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Fukai S, Mizusawa Y, Noda H, Tsujinaka S, Maeda Y, Hasebe R, Eguchi Y, Kanemitsu R, Matsuzawa N, Abe I, Endo Y, Fukui T, Takayama Y, Ichida K, Inoue K, Muto Y, Watanabe F, Futsuhara K, Miyakura Y, Rikiyama T. Superiority trial for the development of an ideal method for the closure of midline abdominal wall incisions to reduce the incidence of wound complications after elective gastroenterological surgery: study protocol for a randomized controlled trial. Trials 2024; 25:327. [PMID: 38760769 PMCID: PMC11100179 DOI: 10.1186/s13063-024-08167-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The recent guidelines from the European and American Hernia Societies recommend a continuous small-bite suturing technique with slowly absorbable sutures for fascial closure of midline abdominal wall incisions to reduce the incidence of wound complications, especially for incisional hernia. However, this is based on low-certainty evidence. We could not find any recommendations for skin closure. The wound closure technique is an important determinant of the risk of wound complications, and a comprehensive approach to prevent wound complications should be developed. METHODS We propose a single-institute, prospective, randomized, blinded-endpoint trial to assess the superiority of the combination of continuous suturing of the fascia without peritoneal closure and continuous suturing of the subcuticular tissue (study group) over that of interrupted suturing of the fascia together with the peritoneum and interrupted suturing of the subcuticular tissue (control group) for reducing the incidence of midline abdominal wall incision wound complications after elective gastroenterological surgery with a clean-contaminated wound. Permuted-block randomization with an allocation ratio of 1:1 and blocking will be used. We hypothesize that the study group will show a 50% reduction in the incidence of wound complications. The target number of cases is set at 284. The primary outcome is the incidence of wound complications, including incisional surgical site infection, hemorrhage, seroma, wound dehiscence within 30 days after surgery, and incisional hernia at approximately 1 year after surgery. DISCUSSION This trial will provide initial evidence on the ideal combination of fascial and skin closure for midline abdominal wall incision to reduce the incidence of overall postoperative wound complications after gastroenterological surgery with a clean-contaminated wound. This trial is expected to generate high-quality evidence that supports the current guidelines for the closure of abdominal wall incisions from the European and American Hernia Societies and to contribute to their next updates. TRIAL REGISTRATION UMIN-CTR UMIN000048442. Registered on 1 August 2022. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055205.
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Affiliation(s)
- Shota Fukai
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuki Mizusawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan.
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yukihisa Maeda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Ryuji Hasebe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yusuke Eguchi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Rina Kanemitsu
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Natsumi Matsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Iku Abe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuhei Endo
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Koetsu Inoue
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
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Chikatani K, Ishida H, Mori Y, Nakajima T, Ueki A, Akagi K, Takao A, Yamada M, Taniguchi F, Komori K, Sasaki K, Sudo T, Miyakura Y, Chino A, Yamaguchi T, Tanakaya K, Tomita N, Ajioka Y. Risk of metachronous colorectal cancer after surgical resection of index rectal cancer in Lynch syndrome: a multicenter retrospective study in Japan. Surg Today 2024:10.1007/s00595-024-02815-z. [PMID: 38502210 DOI: 10.1007/s00595-024-02815-z] [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: 07/29/2023] [Accepted: 01/23/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study evaluated the risk of metachronous colorectal cancer (CRC) after resection of index (first) rectal cancer in patients with Lynch syndrome (LS). METHODS Clinicopathological data of patients with genetically proven LS were retrospectively analyzed in this multicenter Japanese study. The cumulative incidence of metachronous CRC and the overall survival were compared between patients with index rectal cancer (rectal group) and those with index colon cancer (colon group). RESULTS The median age at index CRC surgery was lower in the rectal group than in the colon group (37 vs. 46 years old, P = 0.01). The cumulative 5-, 10-, and 20-year incidences of metachronous CRC were 3.5%, 13.9%, and 21.1%, respectively, in the rectal cancer group and 14.9%, 22.0%, and 57.9%, respectively, in the colon cancer group (P = 0.02). The overall survival curves were not significantly different between two groups (P = 0.23). CONCLUSION This is the first report from an East Asian country to report the risk of metachronous CRC after resection of index rectal cancer in patients with LS. Despite this study having several limitations, we cannot recommend extended resection, such as total proctocolectomy, for index rectal cancer as a standard surgical treatment in patients with LS.
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Affiliation(s)
- Kenichi Chikatani
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
| | - Yoshiko Mori
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Takeshi Nakajima
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Arisa Ueki
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kiwamu Akagi
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Saitama, Japan
| | - Akinari Takao
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Masayoshi Yamada
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Fumitaka Taniguchi
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Koji Komori
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Kazuhito Sasaki
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoya Sudo
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Surgery, Kurume University, Fukuoka, Japan
| | - Yasuyuki Miyakura
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Akiko Chino
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tatsuro Yamaguchi
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kohji Tanakaya
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Naohiro Tomita
- The Committee of Hereditary Colorectal Cancer in the Japanese Society for Cancer of the Colon and Rectum (JSCCR), Tokyo, Japan
- Cancer Treatment Center, Toyonaka Municipal Hospital, Osaka, Japan
| | - Yoichi Ajioka
- Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Sasaki K, Kawai K, Nozawa H, Ishihara S, Ishida H, Ishibashi K, Mori Y, Shichijo S, Tani Y, Takeuchi Y, Chino A, Takao M, Fujiyoshi K, Matsubara T, Miyakura Y, Taniguchi F, Yamaguchi T, Tanakaya K, Tomita N, Ajioka Y. Risk of gastric adenoma and adenocarcinoma in patients with familial adenomatous polyposis in Japan: a nationwide multicenter study. J Gastroenterol 2024; 59:187-194. [PMID: 38263336 PMCID: PMC10904405 DOI: 10.1007/s00535-023-02074-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Patients with familial adenomatous polyposis (FAP) have an increased risk of developing gastric neoplasms. However, the clinical course of FAP with these gastric lesions has not yet been fully clarified. The present study aimed to clarify the changes in the incidence risk of developing gastric adenoma or gastric cancer during the lifespan of patients with FAP. METHODS Four hundred forty-three patients with data regarding gastric adenoma and gastric cancer retrospectively registered in a nationwide Japanese multicenter study were enrolled. The cumulative incidences and hazard rates (HRs) of gastric neoplasms were evaluated. RESULTS The cumulative incidence rates in 50-year-old patients with FAP were 22.8% for gastric adenoma and 7.6% for gastric cancer, respectively. No significant association was found between gastric neoplasms and the colonic phenotype. The peak age for the HR of gastric adenoma was 65 years, with the highest HR (0.043). Regarding the incidence of gastric cancer, the HR increased moderately up to the age of 40 years, but the increase accelerated from the age of 50 years (HR = 0.0067). CONCLUSION Careful surveillance of the upper gastrointestinal tract in elderly patients with FAP, such as shortening the interval of follow-up according to age, may be helpful for early diagnosis of gastric cancer.
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Affiliation(s)
- Kazuhito Sasaki
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.
| | - Kazushige Kawai
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hideyuki Ishida
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Keiichiro Ishibashi
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yoshiko Mori
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Satoki Shichijo
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yasuhiro Tani
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoji Takeuchi
- Department of Genetic Oncology, Division of Hereditary Tumors and Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akiko Chino
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Misato Takao
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kenji Fujiyoshi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takaaki Matsubara
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Yasuyuki Miyakura
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - Fumitaka Taniguchi
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Tatsuro Yamaguchi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kohji Tanakaya
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Naohiro Tomita
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Yoichi Ajioka
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Miyakura Y, Yamaguchi T, Lefor AK, Tamaki S, Takao A, Takao M, Mori Y, Chikatani K, Ishida H, Kono M, Takeuchi Y, Ishikawa H, Nagasaki T, Sasaki K, Matsubara T, Hirata K, Taniguchi F, Tanakaya K, Tomita N, Ajioka Y. Clinical features and distribution of the APC variant in duodenal and ampullary polyps in patients with familial adenomatous polyposis: a multicenter retrospective cohort study in Japan. Int J Clin Oncol 2024; 29:169-178. [PMID: 38142452 DOI: 10.1007/s10147-023-02442-7] [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: 08/11/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Management of duodenal or ampullary adenomas in patients with familial adenomatous polyposis (FAP) is a major challenge for clinicians. Insufficient data are available to evaluate the clinical manifestations and distribution of adenomatous polyposis coli (APC) variants in these patients. METHODS We enrolled 451 patients with data regarding duodenal or ampullary polyps from 632 patients with FAP retrospectively registered in a nationwide Japanese multicenter study. Clinicopathological features and distribution of APC variants were compared between patients with and without duodenal or ampullary polyps. RESULTS Duodenal and ampullary polyps were found in 59% and 18% of patients with FAP, respectively. The incidence of duodenal cancer was 4.7% in patients with duodenal polyps, and that of ampullary cancer was 18% in patients with ampullary polyps. Duodenal polyps were significantly associated with the presence of ampullary polyps and jejunal/ileal polyps. Duodenal polyps progressed in 35% of patients with a median follow-up of 776 days, mostly in those with early Spigelman stage lesions. Ampullary polyps progressed in 50% of patients with a follow-up of 1484 days. However, only one patient developed a malignancy. The proportion of patients with duodenal polyps was significantly higher among those with intermediate- or profuse-type APC variants than attenuated-type APC variants. The presence of duodenal polyps was significantly associated with ampullary and jejunal/ileal polyps in patients with intermediate- or profuse-type APC variants. CONCLUSIONS Periodic endoscopic surveillance of the papilla of Vater and small intestine should be planned for patients with FAP with duodenal polyps.
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Affiliation(s)
- Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama-Shi, Saitama-Ken, 330-8503, Japan.
- Department of Surgery, Jichi Medical University, Tochigi, Japan.
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.
| | - Tatsuro Yamaguchi
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | | | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama-Shi, Saitama-Ken, 330-8503, Japan
| | - Akinari Takao
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Misato Takao
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yoshiko Mori
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Kenichi Chikatani
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hideyuki Ishida
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Mitsuhiro Kono
- Department of Gastrointestinal Oncology, Osaka International Cancer Center, Osaka, Japan
| | - Yoji Takeuchi
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastrointestinal Oncology, Osaka International Cancer Center, Osaka, Japan
| | | | - Toshiya Nagasaki
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazuhito Sasaki
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgical Oncology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Takaaki Matsubara
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Keiji Hirata
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Fumitaka Taniguchi
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Kohji Tanakaya
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Naohiro Tomita
- The Committee of Hereditary Colorectal Cancer of the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Cancer Treatment Center, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Yoichi Ajioka
- Japanese Society for Cancer of Colon and Rectum, Tokyo, Japan
- Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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5
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Chikatani K, Ishida H, Mori Y, Nakajima T, Ueki A, Akagi K, Takao A, Yamada M, Taniguchi F, Komori K, Sasaki K, Sudo T, Miyakura Y, Chino A, Yamaguchi T, Tanakaya K, Tomita N, Ajioka Y. Risk of metachronous colorectal cancer after colectomy for first colon cancer in Lynch syndrome: multicenter retrospective study in Japan. Int J Clin Oncol 2023; 28:1633-1640. [PMID: 37752370 DOI: 10.1007/s10147-023-02412-z] [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: 03/04/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND We evaluated the risk of metachronous colorectal cancer (mCRC) and explored the optimal extent of colectomy in patients with Lynch syndrome (LS) and first colon cancer (fCC) in Japan, where the extent of colectomy for colon cancer (CC) is shorter than that in Western countries. METHODS The clinicopathologic and survival data of patients with LS who developed CC were collected from a nationwide database and analyzed retrospectively. The cumulative incidence of mCRC after actual segmental colectomy was compared with that of mCRC when more extensive colectomy was assumed. RESULTS There were 142 eligible patients (65 female). The median age at fCC surgery was 46.5 (range: 14-80) years. The cumulative incidence of 5-, 10-, and 20-year mCRC rate was 13.4%, 20.8%, and 53.6%, respectively. The incidence was higher in the left-sided group (splenic flexure to rectosigmoid colon, n = 54) than in the right-sided group (cecum to transvers colon, n = 88) (66.3% vs. 45.3% in 20 years, P < 0.01). Assuming that all patients would have undergone hemicolectomy or total colectomy, the estimated mCRC risk was 41.5% and 9.4% (P < 0.01, vs. actual procedures), respectively. The 20-year overall survival rate of all the patients was 83.3% without difference by fCC sidedness (P = 0.38). CONCLUSIONS To reduce the incidence of mCRC, patients with genetically diagnosed LS and fCC, preferentially located in the left-sided colon, may need to undergo more extended colectomy than that usually performed in Japan. However, such extended colectomy should be counterbalanced with favorable overall survival and actual risk of mCRC development.
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Affiliation(s)
- Kenichi Chikatani
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-City, Saitama, 350-8550, Japan.
