Publications (92)172.24 Total impact
-
Dataset: collapse-submergence001
-
Article: Autofluorescence videoendoscopy system using the SAFE-3000 for assessing superficial gastric neoplasia.
[show abstract] [hide abstract]
ABSTRACT: Autofluorescence (AF) videoendoscopy has an advantage over ordinary videoendoscopy in the diagnosis of gastric neoplasias, and the aim of the present study was to evaluate the effectiveness of using the SAFE-3000 videoendoscopy system to diagnose superficial gastric neoplasias. Ordinary videoendoscopy, AF videoendoscopy, and chromoendoscopy (CE) were used to diagnose the tumor existence and extent in 14 patients with gastric adenoma, 40 patients with intestinal-type early gastric cancer (EGC) (10 protruded, and 30 depressed), and nine patients with diffuse-type EGC. The diagnostic accuracies of the three kinds of images were evaluated by comparison with the results of histopathological assessment of resected specimens. For gastric adenomas the diagnostic accuracy between the AF images and white light (WL) images did not differ significantly, and for protruded intestinal-type EGCs and diffuse-type EGCs the diagnostic accuracy did not differ significantly between any of the types of images. For depressed intestinal-type EGCs, the diagnostic accuracy of AF images tended to be higher than that of the WL images (P < 0.05) and it was not significantly different from that of the CE images. The detection rate of pink or orange color in AF images was significantly higher for protruded intestinal-type EGCs than gastric adenomas (P = 0.005), depressed intestinal-type EGCs (P < 0.001), and diffuse-type EGCs (P = 0.027). Autofluorescence videoendoscopy using the SAFE-3000 system for gastric neoplasias might be useful for diagnosing depressed intestinal-type early gastric cancers. The detection of orange or pink color in AF images may be efficacious in discriminating protruded intestinal-type early gastric cancers from gastric adenomas.Journal of Gastroenterology and Hepatology 04/2010; 25(4):706-11. · 2.87 Impact Factor -
Article: Short-term and long-term outcome of endoluminal gastroplication for the treatment of GERD: the first multicenter trial in Japan.
[show abstract] [hide abstract]
ABSTRACT: Endoluminal gastroplication (ELGP) was the first endoscopic therapy for gastroesophageal reflux disease (GERD). Data on the long-term outcomes, including the plication status and data from Asian populations, are limited. The aim of this study was to evaluate the short-term and long-term effectiveness and safety of ELGP for GERD in the Japanese population. This was an open-label, prospective, multicenter trial of ELGP. Forty-eight patients with GERD were enrolled. The procedure involved placing circumferential plications 1-2 cm below the GE junction using the EndoCinch system. Outcome measurements were improvement of heartburn, medication use, endoscopic Los Angeles grade, durability of plications, 24-h esophageal acid exposure, esophageal manometry, and frequency of adverse events. During the 24-month follow-up, the rate of complete resolution of heartburn ranged from 54 to 66%, the rate of discontinuation or reduction of PPI/H2RA use ranged from 65 to 76%, and the rate of endoscopic classification to grade O ranged from 66 to 81%. The status with more than one plication remaining was associated with higher rates of improvement of heartburn, PPI/H2RA use, and endoscopic findings as compared with those associated with the loss of all plications. A modest decrease of the esophageal acid exposure level, but no change of the manometric parameters, was observed after ELGP. No serious adverse events were observed. In this 24-month follow-up study conducted in Japanese subjects, ELGP was found to be effective in about 60% of patients with GERD, and the procedure was safe.Journal of Gastroenterology 06/2009; 44(7):675-84. · 4.16 Impact Factor -
Article: Clinical results of endoscopic hemostasis using a short transparent hood and short hemoclips for non-variceal upper gastrointestinal bleeding.
