1
|
Fujinaka R, Urade T, Kido M, Komatsu S, Gon H, Fukushima K, Komatsu M, Yanagimoto H, Toyama H, Fukumoto T. Spontaneous rupture of splenic hilar lymph node metastasis from hepatocellular carcinoma. Clin J Gastroenterol 2024; 17:557-562. [PMID: 38386256 DOI: 10.1007/s12328-024-01928-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
Spontaneous rupture of a primary hepatocellular carcinoma (HCC) is a frequently observed and fatal complication. However, the rupture of lymph node (LN) metastases from HCC is rare. A 79 year-old male with hepatitis B underwent three liver resections for HCC. Two years and 6 months after the last liver resection, enhanced computed tomography (CT) revealed a nodule with a diameter of 3 cm in the lower pole of the spleen. Splenic metastasis of HCC was suspected, and splenectomy was scheduled. During our hospital stay for a urinary tract infection before the scheduled operation, he complained of acute left-sided abdominal pain, and CT showed intra-abdominal hemorrhage due to rupture of the splenic tumor. Emergency splenectomy was performed, and the postoperative course was uneventful. Histopathological examination revealed a poorly differentiated HCC in the lower splenic pole lesion, which contained LN structures. The ruptured lesion was diagnosed as splenic hilar LN metastasis of HCC. Although laparoscopic partial liver resection was performed for intrahepatic recurrence, and atezolizumab plus bevacizumab therapy was administered for peritoneal metastases, the patient was alive 25 months after the splenectomy. Our case suggests that emergency surgery for LN metastatic rupture can achieve hemostasis and lead to improved survival outcomes.
Collapse
Affiliation(s)
- Ryosuke Fujinaka
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takeshi Urade
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Masahiro Kido
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shohei Komatsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidetoshi Gon
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kenji Fukushima
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Masato Komatsu
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Yanagimoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan
| |
Collapse
|
2
|
Koizumi A, Komatsu S, Omiya S, Yano Y, Fujishima Y, Ishida J, Kido M, Gon H, Fukushima K, Urade T, So S, Yoshida T, Arai K, Fujinaka R, Shimura Y, Yanagimoto H, Toyama H, Ueda Y, Kodama Y, Fukumoto T. Current Roles of Ramucirumab in the Sequential Treatment of Unresectable Hepatocellular Carcinoma. Anticancer Res 2024; 44:2055-2061. [PMID: 38677746 DOI: 10.21873/anticanres.17009] [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: 01/23/2024] [Revised: 03/16/2024] [Accepted: 03/26/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND/AIM The treatment algorithm for systemic therapies for advanced hepatocellular carcinoma (HCC) has changed dramatically; however, the therapeutic landscape for sequential second-line or later-line treatments, including ramucirumab, remains controversial. This study aimed to investigate the role of ramucirumab for treating HCC. PATIENTS AND METHODS We retrospectively analyzed data from 17 patients with advanced HCC who received ramucirumab, and 8 of them who received lenvatinib re-administration after ramucirumab treatment failure. RESULTS The median overall survival of 17 patients treated with ramucirumab was 11.5 months. The median ratios of the 1-month post-treatment α-fetoprotein (AFP) levels and albumin-bilirubin (ALBI) scores to the pre-treatment AFP levels and ALBI scores following ramucirumab treatment were 0.880 and 0.965, respectively. The median ratios of the 1-month post-treatment AFP and ALBI levels to the pre-treatment levels were 1.587 and 0.970 for mALBI grade 1/2a, and 1.313 and 0.936 for mALBI grade 2b/3, respectively. Six of the eight patients who received lenvatinib rechallenge treatment exhibited a decrease in AFP levels one month post-lenvatinib treatment. Deterioration of liver function 3 months post-lenvatinib treatment was noted in five of the eight patients who received lenvatinib rechallenge treatment after ramucirumab. CONCLUSION Ramucirumab may be equally useful in patients with unresectable HCC who have poor liver function or whose liver function is aggravated by other therapies. Rechallenge treatment with lenvatinib after ramucirumab may be a valid treatment option for HCC.
