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Kouzu K, Tsujimoto H, Ishinuki T, Shinji S, Shinkawa H, Tamura K, Uchino M, Ohge H, Shimizu J, Haji S, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Hanai Y, Nobuhara H, Imaoka H, Yoshida M, Mizuguchi T, Mayumi T, Kitagawa Y. The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. J Hosp Infect 2024; 146:174-182. [PMID: 37734678 DOI: 10.1016/j.jhin.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
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Affiliation(s)
- K Kouzu
- Department of Surgery, National Defense Medical College, Japan
| | - H Tsujimoto
- Department of Surgery, National Defense Medical College, Japan.
| | - T Ishinuki
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - S Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Japan
| | - H Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - K Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - M Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Japan
| | - H Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - J Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Japan
| | - S Haji
- Department of Surgery, Soseikai General Hospital, Japan
| | - Y Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Japan
| | - C Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Japan
| | - Y Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Japan
| | - K Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Japan
| | - M Kobayashi
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Japan
| | - Y Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Japan
| | - H Nobuhara
- Department of Dentistry, Hiroshima Prefectural Hospital, Japan
| | - H Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Japan
| | - M Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Japan
| | - T Mizuguchi
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - T Mayumi
- Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Japan
| | - Y Kitagawa
- Keio University, School of Medicine, Japan
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Sugimoto T, Iwagami Y, Kobayashi S, Yamanaka C, Sasaki K, Yamada D, Tomimaru Y, Asaoka T, Noda T, Takahashi H, Shimizu J, Doki Y, Eguchi H. Skeletal Muscle-Derived Irisin Enhances Gemcitabine Sensitivity and Suppresses Migration Ability in Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 2024:10.1245/s10434-024-15118-x. [PMID: 38502294 DOI: 10.1245/s10434-024-15118-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND High skeletal muscle mass might be a prognostic factor for patients with pancreatic ductal adenocarcinoma (PDAC); however, the underlying reason is unclear. We hypothesized that myokines, which are cytokines secreted by the skeletal muscle, function as suppressors of PDAC. We specifically examined irisin, a myokine, which plays a critical role in the modulation of metabolism, to clarify the anticancer mechanisms. METHODS First, the effect of the conditioned medium (CM) from skeletal muscle cells and from irisin-knockdown skeletal muscle cells on PDAC cell lines was evaluated. We then investigated the effects and anticancer mechanism of irisin in PDAC cells, and evaluated the anticancer effect of recombinant irisin in a PDAC xenograft mouse model. Finally, patients undergoing pancreatic resection for PDAC were divided into two groups based on their serum irisin level, and the long-term outcomes were evaluated. RESULTS The CM enhanced gemcitabine sensitivity by inducing apoptosis and decreasing cell migration by inhibiting epithelial-mesenchymal transition (EMT) in PDAC cell lines. The CM derived from irisin-knockdown skeletal muscle cells did not affect the PDAC cell lines. The addition of recombinant irisin to PDAC cell lines facilitated sensitivity to gemcitabine by inhibiting the mitogen-activated protein kinase (MAPK) pathway, and decreased migration by inhibiting EMT via the transforming growth factor-β/SMAD pathway. Xenografts injected with gemcitabine and recombinant irisin grew slower than the xenografts injected with gemcitabine alone. The overall survival was prolonged in the high-irisin group compared with that in the low-irisin group. CONCLUSIONS Skeletal muscle-derived irisin may affect PDAC by enhancing its sensitivity to gemcitabine and suppressing EMT.
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Affiliation(s)
- Tomoki Sugimoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshifumi Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Chihiro Yamanaka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuki Sasaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Daisaku Yamada
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshito Tomimaru
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tadafumi Asaoka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takehiro Noda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Junzo Shimizu
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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Kato K, Noda T, Kobayashi S, Sasaki K, Iwagami Y, Yamada D, Tomimaru Y, Takahashi H, Uemura M, Asaoka T, Shimizu J, Doki Y, Eguchi H. KLK10 derived from tumor endothelial cells accelerates colon cancer cell proliferation and hematogenous liver metastasis formation. Cancer Sci 2024. [PMID: 38475666 DOI: 10.1111/cas.16144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Tumor endothelial cells (TECs), which are thought to be structurally and functionally different from normal endothelial cells (NECs), are increasingly attracting attention as a therapeutic target in hypervascular malignancies. Although colorectal liver metastasis (CRLM) tumors are hypovascular, inhibitors of angiogenesis are a key drug in multidisciplinary therapy, and TECs might be involved in the development and progression of cancer. Here, we analyzed the function of TEC in the CRLM tumor microenvironment. We used a murine colon cancer cell line (CT26) and isolated TECs from CRLM tumors. TECs showed higher proliferation and migration than NECs. Coinjection of CT26 and TECs yielded rapid tumor formation in vivo. Immunofluorescence analysis showed that coinjection of CT26 and TECs increased vessel formation and Ki-67+ cells. Transcriptome analysis identified kallikrein-related peptide 10 (KLK10) as a candidate target. Coinjection of CT26 and TECs after KLK10 downregulation with siRNA suppressed tumor formation in vivo. TEC secretion of KLK10 decreased after KLK10 downregulation, and conditioned medium after KLK10 knockdown in TECs suppressed CT26 proliferative activity. Double immunofluorescence staining of KLK10 and CD31 in CRLM tissues revealed a significant correlation between poor prognosis and positive KLK10 expression in TECs and tumor cells. On multivariate analysis, KLK10 expression was an independent prognostic factor in disease-free survival. In conclusion, KLK10 derived from TECs accelerates colon cancer cell proliferation and hematogenous liver metastasis formation. KLK10 in TECs might offer a promising therapeutic target in CRLM.
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Affiliation(s)
- Kazuya Kato
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takehiro Noda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuki Sasaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshifumi Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Daisaku Yamada
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshito Tomimaru
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mamoru Uemura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tadafumi Asaoka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Junzo Shimizu
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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Kawase T, Imamura H, Yanagimoto Y, Odagiri K, Suzuki Y, Takeyama H, Yamashita M, Sato Y, Kobayashi A, Ikenaga M, Shimizu J, Akagi K, Iwazawa T, Tomita N, Dono K. [Regimen Selection by Narrative Approach in Patients with Advanced Gastric Cancer-Paclitaxel or Nab-Paclitaxel?]. Gan To Kagaku Ryoho 2024; 51:311-313. [PMID: 38494815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND According to the sixth Gastric Cancer Treatment Guideline, the regimen included nab-paclitaxel(nab-PTX) is a conditional recommendation as second-line treatment for advanced gastric cancer. However, the selection criteria of nab-PTX is not clear. METHOD Questionnaire survey as narrative approach on the problems of paclitaxel premedication, the symptoms due to paclitaxel containing alcohol, and infusion time was conducted for patients who had been treated with paclitaxel. RESULTS Thirty-six patients answered the questionnaire. Nonelderly patients(<65 years)or patients without comorbid medications complained of dissatisfaction with the inconvenience due to premedication significantly more than elderly patients(≥65 years)or patients with comorbid medications. Females or nonelderly patients were significantly more troubled by sleepiness due to premedication than males or elderly patients. Eight out of 11 patients who had visited hospital by driving a car for first-line treatment were troubled by prohibition of driving on the day of treatment. Thirty out of 36 patients answered that they would feel benefits from 30-minutes shortening of infusion time. CONCLUSION Questionnaire survey suggests that we may select the patients for nab-PTX properly by clarifying the inconvenience of daily life associated with premedication, the way of transportation for visiting hospital, and the benefits by shortening of infusion time.
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Kawase T, Imamura H, Yanagimoto Y, Odagiri K, Suzuki Y, Takeyama H, Yamashita M, Sato Y, Kobayashi A, Ikenaga M, Shimizu J, Akagi K, Iwazawa T, Tomita N, Dono K. [Questionnaire Survey on Oral Care and Oral Troubles for Patients with Gastric Cancer Received Chemotherapy]. Gan To Kagaku Ryoho 2024; 51:308-310. [PMID: 38494814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND The actual situation of oral care and oral troubles for patients with gastric cancer received chemotherapy is not clear. METHODS Questionnaire survey in the form of oral questions was performed for patients with gastric cancer who received chemotherapy from December 2021 to February 2022. The relevance between the survey results and background factors was examined using the χ2 test. RESULTS We performed the questionnaire survey for 36 patients. Of the 36 patients, 29 patients received dental check-up before starting chemotherapy. Fourteen of the 29 patients(48%)continued the dental check-up. Of 14 patients who continued the dental check-up, 9 patients were 65 years or older, while 14 of 15 patients who discontinued the dental check-up were 65 years or older. Continuity of dental check-up was low among the elderly patients. The rate of dysgeusia were 78 vs 30% in the patients who adopted and who did not adopt oral care other than toothbrushing(p=0.01). The frequency of oral troubles was dysgeusia(47%), stomatitis(42%), and dry mouth(36%). The severity of the oral troubles was, in order, dysgeusia, dry mouth, and pain. The most common side effect due to chemotherapy causing decreased food intake was dysgeusia. CONCLUSIONS Dysgeusia was the most frequent and severe oral trouble.
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Toya K, Tomimaru Y, Fukuchi N, Yokoyama S, Mori T, Tanemura M, Sakai K, Takeda Y, Tsujie M, Yamada T, Miyamoto A, Hashimoto Y, Hatano H, Shimizu J, Sugimoto K, Kashiwazaki M, Matsumoto K, Kobayashi S, Doki Y, Eguchi H. Influence of Percutaneous Transhepatic Gallbladder Aspiration and Drainage for Severe Acute Cholecystitis on the Surgical Outcomes of Subsequent Laparoscopic Cholecystectomy: Post Hoc Analysis of the CSGO-HBP-017 (CSGO-HBP-017C). Surg Laparosc Endosc Percutan Tech 2024; 34:62-68. [PMID: 38063517 DOI: 10.1097/sle.0000000000001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/07/2023] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Percutaneous transhepatic gallbladder aspiration (PTGBA) and/or drainage (PTGBD) are useful approaches in the management of acute cholecystitis in patients who cannot tolerate surgery because of poor general condition or severe inflammation. However, reports regarding its effect on the surgical outcomes of subsequent laparoscopic cholecystectomy (LC) are sparse. The aim of this retrospective study was to investigate the influence of PTGBA on surgical outcomes of subsequent LC by comparing the only-PTGBA group, including patients who did not need the additional-PTGBD, versus the additional-PTGBD group, including those who needed the additional-PTGBD after PTGBA. PATIENTS AND METHODS We conducted a post hoc analysis of our multi-institutional data. This study included 63 patients who underwent LC after PTGBA, and we compared the surgical outcomes between the only-PTGBA group (n = 56) and the additional-PTGBD group (n = 7). RESULTS No postoperative complications occurred among the 63 patients, and the postoperative hospital stay was 11 ± 12 days. Fourteen patients (22.2%) had a recurrence of cholecystitis, of whom 7 patients (11.1%) needed the additional-PTGBD after PTGBA. Significantly longer operative time (245 ± 74 vs 159 ± 65 min, P = 0.0017) and postoperative hospital stay (22 ± 27 vs 10 ± 9 d, P = 0.0118) and greater intraoperative blood loss (279 ± 385 vs 70 ± 208 mL, P = 0.0283) were observed among patients in the additional-PTGBD group compared with the only-PTGBA group, whereas the rates of postoperative complications (Clavien-Dindo grade ≥3: 0% each) and conversion to open surgery (28.6% vs 8.9%, P = 0.1705) were comparable. CONCLUSION PTGBA for acute cholecystitis could result in good surgical outcomes of subsequent LC, especially regarding postoperative complications. However, we should keep in mind that the additional-PTGBD after PTGBA failure, which sometimes happened, would be associated with increased operative difficulty and longer recovery.