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-City, Saitama, 350-8550, Japan
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
| | - Yoshiko Mori
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-City, Saitama, 350-8550, Japan
| | - Takeshi Nakajima
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Arisa Ueki
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kiwamu Akagi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Saitama, Japan
| | - Akinari Takao
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Masayoshi Yamada
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Fumitaka Taniguchi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Koji Komori
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Kazuhito Sasaki
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoya Sudo
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Kurume University, Fukuoka, Japan
| | - Yasuyuki Miyakura
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Akiko Chino
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tatsuro Yamaguchi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kohji Tanakaya
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Naohiro Tomita
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Cancer Treatment Center, Toyonaka Municipal Hospital, Osaka, Japan
| | - Yoichi Ajioka
- Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
- Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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6
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Mizusawa Y, Noda H, Ichida K, Fukai S, Matsuzawa N, Tamaki S, Abe I, Endo Y, Fukui T, Takayama Y, Inoue K, Muto Y, Watanabe F, Miyakura Y, Rikiyama T. A postoperative body weight increase is a novel risk factor for incisional hernia of midline abdominal incision after elective gastroenterological surgery. Langenbecks Arch Surg 2023; 408:452. [PMID: 38032404 DOI: 10.1007/s00423-023-03193-9] [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] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/26/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Midline abdominal incisions (MAIs) are widely used in both open and minimally invasive surgery. Incisional hernia (IH) accounts for most long-term postoperative wound complications. This study explored the risk factors for IH due to MAI in patients with clean-contaminated wounds after elective gastroenterological surgery. METHODS The present study targeted patients enrolled in 2 randomized controlled trials to evaluate the efficacy of intraoperative interventions for incisional SSI prevention after gastroenterological surgery for clean-contaminated wounds. The patients were reassessed, and pre- and intraoperative variables and postoperative outcomes were collected. IH was defined as any abdominal wall gap, regardless of bulge, in the area of a postoperative scar that was perceptible or palpable on clinical examination or computed tomography according to the European Hernia Society guidelines. The risk factors for IH were identified using univariate and multivariate analyses. RESULTS The study population included 1,281 patients, of whom 273 (21.3%) developed IH. Seventy-four (5.8%) patients developed incisional SSI. Multivariate logistic regression analysis revealed that female sex (odds ratio [OR], 1.39; 95% confidence interval [CI] 1.03-1.86, p = 0.031), high preoperative body mass index (OR, 1.81; 95% CI 1.19-2.77, p = 0.006), incisional SSI (OR, 2.29; 95% CI 1.34-3.93, p = 0.003), and postoperative body weight increase (OR, 1.49; 95% CI 1.09-2.04, p = 0.012) were independent risk factors for IH due to MAI in patients who underwent elective gastroenterological surgery. CONCLUSION We identified postoperative body weight increase at one year as a novel risk factor for IH in patients with MAI after elective gastroenterological surgery.
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Affiliation(s)
- Yuki Mizusawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan.
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Shota Fukai
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Natsumi Matsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Iku Abe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuhei Endo
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Koetsu Inoue
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
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7
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Nemoto D, Guo Z, Katsuki S, Takezawa T, Maemoto R, Kawasaki K, Inoue K, Akutagawa T, Tanaka H, Sato K, Omori T, Takanashi K, Hayashi Y, Nakajima Y, Miyakura Y, Matsumoto T, Yoshida N, Esaki M, Uraoka T, Kato H, Inoue Y, Peng B, Zhang R, Hisabe T, Matsuda T, Yamamoto H, Tanaka N, Lefor AK, Zhu X, Togashi K. Computer-aided diagnosis of early-stage colorectal cancer using nonmagnified endoscopic white-light images (with videos). Gastrointest Endosc 2023; 98:90-99.e4. [PMID: 36738793 DOI: 10.1016/j.gie.2023.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/05/2023] [Accepted: 01/25/2023] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Differentiation of colorectal cancers (CRCs) with deep submucosal invasion (T1b) from CRCs with superficial invasion (T1a) or no invasion (Tis) is not straightforward. This study aimed to develop a computer-aided diagnosis (CADx) system to establish the diagnosis of early-stage cancers using nonmagnified endoscopic white-light images alone. METHODS From 5108 images, 1513 lesions (Tis, 1074; T1a, 145; T1b, 294) were collected from 1470 patients at 10 academic hospitals and assigned to training and testing datasets (3:1). The ResNet-50 network was used as the backbone to extract features from images. Oversampling and focal loss were used to compensate class imbalance of the invasive stage. Diagnostic performance was assessed using the testing dataset including 403 CRCs with 1392 images. Two experts and 2 trainees read the identical testing dataset. RESULTS At a 90% cutoff for the per-lesion score, CADx showed the highest specificity of 94.4% (95% confidence interval [CI], 91.3-96.6), with 59.8% (95% CI, 48.3-70.4) sensitivity and 87.3% (95% CI, 83.7-90.4) accuracy. The area under the characteristic curve was 85.1% (95% CI, 79.9-90.4) for CADx, 88.2% (95% CI, 83.7-92.8) for expert 1, 85.9% (95% CI, 80.9-90.9) for expert 2, 77.0% (95% CI, 71.5-82.4) for trainee 1 (vs CADx; P = .0076), and 66.2% (95% CI, 60.6-71.9) for trainee 2 (P < .0001). The function was also confirmed on 9 short videos. CONCLUSIONS A CADx system developed with endoscopic white-light images showed excellent per-lesion specificity and accuracy for T1b lesion diagnosis, equivalent to experts and superior to trainees. (Clinical trial registration number: UMIN000037053.).
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Affiliation(s)
- Daiki Nemoto
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu, Japan
| | - Zhe Guo
- Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Japan; Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shinichi Katsuki
- Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan
| | - Takahito Takezawa
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Keisuke Kawasaki
- Department of Gastroenterology, Iwate Medical University, Morioka, Japan
| | - Ken Inoue
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Akutagawa
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hirohito Tanaka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Koichiro Sato
- Department of Clinical Laboratory and Endoscopy, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Teppei Omori
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Yoshikazu Hayashi
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Yuki Nakajima
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takayuki Matsumoto
- Department of Gastroenterology, Iwate Medical University, Morioka, Japan
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroyuki Kato
- Department of Clinical Laboratory and Endoscopy, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Yuji Inoue
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Boyuan Peng
- Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Japan
| | - Ruiyao Zhang
- Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Japan
| | - Takashi Hisabe
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Tomoki Matsuda
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Japan
| | - Hironori Yamamoto
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Noriko Tanaka
- Health Data Science Research Section, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Xin Zhu
- Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Japan
| | - Kazutomo Togashi
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu, Japan
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Maemoto R, Noda H, Ichida K, Fukai S, Sakai A, Mizusawa Y, Morita R, Hatsuzawa Y, Endo Y, Fukui T, Takayama Y, Kakizawa N, Muto Y, Maeda S, Watanabe F, Miyakura Y, Rikiyama T. Update of risk factors for surgical site infection in clean-contaminated wounds after gastroenterological surgery: An analysis of 1,878 participants enrolled in 2 recent randomized control trials for the prevention of surgical site infection. Surgery 2023:S0039-6060(23)00176-9. [PMID: 37183131 DOI: 10.1016/j.surg.2023.04.002] [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] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/08/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Clean-contaminated wounds should be the main target for reducing the burden of harm caused by surgical site infection after gastroenterological surgery. METHODS The present study targeted 1,973 patients enrolled in 2 randomized controlled trials to evaluate the efficacy of intraoperative interventions for incisional surgical site infection prevention after gastroenterological surgery with clean-contaminated wounds. Patients were reassessed, and preoperative and postoperative variables were collected. Risk factors for surgical site infection were identified by univariate and multivariate analyses. RESULTS The study population included 1,878 patients, among whom 213 (11.3%) developed overall surgical site infection and 119 (6.3%) developed incisional surgical site infection. A multivariate analysis revealed that steroid or immunosuppressant use (odds ratio 3.03; 95% confidence interval 1.37-6.73, P = .0064), open surgery (odds ratio 1.77; 95% confidence interval 1.11-2.83, P = .0167), and long operative time (odds ratio 2.31; 95% confidence interval 1.5-3.56, P < .001) were independent risk factors for incisional surgical site infection. Steroid or immunosuppressant use (odds ratio 2.62; 95% confidence interval 1.29-5.33, P = .0078), open surgery (odds ratio 2.13; 95% confidence interval 1.44-3.16, P < .001), and long operative time (odds ratio 2.92; 95% confidence interval 2.08-4.10, P < .001) were also independent risk factors for overall surgical site infection in the multivariate analysis. Furthermore, a multivariate analysis revealed that a long operative time (odds ratio 3.21; 95% confidence interval 1.69-6.1, P = .00378) was an independent risk factor for incisional surgical site infection in patients who underwent laparoscopic surgery. CONCLUSION Even under current measures for surgical site infection prevention, surgeons should continue to make efforts to appropriately expand the indication of laparoscopic surgery and to reduce operative times even when performing laparoscopic surgery.
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Affiliation(s)
- Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Shota Fukai
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Ayano Sakai
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuki Mizusawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Ryusuke Morita
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuuri Hatsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuhei Endo
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Shimpei Maeda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
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9
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Maemoto R, Noda H, Ichida K, Miyakura Y, Kakizawa N, Machida E, Aizawa H, Kato T, Iseki M, Fukui T, Muto Y, Fukai S, Tsujinaka S, Hatsuzawa Y, Watanabe F, Nagamori M, Takahashi J, Kimura Y, Maeda S, Takayama N, Sakio R, Takahashi R, Takenami T, Matsuzawa N, Mieno M, Rikiyama T. Aqueous Povidone-Iodine Versus Normal Saline For Intraoperative Wound Irrigation on The Incidence of Surgical Site Infection in Clean-Contaminated Wounds After Gastroenterological Surgery: A Single-Institute, Prospective, Blinded-Endpoint, Randomized Controlled Trial. Ann Surg 2023; 277:727-733. [PMID: 36538622 DOI: 10.1097/sla.0000000000005786] [Citation(s) in RCA: 6] [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] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This trial evaluated the superiority of intraoperative wound irrigation (IOWI) with aqueous povidone-iodine (PVP-I) compared with that with saline for reducing the incidence of surgical site infection (SSI). BACKGROUND IOWI with aqueous PVP-I is recommended for the prevention of SSI by the World Health Organization and the Centers for Disease Control and Prevention, although the evidence level is low. METHODS This single institute in Japan, prospective, randomized, blinded-endpoint trial was conducted to assess the superiority of IOWI with aqueous PVP-I in comparison with IOWI with saline for reducing the incidence of SSI in clean-contaminated wounds after gastroenterological surgery. Patients 20 years or older were assessed for eligibility, and the eligible participants were randomized at a 1:1 ratio using a computer-generated block randomization. In the study group, IOWI was performed for 1 minute with 40 mL of aqueous 10% PVP-I before skin closure. In the control group, the procedure was performed with 100 mL of saline. Participants, assessors, and analysts were masked to the treatment allocation. The primary outcome was the incidence of incisional SSI in the intention-to-treat set. RESULTS Between June 2019 and March 2022, 941 patients were randomized to the study group (473 patients) or the control group (468 patients). The incidence of incisional SSI was 7.6% in the study group and 5.1% in the control group (risk difference 0.025, 95% CI -0.006 to 0.056; risk ratio 1.484, 95% CI 0.9 to 2.448; P =0.154). CONCLUSION The current recommendation of IOWI with aqueous PVP-I should be reconsidered.
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Affiliation(s)
- Ryo Maemoto
- Department of Surgery, Saitama Medical Center
| | | | | | | | | | | | | | | | | | - Taro Fukui
- Department of Surgery, Saitama Medical Center
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center
| | - Shota Fukai
- Department of Surgery, Saitama Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | - Makiko Mieno
- Department of Medical Statistics, Center for Information, Jichi Medical University, Saitama, Japan
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10
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Miyakura Y, Chino A, Tanakaya K, Lefor AK, Akagi K, Takao A, Yamada M, Ishida H, Komori K, Sasaki K, Miguchi M, Hirata K, Sudo T, Ishikawa T, Yamaguchi T, Tomita N, Ajioka Y. Current practice of colonoscopy surveillance in patients with lynch syndrome: A multicenter retrospective cohort study in Japan. DEN Open 2022; 3:e179. [PMID: 36330234 PMCID: PMC9624071 DOI: 10.1002/deo2.179] [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] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/21/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
Objectives Colonoscopy surveillance reduces the incidence of colorectal cancer through the detection and endoscopic removal of adenomas. Current guidelines recommend that patients with Lynch syndrome should have colonoscopy surveillance every 1–2 years starting at the age of 20–25. However, insufficient data are available to evaluate the quality and safety of colonoscopy surveillance for patients with Lynch syndrome nationwide in Japan. Methods Patients with Lynch syndrome (n = 309) from 13 institutions who underwent one or more colonoscopy procedures were enrolled in this retrospective analysis. Colonoscopy completion rate, colonoscopy‐related complication rate, proportion with an adequate colonoscopy interval, and adenoma detection rate were reviewed. Results The colonoscopy completion rate was 98.8% and a history of previous colorectal cancer surgery was significantly associated with a higher completion rate. All complications were associated with endoscopic treatment and the rate of bleeding needing hemostasis and perforation needing surgical repair were both 0.16% after colonoscopy with polypectomy. The adenoma detection rate at the first colonoscopy was 25%. Although there was no difference in the completion and complication rates based on differences in the colonoscopy experience of the endoscopist, the detection rate of adenomas and intramucosal cancers was significantly higher with more experienced endoscopists. The proportion of patients developing cancer was significantly higher with a >24 months than a ≤24 months interval. Conclusion High‐volume experienced endoscopists and appropriate surveillance intervals may minimize the risk of developing colorectal cancers in patients with Lynch syndrome.