Collapse
Affiliation(s)
- Akira Koizumi
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shohei Komatsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
| | - Satoshi Omiya
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiko Yano
- Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimi Fujishima
- Division of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Jun Ishida
- Division of Radiology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Masahiro Kido
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidetoshi Gon
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenji Fukushima
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Urade
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichi So
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiko Yoshida
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Arai
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Fujinaka
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuhi Shimura
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Yanagimoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihide Ueda
- Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuzo Kodama
- Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
3
|
Fujinaka R, Komatsu S, Terashima K, Demizu Y, Omiya S, Kido M, Toyama H, Tokumaru S, Okimoto T, Fukumoto T. Clinical impact of spacer placement surgery with expanded polytetrafluoroethylene sheet for particle therapy. Radiat Oncol 2023; 18:173. [PMID: 37875956 PMCID: PMC10594906 DOI: 10.1186/s13014-023-02359-5] [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: 09/03/2023] [Accepted: 10/07/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Spacer placement surgery is useful in particle therapy (PT) for patients with abdominopelvic malignant tumors located adjacent to the gastrointestinal tract. This study aimed to assess the safety, efficacy, and long-term outcomes of spacer placement surgery using an expanded polytetrafluoroethylene (ePTFE) spacer. METHODS This study included 131 patients who underwent ePTFE spacer placement surgery and subsequent PT between September 2006 and June 2019. The overall survival (OS) and local control (LC) rates were calculated using Kaplan-Meier method. Spacer-related complications were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). RESULTS The median follow-up period after spacer placement surgery was 36.8 months. The 3-year estimated OS and LC rates were 60.5% and 76.5%, respectively. A total of 130 patients (99.2%) were able to complete PT. Spacer-related complications of ≥ grade 3 were observed in four patients (3.1%) in the acute phase and 13 patients (9.9%) in the late phase. Ten patients (7.6%) required removal of the ePTFE spacer. CONCLUSIONS Spacer placement surgery using an ePTFE spacer for abdominopelvic malignant tumors is technically feasible and acceptable for subsequent PT. However, severe spacer-related late complications were observed in some patients. Since long-term placement of a non-absorbable ePTFE spacer is associated with risks for morbidity and infection, careful long-term follow-up and prompt therapeutic intervention are essential when complications associated with the ePTFE spacer occur. TRIAL REGISTRATION retrospectively registered.
Collapse
Affiliation(s)
- Ryosuke Fujinaka
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan
| | - Shohei Komatsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, Tatsuno, 679-5165, Hyogo, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, Tatsuno, 679-5165, Hyogo, Japan
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, 1-6-8 Minatojimaminami-machi, Chuo-ku, Kobe, 650-0047, Hyogo, Japan
| | - Satoshi Omiya
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan
| | - Masahiro Kido
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan
| | - Sunao Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, Tatsuno, 679-5165, Hyogo, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, Tatsuno, 679-5165, Hyogo, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan
| |
Collapse
|
4
|
Kotaka S, Adachi S, Fujinaka R, Honda S, Nakata H, Seino Y, Sueno Y, Sumida T, Suzuki J, Tajima O, Takeichi S. Search for Dark Photon Dark Matter in the Mass Range 74-110 μeV with a Cryogenic Millimeter-Wave Receiver. Phys Rev Lett 2023; 130:071805. [PMID: 36867799 DOI: 10.1103/physrevlett.130.071805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
We search for the dark photon dark matter (DPDM) using a cryogenic millimeter-wave receiver. DPDM has a kinetic coupling with electromagnetic fields with a coupling constant of χ and is converted into ordinary photons at the surface of a metal plate. We search for signal of this conversion in the frequency range 18-26.5 GHz, which corresponds to the mass range 74-110 μeV/c^{2}. We observed no significant signal excess, allowing us to set an upper bound of χ<(0.3-2.0)×10^{-10} at 95% confidence level. This is the most stringent constraint to date and tighter than cosmological constraints. Improvements from previous studies are obtained by employing a cryogenic optical path and a fast spectrometer.