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Affiliation(s)
- Keisuke Toya
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Yoshito Tomimaru
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka
| | - Nariaki Fukuchi
- Department of Surgery, Suita Municipal Hospital
- Department of Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Hirakata
| | - Shigekazu Yokoyama
- Department of Surgery, Saiseikai Senri Hospital, Suita
- Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya
| | - Takuji Mori
- Department of Surgery, Tane General Hospital
| | - Masahiro Tanemura
- Department of Surgery, Osaka Police Hospital
- Department of Surgery, Rinku General Medical Center
| | - Kenji Sakai
- Department of Surgery, Japan Community Health Care Organization, Osaka Hospital
- Department of Surgery, National Hospital Organization Osaka National Hospital
| | - Yutaka Takeda
- Department of Surgery, Kansai Rosai Hospital, Amagasaki
| | - Masanori Tsujie
- Department of Surgery, Faculty of Medicine, Nara Hospital, Kinki University, Ikoma
- Department of Surgery, Osaka Rosai Hospital
| | - Terumasa Yamada
- Department of Surgery, Higashiosaka City Medical Center, Higashiosaka
| | - Atsushi Miyamoto
- Department of Surgery, National Hospital Organization Osaka National Hospital
- Department of Surgery, Sakai City Medical Center, Sakai
| | - Yasuji Hashimoto
- Department of Surgery, Yao Municipal Hospital, Yao
- Department of Surgery, Kinan Hospital, Tanabe
| | - Hisanori Hatano
- Department of Surgery, Rinku General Medical Center
- Department of Surgery, Hanwa Memorial Hospital
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka
- Department of Surgery, Osaka Rosai Hospital
| | - Keishi Sugimoto
- Department of Surgery, Minoh City Hospital, Minoh
- Department of Surgery, Kawanishi City Hospital, Kawanishi
| | - Masaki Kashiwazaki
- Department of Surgery, Rinku General Medical Center
- Department of Surgery, Osaka General Medical Center
| | - Kenichi Matsumoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
- Department of Surgery, Ikeda City Hospital, Ikeda, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
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Hokkoku D, Sasaki K, Kobayashi S, Iwagami Y, Yamada D, Tomimaru Y, Asaoka T, Noda T, Takahashi H, Shimizu J, Doki Y, Eguchi H. Apparent diffusion coefficient in intrahepatic cholangiocarcinoma diffusion-weighted magnetic resonance imaging noninvasively predicts Ki-67 expression. Hepatol Res 2024. [PMID: 38254248 DOI: 10.1111/hepr.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
AIM Tumor Ki-67 expression reflects prognosis and cancer grade, and biopsy-based preoperative assessment of Ki-67 expression is key to treatment. Apparent diffusion coefficient (ADC) values obtained with this imaging may noninvasively predict Ki-67 by reflecting tumor cell density and limited water molecule movement from irregular alignment. This study aimed to investigate the ability of ADC values to predict Ki-67 expression in intrahepatic cholangiocarcinoma (ICC). METHOD We retrospectively analyzed 39 cases of ICC confirmed by surgical pathology. All patients had undergone magnetic resonance imaging, and ADC values (mean, minimum, and maximum) were calculated. Ki-67 expression was assessed by immunohistochemistry, and patients were divided into groups of high (n = 18) and low (n = 21) Ki-67 expression. To assess the diagnostic performance of the ADC values for Ki-67 expression, we used the receiver operating characteristic curve and compared the areas under the curve (AUC). RESULTS The mean and minimum ADC values were significantly lower in the group with high Ki-67 expression. For predicting high Ki-67 expression, the AUC values were 0.701 for mean ADC, 0.818 for minimum ADC, and 0.571 for maximum ADC. The diagnostic sensitivity and specificity of the minimum ADC values were 88.9% and 76.2%, respectively. In addition, with ADC values combined, the AUC increased to 0.831. Apparent diffusion coefficient is a useful predictor of Ki-67 expression level in ICC. CONCLUSION Apparent diffusion coefficient values, especially minimum ADC values, can noninvasively predict ICC associated with high Ki-67 expression.
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Affiliation(s)
- Daiki Hokkoku
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kazuki Sasaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yoshifumi Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Daisaku Yamada
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yoshito Tomimaru
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tadafumi Asaoka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takehiro Noda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Junzo Shimizu
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Noura S, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tomita N, Imamura H. [A Case of 30s Female with Advanced Anal Canal Adenocarcinoma Managed with Adolescent-And-Young-Adult Team]. Gan To Kagaku Ryoho 2024; 51:69-71. [PMID: 38247095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
A 30s female complaining of anal pain and melena was referred to our hospital. The support by adolescent-and-young- adult(AYA)team was initiated after the first encounter. Colonoscopic examination revealed an ulcerated tumor on the anterior wall of anal canal with its anal margin on anal verge and the tumor was diagnosed as an adenocarcinoma. Contrast- enhanced CT and MRI revealed adjacency of tumor and vagina, enlarged lymph nodes and multiple pulmonary nodules. 18F-fluorodeoxyglucose(FDG)-positron emission tomography(PET)additionally revealed tracer accumulation in left sciatica, which led us to the diagnosis of advanced anal cancer. We planned and safely performed concomitant partial vaginal resection in robot-assisted laparoscopic abdominoperineal resection for the palliative purpose after discussion on physical and psychosocial issues including stoma and fertility with the patient, her family and AYA members. The pathological diagnosis was pT4b(vagina)N1aM1b, pStage ⅣB, and the local margin was pathologically negative. The postoperative course was smooth and she was discharged on postoperative day 16. Fifty one days after operation, she started systemic chemotherapy after decision on not to take ovarian samples and continues systemic chemotherapy as of writing. Support by AYA team was effective to facilitate the patient's decision-making and the communication between the patient and the medical team.
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Affiliation(s)
- Yozo Suzuki
- Dept. of Surgery, Toyonaka Municipal Hospital
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tamura H, Adachi S, Imamura H. [A Case of Diffuse Large B-Cell Lymphoma Which Was Diagnosed during the Best Supportive Care of Recurrent Ascending Colon Cancer]. Gan To Kagaku Ryoho 2024; 51:84-86. [PMID: 38247100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
A 70s male, who had undergone single-incision laparoscopic ileocecal resection for ascending colon cancer with pathological diagnosis of T3N3M0, Stage Ⅲc(without adjuvant chemotherapy), had enhanced-computed tomography(CT)for 3-month follow-up and a hepatic low-density area, an newly emergent nodule behind inferior vena cava and distal ileal tumor were found. Three months later, enhanced CT showed that the distal ileal tumor got exponentially larger and the diagnosis of"malignant lymphoma"was suspected. The patient became sepsis, so we planned and safely performed partial resection of the tumor. The pathological diagnosis was diffuse large B-cell lymphoma. Postoperative course was smooth except for the Clostridium difficile colitis and he was discharged on postoperative day 19. Although the regrowth of the remnant tumor was observed soon after surgery, partial response was confirmed after introduction of systemic chemotherapy. When we cope with malignant lymphoma of small intestine, we need to keep it in mind that surgery is an option for the prevention of perforation and bacterial translocation.
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Affiliation(s)
- Yozo Suzuki
- Dept. of Surgery, Toyonaka Municipal Hospital
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tamura H, Adachi S, Imamura H. [A Case of Fibromatosis-Like Tumor Which Was Difficult to Differentiate from Local Recurrence of Ascending Colon Cancer]. Gan To Kagaku Ryoho 2024; 51:87-89. [PMID: 38247101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
A 60s female, who had undergone single-incision laparoscopic ileocecal resection for ascending colon cancer with pathological diagnosis of T3N1bM0, Stage Ⅲb, followed by adjuvant therapy with 8 courses CAPOX 2 years ago, had enhanced- computed tomography(CT)for follow-up and a 15-mm nodule near anastomotic site was found. 18F-fluorodeoxyglucose (FDG)-positron emission tomography(PET)CT revealed abnormal accumulation of 18F-FDG only to the lesion and diagnosis of"anastomotic recurrence"was made. We planned and safely performed resection of the anastomotic site and the nodule. The pathological diagnosis was fibromatosis-like tumor without evidence of recurrence, and margin was negative. Postoperative course was smooth and she was discharged on postoperative day 9. When we diagnose local recurrence, we need to keep it in mind that fibromatosis is one of the differential diagnoses, although its incidence rate is low.
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Affiliation(s)
- Yozo Suzuki
- Dept. of Surgery, Toyonaka Municipal Hospital
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11
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Jinushi K, Shimizu J, Yamashita M, Odagiri K, Yanagimoto Y, Takeyama H, Suzuki Y, Ikenaga M, Imamura H, Dono K. Association between methicillin-resistant Staphylococcus aureus nasal carriage and infection after pancreatic surgery. J Hepatobiliary Pancreat Sci 2024; 31:42-49. [PMID: 37792598 DOI: 10.1002/jhbp.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/07/2023] [Accepted: 08/16/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) infections after pancreatectomy are relatively rare; however, they can be fatal when associated with pseudoaneurysms. For the past 12 years, we have been investigating nasal MRSA carriage by polymerase chain reaction testing, postoperatively in patients admitted to the intensive care units, to prevent nosocomial infections. Here, we investigated the relationship between MRSA nasal carriage and postoperative MRSA infection at the surgical site, following pancreatectomy. METHODS This single-center retrospective study analyzed 313 pancreatectomies (220 pancreaticoduodenectomies and 93 distal pancreatectomies), performed at our hospital between January 2011 and June 2022. The incidence of surgical site infection (SSI) and postoperative MRSA infection were compared between the nasal MRSA-positive and nasal MRSA-negative groups. RESULTS MRSA nasal carriage was identified in 24 cases (7.6%), and the frequency of SSIs in the nasal MRSA-positive and MRSA-negative groups were 50% and 36.7%, respectively, with no significant difference (p = .273). However, the frequency of MRSA infection among the SSI cases was significantly higher in the nasal MRSA-positive group (16.7%) than in the nasal MRSA-negative group (1.7%) (p = .003). CONCLUSION It should be noted that MRSA carriers have a significantly higher frequency of MRSA-positive SSIs.
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Affiliation(s)
- Koichi Jinushi
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | | | - Kazuki Odagiri
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | | | - Hiroshi Takeyama
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Masakazu Ikenaga
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Hiroshi Imamura
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
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12
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Ishinuki T, Shinkawa H, Kouzu K, Shinji S, Goda E, Ohyanagi T, Kobayashi M, Kobayashi M, Suzuki K, Kitagawa Y, Yamashita C, Mohri Y, Shimizu J, Uchino M, Haji S, Yoshida M, Ohge H, Mayumi T, Mizuguchi T. Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery: A systematic review and meta-analysis. World J Gastrointest Surg 2023; 15:2879-2889. [PMID: 38222020 PMCID: PMC10784836 DOI: 10.4240/wjgs.v15.i12.2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Surgical site infections (SSIs) increase mortality, hospital stays, additional medical treatment, and medical costs. Subcutaneous drains prevent SSIs in gynecological and breast surgeries; however, their clinical impact in abdominal surgery remains unclear. AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis. METHODS The database search used PubMed, MEDLINE, and the Cochrane Library. The following inclusion criteria were set for the systematic review: (1) Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains; and (2) Studies that described clinical outcomes, such as SSIs, seroma formation, the length of hospital stays, and mortality. RESULTS Eight studies were included in this meta-analysis. The rate of total SSIs was significantly lower in the drained group (54/771, 7.0%) than in the control group (89/759, 11.7%), particularly in gastrointestinal surgery. Furthermore, the rate of superficial SSIs was slightly lower in the drained group (31/517, 6.0%) than in the control group (49/521, 9.4%). No significant differences were observed in seroma formation between the groups. Hospital stays were shorter in the drained group than in the control group. CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation. The timing of drain removal needs to be reconsidered in future studies.