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Affiliation(s)
- Yasuyuki Miyakura
- Department of SurgerySaitama Medical Center Jichi Medical UniversitySaitamaJapan,Department of SurgeryJichi Medical UniversityTochigiJapan,The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan
| | - Akiko Chino
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Kohji Tanakaya
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of SurgeryIwakuni Clinical CenterYamaguchiJapan
| | | | - Kiwamu Akagi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Molecular Diagnosis and Cancer PreventionSaitama Cancer CenterSaitamaJapan
| | - Akinari Takao
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of GastroenterologyTokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Masayoshi Yamada
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
| | - Hideyuki Ishida
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Digestive Tract and General SurgerySaitama Medical Center, Saitama Medical UniversitySaitamaJapan
| | - Koji Komori
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Gastroenterological SurgeryAichi Cancer Center HospitalAichiJapan
| | - Kazuhito Sasaki
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Surgical Oncology, Faculty of MedicineThe University of TokyoTokyoJapan
| | - Masashi Miguchi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of SurgeryHiroshima Prefectural HospitalHiroshimaJapan
| | - Keiji Hirata
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Surgery I, School of MedicineUniversity of Occupational and Environmental HealthFukuokaJapan
| | - Tomoya Sudo
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of SurgeryKurume UniversityFukuokaJapan
| | - Toshiaki Ishikawa
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Medical Oncology, Faculty of MedicineJuntendo UniversityTokyoJapan
| | - Tatsuro Yamaguchi
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Naohiro Tomita
- The Committee of Hereditary Colorectal Cancer, Japanese Society for Cancer of the Colon and RectumTokyoJapan,Cancer Treatment CenterToyonaka Municipal HospitalOsakaJapan
| | - Yoichi Ajioka
- Japanese Society for Cancer of Colon and RectumTokyoJapan,Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
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11
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Tsujinaka S, Kakizawa N, Hatsuzawa Y, Maemoto R, Matsuzawa N, Tamaki S, Takayama Y, Miyakura Y, Rikiyama T. Mid-term Efficacy of Local Repair Using Modified Altemeier Technique for Stomal Prolapse: A Case Series. Cureus 2022; 14:e28193. [PMID: 36003349 PMCID: PMC9391919 DOI: 10.7759/cureus.28193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: Stomal prolapse (SP) is characterized by full-thickness protrusion of the bowel through the stoma site. The surgical procedures for SP include local repair, abdominal wall fixation, and stoma relocation. However, previous reports were mostly case reports or case series with a small number of patients and lacked long-term results. A modified Altemeier technique (MAT) has been used for the local repair of SP in our institution, and this study aimed to evaluate its mid-term efficacy. Methods: We reviewed patients who underwent MAT for SP between August 2013 and December 2020. The variables included patient characteristics, type of stoma, indications of stoma creation, the time interval from stoma creation to prolapse, site of prolapse, reasons for SP surgery, perioperative variables, complications during SP surgery, and length of follow-up. Recurrence of SP was defined as the need for change in stoma care or re-protrusion of the stoma by more than 5 cm in length. Results: Ten patients were included in this study. The median age at the time of SP surgery was 71.5 years. The indications of stoma creation included unresectable or recurrent intra-abdominal malignancies in four patients, diverting ileostomy with rectal cancer surgery in two, transverse colon cancer in one, gastric and rectal cancer in one, rectovaginal fistula in one, and non-occlusive mesenteric ischemia in one. The median interval from stoma creation to prolapse was 2.5 months. Six patients underwent elective SP surgery, and four patients underwent emergency surgery for incarcerated prolapse. The median operative time was 75.5 min. Postoperative complications that included transient mucosal ischemia and subcutaneous abscess occurred in one patient. There were four recurrences (40%), and the median time interval from surgery to recurrence was 4.5 months. Two patients underwent repeated MAT, one of whom underwent stomal reversal with laparotomy for re-recurrence. The median follow-up duration was 19 months. Conclusion: MAT for SP is associated with a high recurrence rate in mid-term follow-up.
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Fukai S, Tsujinaka S, Miyakura Y, Matsuzawa N, Hatsuzawa Y, Maemoto R, Kakizawa N, Rikiyama T. Anal fistula metastasis of rectal cancer after neoadjuvant therapy: a case report. Surg Case Rep 2022; 8:57. [PMID: 35357598 PMCID: PMC8971341 DOI: 10.1186/s40792-022-01410-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anal metastasis of colorectal cancer is very rare and may present synchronously or metachronously, regardless of pre-existing anal diseases. We report a case of anal fistula metastasis after completion of neoadjuvant therapy for rectal cancer, followed by surgical resection of the primary tumor and metastatic lesion. CASE PRESENTATION A 50-year-old man was diagnosed with rectal cancer located 5 cm from the anal verge, with a clinical stage of cT3N0M0. He denied any medical or surgical history, and physical examination revealed no perianal disease. He underwent preoperative chemoradiation therapy (CRT) consisting of a tegafur/gimeracil/oteracil potassium (S-1)-based regimen with 45 Gy of radiation. After completion of CRT, computed tomography (CT) revealed the primary tumor's partial response, but a liver mass highly suggestive of metastasis was detected. This mass was later diagnosed as cavernous hemangioma 3 months after CRT initiation. He then underwent and completed six cycles of consolidation chemotherapy with a capecitabine-based regimen. Subsequent colonoscopy revealed the complete response of the primary tumor, but CT showed thickening of the edematous rectal wall. Therefore, we planned to perform low anterior resection as a radical surgery. However, he presented with persistent anal pain after the last chemotherapy, and magnetic resonance imaging revealed a high-intensity mass behind the anus, suggestive of an anal fistula. We considered the differential diagnosis of a benign anal fistula or implantation metastasis into the anal fistula. Fistulectomy was performed, and a pathological diagnosis of tubular adenocarcinoma, suggestive of implantation metastasis, was made. Thereafter, we performed laparoscopic abdominoperineal resection. Histopathological examination revealed well-differentiated adenocarcinoma, ypT2N0, with a grade 2 therapeutic effect. Subsequent immunohistochemistry of the resected anal fistula showed a CDX-2-positive, CK20-positive, CK7-negative, and GCDFP-15 negative tumor, with implantation metastasis. There was no cancer recurrence 21 months after the radical surgery. CONCLUSIONS This is the first report of anal fistula metastasis after neoadjuvant therapy for rectal cancer in a patient without a previous history of anal disease. If an anal fistula is suspected during or after neoadjuvant therapy, physical and radiological assessment, differential diagnosis, and surgical intervention timing for fistula must be carefully discussed.
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Affiliation(s)
- Shota Fukai
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan.
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Natsumi Matsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Yuuri Hatsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
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Takenami T, Tsujinaka S, Miyakura Y, Kakizawa N, Maemoto R, Machida E, Hatsuzawa Y, Takahashi R, Kimura Y, Tamaki S, Ishikawa H, Rikiyama T. Impact of sarcopenia on surgical and oncologic outcomes of laparoscopic surgery for colorectal cancer. Asian J Surg 2022; 45:2686-2690. [PMID: 35221194 DOI: 10.1016/j.asjsur.2021.12.075] [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: 09/24/2021] [Revised: 12/08/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The study aimed to evaluate the impact of sarcopenia on short- and long-term outcomes for laparoscopic colorectal cancer surgery. METHODS Study participants were 209 patients who underwent laparoscopic surgery for any stage of colorectal cancer between 2016 and 2017. Skeletal muscle indices were calculated with preoperative computed tomography. Patients were divided into sarcopenic and non-sarcopenic groups based on index cut-off values and variables were compared. RESULTS The prevalence of sarcopenia was 41.1%. Sarcopenic patients experienced shorter operative times and a lower incidence of surgical site infections; however, the incidence of severe postoperative complications and readmission were increased for this group. Although the 3-year disease-free survival rate was not statistically different between groups, sarcopenic patients had a significantly worse 3-year overall survival rate compared with than the non-sarcopenic group. CONCLUSION Sarcopenia has both favorable and unfavorable effects on patients who underwent laparoscopic colorectal cancer surgery.
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Affiliation(s)
- Tsutomu Takenami
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Erika Machida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuuri Hatsuzawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rei Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuaki Kimura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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Maemoto R, Noda H, Ichida K, Tamaki S, Kanemitsu R, Machida E, Kikuchi N, Sakio R, Aizawa H, Fukui T, Kakizawa N, Muto Y, Iseki M, Fukuda R, Watanabe F, Kato T, Saito M, Tsujinaka S, Miyakura Y, Rikiyama T. Superiority trial comparing intraoperative wound irrigation with aqueous 10% povidone-iodine to saline for the purpose of reducing surgical site infection after elective gastrointestinal surgery: study protocol for a randomised controlled trial. BMJ Open 2021; 11:e051374. [PMID: 34135056 PMCID: PMC8211046 DOI: 10.1136/bmjopen-2021-051374] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Surgical site infection (SSI) is one of the most common complications after gastrointestinal surgery, with a reported incidence of approximately 10%-25%, which is higher than the rates after other types of surgery. Intraoperative wound irrigation (IOWI) is a simple intervention for SSI prevention, and recent studies have reported that IOWI with aqueous povidone-iodine (PVP-I) is significantly more effective at reducing the incidence of SSI than saline. However, the evidence level of previous trials evaluating the efficacy of aqueous PVP-I solution for preventing SSI has been low. METHODS AND ANALYSES We propose a single-institute, prospective, randomised, blinded-endpoint trial to assess the superiority of IOWI with aqueous 10% PVP-I solution compared with normal saline for reducing SSI in clean-contaminated wounds after elective gastrointestinal surgery. In the study group, IOWI with 40 mL of aqueous 10% PVP-I solution is performed for 1 min before skin suture, and in the control group, IOWI with 100 mL of saline is performed for 1 min before skin suture. We hypothesise that IOWI with aqueous 10% PVP-I solution will achieve a 50% reduction in the incidence of SSIs. The target number of cases is set at 950. The primary outcome is the incidence of incisional SSI up to postoperative day 30 and will be analysed in the modified intention-to-treat set. ETHICS AND DISSEMINATION This trial was designed and is being conducted by Saitama Medical Center, Jichi Medical University, with approval from the Bioethics Committee for Clinical Research, Saitama Medical Center, Jichi Medical University. Participant recruitment began in June 2019. The final results will be reported in international peer-reviewed journals immediately after trial completion. TRIAL REGISTRATION NUMBER UMIN000036889.
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Affiliation(s)
- Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rina Kanemitsu
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Erika Machida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nozomi Kikuchi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ryotaro Sakio
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hidetoshi Aizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masahiro Iseki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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15
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Maemoto R, Tsujinaka S, Miyakura Y, Machida E, Fukui T, Kakizawa N, Tamaki S, Ishikawa H, Rikiyama T. Effect of Antithrombotic Therapy on Secondary Bleeding After Proctological Surgery. Cureus 2021; 13:e14983. [PMID: 33996339 PMCID: PMC8115195 DOI: 10.7759/cureus.14983] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Surgery for patients taking antithrombotic drugs for the prevention and treatment of cardiovascular disease, including anticoagulants and antiplatelet drugs, is increasing because of the aging society. In patients with moderate to high risk for cardiovascular events, receiving antiplatelet therapy, and requiring noncardiac surgery continuing antiplatelet drugs perioperatively is recommended. To date, there have been limited reports on the risk of secondary bleeding after proctological surgery in patients who are administered antithrombotic drugs. The purpose of this study was to identify the incidence and severity of secondary bleeding after proctological surgery for patients with or without antithrombotic therapy. Methods We retrospectively identified 113 patients who underwent proctological surgery in our hospital from March 2009 to February 2019. In general, antiplatelet drugs were continued and anticoagulant drugs were either substituted or withdrawn prior to surgery. The severity of secondary bleeding was classified as mild, moderate, or severe. Results Eighteen patients underwent antithrombotic therapy (A group) and 95 patients did not undergo antithrombotic therapy (N group). Secondary bleeding was observed in nine patients (8.0%) and patients in the A group exhibited a significantly higher rate of secondary bleeding than those in the N group (39% vs. 2.4%, P < 0.01). The median interval from surgery to the onset of secondary bleeding was five days (range: 0-11). The severity of bleeding was the highest in patients administered direct oral anticoagulants (DOAC) and was the lowest in those administered aspirin. There was no mortality or cardiovascular event. Conclusion Antithrombotic therapy carries a high risk of secondary bleeding after proctological surgery. Delaying the postoperative resumption of anticoagulants is considered while balancing the risk of postoperative thromboembolic complications against secondary bleeding.