Collapse
Affiliation(s)
- S Kotaka
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - S Adachi
- Hakubi Center for Advanced Research, Kyoto University, Kyoto 606-8501, Japan
| | - R Fujinaka
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - S Honda
- Division of Physics, Faculty of Pure and Applied Sciences, University of Tsukuba, Ibaraki, 305-8571, Japan
| | - H Nakata
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Seino
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Sueno
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - T Sumida
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - J Suzuki
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - O Tajima
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| | - S Takeichi
- Department of Physics, Faculty of Science, Kyoto University, Kyoto 606-8502, Japan
| |
Collapse
|
5
|
Okamoto S, Otowa Y, Fujinaka R, Arai K, Murata K, Mii Y, Kakinoki K, Oka S, Kanaji S, Kakeji Y, Kuroda D. Purse-string suture after ligating by endoloop for closing of the appendiceal stump is an alternative for endostapler in selected cases: A propensity score-matched study. Asian J Endosc Surg 2021; 14:775-781. [PMID: 33881223 DOI: 10.1111/ases.12942] [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: 01/07/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The closure of the appendiceal stump is a crucial part of a laparoscopic appendectomy, and an endoloop or endostapler is generally used. The endoloop can be more cost effective than the endostapler. However, reports have shown that the endoloop has a higher postoperative abdominal abscess rate than the endostapler in complicated appendicitis. At our institution, we perform a purse-string suture after ligating by endoloop to reduce postoperative abdominal abscess risk. This study aimed to clarify whether this method could reduce the incidence of postoperative abdominal abscess compared with the endostapler. METHODS Patients with acute appendicitis were classified into the purse-string suture group (n = 149) and the endostapler group (n = 82). Postoperative outcomes were compared after propensity score matching (n = 47). RESULTS No significant difference was found between the two groups in terms of the patient characteristics and postoperative complications, including abdominal abscess. However, the purse-string suture group had more drain placement and a shorter hospital stay than the endostapler group (P = .04 and P = .02, respectively). In patients with complicated appendicitis, there was less drain placement and a shorter hospital stay in the purse-string suture group than in the endostapler group (P < .01 and P < .01, respectively). This might have reflected the difficulty of the operation. All postoperative abdominal abscesses occurred in complicated appendicitis cases. CONCLUSIONS Endoloop with additional purse-string suture had a lower incidence of abscess than previous reports of using endoloop alone. Moreover, the postoperative abdominal abscess rate is similar between the two closure methods.
Collapse
Affiliation(s)
- Shuji Okamoto
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Yasunori Otowa
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | | | - Keisuke Arai
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Koichi Murata
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Yasuhiko Mii
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | | | - Shigeteru Oka
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Kuroda
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| |
Collapse
|
6
|
Otowa Y, Okamoto S, Fujinaka R, Arai K, Murata K, Mii Y, Kakinoki K, Oka S, Kuroda D. Feasibility and Effectiveness of Gastrectomy for Elderly Gastric Cancer Patients. In Vivo 2019; 33:1307-1311. [PMID: 31280223 DOI: 10.21873/invivo.11604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 03/20/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIM The benefits of gastrectomy for elderly gastric cancer (GC) patients remain unknown. The aim of this study was to evaluate the validity of gastrectomy. PATIENTS AND METHODS Patients who had R0 or R1 resection and diagnosed as pathological Stage I-III GC were enrolled in this study. Patients were classified according to age: Elderly group (≥80 years old), non-Elderly group (70-79 years old), Standard group (≤69 years old). RESULTS As the age raised, the number of comorbidities increased and patients had a worse physical status. Operative procedure and postoperative complications of the Elderly group were similar to that of the non-Elderly group. The overall survival was similar in pathological Stages I and III between the Elderly and non-Elderly groups, while the Stage II Elderly group had shorter overall survival. Also, the Elderly group did not undergo adjuvant chemotherapy compared to other groups. CONCLUSION Gastrectomy can be performed safely in elderly patients following gastrectomy, survival of elderly patients was similar to non-elderly patients. Therefore, gastrectomy is an acceptable treatment for elderly patients in good condition.