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Affiliation(s)
- Tomohiro Ishinuki
- Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 060-8556, Hokkaido, Japan
| | - Hiroji Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Abeno-Ku 545-0051, Japan
| | - Keita Kouzu
- Department of Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Seiichi Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo 113-8602, Japan
| | - Erika Goda
- Department of Nursing, Japan Health Care University, Sapporo 062-0053, Japan
| | - Toshio Ohyanagi
- Department of Liberal Arts and Sciences, Center for Medical Education, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Masahiro Kobayashi
- Department of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University, Tokyo 108-8641, Japan
| | - Motomu Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Eniwa 061-1395, Japan
| | - Katsunori Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Yuichi Kitagawa
- Department of Gastrointestinal Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Chizuru Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University, Toyoake 470-1192, Japan
| | - Yasuhiko Mohri
- Department of Gastrointestinal Surgery, Mie Prefectural General Medical Center, Yokkaich 510-8561, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka 560-8565, Japan
| | - Motoi Uchino
- Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya 663-8501, Japan
| | - Seiji Haji
- Department of Surgery, Soseikai General Hospital, Kyoto 612-8473, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic & Gastrointestinal Surgery, International University of Health and Welfare, Ichikawa 272-0827, Japan
| | - Hiroki Ohge
- Department of Infectious Disease, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Toshihiko Mayumi
- Department of Intensive Care Unit, Chukyo Hospital, Japan Community Health Care Organization, Nagoya 457-8510, Japan
| | - Toru Mizuguchi
- Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 060-8556, Hokkaido, Japan
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Shimizu J, Yamashita M, Odagiri K, Takeyama H, Yanagimoto Y, Suzuki Y, Ikenaga M, Kawase T, Imamura H, Dono K. [Our Experience with Atezolizumab plus Bevacizumab for Unresectable Hepatocellular Carcinoma]. Gan To Kagaku Ryoho 2023; 50:1513-1515. [PMID: 38303325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
We report our experience with atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. METHODS Fourteen patients with unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab at our department were retrospectively evaluated for antitumor efficacy and adverse events. RESULTS Age ranged from 66-91 years(median 77.5 years), 11 males and 3 females, number of doses ranged from 2-26(median 13), and observation period ranged from 31-790 days (median 427 days). Antitumor efficacy was CR in 3 patients, PR in 3, SD in 6, and PD in 2. One patient with PD died 650 days after the start of treatment, but the others are still alive. Adverse events included proteinuria in 9 patients who discontinued bevacizumab, hypothyroidism requiring levothyroxine sodium hydrate in 7 patients, dermatitis in 2 patients, and colitis requiring hospitalization in 2 patients. DISCUSSION Despite the small number of cases, a high antitumor effect was observed with a CR rate of 21%. Although proteinuria and hypothyroidism were observed relatively frequently as adverse events, they were easily controlled and did not pose a major clinical problem.
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Fukuda K, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Suzuki Y, Ikenaga M, Kawase T, Shimizu J, Imamura H, Dono K. [A Case of Preoperative Chemotherapy for Advanced Gastric Cancer, Laparoscopic Total Gastrectomy, Pancreaticoduodenectomy, and Para-Aortic Lymph Node Dissection]. Gan To Kagaku Ryoho 2023; 50:1438-1440. [PMID: 38303300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Bulky N+ gastric cancer has a poor prognosis. The results of JCOG0405 showed the efficacy of neoadjuvant chemotherapy with S-1 plus cisplatin combination therapy for Bulky N+ gastric cancer. JLSSG0901 demonstrated the safety and efficacy of laparoscopic surgery for advanced gastric cancer. But the safety of laparoscopic surgery for locally advanced and extensive nodal metastasis cancer(T4b, para-aortic lymph node metastasis)is not apparent. After DOS therapy, we performed total laparoscopic gastrectomy, DP(distal pancreatectomy), D2+ #16a2/b1 lat, and Roux-en-Y reconstruction, and histopathological results showed that the aortic lymph node metastasis disappeared. We controlled extensive lymph node metastasis using preoperative triplet chemotherapy. Laparoscopic surgery after preoperative chemotherapy for Bulky N+ gastric cancer can be a treatment option because we performed laparoscopic resection and para-aortic lymph node dissection with no complications, including pancreatic complications.
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Kinoshita U, Kawase T, Yanagimoto Y, Odagiri K, Yamashita M, Takeyama H, Suzuki Y, Ikenaga M, Shimizu J, Imamura H, Tomita N, Dono K. [A Case Report of SOX Therapy for an Elderly Patient with Hemorrhagic Primary Duodenal Carcinoma]. Gan To Kagaku Ryoho 2023; 50:1777-1779. [PMID: 38303204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Although pancreatoduodenectomy is recommended as a radical surgery for duodenal carcinoma, it has been reported that pancreatoduodenectomy in elderly patients has a high risk of surgical complications. CASE PRESENTATION A man in his 80's was diagnosed with advanced duodenal carcinoma, presenting with anemia(Hb 5.4 g/dL). Computed tomography scanning showed wall thickening in the descending leg of the duodenum, pancreatic invasion was suspected, and clinical diagnosis was Stage ⅡB(cT4N0M0). Although radical surgery was possible, the patient refused surgery considering the risks of surgical complications. The gastroduodenal bypass surgery was performed to control bleeding, and the patient was treated with S-1 plus oxaliplatin(SOX; S-1 100 mg/body, days 1-14; oxaliplatin 100 mg/m2, day 1 q21 days). After 6 courses of the SOX regimen, the wall thickening of duodenum disappeared, and SOX was switched to S-1 monotherapy (S-1 100 mg/body, days 1-28, q42 days)according to Grade 2 thrombocytopenia and decreased performance status. After 11 courses of S-1, upper gastrointestinal endoscopy showed that the tumor had disappeared, the biopsy of duodenum showed no evidence of malignancy, and chemotherapy was terminated. The patient has been followed up for 7 months without recurrence. CONCLUSIONS SOX for elderly patient showed efficacy against hemorrhagic duodenal carcinoma.
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Yamashita M, Shimizu J, Sato Y, Noma T, Hagihara K, Yanagimoto Y, Suzuki Y, Ikenaga M, Kawase T, Imamura H, Akagi K, Iwasawa S, Tomita N. [Tolerability and Outcome of Neoadjuvant GS Therapy for Resectable Pancreatic Cancer]. Gan To Kagaku Ryoho 2023; 50:1411-1413. [PMID: 38303291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Neoadjuvant chemotherapy with gemcitabine plus S-1(NAC GS)has been reported to prolong the prognosis of resectable pancreatic cancer, and is now being used in daily practice. In this study, we investigated the tolerability and outcome of neoadjuvant GS therapy for resectable pancreatic cancer in our hospital. PATIENTS Fifty-two patients who underwent NAC GS for resectable pancreatic cancer between November 2019 and March 2023 were included in this study. RESULTS The mean age of all 52 patients was 75 years, 28 were male and 24 were female. Tumor site was pancreatic head cancer in 32 patients, pancreatic body cancer in 13 patients, and pancreatic tail cancer in 8 patients. Only 2 patients of the 52 patients completed 2 cycles of GS therapy with full dose, and dose reduction and treatment deferral were performed in remaining 50 patients. The dose intensity was 78.4% for gemcitabine and 66.7% for S-1. Grade 3 or higher adverse events included neutropenia in 21 patients(40.4%), biliary tract infection in 6 patients(11.5%), fatigue, anorexia, hepatic dysfunction, and constipation in 1 patient each(1.9%). 47 patients(90.4%)underwent R0 resection. 4 patients had pancreatic fistula, which was classified as Grade Ⅲ by Clavien-Dindo, and one of them died in the hospital due to bleeding from a pseudoaneurysm. CONCLUSION NAC GS therapy for resectable pancreatic cancer was considered feasible with appropriate management of adverse events.
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Okuda T, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Suzuki Y, Ikenaga M, Kawase T, Shimizu J, Imamura H, Dono K. [Conversion Surgery Performed after SOX plus Nivolumab Therapy for Advanced Gastric Cancer with Para-Aortic Lymph Node Metastasis]. Gan To Kagaku Ryoho 2023; 50:1671-1673. [PMID: 38303168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The patient was a 78-year-old woman. She presented with anemia and a positive fecal occult blood test. Endoscopic findings revealed type 3 advanced gastric cancer. As it had metastasized to the para-aortic lymph node(PALN: No. 16a2 lat), it was diagnosed as gastric cancer at cardia cT4aN1(No.1)M1(No.16a2 lat), cStage Ⅳ. She was administered S-1, oxaliplatin, and nivolumab(SOX plus Nivo)therapy as a first-line treatment. SOX plus Nivo resulted in a remarkable reduction of the lymph nodes, which were PR. After 3 courses of chemotherapy, a laparoscopic proximal gastrectomy was performed, with D2 plus No. 16a2 int/lat lymph nodes dissection as conversion surgery. Histopathological examination was pT3N0M0, and R0 resection was pStage ⅡA. She was discharged at POD21 and started S-1 from POD69. The patient is alive with no signs of recurrence 10 months postoperatively.
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18
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Jinushi K, Ikenaga M, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Suzuki Y, Kawase T, Shimizu J, Imamura H, Dono K. [Clinical Outcome of Five Patients with Perforated Colorectal Cancer]. Gan To Kagaku Ryoho 2023; 50:1566-1568. [PMID: 38303343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
We studied the clinicopathological findings of 5 patients with perforated colorectal cancer. Three patients were male, and the primary cancer site was left side colon in 4 patents. Two patients had endoscopy-related perforation. The chief complaint was abdominal pain in all cases. All patients underwent emergency surgery. Two patients had Stage Ⅱ cancer, 3 had Stage Ⅳ. The mean ICU stay was 2.8 days. The average postoperative hospital stay was 71.8 days. Three patients were discharged home and 2 were transferred to other hospitals. The 3 patients who were discharged home received chemotherapy. Perforation of the cancer site is a risk factor for recurrence, and early recovery and additional treatment should be considered.
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Iijima K, Ikenaga M, Takeyama H, Suzuki Y, Tomita N, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Dono K. [A Case Report of the Ascending Colon Cancer with Bullous Pemphigoid]. Gan To Kagaku Ryoho 2023; 50:1589-1591. [PMID: 38303351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The patient was a 70-year-old man. The patient had progressive anemia while taking 10 mg/day of prednisolone and 100 mg/day of mizoribine orally for bullous pemphigoid, a colonoscopy diagnosed ascending colon cancer. Adenocarcinoma, Group 5 was detected on biopsy. Abdominal computed tomography showed no metastases. The tumor was diagnosed as ascending colon cancer, cT4aN0M0, cStage Ⅱb. We performed laparoscopic right hemicolectomy and D3 dissection. Histopathological examination revealed pT3N0M0, pStage Ⅱa. In the present report, we describe a case of the ascending colon cancer with bullous pemphigoid, and discuss the case with a review of the literature.