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Affiliation(s)
- Ryo Maemoto
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Shingo Tsujinaka
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Yasuyuki Miyakura
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Erika Machida
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Taro Fukui
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Nao Kakizawa
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Sawako Tamaki
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Hideki Ishikawa
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Toshiki Rikiyama
- Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JPN
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16
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Maemoto R, Tsujinaka S, Miyakura Y, Fukuda R, Kakizawa N, Takenami T, Machida E, Kikuchi N, Kanemitsu R, Tamaki S, Ishikawa H, Rikiyama T. Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy. Asian J Surg 2021; 44:1037-1042. [PMID: 33549406 DOI: 10.1016/j.asjsur.2021.01.002] [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: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Stoma-related obstruction (SRO) is defined as small bowel obstruction occurring around the limbs of diverting ileostomy (DI). This study was aimed to investigate the incidence, risk factors, and management of SRO after laparoscopic colorectal surgery with DI creation. METHODS This study included 155 patients who underwent laparoscopic colorectal surgery with DI creation for rectal cancer (n = 138), ulcerative colitis (UC) (n = 14), and familial adenomatous polyposis (FAP) (n = 3) between 2011 and 2019. Univariate and multivariate analyses were performed to identify the risk factors of SRO. RESULTS The incidence of SRO was 7.7% (n = 12), and it was significantly lower (P < 0.01) in patients with lower anterior resection or intersphincteric resection (4.3%) than in those with ileal-pouch anal anastomosis (IPAA) (35.2%). The multivariate analysis revealed that IPAA was independently associated with the development of SRO (P = 0.001; odds ratio, 9.4; 95% confidence interval, 2.5-35.4). Eleven of 12 patients (92%) with SRO required trans-stomal tube decompression, and 8 of those (67%) underwent early stoma closure. CONCLUSION IPAA was an independent risk factor of SRO in laparoscopic colorectal surgery with DI creation. Early stoma closure was needed in most cases of SRO.
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Affiliation(s)
- Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Tsutomu Takenami
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Erika Machida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nozomi Kikuchi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rina Kanemitsu
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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17
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Takahashi J, Tsujinaka S, Maemoto R, Miyakura Y, Suzuki K, Fukuda R, Sakio R, Machida E, Rikiyama T. Tolerability and Adverse Events of Adjuvant Chemotherapy for Rectal Cancer in Patients With Diverting Ileostomy. In Vivo 2020; 34:3399-3406. [PMID: 33144447 DOI: 10.21873/invivo.12178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/08/2020] [Revised: 07/25/2020] [Accepted: 07/31/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIM The impact of diverting ileostomy on the feasibility of adjuvant chemotherapy (ACT) remains unclear. We retrospectively investigated the tolerability and adverse events of ACT for rectal cancer in patients with diverting ileostomy. PATIENTS AND METHODS Thirty-three patients who received ACT after curative resection with ileostomy construction for rectal cancer were analyzed. We assessed completion rate, the mean relative dose intensities, and the factors affecting the tolerability of ACT. RESULTS The completion rate of each chemotherapy regimen was 10 out of 16 patients in oral uracil-tegafur plus leucovorin (UFT/LV), 1 out of 3 patients in oral capecitabine (Capecitabine) and 2 out of 14 patients in capecitabine plus oxaliplatin (CAPOX). The mean relative dose intensities were 77% in UFT/LV, 48% in Capecitabine, and 57% of capecitabine and 42% of oxaliplatin in CAPOX. In multivariate analysis, laparoscopic surgery (Odds ratio=11.6, p=0.021) and receiving preoperative chemoradiotherapy (Odds ratio=32.4, p=0.021) were associated with treatment completion. CONCLUSION Completion rate of ACT in patients with diverting ileostomy was lower than that of colorectal cancer patients in the previous studies. UFT/LV may be a more tolerable regimen than Capecitabine or CAPOX in colorectal cancer patients with diverting ileostomy.
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Affiliation(s)
- Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ryotaro Sakio
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Erika Machida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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18
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Maemoto R, Miyakura Y, Tamaki S, Takahashi J, Takayama N, Fukuda R, Ishikawa H, Tsujinaka S, Lefor AK, Rikiyama T. Intra-abdominal desmoid tumor after laparoscopic low anterior resection for rectal cancer: A case report. Asian J Endosc Surg 2020; 13:426-430. [PMID: 31389170 DOI: 10.1111/ases.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/04/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023]
Abstract
Desmoid tumors are monoclonal fibroblastic proliferations arising from soft tissue classified as intra-abdominal, extra-abdominal and abdominal wall types. We present a patient with an intra-abdominal desmoid tumor diagnosed 20 months after laparoscopic resection of rectal cancer. A 70-year-old woman with hematochezia was diagnosed with advanced rectal cancer. Preoperative chemoradiotherapy followed by laparoscopic low anterior resection was performed. During follow-up, a nodular soft-tissue density measuring 28 mm was detected in the presacral region. Metastasis from rectal cancer was diagnosed and four courses of chemotherapy were given, including capecitabine, oxaliplatin and bevacizumab. Computed tomography scan showed that the mass slightly decreased in size and surgical resection was performed. Histopathological examination revealed a proliferation of spindle-shaped cells and collagenous stroma diagnosed as a desmoid tumor. This report highlights the possibility of a desmoid tumor in the differential diagnosis of an intra-abdominal mass found during follow-up after resection of colorectal cancer including following laparoscopic resection.
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Affiliation(s)
- Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.,Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Noriya Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Alan K Lefor
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
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19
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Takahashi J, Miyakura Y, Maemoto R, Takayama N, Fukuda R, Tamaki S, Ishikawa H, Tsujinaka S, Lefor AK, Rikiyama T. Idiopathic mesenteric phlebosclerosis treated with laparoscopic subtotal colectomy: A case report. Asian J Endosc Surg 2020; 13:223-226. [PMID: 31240856 DOI: 10.1111/ases.12727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/30/2019] [Revised: 05/11/2019] [Accepted: 05/20/2019] [Indexed: 12/24/2022]
Abstract
Idiopathic mesenteric phlebosclerosis is a rare entity characterized by chronic intestinal ischemia due to calcification and obstruction of the mesenteric veins. Here, we report a patient with idiopathic mesenteric phlebosclerosis treated with laparoscopic subtotal colectomy after evaluation by imaging studies. The patient was a 68-year-old Japanese woman with recurrent abdominal pain who had taken a Chinese herbal medicine for more than 20 years. Abdominal CT showed wall thickening of the right colon with calcification of branches of the superior mesenteric vein. Colonoscopy showed cyanotic mucosa from the cecum to the sigmoid colon. The affected area seen on colonoscopy extended to the distal colon. Despite discontinuation of the herbal medicine, her symptoms did not improve. Laparoscopic subtotal colectomy was performed. This report highlights the importance of appropriately evaluating the extent of the affected preoperatively area based on findings from colonoscopy, CT, and contrast enema.
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Affiliation(s)
- Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ryo Maemoto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Noriya Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rintaro Fukuda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Alan K Lefor
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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20
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Tsujinaka S, Tan KY, Miyakura Y, Fukano R, Oshima M, Konishi F, Rikiyama T. Current Management of Intestinal Stomas and Their Complications. J Anus Rectum Colon 2020; 4:25-33. [PMID: 32002473 PMCID: PMC6989127 DOI: 10.23922/jarc.2019-032] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the “principles of perioperative patient management” section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the “early complications” section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the “late complications” section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre- and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.
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Affiliation(s)
- Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kok-Yang Tan
- Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rieko Fukano
- Department of Nursing, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Mitsuko Oshima
- Department of Nursing, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumio Konishi
- Department of Surgery, Nerima Hikarigaoka Hospital, Tokyo, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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21
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Fukui T, Suzuki K, Tamaki S, Abe I, Endo Y, Ishikawa H, Kakizawa N, Watanabe F, Saito M, Tsujinaka S, Futsuhara K, Miyakura Y, Noda H, Rikiyama T. Temporary loss of consciousness during cetuximab treatment of a patient with metastatic colon cancer: a case report. Surg Case Rep 2019; 5:145. [PMID: 31637554 PMCID: PMC6803608 DOI: 10.1186/s40792-019-0707-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/13/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Anti-epidermal growth factor receptor (EGFR) antibody is widely used for the treatment of patients with metastatic colorectal cancer. Hypomagnesemia is a comparatively frequent adverse event of this drug, which is likely overlooked because it occurs later in treatment without symptoms. Furthermore, hypomagnesemia and hypomagnesemia-induced corrected QT (QTc) prolongation may lead to loss of consciousness (LOC), the onset of which is not generally considered associated with the treatment of anti-EGFR antibody because of its rare occurrence. Here, we present a colorectal cancer patient treated with anti-EGFR antibody, who suffered LOC during treatment while severe hypomagnesemia or QTc prolongation was not observed. CASE PRESENTATION A 69-year-old man with metastatic colon cancer was treated with cetuximab (anti-EGFR antibody) plus irinotecan as third-line chemotherapy. His serum magnesium level gradually decreased, and grade 2 hypomagnesemia (a serum magnesium level of 0.9 mg/dL) was observed at the 12th administration of cetuximab. In light of this development, intravenous supplementation of 20 mEq magnesium sulfate began with careful blood monitoring despite the lack of clinical symptoms. Electrocardiogram (ECG) showed prolonged QT or corrected QT (QTc) intervals (grade 1). His serum magnesium level remained at 0.9 mg/dL, and no hypomagnesemia symptoms were observed by the 17th administration of cetuximab. After the treatment, however, he suddenly lost consciousness without symptoms related to infusion or allergic reactions. Circulatory collapse following dermatological reactions and respiratory events were not evident. Intravenous supplementation of magnesium sulfate was administered again. He awakened 2 min after the onset of temporary LOC without any other symptoms related to hypomagnesemia, such as lethargy, tremor, tetany, and seizures. No other etiology outside of the low level of serum magnesium was confirmed in further examinations. Cetuximab was discontinued, and his serum magnesium level returned to a level within the normal range after 6 weeks. Because of tumor progression, regorafenib and TAS-102 (trifluridine tipiracil hydrochloride) were introduced sequentially for 6 months. Five months after the final treatment of TAS-102, he died of his primary disease, which reflected a survival period of 4 years and 6 months since the beginning of treatment. CONCLUSIONS This case report reminds clinicians that LOC can be induced without severe hypomagnesemia or QTc prolongation, during anti-EGFR antibody treatment for metastatic colorectal cancer even while under carefully monitored magnesium supplementation.
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Affiliation(s)
- Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Iku Abe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Yuhei Endo
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
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22
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Nishizaki D, Hida K, Sumii A, Sakai Y, Konishi T, Akagi T, Yamaguchi T, Akiyoshi T, Fukuda M, Yamamoto S, Maruyama S, Okajima M, Miyakura Y, Okamura R, Arizono S, Yamamoto M, Kawada K, Morita S, Watanabe M. Neoadjuvant chemoradiotherapy with/without lateral lymph node dissection for low rectal cancer: Which patients can benefit? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Aizawa M, Utano K, Tsunoda T, Ichii O, Kato T, Miyakura Y, Saka M, Nemoto D, Isohata N, Endo S, Ejiri Y, Lefor AK, Togashi K. Delayed hemorrhage after cold and hot snare resection of colorectal polyps: a multicenter randomized trial (interim analysis). Endosc Int Open 2019; 7:E1123-E1129. [PMID: 31475229 PMCID: PMC6715428 DOI: 10.1055/a-0854-3561] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Indexed: 02/07/2023] Open
Abstract
Background and study aims Delayed bleeding is believed to occur less frequently after cold snare polypectomy (CSP), but this has not been validated in clinical trials. This study aimed to compare rates of delayed bleeding after CSP and hot snare polypectomy (HSP). Patients and methods We conducted a multicenter, randomized controlled trial. Participants scheduled to undergo endoscopic resection of colorectal polyps ≤ 10 mm were enrolled and randomly assigned to CSP or HSP. Prophylactic clipping was performed at the endoscopists' discretion. The primary outcome was delayed bleeding rate. Secondary outcomes included immediate bleeding rate and clipping rate. Sample size calculation showed that 451 patients were required in each arm. Results At the end of the study period decided in advance, 308 participants were recruited and an interim analysis was performed. A total of 273 patients (mean age 62.2 ± 8.8 years; 188 males) were analyzed, with 139 patients allocated to CSP and 134 to HSP. In total, 367 polyps were resected with CSP and 360 polyps with HSP. There were no significant differences in patient demographics or polyp characteristics. In per-patient-based analysis, delayed bleeding rates were 0.7 % after CSP and 0.7 % after HSP. Per-polyp analysis showed similar results (CSP: 0.3 % vs. HSP: 0.6 %). The immediate bleeding rate was significantly higher with CSP vs. HSP (54 % vs.14 %, P < 0.0001), while clipping rates were 18 % and 19 %, respectively. Conclusion This interim analysis did not demonstrate that delayed bleeding after CSP is less frequent than after HSP. The delayed bleeding rate after HSP was lower than expected. Meeting presentations: Digestive Disease Week 2017.