[show abstract] [hide abstract]
ABSTRACT: Endoscopic hemostasis using hemoclips is useful, but there are technical difficulties because the angle of the approach is tangential. A transparent hood facilitates the observation and treatment of these lesions, and a shorter hood provides a wider visible field. Endoscopic hemoclipping of hard lesions with hemoclips of the conventional size does not reliably result in sustained hemostasis because the clips slip. Short clips, however, can be easily clamped on protruded visible vessels without slip. The aim of the present study was to evaluate the efficacy of endoscopic hemostasis with a short transparent hood and short clips. Subjects were 198 patients with 214 lesions of non-variceal upper gastrointestinal bleeding at Keio University Hospital. We used a video endoscope with a short transparent hood attached to its distal tip and carried out hemostasis using short hemoclips. The short transparent hood provided a good visual field. If the lesions were in the tangential, the short hood made it possible to observe them in the frontal view and made clip hemostasis much easier. The short clip could be securely clamped against protruded visible vessels. Of 214 lesion, 211 (98.6%) had temporal hemostasis. Rebleeding occurred in 13 of 211 lesions (6.2%), and 205 of 214 lesions (95.8%) had permanent hemostasis. Nine cases were endoscopically difficult. Endoscopic hemostasis with a short transparent hood and short clips is useful for non-variceal upper gastrointestinal bleeding.Digestive Endoscopy 05/2009; 21(2):93-6. · 1.19 Impact Factor -
Article: Novel technique of endoscopic submucosal dissection using an external grasping forceps for superficial gastric neoplasia.
[show abstract] [hide abstract]
ABSTRACT: Endoscopic submucosal dissection (ESD) for early stage gastric cancer (EGC) has improved the success rate of en bloc resection but results in perforation more often than does endoscopic mucosal resection. We report a novel technique of ESD using an external grasping forceps. A total of 265 lesions with EGC or gastric adenoma were enrolled in this study. Sixteen lesions were located in the upper third portion of the stomach, 114 in the middle third portion, and 135 in the lower third portion. After submucosal injection followed by circumcision of the lesions with a flex knife, the external grasping forceps was introduced with the help of a second grasping forceps and anchored at the margin of the lesion. Oral traction applied with this forceps could elevate the lesion and make the submucosal layer wider and more visible, thereby facilitating dissection of the submucosal layer under direct vision. The mean lesion size was 15.0 mm (range: 5-50 mm). All but 11 lesions (95.8%) could be resected en bloc with free margins. Mean procedure time was 45 min (range: 20-180 min). It was difficult to carry out this procedure when the lesions were located in the cardia, lesser curvature, or posterior wall of the upper third of the gastric body. Bleeding after ESD occurred in 10 patients (3.8%) and perforation occurred in one patient (0.4%). The endoscopic submucosal dissection using an external grasping forceps for superficial gastric neoplasia is efficacious and safe.Digestive Endoscopy 05/2009; 21(2):122-7. · 1.19 Impact Factor -
Article: Subclassification of superficial cardia cancer in relation to the endoscopic esophagogastric junction.
[show abstract] [hide abstract]
ABSTRACT: The incidence of adenocarcinoma of the gastric cardia has been reported to be increasing, but the endoscopic characteristics of the mucosal background of the tumor remain unclear. The purpose of the present study was to evaluate the relationship between the location of the adenocarcinoma according to the esophagogastric junction (EGJ) and mucosal characteristics. Patients with superficial adenocarcinoma of the gastric cardia diagnosed pathologically were enrolled and divided into the above-EGJ group and the below-EGJ group according to tumor location. The EGJ was judged as the lower end of the esophageal longitudinal vessels. We retrospectively reviewed endoscopic findings with respect to the classification of reflux esophagitis, hiatus hernia, valvular appearance of the cardia and the pattern of atrophic gastritis. The incidence of reflux esophagitis in the above-EGJ group and below-EGJ group was 75.0% and 30.0%, respectively. The severity of hiatus hernia and the valvular appearance of the cardia of patients in the above-EGJ group were worse than in the patients in the below-EGJ group. The pattern of atrophic gastritis in the patients in the above-EGJ group was the closed type, whereas patients in the below-EGJ group had the open type. There were significant differences between cancers above or below the EGJ, so classification of adenocarcinoma of the gastric cardia according to location is recommended.Journal of Gastroenterology and Hepatology 01/2009; 23 Suppl 2:S273-7. · 2.87 Impact Factor -
Article: Candida albicans infection delays duodenal ulcer healing in cysteamine-induced duodenal ulcers in rats.