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Affiliation(s)
- Ken Iijima
- Dept. of Surgery, Toyonaka Municipal Hospital
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Nakamura I, Hatano E, Baba H, Kamei K, Wada H, Shimizu J, Kanai M, Yoshimura K, Nagano H, Ioka T. Impact of conversion surgery after chemotherapy in patients with initially unresectable and recurrent biliary tract cancer. Ann Gastroenterol Surg 2023; 7:1009-1020. [PMID: 37927929 PMCID: PMC10623972 DOI: 10.1002/ags3.12713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose Gemcitabine, cisplatin, and S-1 chemotherapy was superior to gemcitabine and cisplatin chemotherapy for progression-free survival and overall survival for unresectable and recurrent biliary tract cancer in a randomized phase III trial (KHBO1401). This study aimed to evaluate the outcome of conversion surgery after chemotherapy in biliary tract cancer patients (ancillary study, KHBO1401-3C). Methods A total of 246 patients were enrolled in KHBO1401. We compared progression-free and overall survivals between the conversion surgery and non-conversion surgery groups. Results Eight patients (3.3%) underwent conversion surgery with chemotherapy, seven of whom were diagnosed with unresectable disease and one with recurrence. Six and two patients received gemcitabine, cisplatin, and S-1 chemotherapy as well as gemcitabine and cisplatin chemotherapy, respectively. Three patients in the conversion surgery group who received gemcitabine, cisplatin, and S-1 chemotherapy showed no disease progression and survived without postoperative chemotherapy. Preoperative carbohydrate antigen 19-9 (CA19-9) level was a prognostic factor for conversion surgery. After correcting for immortal time bias, 1-year progression-free survival rates in the conversion surgery and non-conversion surgery groups were 50.0% and 19.0%, respectively (hazard ratio 0.343, 95% confidence interval 0.286-0.843, p = 0.0092). One-year overall survival rates in the conversion surgery and non-conversion surgery groups were 87.5% and 56.0%, respectively (hazard ratio 0.222, 95% confidence interval 0.226-0.877, p = 0.0197). Conclusions Conversion surgery might be an option for the treatment of unresectable and recurrent biliary tract cancer in patients with normal preoperative CA19-9 level.
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Affiliation(s)
- Ikuo Nakamura
- Department of Gastroenterological SurgeryHyogo Medical UniversityHyogoJapan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical ScienceKumamoto UniversityKumamotoJapan
| | - Keiko Kamei
- Department of SurgeryKindai University Faculty of MedicineOsakasayamaJapan
| | - Hiroshi Wada
- Department of Gastroenterological SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Junzo Shimizu
- Department of SurgeryToyonaka Municipal HospitalToyonakaJapan
| | - Masashi Kanai
- Department of Clinical Oncology and Pharmacogenomics, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Kenichi Yoshimura
- Center for Integrated Medical ResearchHiroshima UniversityHiroshimaJapan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Graduate School of MedicineYamaguchi UniversityYamaguchiJapan
| | - Tatsuya Ioka
- Oncology CenterYamaguchi University HospitalUbeJapan
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Yanagimoto Y, Imamura H, Adachi S, Odagiri K, Kawase T, Yamashita M, Takeyama H, Suzuki Y, Ikenaga M, Shimizu J, Tomita N, Dono K. The effect of specimen processing time on HER2 expression in gastric cancer and esophagogastric junction cancer: a single-center retrospective observational study. BMC Cancer 2023; 23:645. [PMID: 37434116 DOI: 10.1186/s12885-023-11148-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/04/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Recent developments in the field of companion diagnosis and molecular-targeting therapeutic agents have helped in developing treatments targeting human epidermal growth factor receptor 2 (HER2) in gastric cancer (GC) and esophagogastric junction cancer (EGJC), and the importance of accurate diagnosis of HER2 expression is increasing. However, the HER2-positivity rate significantly differs among reports in GC and EGJC, and factors that affect HER2-positivity require elucidation. METHODS The present study retrospectively examined factors related to HER2-positivity in a single institution, including age, sex, body mass index, the American Society of Anesthesiologists physical status, tumor information, and surgery information, including time to specimen processing. RESULTS Our study included 165 patients tested for HER2 using GC and EGJC surgery specimens among the 1,320 patients who underwent gastrectomy from January 2007 to June 2022. In total, 35 (21.2%) and 130 (78.8%) patients were HER2-positive and -negative, respectively. Multivariate analysis revealed that intestinal type (odds ratio [OR]: 3.41, 95% confidence interval [CI]: 1.44-8.09, p = 0.005), pM1 (OR: 3.99, 95% CI: 1.51-10.55, p = 0.005), and time to specimen processing of < 120 min (OR: 2.65, 95% CI: 1.01-6.98, p = 0.049) were independent factors that affected HER2-positivity. CONCLUSIONS The outcomes of the present study indicated that intestinal type, pM, and time to specimen processing are important factors affecting HER2-positive rates in GC and EGJC. Therefore, the risk of false-negative HER2 results may be reduced by decreasing the time required to process the resected specimen. Additionally, accurate diagnosis of HER2 expression may increase the opportunity to administer molecular-targeted drugs that can expect therapeutic effects to patients appropriately. TRAIL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Yoshitomo Yanagimoto
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan.
| | - Hiroshi Imamura
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Shiro Adachi
- Department Diagnostic Pathology, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Kazuki Odagiri
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Tomono Kawase
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Masafumi Yamashita
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Hiroshi Takeyama
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Masakazu Ikenaga
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Naohiro Tomita
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
| | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shimahara-Cho, Toyonaka, Osaka, 560-8565, Japan
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Ioka T, Kanai M, Kobayashi S, Sakai D, Eguchi H, Baba H, Seo S, Taketomi A, Takayama T, Yamaue H, Takahashi M, Sho M, Kamei K, Fujimoto J, Toyoda M, Shimizu J, Goto T, Shindo Y, Yoshimura K, Hatano E, Nagano H. Randomized phase III study of gemcitabine, cisplatin plus S-1 versus gemcitabine, cisplatin for advanced biliary tract cancer (KHBO1401- MITSUBA). J Hepatobiliary Pancreat Sci 2023; 30:102-110. [PMID: 35900311 PMCID: PMC10086809 DOI: 10.1002/jhbp.1219] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Gemcitabine/cisplatin (GC) combination therapy has been the standard palliative chemotherapy for patients with advanced biliary tract cancer (BTC). No randomized clinical trials have been able to demonstrate the survival benefit over GC during the past decade. In our previous phase II trial, adding S-1 to GC (GCS) showed promising efficacy and we aimed to determine whether GCS could improve overall survival compared with GC for patients with advanced BTC. METHODS We performed a mulitcenter, randomized phase III trial across 39 centers. Enrolled patients were randomly allocated (1:1) to either the GCS or GC arm. The GCS regimen comprised gemcitabine (1000 mg/m2 ) and cisplatin (25 mg/m2 ) infusion on day 1 and 80 mg/m2 of S-1 on days 1-7 every 2 weeks. The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS), response rate (RR), and adverse events (AEs). This study is registered with Clinical trial identification: NCT02182778. RESULTS Between July 2014 and February 2016, 246 patients were enrolled. The median OS and 1-year OS rate were 13.5 months and 59.4% in the GCS arm and 12.6 months and 53.7% in the GC arm, respectively (hazard ratio [HR] 0.79, 90% confidence interval [CI]: 0.628-0.996; P = .046 [stratified log-rank test]). Median PFS was 7.4 months in the GCS arm and 5.5 months in the GC arm (HR 0.75, 95% CI: 0.577-0.970; P = .015). RR was 41.5% in the GCS arm and 15.0% in the GC arm. Grade 3 or worse AEs did not show significant differences between the two arms. CONCLUSIONS GCS is the first regimen which demonstrated survival benefits as well as higher RR over GC in a randomized phase III trial and could be the new first-line standard chemotherapy for advanced BTC. To exploit the advantage of its high RR, GCS is now tested in the neoadjuvant setting in a randomized phase III trial for potentially resectable BTC.
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Affiliation(s)
- Tatsuya Ioka
- Department of Oncology Center, Yamaguchi University Hospital, Yamaguchi, Japan.,Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masashi Kanai
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Sakai
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University, Osaka, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Satoru Seo
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Tadatoshi Takayama
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Nara, Japan
| | - Keiko Kamei
- Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Jiro Fujimoto
- Department of Gastroenterological Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Masanori Toyoda
- Department of Medical Oncology/Hematology, Kobe University Hospital and Graduate School of Medicine, Hyogo, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Takuma Goto
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Hokkaido, Japan
| | - Yoshitaro Shindo
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kenichi Yoshimura
- Medical Center for Clinical and Translational Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
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23
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Suzuki Y, Ikenaga M, Takeyama H, Noura S, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, Tomita N, Dono K. [A Case of Peritoneal Recurrence from Ascending Colon Cancer Successfully Treated with Laparoscopic Concomitant Right Seminal Vesiculectomy in Low Anterior Resection]. Gan To Kagaku Ryoho 2022; 49:1503-1505. [PMID: 36733116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 60s male, who had laparoscopic ileocecal resection for ascending colon cancer 2 years ago, had enhanced computed tomography(CT)for follow-up and a 12-mm nodule in Douglas' pouch adjacent to right seminal vesicle and rectum was found. 18F-fluorodeoxyglucose(FDG)-positron emission tomography CT revealed abnormal accumulation of 18F-FDG only to the lesion(standardized uptake value max 2.60)and the diagnosis of peritoneal recurrence of ascending colon cancer was made. We planned and safely performed laparoscopic concomitant right seminal vesiculectomy in low anterior resection. The pathological diagnosis was peritoneal dissemination of colon cancer and the margin was pathologically negative. The postoperative course was smooth except for temporary dysuria and he was discharged on postoperative day 17. As of writing 1 year after surgery, the patient continues to do well with no sign of recurrence. Laparoscopic concomitant seminal vesiculectomy in low anterior resection can be a good option for the curative resection of peritoneal recurrence.
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Affiliation(s)
- Yozo Suzuki
- Dept. of Surgery, Toyonaka Municipal Hospital
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24
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Hasegawa N, Takeyama H, Suzuki Y, Noura S, Ikenaga M, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, Dono K. Robot-assisted laparoscopic surgery with a fluorescent near-infrared ray ureteral catheter for a rectal cancer patient with pelvic kidney: A case report. Asian J Endosc Surg 2022; 16:279-283. [PMID: 36250771 DOI: 10.1111/ases.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 11/28/2022]
Abstract
An 85-year-old woman presented with a stomachache after a meal and was admitted to the previous clinic. Multi-detector computed tomography (CT) of the abdomen showed wall thickening in the rectum and right ectopic pelvic kidney. Colonoscopy revealed a mass at the rectum, and a biopsy showed adenocarcinoma. CT showed no lymphadenopathy or distant metastasis. Hartmann's procedure with fluorescent near-infrared ray ureteral catheters was used to avoid causing urinary injury. Robotic surgery was performed while checking the route of the ureter in near-infrared mode. The patient was discharged on postoperative day 14 without specific complications. This case appears to be the first of robot-assisted laparoscopic surgery for a rectal cancer patient with pelvic kidney.