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Affiliation(s)
- Masato Aizawa
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Kenichi Utano
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Takuya Tsunoda
- Department of Gastroenterology, Takeda General Hospital, Fukushima, Japan
| | - Osamu Ichii
- Department of Gastroenterology, Fukushima Rosai Hospital, Fukushima, Japan
| | - Takashi Kato
- Department of Gastroenterology, Hokkaido Gastroenterology Hospital, Hokkaido, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - Mitsuru Saka
- Department of Gastroenterology, Fujita General Hospital, Fukushima, Japan
| | - Daiki Nemoto
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Noriyuki Isohata
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Shungo Endo
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Yutaka Ejiri
- Department of Gastroenterology, Fukushima Rosai Hospital, Fukushima, Japan
| | | | - Kazutomo Togashi
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan,Corresponding author Kazutomo Togashi, MD, PhD Department of ColoproctologyAizu Medical Center Fukushima Medical University21-2 Maeda, TanisawaKawahigashi-machi, Aizuwakamatsu-cityFukushima 969-3492Japan+81-242752568
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24
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Kakizawa N, Suzuki K, Ishikawa H, Watanabe F, Hasegawa F, Kikugawa R, Tsujinaka S, Futsuhara K, Miyakura Y, Rikiyama T. Significance of monitoring plasma vascular endothelial growth factor signals during treatment of colorectal cancer patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.577] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
577 Background: Vascular endothelial growth factor (VEGF) signals may change during colorectal cancer (CRC) treatment, but monitoring real time changes has not been conducted. Methods: Blood monitoring was carried out to track changes in the status of VEGF ligands (A, C, and D) in CRC patients. Expression was determined by ELISA. Results: VEGF-A monitoring was performed in 148 CRC patients preoperatively and VEGF-C and -D monitoring was performed in 52 metastatic CRC patients. Patients with high VEGF-A had significantly shorter recurrence free survival (p = 0.00438). Univariate analysis associating with recurrence detected high VEGF-A, high pathological stage, and with lymph node metastasis were risk factors, and high VEGF-A was identified as an independent risk factor of recurrence by multivariate analysis. There was no significant difference in prognosis between metastatic CRC patients with high and low VEGF-D in early-line treatment, however, in late line patients with high VEGF-D had significantly worse prognosis than those with low VEGF-D (p = 0.0121). When they had treatment with bevacizumab, same result was seen in late line (p = 0.0416). VEGF-C showed no significant correlation with prognosis. Conclusions: Preoperative high VEGF-A is an important risk factor of recurrence and VEGF targeting drugs might be useful as an adjuvant chemotherapy for the patients with high VEGF-A. In late line chemotherapy, patients with high VEGF-D had poor prognosis in regardless of bevacizumab, therefore, they will be candidates of other anti-VEGF drugs than bevacizumab in late line chemotherapy. Measurement of plasma VEGF level can have benefit for the treatment of CRC patients to predict their recurrence and prognosis. It would be helpful for VEGF targeting drug selection and provide useful information for better treatment strategy.
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Affiliation(s)
- Nao Kakizawa
- Saitama Mediacl Center, Jichi Medical University, Saitama, Japan
| | | | - Hideki Ishikawa
- Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | | | | | | | | | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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25
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Machida E, Miyakura Y, Takahashi J, Tamaki S, Ishikawa H, Hasegawa F, Kikugawa R, Tsujinaka S, Lefor AK, Rikiyama T. Bevacizumab is associated with delayed anastomotic leak after low anterior resection with preoperative radiotherapy for rectal cancer: a case report. Surg Case Rep 2019; 5:14. [PMID: 30706233 PMCID: PMC6357210 DOI: 10.1186/s40792-019-0573-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/28/2018] [Accepted: 01/21/2019] [Indexed: 12/14/2022] Open
Abstract
Background Bevacizumab is an anti-angiogenesis agent used to treat patients with metastatic colorectal cancer and is associated with a variety of complications. We present a patient with rectal cancer who developed a delayed anastomotic leak more than 5 years after undergoing low anterior resection. Case report A 78-year-old man with hematochezia was diagnosed with two synchronous rectal cancers 7 years prior to presentation. Preoperative chemo-radiotherapy was given followed by a very low anterior resection. During follow-up, multiple lymph node metastases developed, which were treated with chemotherapy. First-line chemotherapy, capecitabine, oxizaliplatin, and bevacizumab, was given over 3 years, and second-line chemotherapy, capecitabine, irinotecan, and bevacizumab, was administered over a 3-month period. After the last treatment, the patient presented with pneumaturia and fecaluria. Computed tomography scan revealed extraluminal air between the prostate and rectum, adjacent to the anastomotic site. Ulceration and fistula formation were observed on colonoscopy, and contrast radiography demonstrated a fistula at the anastomotic site. An anastomotic-urethral fistula was diagnosed and transverse colostomy was performed. Conclusions This patient highlights a rare late adverse event at the anastomotic site associated with bevacizumab treatment and preoperative chemo-radiotherapy. Signs and symptoms suggesting anastomotic complications should be thoroughly evaluated during bevacizumab treatment, even long after surgical resection.
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Affiliation(s)
- Erika Machida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan.
| | - Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
| | | | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan
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26
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Kakizawa N, Tsujinaka S, Miyakura Y, Kikugawa R, Hasegawa F, Ishikawa H, Tamaki S, Takahashi J, Rikiyama T. The surgical treatment of acute and severe diversion colitis mimicking ulcerative colitis: a case report. Surg Case Rep 2018; 4:86. [PMID: 30073476 PMCID: PMC6081828 DOI: 10.1186/s40792-018-0490-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Diversion colitis (DC) is characterized by nonspecific inflammation in the remaining colon or rectum, and loss of the fecal stream plays a major role in the disease's development. Although the majority of patients are asymptomatic, medical and/or surgical treatment is required for those who are symptomatic. There is a particular interest on how to manage patients with acute and severe clinical presentations, but the pathogenesis is not fully understood. We report the rare case of a man with acute and severe DC mimicking ulcerative colitis (UC) with extra-intestinal manifestations that was successfully managed with surgical treatment. CASE PRESENTATION A 68-year-old man with a history of laparoscopic intersphincteric resection of the rectum with diverting loop ileostomy for lower rectal cancer suffered from anastomotic stenosis requiring repeated endoscopic dilatation. His loop stoma was not reversed because these treatments were unsuccessful. He denied having a history of inflammatory bowel disease. Twelve years postoperatively, he developed a perineal abscess requiring drainage. Subsequently, he developed a high-grade fever, bloody discharge per anus, and skin ulcers in the right ankle and around the stoma. Because culture tests were negative for bacteria, it was deemed that his acute illness reflected an inflammatory response rather than an infectious disease. Colonoscopy revealed anastomotic stenosis, a colonic fistula, and mucosa that hemorrhaged easily, with lacerations. A pathological examination with biopsy revealed inflammatory infiltration without malignancy. After reviewing the patient's clinical episodes and discussing the case with physicians in multiple specialties, we performed total colectomy with end ileostomy in accordance with the abdominoperineal resection. The postoperative course was uneventful. A resected specimen showed atrophic mucosa with the disappearance of haustra in the distal colon, as well as edematous and dilated mucosa in the proximal colon. The pathological diagnosis was suggestive of UC, including erosion and ulceration in edematous wall, crypt abscess, and inflammatory infiltration into the mucosa. The skin ulcers in the right ankle and around the stoma healed over time. CONCLUSIONS DC can eventuate in a long-term period after fecal diversion surgery, possibly with extra-intestinal manifestations mimicking UC. Surgical treatment seems feasible for patients with acute and severe DC.
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Affiliation(s)
- Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan.
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya, Saitama-shi, Saitama, 330-8503, Japan
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27
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Kikuchi N, Miyakura Y, Takahashi J, Takayama N, Tamaki S, Ishikawa H, Kakizawa N, Hasegawa F, Kikugawa R, Tsujinaka S, Lefor AK, Rikiyama T. Intussusception secondary to descending colon lipoma presenting with simultaneous acute appendicitis. J Surg Case Rep 2018; 2018:rjy152. [PMID: 29992005 PMCID: PMC6030933 DOI: 10.1093/jscr/rjy152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/12/2018] [Indexed: 12/29/2022] Open
Abstract
We report a patient with a descending colon lipoma presenting with hematochezia who developed intussusception, which was simultaneously accompanied by acute appendicitis. A 43-year-old man presented with hematochezia. Colonoscopy revealed a submucosal tumor with a reddish surface in the descending colon. A solid mass with fat density value measuring 5 cm in diameter was observed in the descending colon on CT. While awaiting elective resection, the patient developed lower abdominal pain. CT demonstrated antegrade colo-colonic intussusception in the descending colon. Simultaneously, the appendix was inflamed with a high density intraluminal lesion suspected to be a fecalith. The diagnosis of simultaneous intussusception and acute appendicitis was made. Appendectomy and partial resection of the descending colon was performed. Histopathological examination was consistent with descending colon lipoma and acute appendicitis. The mechanism for developing hematochezia and the risk for development of colo-colonic intussusception due to large colon lipoma and acute appendicitis were highlighted.
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Affiliation(s)
- Nozomi Kikuchi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Noriya Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Sawako Tamaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan.,Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Japan
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28
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Ishida H, Yamaguchi T, Tanakaya K, Akagi K, Inoue Y, Kumamoto K, Shimodaira H, Sekine S, Tanaka T, Chino A, Tomita N, Nakajima T, Hasegawa H, Hinoi T, Hirasawa A, Miyakura Y, Murakami Y, Muro K, Ajioka Y, Hashiguchi Y, Ito Y, Saito Y, Hamaguchi T, Ishiguro M, Ishihara S, Kanemitsu Y, Kawano H, Kinugasa Y, Kokudo N, Murofushi K, Nakajima T, Oka S, Sakai Y, Tsuji A, Uehara K, Ueno H, Yamazaki K, Yoshida M, Yoshino T, Boku N, Fujimori T, Itabashi M, Koinuma N, Morita T, Nishimura G, Sakata Y, Shimada Y, Takahashi K, Tanaka S, Tsuruta O, Yamaguchi T, Sugihara K, Watanabe T. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2016 for the Clinical Practice of Hereditary Colorectal Cancer (Translated Version). J Anus Rectum Colon 2018; 2:S1-S51. [PMID: 31773066 PMCID: PMC6849642 DOI: 10.23922/jarc.2017-028] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/15/2017] [Indexed: 02/07/2023] Open
Abstract
Hereditary colorectal cancer accounts for less than 5% of all colorectal cancer cases. Some of the unique characteristics that are commonly encountered in cases of hereditary colorectal cancer include early age at onset, synchronous/metachronous occurrence of the cancer, and association with multiple cancers in other organs, necessitating different management from sporadic colorectal cancer. While the diagnosis of familial adenomatous polyposis might be easy because usually 100 or more adenomas that develop in the colonic mucosa are in this condition, Lynch syndrome, which is the most commonly associated disease with hereditary colorectal cancer, is often missed in daily medical practice because of its relatively poorly defined clinical characteristics. In addition, the disease concept and diagnostic criteria for Lynch syndrome, which was once called hereditary non-polyposis colorectal cancer, have changed over time with continual research, thereby possibly creating confusion in clinical practice. Under these circumstances, the JSCCR Guideline Committee has developed the "JSCCR Guidelines 2016 for the Clinical Practice of Hereditary Colorectal Cancer (HCRC)," to allow delivery of appropriate medical care in daily practice to patients with familial adenomatous polyposis, Lynch syndrome, or other related diseases. The JSCCR Guidelines 2016 for HCRC were prepared by consensus reached among members of the JSCCR Guideline Committee, based on a careful review of the evidence retrieved from literature searches, and considering the medical health insurance system and actual clinical practice settings in Japan. Herein, we present the English version of the JSCCR Guidelines 2016 for HCRC.