Collapse
Affiliation(s)
- Yasunori Otowa
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Shuji Okamoto
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | | | - Keisuke Arai
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Koichi Murata
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Yasuhiko Mii
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | | | - Shigeteru Oka
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Daisuke Kuroda
- Department of Surgery, Kita-Harima Medical Center, Ono, Japan
| |
Collapse
|
7
|
Fujinaka R, Otowa Y, Yokoo H, Arai K, Murata K, Mii Y, Kakinoki K, Oka S, Kuroda D. [Adjuvant Chemotherapy for High-Risk Stage Ⅱ Colon Cancer]. Gan To Kagaku Ryoho 2019; 46:1327-1329. [PMID: 31501381] [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
BACKGROUND This study was designed to clarify effects of postoperative adjuvant chemotherapy for high-risk Stage Ⅱ colorectal cancer. METHOD The subjects were 99 patients with high-risk Stage Ⅱcolorectal cancer who underwent surgery at our department from October 2013 to March 2018. Patients were classified into adjuvant chemotherapy group and nonadjuvant chemotherapy group. Overall survival(OS)and recurrence-free survival(RFS)were analyzed between the 2 groups. RESULTS Thirty six patients(36.4%)underwent adjuvant chemotherapy. Adjuvant chemotherapy group were younger(p<0.010), had a better ASA-PS(p<0.010), good preoperative Hb(p<0.010), and preoperative Alb(p<0.010)compared to non-adjuvant chemotherapy group. There was no difference between the 2 groups in the high-risk factors for recurrence. Most patient had an oral medication as for adjuvant chemotherapy. There was no difference in OS and RFS between the 2 groups. CONCLUSION Postoperative adjuvant chemotherapy for high-risk Stage Ⅱ colorectal cancer did not significantly improve the OS and RFS. Further study is necessary to asses the suitable regimen and patients eligible for chemotherapy.
Collapse
|
8
|
Murata K, Kuroda D, Okamoto S, Fujinaka R, Arai K, Otowa Y, Mii Y, Kakinoki K, Mani M, Oka S. [Preoperative Chemotherapy with DCF for Advanced Esophageal Cancer]. Gan To Kagaku Ryoho 2019; 46:1337-1339. [PMID: 31501384] [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
We conducted a retrospective study to evaluate the efficacy and the problem of the neoadjuvant chemotherapy using DCF for cStage Ⅲ/Ⅳ(squamous cell)esophageal cancer. Eleven patients from January 2017 to December 2018 were enrolled into this study. The median age was 67 years old, male/female ratio was 9:2, performance status was 0 in all patients, and UICC cStage Ⅲ/Ⅳa was 7:4. Cycles of chemotherapy was 2 in 1 patients, 3 in 5 patients and additional 2 courses in 1 patient. Four patients switched to FP therapy after a course of DCF. The efficacy of chemotherapy was evaluated by the clinical response rate, average tumor reduction rate, and histological therapeutic effect rate over Grade 2 which was 63.6%, 48.3%, and 40%, respectively. Neutropenia over Grade 3 was observed in all patients and Grade 4 was observed in 6 patients. In conclusion, preoperative chemotherapy with DCF therapy is useful for the treatment of cStage Ⅲ/Ⅳ(squamous cell) esophageal cancer as long as bone marrow suppression is managed.