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Affiliation(s)
- Noboru Hasegawa
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Hiroshi Takeyama
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Shingo Noura
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Masakazu Ikenaga
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Kazuki Odagiri
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | | | | | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Tomono Kawase
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Hiroshi Imamura
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Takashi Iwazawa
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Naohiro Tomita
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
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25
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Utsumi M, Yamada T, Yamabe K, Katsura Y, Fukuchi N, Fukunaga H, Tanemura M, Shimizu J, Kagawa Y, Kobayashi S, Takahashi H, Tanaka K, Mizushima T, Eguchi H, Nakayama N, Makimoto K, Doki Y. Differences in risk factors for surgical site infection between laparotomy and laparoscopy in gastrointestinal surgery. PLoS One 2022; 17:e0274887. [PMID: 36121818 PMCID: PMC9484690 DOI: 10.1371/journal.pone.0274887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Extensive gastrointestinal surgery surveillance data in Japan were analyzed to examine the differences in the risk factors for surgical site infection (SSI) between laparotomy and laparoscopic abdominal procedures. Surgical procedures investigated in the study were gastrectomy, cholecystectomy, colectomy, rectal resection, and appendectomy. A total of 32,629 patients were included in the study. The study participants were divided into two groups according to the year of surgery, 2003–2009 (first study period) and 2010–2015 (second study period), due to the increase in the number of laparoscopic surgeries in the second study period. The incidence of SSI was stratified by three SSI classifications (superficial incisional, deep incisional, and organ/space SSI). Multiple logistic regression analysis was performed to predict the risk factors for SSI. The percentage of laparoscopic surgeries performed has increased linearly since 2010. Patients in the second study period were significantly older and had a higher prevalence of SSI risk factors compared with those in the first study period. In addition, the predictive factors changed substantially in most surgical procedures between the two study periods. Wound class ≥ 3 was a ubiquitous risk factor for superficial incisional SSI (SI-SSI) and organ/space SSI (OS-SSI) in both open (laparotomy) and laparoscopic procedures in the first study period. Meanwhile, in the second study period, operative duration was a ubiquitous risk factor in both procedures. The risk factors for SI-SSI differed from those for OS-SSI in the five abdominal surgeries investigated in the study. Periodic examination of risk factors for SSI is recommended in an aging society.
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Affiliation(s)
- Momoe Utsumi
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
- * E-mail:
| | - Terumasa Yamada
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Higashiosaka City, Osaka, Japan
| | - Kazuo Yamabe
- Department of Surgery, Kinan Hospital, Tnabe City, Osaka, Japan
| | - Yoshiteru Katsura
- Department of Surgery, Kansai Rosai Hospital, Amagasaki City, Hyogo, Japan
| | - Nariaki Fukuchi
- Department of Surgery, Suita Municipal Hospital, Suita City, Osaka, Japan
| | - Hiroki Fukunaga
- Department of Surgery, Itami City Hospital, Itami City, Hyogo, Japan
| | - Masahiro Tanemura
- Department of Surgery, Rinku General Medical Center, Izumisano City, Osaka, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka City, Osaka, Japan
| | - Yoshinori Kagawa
- Department of Gastroenterological Surgery, Osaka General Medical Center, Osaka City, Osaka, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Koji Tanaka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | | | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Nana Nakayama
- Department of Nursing, Kyoto University Hospital, Kyoto City, Kyoto, Japan
| | - Kiyoko Makimoto
- Emeritus Professor, Osaka University, Suita City, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
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26
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Tamiya M, Goto Y, Kenmotsu H, Kurata T, Murakami S, Yanagitani N, Taniguchi H, Kuyama S, Shimizu J, Yokoyama T, Shimada N, T. M, Tamiya A, Uchiyama A, Imaizumi K, Takahama T, Nishio M, Hayashi H, Shiraiwa N, Okura M, Kikkawa H, Thomaidou D, Kato T. EP08.02-115 A Retrospective, Multicenter, Observational Study to Evaluate Outcomes With Lorlatinib After Alectinib in ALK+ NSCLC in Japan. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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27
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Tomihara H, Tomimaru Y, Hashimoto K, Fukuchi N, Yokoyama S, Mori T, Tanemura M, Sakai K, Takeda Y, Tsujie M, Yamada T, Miyamoto A, Hashimoto Y, Hatano H, Shimizu J, Sugimoto K, Kashiwazaki M, Matsumoto K, Kobayashi S, Doki Y, Eguchi H. Preoperative risk score to predict subtotal cholecystectomy after gallbladder drainage for acute cholecystitis: Secondary analysis of data from a multi-institutional retrospective study (CSGO-HBP-017B). Asian J Endosc Surg 2022; 15:555-562. [PMID: 35302288 DOI: 10.1111/ases.13051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Subtotal cholecystectomy (STC) has become recognized as a "bailout procedure" to prevent bile duct injury in patients undergoing laparoscopic cholecystectomy (LC). Predictors of conversion to STC have not been identified because LC difficulty varies based on pericholecystic inflammation. We analyzed data from patients enrolled in a previously performed multi-institutional retrospective study of the optimal timing of LC after gallbladder drainage for acute cholecystitis (AC). These patients presumably had a considerable degree of pericholecystic inflammation. METHODS In total, 347 patients who underwent LC after gallbladder drainage for AC were analyzed to examine preoperative and perioperative factors predicting conversion to STC. RESULTS Three hundred patients underwent total cholecystectomy (TC) and 47 underwent conversion to STC. Eastern Cooperative Oncology Group Performance Status (ECOG PS) (P < .01), severity of cholecystitis (P = .04), previous history of treatment for common bile duct stones (CBDS) (P < .01), and surgeon experience (P = .03) were significantly associated with conversion to STC. Logistic regression analyses showed that ECOG PS (odds ratio 0.2; P < .0001) and previous history of treatment for CBDS (odds ratio 0.37; P = .0073) were independent predictors of conversion to STC. Our predictive risk score using these two variables suggested that a score ≥2 could discriminate between TC and STC (P < .0001). CONCLUSION Poor ECOG PS and previous history of treatment for CBDS were significantly associated with conversion to STC after gallbladder drainage for AC.
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Affiliation(s)
- Hideo Tomihara
- Department of Surgery, Faculty of Medicine, Nara Hospital, Kindai University, Ikoma, Japan.,Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan
| | - Yoshito Tomimaru
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kazuhiko Hashimoto
- Department of Surgery, Faculty of Medicine, Nara Hospital, Kindai University, Ikoma, Japan.,Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan
| | - Nariaki Fukuchi
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | - Shigekazu Yokoyama
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
| | - Takuji Mori
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Tane General Hospital, Osaka, Japan
| | - Masahiro Tanemura
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Osaka Police Hospital, Osaka, Japan.,Department of Surgery, Rinku General Medical Center, Osaka, Japan
| | - Kenji Sakai
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Japan Community Health Care Organization, Osaka Hospital, Osaka, Japan
| | - Yutaka Takeda
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Masanori Tsujie
- Department of Surgery, Faculty of Medicine, Nara Hospital, Kindai University, Ikoma, Japan.,Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Terumasa Yamada
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Higashiosaka City Medical Center, Higashiosaka, Japan
| | - Atsushi Miyamoto
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.,Department of Surgery, Sakai City Medical Center, Sakai, Japan
| | - Yasuji Hashimoto
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Yao Municipal Hospital, Yao, Japan
| | - Hisanori Hatano
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Osaka Police Hospital, Osaka, Japan.,Department of Surgery, Ashiya Municipal Hospital, Ashiya, Japan
| | - Junzo Shimizu
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.,Department of Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Keishi Sugimoto
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Minoh City Hospital, Minoh, Japan.,Department of Surgery, Kawanishi City Hospital, Kawanishi, Japan
| | - Masaki Kashiwazaki
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Surgery, Osaka General Medical Center, Osaka, Japan.,Department of Surgery, Otemae Hospital, Osaka, Japan
| | - Kenichi Matsumoto
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Shogo Kobayashi
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuichiro Doki
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidetoshi Eguchi
- Hepato-Biliary-Pancreatic Group, Clinical Study Group of Osaka University, Osaka, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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28
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Kishikawa S, Hayashi T, Shimizu J, Fuwa B, Nonomura A, Saito T, Yatabe Y, Yao T. Low-grade tracheal adenocarcinoma with ETV6::NTRK3 fusion: unique morphology akin to subsets of sinonasal low-grade non-intestinal-type adenocarcinoma. Virchows Arch 2022; 481:793-797. [PMID: 35670854 DOI: 10.1007/s00428-022-03353-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/21/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
The prevalence of NTRK fusions in non-small cell carcinoma (NSCLC) is only approximately 0.2%, most of which harbor NTRK1 fusions. NSCLCs with NTRK3 fusions are extremely rare. Herein, we report a case of low-grade tracheal adenocarcinoma in a 64-year-old woman. Histologically, areas of complicated tubule-papillary or cribriform patterns constituted a major component of the tumor and comprised cuboidal to columnar epithelial tumor cells with pale eosinophilic cytoplasm and cytoplasmic mucin, similar to subsets of sinonasal low-grade non-intestinal-type adenocarcinomas. Immunohistochemically, the tumor was positive for MUC5AC and MUC4 and showed nuclear expression of the pan-Trk antibody. ETV6::NTRK3 was identified by reverse transcription-polymerase chain reaction using formalin-fixed paraffin-embedded tissues. To the best of our knowledge, this is the first case of low-grade tracheal adenocarcinoma with ETV6::NTRK3 fusion. Our case illustrates that low-grade adenocarcinomas with ETV6::NTRK3 fusion may exist throughout the respiratory tract.
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Affiliation(s)
- Satsuki Kishikawa
- Department of Human Pathology, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takuo Hayashi
- Department of Human Pathology, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Junzo Shimizu
- Department of Chest Surgery, Hokuriku Central Hospital, Oyabe, Toyama, 932-8503, Japan
| | - Bungo Fuwa
- Department of Pathology, Hokuriku Central Hospital, Oyabe, Toyama, 932-8503, Japan
| | - Akitaka Nonomura
- Department of Pathology, Hokuriku Central Hospital, Oyabe, Toyama, 932-8503, Japan
| | - Tsuyoshi Saito
- Department of Human Pathology, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takashi Yao
- Department of Human Pathology, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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29
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Takeyama H, Noura S, Suzuki Y, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, Dono K. Higher Body Mass Index Is a Simple Favorable Non-cancer Prognostic Marker for Japanese Elderly Colorectal Cancer Patients after Curative Resection. J Anus Rectum Colon 2022; 6:134-142. [PMID: 35572483 PMCID: PMC9045859 DOI: 10.23922/jarc.2021-056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: In elderly colorectal cancer (CRC) patients, preoperative surgical indications can be controversial in some cases depending on the patient's physical condition. In comparison with younger patients, both cancer-specific survival (CSS) and non-CCS (NCSS) have an impact on the prognosis and both CSS and NCSS should be considered in the preoperative assessment. We aimed to investigate the impact of body mass index (BMI) on CSS and NCSS in Japanese elderly CRC patients. Methods: We retrospectively collected data from 471 Japanese elderly patients (≥80 years) with stage I-III CRC who underwent curative surgery from 1998 to 2017. A Kaplan-Meier survival analysis with propensity score matching (PSM) and a multivariate Cox regression analysis were performed. Results: After PSM, 123 higher BMI (≥23) and 123 lower BMI (<23) cases were matched. The higher BMI group had significantly better survival than the lower BMI group regarding NCSS and overall survival (OS; P < .001 and P < .001, respectively). The multivariate survival analysis further confirmed that the higher BMI group had significantly better survival than the lower BMI group regarding CSS, NCSS, and OS (P = .027, P < .001, and P < .001, respectively). Conclusions: In Japanese elderly patients with stage I-III CRC who underwent curative surgery, preoperative higher BMI was a significant and simple favorable prognostic predictor, especially for NCSS and OS.