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Affiliation(s)
- Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitma Medical University, Kawagoe, Japan
| | - Tatsuro Yamaguchi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kohji Tanakaya
- Department of Surgery, Iwakuni Clinical Center, Iwakuni, Japan
| | - Kiwamu Akagi
- Department of Cancer Prevention and Molecular Genetics, Saitama Prefectural Cancer Center, Saitama, Japan
| | - Yasuhiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kensuke Kumamoto
- Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Hideki Shimodaira
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Shigeki Sekine
- Division of Pathology and Clinical Laboratories, National Cancer Center, Hospital, Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, The Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Chino
- Division of Gastroenterology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naohiro Tomita
- Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takeshi Nakajima
- Endoscopy Division/Department of Genetic Medicine and Service, National Cancer Center Hospital, Tokyo, Japan
| | | | - Takao Hinoi
- Department of Surgery, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Akira Hirasawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyuki Miyakura
- Department of Surgery Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yoshie Murakami
- Department of Oncology Nursing, Faculty of Nursing, Toho University, Tokyo, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoichi Ajioka
- Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | | | - Yoshinori Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Hamaguchi
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Megumi Ishiguro
- Department of Translational Oncology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, The Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukihide Kanemitsu
- Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Kawano
- Department of Gastroenterology, St. Mary's Hospital, Fukuoka, Japan
| | - Yusuke Kinugasa
- Department of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Norihiro Kokudo
- Hepato-Pancreato-Biliary Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Keiko Murofushi
- Radiation Oncology Department, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takako Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shiro Oka
- Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Akihiko Tsuji
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Takamatsu, Japan
| | - Keisuke Uehara
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Saitama, Japan
| | - Kentaro Yamazaki
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Chemotherapy Research Institute, International University of Health and Welfare, Ichikawa, Japan
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Narikazu Boku
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Michio Itabashi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuo Koinuma
- Department of Health Administration and Policy, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takayuki Morita
- Department of Surgery, Cancer Center, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Genichi Nishimura
- Department of Surgery, Japanese Red Cross Kanazawa Hospital, Ishikawa, Japan
| | - Yuh Sakata
- CEO, Misawa City Hospital, Misawa, Japan
| | - Yasuhiro Shimada
- Division of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan
| | - Keiichi Takahashi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Osamu Tsuruta
- Division of GI Endoscopy, Kurume University School of Medicine, Fukuoka, Japan
| | - Toshiharu Yamaguchi
- Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Toshiaki Watanabe
- Department of Surgical Oncology, The Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Takayama Y, Suzuki K, Fukui T, Ichida K, Watanabe F, Kakizawa N, Kikugawa R, Hasegawa F, Tsujinaka S, Miyakura Y, Konishi F, Rikiyama T. Monitoring circulating tumor DNA revealed dynamic changes in KRAS status in patients with metastatic colorectal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Taro Fukui
- Jichi Medical University, Saitama, Japan
| | | | | | - Nao Kakizawa
- Saitama Medical Cener, Jichi Medical University, Saitama, Japan
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Suzuki K, Kakizawa N, Takayama Y, Ichida K, Fukui T, Watanabe F, Kikugawa R, Tsujinaka S, Hasegawa F, Ishikawa H, Miyakura Y, Futsuhara K, Noda H, Rikiyama T. The significance of monitoring KRAS, human epidermal growth factor receptor 2, and vascular endothelial growth factor signals in the blood of colorectal cancer patients during treatment. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Nao Kakizawa
- Saitama Medical Cener, Jichi Medical University, Saitama, Japan
| | | | | | - Taro Fukui
- Jichi Medical University, Saitama, Japan
| | | | | | | | | | | | | | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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31
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Kakizawa N, Suzuki K, Ishikawa H, Watanabe F, Hasegawa F, Kikugawa R, Tsujinaka S, Miyakura Y, Noda H, Rikiyama T. Significance of monitoring vascular endothelial growth factor signals in blood during treatment of colorectal cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Nao Kakizawa
- Saitama Medical Cener, Jichi Medical University, Saitama, Japan
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Ishikawa H, Suzuki K, Kakizawa N, Watanabe F, Ichida K, Takayama Y, Fukui T, Hasegawa F, Kikugawa R, Futsuhara K, Tsujinaka S, Miyakura Y, Noda H, Rikiyama T. Efficacy, tolerability, and manageability of TAS-102 plus bevacizumab for metastatic colorectal cancer patients in clinical practice. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Nao Kakizawa
- Saitama Medical Cener, Jichi Medical University, Saitama, Japan
| | | | | | | | - Taro Fukui
- Jichi Medical University, Saitama, Japan
| | | | | | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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33
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Takayama Y, Suzuki K, Muto Y, Ichida K, Fukui T, Kakizawa N, Ishikawa H, Watanabe F, Hasegawa F, Saito M, Tsujinaka S, Futsuhara K, Miyakura Y, Noda H, Konishi F, Rikiyama T. Monitoring circulating tumor DNA revealed dynamic changes in KRAS status in patients with metastatic colorectal cancer. Oncotarget 2018; 9:24398-24413. [PMID: 29849949 PMCID: PMC5966256 DOI: 10.18632/oncotarget.25309] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 12/27/2017] [Accepted: 04/13/2018] [Indexed: 12/15/2022] Open
Abstract
KRAS mutated circulating tumor DNA (MctDNA) can be monitored in the blood of patients with metastatic colorectal cancer (mCRC), but dynamic changes have not been determined. Four hundred and fifty-seven plasma samples were collected prospectively from 85 mCRC patients who underwent chemotherapy. MctDNA in plasma was detected by droplet digital PCR, and the percentage of MctDNA in total circulating cell-free DNA was calculated. KRAS assessment in tumor tissues showed 29 patients with the mutant-type (MT) and 56 patients with the wild-type (WT). Twenty-three of 29 MT patients (79.3%) and 28 of 56 WT patients (50.0%) showed MctDNA. Emergence of MctDNA was recognized during treatments with various drugs. Regardless of KRAS status in tumor tissues, patients with MctDNA in blood showed poor progression-free survival with first-line treatment. Median percentage of MctDNA accounted for 10.10% in MT patients and 0.22% in WT patients. These differences between MT and WT likely affected patterns of changes in MctDNA. KRAS monitoring identified dynamic changes in MctDNA, such as continuous, intermittent, and transient changes (quick elevation and disappearance). Emergence of MctDNA involved drug resistance, except for transient changes, which were seen in WT patients and likely corresponded with the drug response. Transient changes could be involved in recovery of sensitivity to anti-EGFR antibody in WT patients. Monitoring MctDNA during various treatments showed dynamic changes in KRAS status and could provide useful information for determining treatments for patients with mCRC.
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Affiliation(s)
- Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Fumio Konishi
- Department of Surgery, Nerima-Hikarigaoka Hospital, Nerima-ku, Tokyo 179-0072, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
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Takayama N, Tsujinaka S, Kakizawa N, Someya S, Takahashi J, Hasegawa F, Kikugawa R, Miyakura Y, Rikiyama T. Successful treatment of recurrent stoma prolapse after Hartmann's procedure through ileorectal anastomosis: A case report. Int J Surg Case Rep 2018; 41:489-492. [PMID: 29546023 PMCID: PMC5711666 DOI: 10.1016/j.ijscr.2017.11.041] [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: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022] Open
Abstract
The patient with Parkinson’s disease had stoma prolapse after Hartmann’s procedure. Local procedure had failed, and stoma reversal was considered to be favorable. We assumed that stoma reversal alone led to worsening of concomitant constipation. We performed resection of the remnant colon with ileorectal anastomosis. It may be an optimal treatment for patients with concomitant colonic motility disorder.
Introduction Treatment strategy for recurrent stoma prolapse has not been well-established because of the rarity and complexity of the condition. We report a case of recurrent stoma prolapse that was successfully managed using unique surgical treatments. Presentation of case A 72-year-old man with a history of Parkinson's disease presented with transverse (T3N0M0) and sigmoid (T3N0M0) colon cancer. Considering the status of large bowel obstruction, Hartmann's procedure was indicated. Four months after surgery, stoma prolapse occurred, which became irreducible. Six months after surgery, local resection of the prolapsed bowel was performed. The patient continued to receive laxatives for bowel movement control and his abdomen remained distended. Ten months later, stoma prolapse recurred with evident bowel dilatation. Initially, we planned Hartmann’s reversal. However, as the patient had intractable constipation secondary to Parkinson’s disease, resection of the proximal colon and ileorectal anastomosis were considered as the treatment choices. Therefore, we performed right colectomy with ileorectal anastomosis. At 1.5 years after the last surgery, complications such as small bowel obstruction, difficulty in defecation, or fecal incontinence were not detected. Discussion The cause of stoma prolapse is generally ascribed to various anatomical factors such as redundant intestine, high intra-abdominal pressure, and intraperitoneal route. Stoma prolapse is also influenced by other factors, including old age, obesity, and the severity of illness that necessitated stoma creation. In this case, the decision regarding surgical management was complicated by colonic motility disorder with concomitant Parkinson’s disease. Conclusion We suggest that ileorectal anastomosis may be an optimal surgical treatment for patients with recurrent stoma prolapse and concomitant colonic motility disorder who have undergone Hartmann’s procedure.
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Affiliation(s)
- Noriya Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Soutoku Someya
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Jun Takahashi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan
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Ichida K, Suzuki K, Fukui T, Takayama Y, Kakizawa N, Watanabe F, Ishikawa H, Muto Y, Kato T, Saito M, Futsuhara K, Miyakura Y, Noda H, Ohmori T, Konishi F, Rikiyama T. Overexpression of satellite alpha transcripts leads to chromosomal instability via segregation errors at specific chromosomes. Int J Oncol 2018; 52:1685-1693. [PMID: 29568894 DOI: 10.3892/ijo.2018.4321] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/22/2018] [Indexed: 11/05/2022] Open
Abstract
The impairment of the stability of the chromosomal structure facilitates the abnormal segregation of chromosomes, thus increasing the risk of carcinogenesis. Chromosomal stability during segregation is managed by appropriate methylation at the centromere of chromosomes. Insufficient methylation, or hypomethylation, results in chromosomal instability. The centromere consists of satellite alpha repetitive sequences, which are ideal targets for DNA hypomethylation, resulting in the overexpression of satellite alpha transcript (SAT). The overexpression of SAT has been reported to induce the abnormal segregation of chromosomes. In this study, we verified the oncogenic pathway via chromosomal instability involving DNA hypomethylation and the overexpression of SAT. For this purpose, we constructed lentiviral vectors expressing SAT and control viruses and then infected human mammary epithelial cells with these vectors. The copy number alterations and segregation errors of chromosomes were evaluated by microarray-based comparative genomic hybridization (array CGH) and immunocytochemistry, respectively. The levels of hypomethylation of satellite alpha sequences were determined by MethyLight polymerase chain reaction. Clinical specimens from 45 patients with breast cancer were recruited to verify the data in vitro. The results of immunocytochemistry revealed that the incidence of segregation errors was significantly higher in the cells overexpressing SAT than in the controls. An array CGH identified the specific chromosomes of 8q and 20q as frequent sites of copy number alterations in cells with SAT overexpression, although no such sites were noted in the controls, which was consistent with the data from clinical specimens. A regression analysis revealed that the expression of SAT was significantly associated with the levels of hypomethylation of satellite alpha sequences. On the whole, the overexpression of SAT led to chromosomal instability via segregation errors at specific chromosomes in connection with DNA hypomethylation, which was also recognized in clinical specimens of patients with breast cancer. Thus, this oncogenic pathway may be involved in the development of breast cancer.
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Affiliation(s)
- Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Hideki Ishikawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
| | - Tsukasa Ohmori
- Department of Biochemistry, Jichi Medical University, Shimotsuke-shi, Tochigi 329-0498, Japan
| | | | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama 330-8503, Japan
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Takayama Y, Suzuki K, Ichida K, Fukui T, Kakizawa N, Watanabe F, Kikugawa R, Hasegawa F, Tsujinaka S, Miyakura Y, Konishi F, Rikiyama T. Dynamics and characteristics of KRAS mutated circulating tumor DNA in patients with metastatic colorectal cancer during various treatments. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.665] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
665 Background: KRAS mutated circulating tumor DNA (MctDNA) can be detected in blood of patients with metastatic colorectal cancer (mCRC) but its dynamics and characteristics during anti-EGFR and other treatments are not well known. Methods: Four hundred and fifty-one plasma samples were collected prospectively from 85 patients who underwent chemotherapy due to mCRC in 2014 - 2017. KRAS mutation in codon12/13/61 was explored in tumor tissues and plasma. Results: KRAS assessment in tumor tissues showed 29 patients with KRAS mutation (MT), 56 patients without mutation (WT). Sensitivity and specificity of MctDNA was 86.4% and 100%, respectively. In 29 patients with MT, significant difference in PFS was observed between patients with MctDNA and without during 1st line treatment (3.0 months vs.15.0 months; p = 0.005). In 56 patients with WT, 27 patients showed MctDNA during various treatments. Different characteristics in appearance were recognized during several treatments including anti-VEGF, TAS-102 and regorafenib. KRAS mutation in codon12/13 was appeared before and after disease progression. KRAS mutation in codon 61 was, however, frequently detected before disease progression. A spike like appearance of KRAS mutation in codon12/13 was likely seen in response to induction of the sequential treatment. Significant difference in PFS was observed between patients with MctDNA and without during 1st line treatment (6.0 months vs. 13.0 months; p = 0.0017), as was observed in patients with MT. Conclusions: Dynamics and characteristics of KRAS status in blood may be involved in the treatment response and outcome in mCRC patients.
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Affiliation(s)
| | | | | | - Taro Fukui
- Jichi Medical University, Saitama, Japan
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Kaneda Y, Noda H, Endo Y, Kakizawa N, Ichida K, Watanabe F, Kato T, Miyakura Y, Suzuki K, Rikiyama T. En bloc pancreaticoduodenectomy and right hemicolectomy for locally advanced right-sided colon cancer. World J Gastrointest Oncol 2017; 9:372-378. [PMID: 28979719 PMCID: PMC5605337 DOI: 10.4251/wjgo.v9.i9.372] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 01/28/2017] [Revised: 05/20/2017] [Accepted: 07/17/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To assess the usefulness of en bloc right hemicolectomy with pancreaticoduodenectomy (RHCPD) for locally advanced right-sided colon cancer (LARCC).