Collapse
|
9
|
Urade T, Sawa H, Iwatani Y, Abe T, Fujinaka R, Murata K, Mii Y, Man-I M, Oka S, Kuroda D. Laparoscopic anatomical liver resection using indocyanine green fluorescence imaging. Asian J Surg 2019; 43:362-368. [PMID: 31043331 DOI: 10.1016/j.asjsur.2019.04.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 02/25/2019] [Revised: 03/22/2019] [Accepted: 04/11/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Anatomical liver resections guided by a demarcation line after portal staining or inflow clamping of the target area have been established as essential methods for curative treatment of hepatocellular carcinoma (HCC) and have subsequently been applied to other malignancies. However, laparoscopic anatomical liver resection (LALR) procedures are very difficult to reproduce, and the confirmation of demarcation of the hepatic segment on a monitor is also challenging. Recently, indocyanine green (ICG) fluorescence imaging has been used to identify hepatic tumors and segmental boundaries during hepatectomy. Herein, we describe LALR using ICG fluorescence imaging. METHODS Three patients underwent pure LALR using ICG fluorescence imaging at our institute. One patient underwent anatomical partial liver resection for HCC, another underwent segmentectomy 3 for metastatic liver cancer, and the third underwent right anterior sectionectomy for HCC. To visualize hepatic perfusion and the demarcation line by negative staining using an optical imaging system, 2.5 mg ICG was injected intravenously during surgery following clamping or closure of the proximal Glissonean pedicles. RESULTS For all three cases, ICG fluorescent imaging clearly delineated the demarcation lines and allowed identification of intersegmental planes to some extent because the tumor-bearing hepatic region became non-fluorescing parenchyma during parenchymal transection. This allowed surgeons to recognize the direction and guide the transection of the liver parenchyma when performing LALR. CONCLUSION LALR using ICG fluorescence imaging is a feasible procedure for resection of the tumor-bearing hepatic region and facilitates visualization of the demarcation line and identification of the boundaries of the hepatic sections.
Collapse
Affiliation(s)
- Takeshi Urade
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan; Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Hidehiro Sawa
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan; Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiteru Iwatani
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Tomoki Abe
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Ryosuke Fujinaka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Koichi Murata
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Yasuhiko Mii
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Mariko Man-I
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Shigeteru Oka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Daisuke Kuroda
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| |
Collapse
|
10
|
Fujinaka R, Urade T, Fukuoka E, Murata K, Mii Y, Sawa H, Man-I M, Oka S, Iwatani Y, Kuroda D. Laparoscopic transabdominal preperitoneal approach for giant inguinal hernias. Asian J Surg 2018; 42:414-419. [PMID: 29371050 DOI: 10.1016/j.asjsur.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/20/2017] [Revised: 12/13/2017] [Accepted: 12/28/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Many surgical techniques have been developed to treat inguinal hernia. In recent years, the laparoscopic transabdominal preperitoneal (TAPP) approach has been widely performed to repair inguinal hernia. Giant inguinal hernia (GIH) is an extremely rare disease that is a challenge for general surgeons. GIH appears when patients neglect the treatment for many years and it is defined as an inguinal hernia that extends below the midpoint of inner thigh in standing position. According to previous publications, the Lichtenstein tension-free hernioplasty is recommended to repair GIH. In this article, we describe consecutive four cases of GIH repaired via the TAPP approach. METHODS From April 2015 to March 2017, 200 patients underwent hernioplasty against inguinal hernia at our hospital. Inguinal hernias were treated via the TAPP approach in principle. We performed hernioplasty via the TAPP approach in all 4 patients (2%) who met the definition of Type 1 GIH. Demographic information, maximum diameter of hernia sac, hernia orifice size, and surgical data were obtained. RESULTS The mean operative time was 135 min. No intraoperative complications were encountered. All patients could walk from postoperative day 1 and were discharged home early, but they all had scrotal seromas. Three patients did not need puncture or drainage, but one of them required puncture. All seromas disappeared within 6 months. There was no recurrence in the 8- to 24-month follow-up. CONCLUSION The TAPP approach is a feasible, safe therapeutic option that may reduce wound size and pain following surgical treatment of Type 1 GIH.
Collapse
Affiliation(s)
- Ryosuke Fujinaka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Takeshi Urade
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan.
| | - Eiji Fukuoka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Koichi Murata
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Yasuhiko Mii
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Hidehiro Sawa
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Mariko Man-I
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Shigeteru Oka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Yoshiteru Iwatani
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| | - Daisuke Kuroda
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, Ono, Japan
| |
Collapse
|