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Affiliation(s)
| | - Shingo Noura
- Department of Surgery, Toyonaka Municipal Hospital
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital
| | | | | | | | | | | | | | | | | | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital
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30
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Fujimoto N, Odagiri K, Yanagimoto Y, Noguchi K, Takeyama H, Suzuki Y, Noura S, Shimizu J, Kawase T, Imamura H, Dono K. [A Case of Improvement by SOX Therapy for DIC Caused by Gastric Cancer]. Gan To Kagaku Ryoho 2021; 48:1892-1894. [PMID: 35045438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Disseminated intravascular coagulation(DIC)has a poor prognosis in gastric cancer. The patient was a 78-year-old man. He had been diagnosed with Stage Ⅳ gastric cancer. Before chemotherapy, thrombocytopenia and elevated D-dimer occurred, and we diagnosed DIC. We started SOX therapy to treat gastric cancer with DIC. DIC improved on the 10th day after the onset of DIC. But developed DIC again on the 21st day. We started SOX therapy again. However, the DIC did not improve. The patient died 32 days after the initial DIC. Oxaliplatin regimen may be a potential treatment for DIC.
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31
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Hasegawa N, Takeyama H, Suzuki Y, Noura S, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, Dono K. Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report. Surg Case Rep 2021; 7:213. [PMID: 34546429 PMCID: PMC8455758 DOI: 10.1186/s40792-021-01292-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Paraduodenal hernia is a rare internal hernia which accounts for only 1% of all intestinal hernias. There have been limited reported cases of paraduodenal hernia treated by laparoscopic surgery. We report a case of left paraduodenal hernia that was successfully treated by single-incision laparoscopic surgery (SILS). Case presentation A 17-year-old woman presented with left upper abdominal pain. An abdominal enhanced multi-detector computed tomography demonstrated encapsulated cluster of small bowel loops in the left upper quadrant which passed through the dorsal side of the inferior mesenteric vein, and showed that blood flow of the prolapsed small bowel was preserved. We preoperatively diagnosed left paraduodenal hernia without ischemia or necrosis. We performed elective SILS because she was a young actress training school student and cosmetic benefit was thought to be important. We pulled out the protruded small bowel and closed a defect with a running suture by SILS. The patient was discharged 3 days after the surgery with no complications. Conclusions We reported the case of left paraduodenal hernia successfully diagnosed and treated by SILS.
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Affiliation(s)
- Noboru Hasegawa
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Hiroshi Takeyama
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan.
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Shingo Noura
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Kazuki Odagiri
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Yoshitomo Yanagimoto
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Masafumi Yamashita
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Tomono Kawase
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Hiroshi Imamura
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Takashi Iwazawa
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Naohiro Tomita
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
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Yamada D, Kobayashi S, Takahashi H, Akita H, Yamada T, Asaoka T, Shimizu J, Takeda Y, Yokoyama S, Tsujie M, Tomokuni A, Tanemura M, Morimoto O, Murakami M, Kim Y, Nakahira S, Hama N, Sugimoto K, Hashimoto K, Doki Y, Eguchi H. Randomized phase II study of gemcitabine and S-1 combination therapy versus gemcitabine and nanoparticle albumin-bound paclitaxel combination therapy as neoadjuvant chemotherapy for resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC-GS/GA-rP2, CSGO-HBP-015). Trials 2021; 22:568. [PMID: 34446057 PMCID: PMC8394677 DOI: 10.1186/s13063-021-05541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease, and multimodal strategies, such as surgery plus neoadjuvant chemotherapy (NAC)/adjuvant chemotherapy, have been attempted to improve survival in patients with localized PDAC. To date, there is one prospective study providing evidence for the superiority of a neoadjuvant strategy over upfront surgery for localized PDAC. However, which NAC regimen is optimal remains unclear. METHODS A randomized, exploratory trial is performed to examine the clinical benefits of two chemotherapy regimens, gemcitabine plus S-1 (GS) and gemcitabine plus nab-paclitaxel (GA), as NAC for patients with planned PDAC resection. Patients are enrolled after the diagnosis of resectable or borderline resectable PDAC. They are randomly assigned to either NAC regimen. Adjuvant chemotherapy after curative resection is highly recommended for 6 months in both arms. The primary endpoint is tumor progression-free survival time, and secondary endpoints include the rate of curative resection, the completion rate of protocol therapy, the recurrence type, the overall survival time, and safety. The target sample size is set as at least 100. DISCUSSION This study is the first randomized phase II study comparing GS combination therapy with GA combination therapy as NAC for localized pancreatic cancer. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000021484 . This trial began in April 2016.
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Affiliation(s)
- Daisaku Yamada
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2-E2, Suita, Osaka, 565-0871, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2-E2, Suita, Osaka, 565-0871, Japan
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hirofumi Akita
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2-E2, Suita, Osaka, 565-0871, Japan
| | - Terumasa Yamada
- Department of Surgery, Higashiosaka City Medical Center, Higashiōsaka, Japan
| | - Tadafumi Asaoka
- Department of Gastroenterological Surgery, Osaka Police Hospital, Osaka, Japan
| | - Junzo Shimizu
- Department of Gastroenterological Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Yutaka Takeda
- Department of Gastroenterological Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Shigekazu Yokoyama
- Department of Gastroenterological Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
| | - Masanori Tsujie
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Akira Tomokuni
- Department of Gastroenterological Surgery, Osaka General Medical Center, Osaka, Japan
| | - Masahiro Tanemura
- Department of Gastroenterological Surgery, Rinku General Medical Center, Izumisano, Japan
| | - Osakuni Morimoto
- Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - Masahiro Murakami
- Department of Gastroenterological Surgery, Itami City Hospital, Itami, Japan
| | - Yongkook Kim
- Department of Surgery, Kaizuka City Hospital, Kaizuka, Japan
| | - Shin Nakahira
- Department of Surgery, Sakai City Medical Center, Sakai, Japan
| | - Naoki Hama
- Department of Surgery, Ikeda City Hospital, Ikeda, Japan
| | | | | | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2-E2, Suita, Osaka, 565-0871, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2-E2, Suita, Osaka, 565-0871, Japan.
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33
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Takaichi S, Tomimaru Y, Kobayashi S, Takeda Y, Nakahira S, Tsujie M, Yukawa M, Shimizu J, Murakami M, Miyamoto A, Asaoka T, Sakai K, Morimoto O, Tori M, Yamamoto T, Fukuchi N, Nagano H, Doki Y, Eguchi H. Drainage after laparoscopic liver surgery in the CSGO-HBP-004 study: propensity score-matched analysis. Br J Surg 2021; 108:e57-e58. [PMID: 33711105 DOI: 10.1093/bjs/znaa018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Affiliation(s)
- S Takaichi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Tomimaru
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - S Kobayashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Takeda
- Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - S Nakahira
- Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan.,Department of Surgery, Sakai City Medical Center, Sakai, Japan
| | - M Tsujie
- Department of Surgery, Kindai University Nara Hospital, Ikoma, Japan.,Department of Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - M Yukawa
- Department of Surgery, Kindai University Nara Hospital, Ikoma, Japan
| | - J Shimizu
- Department of Surgery, Osaka Rosai Hospital, Sakai, Japan.,Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - M Murakami
- Department of Surgery, Osaka Rosai Hospital, Sakai, Japan.,Department of Surgery, Itami City Hospital, Itami, Japan
| | - A Miyamoto
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - T Asaoka
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Surgery, Osaka Police Hospital, Osaka, Japan
| | - K Sakai
- Department of Surgery, Japan Community Health Care Organization, Osaka Hospital, Osaka, Japan
| | - O Morimoto
- Department of Surgery, Ikeda City Hospital, Ikeda, Japan
| | - M Tori
- Department of Surgery, Osaka Police Hospital, Osaka, Japan
| | - T Yamamoto
- Department of Surgery, Sakai City Medical Center, Sakai, Japan.,Tamesan Clinic, Toyonaka, Japan
| | - N Fukuchi
- Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | - H Nagano
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Y Doki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - H Eguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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34
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Suzuki Y, Tanida T, Noura S, Yanagimoto Y, Noguchi K, Hirota M, Oshima K, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, Dono K. [A Case of Anastomotic Recurrent Descending Colon Cancer Successfully Treated with Single-Incision Laparoscopic Partial Colectomy with Intracorporeal Anastomosis]. Gan To Kagaku Ryoho 2021; 48:245-247. [PMID: 33597370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 60s-year-old male, who had laparoscopic partial colectomy with resection of left colic artery for descending colon cancer 8 years ago and completed 5-year-follow-up without the evidence of recurrence, was diagnosed as anastomotic recurrence of descending colon cancer, and referred to our hospital. We planned and safely performed single-incision laparoscopic colectomy(SILC)with intracorporeal anastomosis(ICA)(operation time of 390 min and estimated blood loss of 60 g). Following the adhesiolysis, the intracorporeal resection of the lesion was performed with automatic stapling device preserving middle colic and inferior mesenteric arteries and veins. Then, after the recovery of the specimen, ICA was performed as follows; after making a small hole just below the staple line at the opposite side of mesenteric attachment, the oral and the anal stump of colon was pulled-up and placed side-by-side with temporary strings and automatic suturing device was inserted into the holes and fired to form a side-to-side anastomosis, then the common stab incision was pulled- up with 3 temporary strings and closed with a stapler. The postoperative course was smooth and discharged on postoperative day 8. The ICA can be a good option for SILC when colonic and vascular tension would be the limiting factor of anastomosis.
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Affiliation(s)
- Yozo Suzuki
- Dept. of Surgery, Toyonaka Municipal Hospital
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35
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Tanida T, Noura S, Yanagimoto Y, Noguchi K, Hirota M, Oshima K, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, Dono K. [A Case of Locally Advanced Rectal Cancer with Multiple Liver Metastases Could Be Resected after Triplet Chemotherapy]. Gan To Kagaku Ryoho 2021; 48:127-129. [PMID: 33468743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The patient was a 60's man, whose chief complaints were melena and weight loss. He visited our hospital, and further evaluation revealed rectal cancer(Ra)invading the abdominal wall with multiple liver metastases. The clinical diagnosis was cT4b(abdominal wall)N2bM1a(H1), cStage Ⅳ. We performed a transverse colostomy on the day prior to chemotherapy administration. He was administered 8 courses of FOLFOXIRI plus bevacizumab. After the chemotherapy, the primary tumor and liver metastases showed PR, with a diagnosis of ycT3N1bM1a(H1), Stage Ⅳ. We performed a robot-assisted laparoscopic low anterior resection for the primary tumor. Two months later, the partial resection of liver S6 and S8 was performed. The patient has been cancer-free for 6 months now.