METHODS We retrospectively reviewed the database of Saitama Medical Center, Jichi Medical University, between January 2009 and December 2016. During this time, 299 patients underwent radical right hemicolectomy for right-sided colon cancer. Among them, 5 underwent RHCPD for LARCC with tumor infiltration to adjacent organs. Preoperative computed tomography (CT) was routinely performed to evaluate local tumor infiltration into adjacent organs. During the operation, we evaluated the resectability and the amount of infiltration into the adjacent organs without dissecting the adherent organs from the cancer. When we confirmed that radical resection was feasible and could lead to R0 resection, we performed RHCPD. The clinical data were carefully reviewed, and the demographic variables, intraoperative data, and postoperative parameters were recorded.
RESULTS The median age of the 5 patients who underwent RHCPD for LARCC was 70 years. The tumors were located in the ascending colon (three patients) and transverse colon (two patients). Preoperative CT revealed infiltration of the tumor into the duodenum in all patients, the pancreas in four patients, the superior mesenteric vein (SMV) in two patients, and tumor thrombosis in the SMV in one patient. We performed RHCPD plus SMV resection in three patients. Major postoperative complications occurred in 3 patients (60%) as pancreatic fistula (grade B and grade C, according to International Study Group on Pancreatic Fistula Definition) and delayed gastric empty. None of the patients died during their hospital stay. A histological examination confirmed malignant infiltration into the duodenum and/or pancreas in 4 patients (80%), and no patients showed any malignant infiltration into the SMV. Two patients were histologically confirmed to have tumor thrombosis in the SMV. All of the tumors had clear resection margins (R0). The median follow-up time was 77 mo. During this period, two patients with tumor thrombosis died from liver metastasis. The overall survival rates were 80% at 1 year and 60% at 5 years. All patients with node-negative status (n = 2) survived for more than seven years.
CONCLUSION This study showed that the long-term survival is possible for patients with LARCC if RHCPD is performed successfully, particularly in those with node-negative status.
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Affiliation(s)
- Yuji Kaneda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yuhei Endo
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
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Okamura R, Hida K, Yamaguchi T, Akagi T, Konishi T, Yamamoto M, Ota M, Matoba S, Bando H, Goto S, Sakai Y, Watanabe M, Watanabe K, Otsuka K, Takemasa I, Tanaka K, Ikeda M, Matsuda C, Fukuda M, Hasegawa J, Akamoto S, Shiozawa M, Tsuruta A, Akiyoshi T, Kato T, Tsukamoto S, Ito M, Naito M, Kanazawa A, Takahashi T, Ueki T, Hayashi Y, Morita S, Yamaguchi T, Nakanishi M, Hasegawa H, Okamoto K, Teraishi F, Sumi Y, Tashiro J, Yatsuoka T, Nishimura Y, Okita K, Kobatake T, Horie H, Miyakura Y, Ro H, Nagakari K, Hidaka E, Umemoto T, Nishigori H, Murata K, Wakayama F, Makizumi R, Fujii S, Sunami E, Kobayashi H, Nakagawa R, Enomoto T, Ohnuma S, Higashijima J, Ozawa H, Ashida K, Fujita F, Uehara K, Maruyama S, Ohyama M, Yamamoto S, Hinoi T, Yoshimitsu M, Okajima M, Tanimura S, Kawasaki M, Ide Y, Hazama S, Watanabe J, Inagaki D, Toyokawa A. Local control of sphincter-preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis. Ann Gastroenterol Surg 2017; 1:199-207. [PMID: 29863157 PMCID: PMC5881346 DOI: 10.1002/ags3.12032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/10/2017] [Indexed: 12/13/2022] Open
Abstract
Sphincter‐preserving procedures (SPPs) for surgical treatment of low‐lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II‐III rectal cancer between 2010 and 2011. Patients with tumors 2‐5 cm from the anal verge and clinical stage T3‐4 were eligible. Primary outcome was 3‐year local recurrence rate, and confounding effects were minimized by propensity score matching. The study involved 794 patients (456 SPPs and 338 APR). Before matching, candidates for APR were more likely to have lower and advanced lesions, whereas SPPs were carried out more often following preoperative treatment, by laparoscopic approach, and at institutions with higher case volume. After matching, 398 patients (199 each for SPPs and APR) were included in the analysis sample. Postoperative morbidity was similar between the SPPs and APR groups (38% vs 39%; RR 0.98, 95% CI 0.77‐1.27). Margin involvement was present in eight patients in the SPPs group (one and seven at the distal and radial margins, respectively) and in 12 patients in the APR group. No difference in 3‐year local recurrence rate was noted between the two groups (11% vs 14%; HR 0.77, 95% CI 0.42‐1.41). In this observational study, comparability was ensured by adjusting for possible confounding factors. Our results suggest that SPPs and APR for locally advanced low rectal cancer have demonstrably equivalent oncological local control.
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Affiliation(s)
| | - Koya Hida
- Department of Surgery Kyoto University Kyoto Japan
| | - Tomohiro Yamaguchi
- Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan
| | - Tsuyoshi Konishi
- Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan
| | - Michio Yamamoto
- Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan
| | - Mitsuyoshi Ota
- Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan
| | - Shuichiro Matoba
- Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan
| | - Hiroyuki Bando
- Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan
| | - Saori Goto
- Department of Surgery Kyoto University Kyoto Japan
| | | | - Masahiko Watanabe
- Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | | | - Kazuteru Watanabe
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Koki Otsuka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ichiro Takemasa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keitaro Tanaka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masataka Ikeda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Chu Matsuda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Meiki Fukuda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Junichi Hasegawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shintaro Akamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Manabu Shiozawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Atsushi Tsuruta
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Akiyoshi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takeshi Kato
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shunsuke Tsukamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masaaki Ito
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masaki Naito
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Akiyoshi Kanazawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takao Takahashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Ueki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yuri Hayashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Satoshi Morita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Yamaguchi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masayoshi Nakanishi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hirotoshi Hasegawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ken Okamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fuminori Teraishi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yasuo Sumi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jo Tashiro
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Toshimasa Yatsuoka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yoji Nishimura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kenji Okita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takaya Kobatake
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hisanaga Horie
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yasuyuki Miyakura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hisashi Ro
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kunihiko Nagakari
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Eiji Hidaka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takehiro Umemoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hideaki Nishigori
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kohei Murata
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fuminori Wakayama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ryoji Makizumi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shoichi Fujii
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Eiji Sunami
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hirotoshi Kobayashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ryosuke Nakagawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Toshiyuki Enomoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shinobu Ohnuma
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jun Higashijima
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Heita Ozawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keigo Ashida
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fumihiko Fujita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keisuke Uehara
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Satoshi Maruyama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masato Ohyama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Seiichiro Yamamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takao Hinoi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masanori Yoshimitsu
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masazumi Okajima
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shu Tanimura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masayasu Kawasaki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yoshihito Ide
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shoichi Hazama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jun Watanabe
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Daisuke Inagaki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Akihiro Toyokawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
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39
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Suzuki K, Muto Y, Ichida K, Fukui T, Takayama Y, Kakizawa N, Kato T, Hasegawa F, Watanabe F, Kaneda Y, Kikukawa R, Saito M, Tsujinaka S, Futsuhara K, Takata O, Noda H, Miyakura Y, Kiyozaki H, Konishi F, Rikiyama T. Morphological response contributes to patient selection for rescue liver resection in chemotherapy patients with initially un-resectable colorectal liver metastasis. Oncol Lett 2017; 14:1491-1499. [PMID: 28789370 PMCID: PMC5529781 DOI: 10.3892/ol.2017.6338] [Citation(s) in RCA: 5] [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: 03/07/2016] [Accepted: 02/13/2017] [Indexed: 12/12/2022] Open
Abstract
Morphological response is considered an improved surrogate to the Response Evaluation Criteria in Solid Tumors (RECIST) model with regard to predicting the prognosis for patients with colorectal liver metastases. However, its use as a decision-making tool for surgical intervention has not been examined. The present study assessed the morphological response in 50 patients who underwent chemotherapy with or without bevacizumab for initially un-resectable colorectal liver metastases. Changes in tumor morphology between heterogeneous with uncertain borders and homogeneous with clear borders were defined as an optimal response (OR). Patients were also assessed as having an incomplete response (IR), and an absence of marked changes was assessed as no response (NR). No significant difference was observed in progression-free survival (PFS) between complete response/partial response (CR/PR) and stable disease/progressive disease (SD/PD), according to RECIST. By contrast, PFS for OR/IR patients was significantly improved compared with that for NR patients (13.2 vs. 8.7 months; P=0.0426). Exclusion of PD enhanced the difference in PFS between OR/IR and NR patients (15.1 vs. 9.3 months; P<0.0001), whereas no difference was observed between CR/PR and SD. The rate of OR and IR in patients treated with bevacizumab was 47.4% (9/19), but only 19.4% (6/31) for patients that were not administered bevacizumab. Comparison of the survival curves between OR/IR and NR patients revealed similar survival rates at 6 months after chemotherapy, but the groups exhibited different survival rates subsequent to this period of time. Patients showing OR/IR within 6 months appeared to be oncologically stable and could be considered as candidates for surgical intervention, including rescue liver resection. Comparing the pathological and morphological features of the tumor with representative optimal response, living tumor cells were revealed to be distributed within the area of vascular reconstruction induced by bevacizumab, resulting in a predictive value for prognosis in the patients treated with bevacizumab. The present findings provided the evidence for physicians to consider patients with previously un-resectable metastatic colorectal cancer as candidates for surgical treatment. Morphological response is a useful decision-making tool for evaluating these patients for rescue liver resection following chemotherapy.
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Affiliation(s)
- Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yuji Kaneda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Rina Kikukawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Osamu Takata
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Hirokazu Kiyozaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
| | - Fumio Konishi
- Department of Surgery, Nerima-Hikarigaoka Hospital, Tokyo 179-0072, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
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40
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Tamaki S, Miyakura Y, Someya S, Ishikawa H, Kakizawa N, Hasegawa F, Tanaka H, Kikugawa R, Tsujinaka S, Tanaka A, Lefor AK, Rikiyama T. Laparoscopic resection of retroperitoneal ectopic thyroid tissue. Asian J Endosc Surg 2017; 10:331-333. [PMID: 28321997 DOI: 10.1111/ases.12367] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/18/2017] [Accepted: 01/29/2017] [Indexed: 12/16/2022]
Abstract
A 43-year-old otherwise healthy woman was found to have a retroperitoneal mass during a routine medical examination and was referred for further evaluation. Abdominal CT scan showed a well-delineated, low-density area that exhibited heterogeneous contrast enhancement. The area measured about 20 mm in size and was to the left of the aorta at the level of the inferior mesenteric artery. MRI showed a mass with heterogeneous hypointensity on T1 -weighted images and heterogeneous hyperintensity on T2 -weighted images. PET-CT scan showed slightly increased 18 F-fluorodeoxyglucose accumulation within the mass. Laparoscopic resection was performed. A smooth, brownish mass was seen in the retroperitoneum and was resected with minimal blood loss. Histopathological examination showed a nodular mass measuring 40 × 26 × 20 mm that was composed solely of ectopic thyroid tissue. This case shows the exceptional development of ectopic thyroid in the infradiaphragmatic retroperitoneum and demonstrates the usefulness of laparoscopy for resecting such masses.
