8006 to 0.8432; P<0.001). Conclusion Bland-Altman analysis demonstrated that 2D-SWE and MRE were interchangeable within a clinically acceptable range.