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Affiliation(s)
- Tsukasa Tanida
- Dept. of Gastroenterological Surgery, Higashiosaka City Medical Center
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36
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Shimizu J, Moriya M, Kamesui T, Miyamoto S, Nagayoshi T, Nonomura A, Arano Y. A case of thyroid carcinoma with cervical and mediastinal lymph node metastases that required mediastinal lymph node dissection via median sternotomy. Chirurgia (Bucur) 2020. [DOI: 10.23736/s0394-9508.19.05045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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37
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Tezuka T, Higuchi R, Hagiya K, Saji M, Takamisawa I, Shimizu J, Iguchi N, Takanashi S, Doi S, Okazaki S, Sato K, Tamura H, Takayama M. The effect of underweight on mid-term outcome following transcatheter aortic valve implantation: an insight from multicenter registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Obesity has the adverse prognostic impact in the general population, whereas paradoxical effect of obesity has been reported in patients with heart failure. Several studies have suggested the same obesity paradox in patients undergoing transcatheter aortic valve implantation (TAVI), however, they included limited number of underweight patients.
Purpose
The aim of this study was to clarify the effect of underweight on outcome following TAVI.
Methods
We retrospectively analyzed consecutive 1,027 patients undergoing TAVI between April 2010 and June 2019. The patients were categorized according to body mass index (BMI) as follows: underweight (<18.5 kg/m2, n=150), normal weight (18.5 to 25 kg/m2, n=657), and overweight (>25 kg/m2, n=220). BMI was defined as body weight (kg) divided by the square of body height (m) measured at the hospital admission. We compared the short- and mid-term outcome after TAVI among three groups, and all clinical events were accordance with Valve Academic Research Consortium-2 criteria.
Results
Underweight patients were more often female, and had a higher prevalence of hypertension, dyslipidemia, peripheral artery disease, anemia, and hypoalbuminemia. They also presented lower ejection fraction, smaller aortic valve area, and higher surgical risk score. In procedural findings, device unsuccess and major vascular complication more occurred in underweight patients, but 30-day mortality was equivalent among three groups. The mid-term survival of the underweight was inferior to the other two groups (figure).In the multivariate analysis, female (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.37–0.73, P=0.0002), atrial fibrillation (HR 2.22, 95% CI 1.56–3.17, P<0.0001), albumin value (HR 0.37 per 1-g/dl increase, 95% CI 0.25–0.55, P<0.0001), Society of Thoracic Surgeons score (HR 1.06 per 1% increase, 95% CI 1.02–1.06, P=0.0039), 30-day combined endpoint (HR 2.12, 95% CI 1.33–3.38, P=0.0017), and underweight (HR 1.59, 95% CI 1.04–2.37, P=0.026) were associated with the survival after TAVI.
Conclusion
The underweight had a worse mid-term prognosis, representing the obesity paradox in the TAVI population.
Kaplan-Meier curves
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Tezuka
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | - R Higuchi
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | - K Hagiya
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | - M Saji
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | | | - J Shimizu
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | - N Iguchi
- Sakakibara heart institute, Fucyu Tokyo, Japan
| | - S Takanashi
- Kawasaki Saiwai Hospital, Cardiovascular Surgery, Kawasaki City, Japan
| | - S Doi
- Juntendo university graduate school of medicine, Cardiovascular Medicine, bunkyo-ku, Japan
| | - S Okazaki
- Juntendo university graduate school of medicine, Cardiovascular Medicine, bunkyo-ku, Japan
| | - K Sato
- Mie university hospital, Cardiology, Tsu, Japan
| | - H Tamura
- Yamagata University, Cardiology, Pulmonology and Nephrology, Yamagata, Japan
| | - M Takayama
- Sakakibara heart institute, Fucyu Tokyo, Japan
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38
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Nishida T, Suzuki N, Ono Y, Shimizu J, Nakamatsu D, Matsumoto K, Yamamoto M. How to make an alternative plastic gown during the personal protective equipment shortage due to the COVID-19 pandemic. Endoscopy 2020; 52:E388-E389. [PMID: 32599625 PMCID: PMC7516357 DOI: 10.1055/a-1197-5949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tsutomu Nishida
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Norihiro Suzuki
- Infection Control Office, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Yuji Ono
- Infection Control Office, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Junzo Shimizu
- Infection Control Office, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan,Department of Surgery, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Dai Nakamatsu
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Kengo Matsumoto
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
| | - Masashi Yamamoto
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka, Japan
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39
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Toi Y, Hayashi H, Fujimoto D, Tachihara M, Furuya N, Otani S, Shimizu J, Katakami N, Azuma K, Miura N, Nishino K, Hara S, Teraoka S, Morita S, Nakagawa K, Yamamoto N. 1259O A randomized phase II study of osimertinib with or without bevacizumab in advanced lung adenocarcinoma patients with EGFR T790M mutation (West Japan Oncology Group 8715L). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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40
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Shimizu J, Akamatsu H, Murakami H, Harada H, Hayashi H, Daga H, Hasegawa Y, Kim Y, Kato T, Tokunaga S, Nishimura Y, Yamamoto N, Nakagawa K. 1236MO A single-arm phase II study of gefitinib with concurrent thoracic radiotherapy in unresectable locally-advanced non-small cell lung cancer patients with EGFR mutation (West Japan Oncology Group 6911L). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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41
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Tomimaru Y, Fukuchi N, Yokoyama S, Mori T, Tanemura M, Sakai K, Takeda Y, Tsujie M, Yamada T, Miyamoto A, Hashimoto Y, Hatano H, Shimizu J, Sugimoto K, Kashiwazaki M, Kobayashi S, Doki Y, Eguchi H. Optimal timing of laparoscopic cholecystectomy after gallbladder drainage for acute cholecystitis: A multi‐institutional retrospective study. J Hepatobiliary Pancreat Sci 2020; 27:451-460. [DOI: 10.1002/jhbp.768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 12/24/2022]
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42
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Machida Y, Kobata T, Yamada S, Nakagawa K, Iguchi M, Toga H, Shimizu J. [Resection of Metastatic Lung Tumor with a Right Displaced Segmental Bronchus (B1+3);Report of a Case]. Kyobu Geka 2020; 73:389-391. [PMID: 32398399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We experienced a resected case of metastatic lung tumor with a right displaced segmental bronchus (B1+3). The patient was an 82-year-old woman who had a history of surgery for transverse colon cancer. A chest computed tomography (CT) scan revealed a nodular shadow with an irregular margin( 3.1 cm in diameter) in the right upper lobe, which was suspected of a primary lung cancer. Chest CT and bronchoscopy revealed B1+3 displaced segmental bronchus. Thoracoscope-assisted right upper lobectomy was performed for diagnostic and therapeutic purposes. The pathological diagnosis was a metastatic lung tumor from the transverse colon cancer.
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Affiliation(s)
- Yuichiro Machida
- Department of Thoracic and Cardiovascular Surgery, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan
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43
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Uchino M, Ikeuchi H, Shimizu J, Ohge H, Haji S, Mizuguchi T, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Sakamoto F, Yoshida M, Mayumi T, Hirata K, Takesue Y. Association between preoperative tumor necrosis factor alpha inhibitor and surgical site infection after surgery for inflammatory bowel disease: a systematic review and meta-analysis. Surg Today 2020; 51:32-43. [PMID: 32277281 DOI: 10.1007/s00595-020-02003-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
Tumor necrosis factor-alpha inhibitor (TNFi) treatment is effective for ulcerative colitis (UC) and Crohn's disease (CD). Although several meta-analyses have been performed to evaluate the association between TNFi treatment and surgical morbidity, the results are controversial. We conducted a systematic review and meta-analysis of the prevention of surgical site infection (SSI) after surgery for UC and CD in patients on TNFis, based on literature published between January 2000 and May 2019 (registered on PROSPERO, No. CRD42019134156). Overall, 2175 UC patients in 13 observational studies (OBSs) and 7084 CD patients in 16 OBSs were included. The incidences of incisional (INC) SSI and organ/space (O/S) SSI after surgery for UC were 179/1985 (9.0%) and 176/2175 (8.1%), respectively. TNFi use was not associated with the incidences of INC SSI (odds ratio (OR) 1.04, 95% confidence interval (CI) (0.47-2.32) or O/S SSI (OR 1.85, 95% CI (0.82-4.20)) after surgery for UC. The INC SSI and O/S SSI incidences after surgery for CD were 289/3089 (9.4%) and 526/7,084 (7.4%), respectively. Preoperative TNFi use was not associated with INC SSI (OR 0.98, 95% CI (0.52-1.83)) or O/S SSI incidence (OR 1.09, 95% CI (0.78-1.52)) after surgery for CD. We did not find a significant association between preoperative TNFi use and SSI in surgery for UC or CD.
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Affiliation(s)
- Motoi Uchino
- Department of Inflammatory Bowel Disease, Hyogo College of Medicine, 1-1, Mukogawacho, Nishinomiya, Hyogo, Japan.
| | - Hiroki Ikeuchi
- Department of Inflammatory Bowel Disease, Hyogo College of Medicine, 1-1, Mukogawacho, Nishinomiya, Hyogo, Japan
| | - Junzo Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Seiji Haji
- Department of Surgery, Takatsuki General Hospital, Osaka, Japan
| | - Toru Mizuguchi
- Department of Nursing, Surgical Science and Technology, Sapporo Medical University, Sapporo, Japan
| | - Yasuhiko Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Mie, Japan
| | - Chizuru Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Yuichi Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsunori Suzuki
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Motomu Kobayashi
- Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama, Japan
| | | | - Fumie Sakamoto
- Infection Control Manager, QI Center, St. Luke's International Hospital, Tokyo, Japan
| | - Masahiro Yoshida
- Hemodialysis and Surgery, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Toshihiko Mayumi
- Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Koichi Hirata
- Department of Surgery, JR Sapporo Hospital, Sapporo, Japan
| | - Yoshio Takesue
- Division of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya, Japan
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Ozato Y, Tei M, Sueda T, Matsumura T, Furukawa H, Koga C, Wakasugi M, Miyagaki H, Kawabata R, Shimizu J, Miwa H, Hasegawa J. [pCR Achievement in Two Cases Treated with XELOXIRI as Neoadjuvant Chemotherapy for Locally Advanced Rectal Cancer]. Gan To Kagaku Ryoho 2020; 47:484-486. [PMID: 32381923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Neoadjuvant chemotherapy is designed to prevent disease recurrence, particularly distant recurrence, and to improve overall patient survival. We present 2 cases where pathological complete response(pCR)was obtained after administering XELOXIRI as neoadjuvant chemotherapy for locally advanced rectal cancer. Case 1: The patient was a 63-year-old man diagnosed with rectal cancer(Ra, cT4aN1M0, cStage Ⅲa)and treated with 6 courses of XELOXIRI as neoadjuvant chemotherapy. After systemic chemotherapy, he underwent laparoscopy-assisted low anterior resection and showed a pCR. Case 2: The patient was a 56-year-old man diagnosed with rectal cancer(Rb, cT3N3M0, cStage Ⅲb)and treated with 6 couses of XELOXIRI as neoadjuvant chemotherapy. After systemic chemotherapy, he underwent low anterior resection and showed a pCR. CONCLUSION We present 2 cases treated with XELOXIRI as neoadjuvant chemotherapy for locally advanced rectal cancer where pCRwas achieved.