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Affiliation(s)
- Sawako Tamaki
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Soutoku Someya
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideki Ishikawa
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumi Hasegawa
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroyuki Tanaka
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rina Kikugawa
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Akira Tanaka
- Departments of Pathology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | | | - Toshiki Rikiyama
- Departments of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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41
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Kato T, Noda H, Kaneda Y, Watanabe F, Endo Y, Saito M, Tsujinaka S, Miyakura Y, Kiyozaki H, Rikiyama T. Extrapancreatic malignancies in 76 Japanese patients with histologically proven intraductal papillary mucinous neoplasms (IPMN) of the pancreas. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.221] [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: 11/14/2022] Open
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42
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Takayama Y, Suzuki K, Ichida K, Fukui T, Watanabe F, Kakizawa N, Muto Y, Kikugawa R, Hasegawa F, Tsujinaka S, Noda H, Miyakura Y, Konishi F, Rikiyama T. Difference in appearance of KRAS mutated circulating tumor DNA in patients with metastatic colorectal cancer during treatments. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e23025] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23025 Background: Emergence of KRAS mutation in blood is observed in colorectal cancer patients who undergo chemotherapy, but its clinical significance is not well known. In this study, we focused on the difference in appearance of KRAS mutated circulating tumor DNA (MctDNA) and elucidated its association with treatments. Methods: Four hundred and fifty-one plasma samples were collected prospectively from 85 patients (pts) who underwent chemotherapy due to metastatic colorectal cancer in 2014 - 2016. Seven types of KRAS mutation in MctDNA were detected by droplet digital PCR creating oil droplets. To exclude false positive detection, mutation was validated. MctDNA amplified in oil droplets was selectively sorted by On-chip sorting system and mutation was determined by Sanger sequencing. Results: KRAS assessment in tumor tissues showed 29 pts with KRAS mutation (MT), 56 pts without KRAS mutation (WT). Among 29 pts with MT, KRAS assessment in plasma displayed 23 pts with MctDNA and 6 pts without MctDNA. The type of mutation in MctDNA was consistent with that detected in tumor tissues, indicating mutual exclusivity in KRAS mutation was confirmed. In 56 pts with WT, 28 pts showed MctDNA during treatments. Difference in appearance of MctDNA was recognized in several treatments. Gradual increase in detection of MctDNA was observed with anti-EGFR antibody, resulted in treatment resistance. Transient spike elevation was frequently seen in TAS-102, which associated with drug response. No specific appearance was recognized during treatments with other drugs including anti-VEGF antibody. MctDNA in oil droplets were successfully sorted even if a few droplets were targeted, and mutation was confirmed. Conclusions: Difference in appearance of MctDNA may associate with treatment response in patients with metastatic colorectal cancer during treatments. [Table: see text]
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Affiliation(s)
- Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumio Konishi
- Department of Surgery, Nerima Hikarigtaoka Hospital, Tokyo, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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43
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Fukui T, Suzuki K, Ichida K, Takayama Y, Kakizawa N, Muto Y, Hasegawa F, Watanabe F, Kikugawa R, Saito M, Tsujinaka S, Miyakura Y, Rikiyama T. Sequential administration of XELOX and XELIRI is effective, feasible and well tolerated by patients with metastatic colorectal cancer. Oncol Lett 2017; 13:4947-4952. [PMID: 28599498 DOI: 10.3892/ol.2017.6100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/09/2016] [Accepted: 03/03/2017] [Indexed: 02/01/2023] Open
Abstract
Sequential administration of the chemotherapy regimes capecitabine and oxaliplatin (XELOX) and capecitabine and irinotecan (XELIRI) in the first- to second-line treatment setting would allow patients to be managed more easily in an outpatient unit. However, a small number of studies have raised concerns of cumulative adverse events as a consequence of the continuous use of capecitabine. To investigate this, the present study conducted a retrospective review of 81 consecutive metastatic colorectal cancer (mCRC) patients treated with the oxaliplatin, fluorouracil and leucovorin-irinotecan, fluorouracil and leucovorin (FOLFOX-FOFIRI/F-F) regimen (n=40) or the XELOX-XELIRI (X-X) regimen (n=41) in first- to second-line chemotherapy in Saitama Medical Center between 2006 and 2012. The disease control rate (DCR), the progression free survival (PFS), the overall survival (OS) and the time to failure of strategy (TFS) from first to second-line chemotherapy, as well as adverse events, were assessed and compared between patients receiving X-X or F-F. A total of 10 and 20 patients were additionally treated with bevacizumab in the F-F and X-X regimens, respectively, during first or second-line chemotherapy. There was no significant difference in DCR and the median PFS between the two regimens for first or second-line chemotherapy. There was no significant difference in the median OS and TFS between the two regimens (OS=24.5 and TFS=14 months in the F-F vs. 23.2 and 12.0 months in the X-X). Regarding adverse events, 45.0% of patients (18/40) exhibited grade 3-4 neutropenia throughout treatment with F-F. Whilst, 15.0% of patients (6/41) exhibited grade 3 hypertension throughout treatment with X-X, which was effectively controlled by a single antihypertensive drug. The results show that sequential administration of X-X is as effective and feasible as F-F treatment, while additionally reducing the frequency of infusion visits and eliminating the need for a central venous access device or home infusion pump, thereby offering a more convenient treatment option to patients with mCRC.
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Affiliation(s)
- Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan
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Kakizawa N, Suzuki K, Fukui T, Takayama Y, Ichida K, Muto Y, Hasegawa F, Watanabe F, Kikugawa R, Tsujinaka S, Futsuhara K, Miyakura Y, Noda H, Rikiyama T. Clinical and molecular assessment of regorafenib monotherapy. Oncol Rep 2017; 37:2506-2512. [PMID: 28259999 DOI: 10.3892/or.2017.5456] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/30/2017] [Indexed: 11/05/2022] Open
Abstract
Regorafenib has shown survival benefits in metastatic colorectal cancer patients who were exacerbated after all standard therapies. Some patients, however, exhibit severe adverse events (AEs) resulting in treatment discontinuation. Therefore, the selection of patients likely to benefit from regorafenib is crucial. Twenty patients were treated with regorafenib for metastatic colorectal cancer; 122 plasma samples were taken from 16 of these patients for monitoring of circulating tumor DNA (ctDNA) in the blood. The treatment response, AEs, overall survival (OS), progression-free survival (PFS) and tumor morphologic changes on CT images were evaluated. KRAS mutant ctDNA was determined using digital PCR. Median PFS and OS were 2.5 and 5.9 months, respectively. Treatment was discontinued because of disease progression (PD) in 10 patients, and AEs in another 10 patients. AEs included hyperbilirubinemia, severe fatigue and skin rash. Hyperbilirubinemia was seen in two patients with multiple bilateral liver metastases, and severe fatigue in another 2 patients with poor performance status (PS). These severe AEs resulted in treatment discontinuation. Ten patients had a median PFS of 2.1 months with AE related discontinuation; PD occurred at 3.5 months (p=0.00334). Four patients exhibited a morphologic response, achieving better PFS times of 3.5, 5.3, 5.6 and 14.2 months. Emergence of the KRAS mutation in ctDNA was observed during anti-EGFR antibody treatment in 3 patients among 11 with KRAS wild-type tumors; it was detectable in the blood prior to radiographic detection of PD. Moreover, the KRAS mutation declined in two patients during regorafenib monotherapy. These patients were re-challenged with anti-EGFR antibody. Patients with extensive multiple liver metastases or poor PS are unlikely to benefit from regorafenib. Patients with a morphologic response will probably benefit from regorafenib with adequate management of other AEs. KRAS monitoring in ctDNA could be useful regarding treatment response and in determining treatment strategy.
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Affiliation(s)
- Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama 330-8503, Japan
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Kanazawa H, Utano K, Kijima S, Sasaki T, Miyakura Y, Horie H, Lefor AK, Sugimoto H. Combined assessment using optical colonoscopy and computed tomographic colonography improves the determination of tumor location and invasion depth. Asian J Endosc Surg 2017; 10:28-34. [PMID: 27651020 DOI: 10.1111/ases.12313] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 06/28/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION An accurate assessment of the depth of tumor invasion in patients with colon cancer is an important part of the preoperative evaluation. Whether computed tomographic colonography (CTC) or optical colonoscopy (OC) is better to accurately determine tumor location and invasion depth has not been definitively determined. The aim of this study was to determine the diagnostic accuracy of tumor localization and tumor invasion depth of colon cancer by preoperative OC alone or combined with CTC. METHODS Study participants include 143 patients who underwent both preoperative CTC using automated CO2 insufflation and OC from July 2012 to August 2013. RESULTS The accuracy of tumor localization was significantly better with CTC than with OC (OC, 90%; CTC, 98%; P < 0.05). No tumor in the descending colon was localized accurately via OC alone. The accuracy of tumor invasion depth was better with CTC plus OC than with OC alone (OC, 55%; CTC, 73%; P < 0.05). CONCLUSIONS OC combined with CTC provides a more accurate preoperative determination of tumor localization and invasion depth than OC alone.
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Affiliation(s)
- Hidenori Kanazawa
- Department of Radiology, Jichi Medical University, Shimotsuke, Japan
| | - Kenichi Utano
- Department of Coloproctology, Aizu Medical Center, Aizuwakamatsu, Japan
| | - Shigeyoshi Kijima
- Department of Radiology, Jichi Medical University, Shimotsuke, Japan
| | - Takahiro Sasaki
- Department of Radiology, Jichi Medical University, Shimotsuke, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan.,Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hisanaga Horie
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | | | - Hideharu Sugimoto
- Department of Radiology, Jichi Medical University, Shimotsuke, Japan
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Ichida K, Suzuki K, Fukui T, Takayama Y, Kakizawa N, Muto Y, Kato T, Hasegawa F, Watanabe F, Kaneda Y, Kikugawa R, Saito M, Tsujinaka S, Futsuhara K, Miyakura Y, Noda H, Kiyozaki H, Rikiyama T. Significance of the Difference in the Size of Liver Tumors in the Management of Patients with Colorectal Liver Metastases. J Mol Genet Med 2017. [DOI: 10.4172/1747-0862.1000254] [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: 11/09/2022] Open
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47
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Ichida K, Suzuki K, Muto Y, Fukui T, Takayama Y, Futsuhara K, Tsujinaka S, Miyakura Y, Noda H, Rikiyama T. 208P Significance of the difference in size of liver tumors in management of patients with colorectal liver metastases. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00366-5] [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: 10/22/2022] Open
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48
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Kato T, Alonso S, Muto Y, Noda H, Miyakura Y, Suzuki K, Tsujinaka S, Saito M, Perucho M, Rikiyama T. Clinical characteristics of synchronous colorectal cancers in Japan. World J Surg Oncol 2016; 14:272. [PMID: 27776528 PMCID: PMC5078884 DOI: 10.1186/s12957-016-1027-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 10/18/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Incidence and clinical characteristics of synchronous colorectal cancer (sCRC) patients significantly vary among studies, likely due to differences in surveillance methodology. If remain undetected, sCRC can progress to more advanced stages seriously aggravating patient prognosis. We studied the incidence and clinicopathological characteristics of Japanese patients with sCRCs who underwent surgery for primary CRC and received exhaustive perioperative surveillance. METHODS We recruited 1005 patients with surgically resected CRCs between January 2007 and December 2011. The associations of clinical and pathological factors with sCRC development were assessed by univariate and multivariate logistic regression. RESULTS Eighty-four patients (8.4 %) developed sCRCs, 16 of them (19.0 %) harboring three or more cancers. Companion sCRCs were smaller and earlier stage than the index lesion (P < 0.0001). In multivariate analysis, advanced age (odds ratio (OR) 1.03 per year; P = 0.009) and left colon tumor location (OR 1.78; P = 0.013) are associated with higher risk of sCRCs, particularly in females. Overall survival did not differ between solitary CRC and sCRC (P = 0.62). CONCLUSIONS Our results highlight the importance of perioperative colonoscopy examination to ensure the absence of sCRCs that, being small and early staged, are more difficult to detect. The incidence of sCRC, and notably of triple or more sCRCs, was higher than previously recognized. Because they are also significantly higher than expected by merely stochastic accumulation of individual cancerous lesions, we suggest that the occurrence of many sCRC reflects a hitherto uncharacterized predisposition condition.
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Affiliation(s)
- Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
- Institute of Predictive and Personalized Medicine of Cancer (IMPPC), Institut d’investigació en ciéncies de la salut Germans Trias I Pujol (IGTP), Campus Can Ruti, 08916 Barcelona, Spain
| | - Sergio Alonso
- Institute of Predictive and Personalized Medicine of Cancer (IMPPC), Institut d’investigació en ciéncies de la salut Germans Trias I Pujol (IGTP), Campus Can Ruti, 08916 Barcelona, Spain
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
| | - Manuel Perucho
- Institute of Predictive and Personalized Medicine of Cancer (IMPPC), Institut d’investigació en ciéncies de la salut Germans Trias I Pujol (IGTP), Campus Can Ruti, 08916 Barcelona, Spain
- Sanford Burnham Prebys Medical Discovery Institute, 10901 N. Torrey Pines Rd., La Jolla, CA 92037 USA
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Catalan Institution for Research and Advanced Studies, Pg. Lluís Companys 23, 08010 Barcelona, Spain
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan
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Muto Y, Suzuki K, Kato T, Tsujinaka S, Ichida K, Takayama Y, Fukui T, Kakizawa N, Watanabe F, Saito M, Futsuhara K, Noda H, Miyakura Y, Konishi F, Rikiyama T. Heterogeneous expression of zinc-finger E-box-binding homeobox 1 plays a pivotal role in metastasis via regulation of miR-200c in epithelial-mesenchymal transition. Int J Oncol 2016; 49:1057-67. [PMID: 27315529 DOI: 10.3892/ijo.2016.3583] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 05/18/2016] [Indexed: 11/06/2022] Open
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50
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Suzuki K, Takayama Y, Ichida K, Fukui T, Kakizawa N, Obitsu T, Muto Y, Hasegawa F, Watanabe F, Kikugawa R, Kato T, Kaneda Y, Saito M, Tsujinaka S, Futsuhara K, Miyakura Y, Noda H, Kiyozaki H, Konishi F, Rikiyama T. Practical applications of “liquid biopsy” in the colorectal cancer treatment. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e23044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Koichi Suzuki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuji Takayama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kosuke Ichida
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Taro Fukui
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nao Kakizawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Tamotsu Obitsu
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuta Muto
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumi Hasegawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Rina Kikugawa
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takaharu Kato
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yuji Kaneda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masaaki Saito
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Tsujinaka
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kazushige Futsuhara
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasuyuki Miyakura
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hirokazu Kiyozaki
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumio Konishi
- Department of Surgery, Nerima Hikarigtaoka Hospital, Tokyo, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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