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Hasegawa J, Tei M, Matsumura T, Sueda T, Furukawa H, Koga C, Wakasugi M, Miyagaki H, Kawabata R, Oda N, Morishima H, Miwa H, Shimizu J. [A Case of Colon Cancer with Peritoneal Dissemination and Liver Metastasis That Responded to Comprehensive Treatment by Perioperative Chemotherapy and Cytoreductive Surgery]. Gan To Kagaku Ryoho 2020; 47:370-372. [PMID: 32381992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 64-year-old man was referred to our hospital to determine the cause of fecal occult blood. Colonoscopy revealed a type Ⅱtumor located in the ascending colon. Histopathologic analysis of the tumor biopsy specimen revealed moderately differen- tiated, tubular adenocarcinoma with KRAS exon 2(G12V)mutation. FDG-PET/CT revealed high trace accumulation in the S4 of the liver and in multiple sites spread across the abdominal cavity(cT4aN1M1c2[H1, P3], cStage Ⅳc). Chemotherapy using S-1 plus oxaliplatin(SOX)with bevacizumab(Bmab)was administered. After 8 courses of SOX with Bmab, the volume of the ascending colon cancer and liver metastasis reduced, and peritoneal disseminations disappeared. We, therefore, considered that curability B resection was suitable, and performed right hemicolectomy, total omentectomy, and resection of the rectovesical peritoneum. Histopathological examination of surgical specimens revealed extensive fibrosis from the submucosa to subserosal tissue with some tubular adenocarcinoma cells(histological effect: Grade 2). For maintenance therapy, trifluri- dine/tipiracil plus Bmab was administered after cytoreduction. The patient is in remission for 26 months without recurrence. Perioperative chemotherapy and cytoreductive surgery are useful for the treatment of colon cancer with diffuse peritoneal dissemination.
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Shinno N, Kawabata R, Furukawa H, Goda S, Sueda T, Matsumura T, Koga C, Noura S, Shimizu J, Okada A, Hasegawa J. A case of esophagojejunal varices rupture after proximal gastrectomy with double-tract reconstruction. Surg Case Rep 2020; 6:12. [PMID: 31919714 PMCID: PMC6952481 DOI: 10.1186/s40792-020-0775-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The varices after proximal or total gastrectomy are uncommon because the supplying vessels are all divided. Emergent upper gastrointestinal endoscopy is the cornerstone of first-line management for the diagnosis and treatment of esophageal varices. However, there is no widely accepted standard strategy for esophagojejunal varices. We report a patient with esophagojejunal varices rupture 3 months after proximal gastrectomy treated with percutaneous transhepatic obliteration. CASE PRESENTATION A 50-year-old man who had undergone proximal gastrectomy with double-tract reconstruction for esophagogastric junctional cancer 3 months before was admitted to the hospital due to gastrointestinal perforation. We performed emergency surgery and abdominal symptoms and inflammatory response improved postoperative. However, on POD3, he had eruptive bleeding at the just anal side of esophagojejunal anastomosis. Endoscopic clipping was unsuccessful because the mucosa was fragile and easily lacerated. Contrast-enhanced CT scan revealed the dilatation of the jejunal vein flowing into the ascending jejunal limb. Therefore, he was diagnosed as esophagojejunal varices rupture and percutaneous transhepatic obliteration (PTO) was tried for hemostasis. The portal and superior mesenteric veins were catheterized with the percutaneous transhepatic approach. Contrast agent injection into the jejunal branch demonstrated retrograde flow to the azygos vein through esophagojejunal varices. The microcatheter was inserted into the variceal blood supply branch and 10 mL of 5% ethanolamine oleate with iopamidol was injected. After obliteration therapy, the superior mesenteric venogram showed complete occlusion of the variceal supply branch. The patient was discharged from the hospital without any complications after 14 days. CONCLUSION PTO can be effective for gastroesophageal varices rupture with a dilated jejunal vein of the ascending limb, few supplying vessels, and little ascites.
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Affiliation(s)
- Naoki Shinno
- Departments of Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. .,Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan.
| | - Ryohei Kawabata
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Haruna Furukawa
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Seiichi Goda
- Departments of Radiology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Toshinori Sueda
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Tae Matsumura
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Chikato Koga
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Shingo Noura
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan.,Departments of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, 560-8565, Japan
| | - Junzo Shimizu
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan.,Departments of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, 560-8565, Japan
| | - Atsuya Okada
- Departments of Radiology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Junichi Hasegawa
- Departments of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
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47
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Mikuriya K, Koga C, Shimizu J, Tsujie M, Wakasugi M, Makutani Y, Marukawa D, Ozato Y, Furukawa H, Sueda T, Matsumura T, Miyagaki H, Tei M, Kawabata R, Hasegawa J. [A Case of Unresectable Gallbladder Cancer with Relatively Good Prognosis Treated with Upfront Surgery Followed by Systemic Chemotherapy]. Gan To Kagaku Ryoho 2020; 47:168-170. [PMID: 32381894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A female patient in her 60s was diagnosed with advanced gallbladder cancer invading the hilar plate. Exploratory laparoscopic examination showed limited peritoneal dissemination. Despite endoscopic nasobiliary drainage, it was difficult to treat infectious cholangitis. To initiate chemotherapy, it was imperative to control the infection; hence, we chose to perform extended right hepatectomy, extrahepatic bile duct resection, lymph node dissection, and cholangiojejunostomy. We have been able to continue systemic chemotherapy for more than 2 years after surgery, and the patient did not experience infectious cholangitis. She has survived for almost 2 years and 8 months post-diagnosis.
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Furuichi Y, Shimizu J, Higuchi R. P112 Early respiratory changes after transcatheter aortic valve replacement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Sakakibara heart Institute
Introduction
Transcatheter aortic valve replacement (TAVR) is an alternative treatment for inoperative or high-risk patients requiring surgical aortic valve replacement (SAVR). In previous studies, the vital capacity falls to about 50% immediately after SAVR. Although the vital capacity recovers to about 60-70% in one week, it does not recover to preoperative levels at 3 months following SAVR 1)2). TAVR is expected to preserve respiratory function because TAVR does not require a sternotomy.
Purpose
The purpose of this study was to investigate early stage respiratory function after a TAVR. We assumed that respiratory function is not reduced after a TAVR.
Methods
This prospective study was approved by the local ethics committee of our Institute. Written informed consent was obtained from all patients. The subjects were patients who underwent TAVI at our Institute from July 2017 to March 2019. Exclusion criteria included patients who refused to provide informed consent, emergent cases, NYHA (New York Heart Association) Class IV patients, patients receiving inotropes, patients under mechanical ventilation, patients enrolled in other studies, or patients for whom conducting pulmonary function tests were judged to be difficult. The pulmonary function test was conducted once a day until one week after the TAVR procedure.
Results
The target number was 100, and we ceased registration when informed consent was obtained from 100 patients. TAVR was conducted for 142 cases in this period and 42 cases were excluded. After informed consent was obtained, 17 cases were excluded because they met the exclusion criteria, and the analysis was conducted with 83 cases. The vital capacity and % of vital capacity were significantly reduced from the first day to the sixth day and recovered to preoperative levels at the seventh day after TAVR. The forced expiratory volume was significantly reduced from the first day to the fifth day, and recovered to preoperative levels at the sixth day after TAVR. The percentage of forced expiratory volume at one second was not significantly reduced.
Conclusions
The respiratory function was reduced in the early stages after TAVR. The respiratory function was reduced mostly on the first day after TAVR and recovered to preoperative levels on the seventh day after TAVR. After TAVR, the respiratory function recovered earlier than after SAVR. We believe that TAVR is more suitable for patients with reduced respiratory function.
Abstract P112 Figure. respiratory function after TAVR
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Affiliation(s)
- Y Furuichi
- Sakakibara Heart Institute, Department of Anesthesiology, Fuchu Tokyo, Japan
| | - J Shimizu
- Sakakibara Heart Institute, Department of Anesthesiology, Fuchu Tokyo, Japan
| | - R Higuchi
- Sakakibara Heart Institute, Department of Cardiology, Fuchu Tokyo, Japan
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Eguchi H, Takeda Y, Takahashi H, Nakahira S, Kashiwazaki M, Shimizu J, Sakai D, Isohashi F, Nagano H, Mori M, Doki Y. A Prospective, Open-Label, Multicenter Phase 2 Trial of Neoadjuvant Therapy Using Full-Dose Gemcitabine and S-1 Concurrent with Radiation for Resectable Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 2019; 26:4498-4505. [PMID: 31440928 DOI: 10.1245/s10434-019-07735-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Neoadjuvant therapy reportedly shows only marginal clinical benefit in pancreatic ductal adenocarcinoma (PDAC), especially in resectable cases. However, with more effective regimens, neoadjuvant therapy may become a standard of care for resectable cases. A prospective, open-label, multicenter phases 1 and 2 trial of neoadjuvant therapy was conducted using full-dose gemcitabine and S-1 concurrently with 50.4 Gy of radiation therapy (GSRT) for resectable PDAC. This report describes the phase 2 results. METHODS The phase 2 part of this study enrolled 57 patients with cytologically or histologically proven PDAC deemed resectable based on imaging before neoadjuvant therapy. These patients received GSRT. After reevaluation by computed tomography scan, surgical exploration was performed, followed by adjuvant therapy. According to the prescribed protocol of the clinical trial, statistical analyses included 57 phase 2 patients and 6 phase 1 patients who received the same dosage as in phase 2. RESULTS This trial enrolled 63 patients (42 men and 21 women) with a median age of 70 years. Leukopenia or neutropenia of grade 3 or higher occurred for 79% of the patients, but no other severe adverse events were observed. Among the 63 patients, 54 underwent surgical resection. Intention-to-treat analysis of the 63 patients showed an excellent median survival time lasting as long as 55.3 months. The patients who completed neoadjuvant therapy, surgery, and adjuvant therapy had a 5-year survival rate of 56.6%. CONCLUSIONS This regimen showed outstanding clinical efficacy with acceptable tolerability for patients with resectable PDAC.
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Affiliation(s)
- Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan.
| | - Yutaka Takeda
- Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Hidenori Takahashi
- Department of Surgery, Osaka International Cancer Institute, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Shin Nakahira
- Department of Surgery, Sakai City Medical Center, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Masaki Kashiwazaki
- Department of Surgery, Osaka General Medical Center, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Junzo Shimizu
- Department of Surgery, Osaka Rosai Hospital, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Daisuke Sakai
- Department of Frontier Science for Cancer and Chemotherapy, Graduate School of Medicine, Osaka University, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Fumiaki Isohashi
- Department of Radiation Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, Osaka, Japan
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50
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Inoue T, Tei M, Mikuriya K, Makutani Y, Ozato Y, Marukawa D, Furukawa H, Sueda T, Matsumura T, Koga C, Wakasugi M, Miyagaki H, Kawabata R, Shimizu J, Hasegawa J. [A Case of Rectal Cancer with Multiple Liver Metastases Curatively Resected after Systemic Chemotherapy]. Gan To Kagaku Ryoho 2019; 46:2363-2365. [PMID: 32156932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 61-year-old man complainingof bloody stool was diagnosed with advanced rectal cancer with multiple liver metastases (cT3[A]N1M1a[H2], cStage Ⅳ). We introduced bevacizumab combined systemic chemotherapy prior to radical surgery and confirmed tumor shrinkage in both the primary tumor and liver metastases following systemic chemotherapy. We performed laparoscopic lower-anterior resection, and then the patient underwent liver metastases resection. The histologic evaluation was Grade 2. This was a pathologically curative resection, and the patient has been disease-free since the last operation.
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