[show abstract] [hide abstract]
ABSTRACT: A low curability of ulcers infected with Candida has been reported in the literature. The aim of the study reported here was to investigate experimentally whether Candida infection affects the healing of ulcers. Candida albicans (the Candida group) or saline (the control group) was administered intragastrically into rats with a cysteamine-induced duodenal ulcer. The duodenal lesions, vascular endothelial growth factor A (VEGF-A) and proliferating cell nuclear antigen (PCNA) were assessed. On Day 7 post-administration, 70.4% rats of the Candida group had a duodenal ulcer compared with 33.3% in the control group (P < 0.05). The duodenal ulcer in the Candida group was significantly larger and deeper than that in the control group. The number of VEGF-A- and PCNA-positive cells was smaller and the area of VEGF-A expression was lower in the Candida group. Using a rat model, we have demonstrated that Candida infection can delay the wound healing process of duodenal ulcers by means of a low expression of VEGF-A and PCNA.Digestive Diseases and Sciences 07/2008; 53(11):2878-85. · 2.12 Impact Factor -
Article: Gastric microcirculatory disturbance and behaviour of leucocytes after thermal injury: Intravital observation of arteriovenous shunting channels in the gastric submucosal layer
[show abstract] [hide abstract]
ABSTRACT: In order to investigate the pathogenesis of acute gastric mucosal lesion after thermal injury, microcirculatory disturbance was assessed and observation of the behaviour of leucocytes was performed. Gastric blood flow decreased at 15 min post-thermal injury, and partially improved at 2 h; however, it decreased again at 5 h post-thermal injury. Mucosal microcirculatory disturbance was observed by using vascular labelling with monastral blue B. Deposits of monastral blue B were observed centring mainly on collecting venules but were also observed in the capillaries. Submucosal microcirculatory disturbance was observed through an intravital microscope. The irregularity of the wall and segmental constriction in the venules and presence of an arteriovenous shunting channel was observed in the submucosal layer at 5 h post-thermal injury. The percentage of rolling or sticking leucocytes that passed the confluence of a prevenule and a venule were significantly increased at 5 h after thermal injury. The present study revealed depression of gastric blood flow, mucosal and submucosal microcirculatory disturbance, and a significant increase of rolling and sticking leucocytes in the peripheral part of venules after thermal injury. Leucocyte-endothelial interactions may occur under such conditions and this interaction may play an important role in inducing the microcirculatory disturbance that results in an acute gastric mucosal lesion after thermal injury. The present study also demonstrated the possibility of intravital study of gastric submucosal arteriovenous shunting channels.Journal of Gastroenterology and Hepatology 06/2008; 10(4):365 - 370. · 2.87 Impact Factor -
Article: Phase II study of chemoradiotherapy with S-1 and low-dose cisplatin for inoperable advanced gastric cancer.
[show abstract] [hide abstract]
ABSTRACT: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions.International Journal of Radiation OncologyBiologyPhysics 05/2008; 71(1):173-9. · 4.11 Impact Factor -
Article: [Clinical experience of second-line chemotherapy with S-1/CPT-11 for highly advanced gastric cancer].
[show abstract] [hide abstract]
ABSTRACT: We have performed chemoradiation with S-1 and low-dose CDDP as an initial treatment for 27 patients with incurable or unresectable highly advanced gastric cancer since 2002. Twelve out of 27 patients received combination chemotherapy of S-1 and CPT-11 as the second-line chemotherapy. On this regimen, S-1 was administered orally at a dose of 80 mg-120 mg daily, and CPT-11 at a dose of 60 mg/m(2) once in 2 or 3 weeks for outpatients. Clinical effects after therapy showed a response rate of 30.0%. Considering the prognostic outcome of the regimen, the one-year survival rate of the therapy was 66.7%, and the median survival time was more than 1 year, suggesting second-line chemotherapy will be one of the beneficial regimens in gastric cancer patients. Although 4 patients showed grade 3 bone marrow suppression (33.3%), they were all able to continue the therapy, after recovering from toxicity by means of G-CSF and/ or cessation of chemotherapy. The incidence and level of toxicity accompanying subjective symptoms, however, were relatively low, and the regimen was useful as an outpatient treatment maintaining good quality of life and improving their prognosis. Treatment with an appropriate regimen at an appropriate time will enable these patients to have good quality of life and survival.Gan to kagaku ryoho. Cancer & chemotherapy 03/2008; 35(2):245-50. -
Article: Clinical impact of a newly developed capsule endoscope: usefulness of a real-time image viewer for gastric transit abnormality.
[show abstract] [hide abstract]
ABSTRACT: A new capsule endoscope has been developed by Olympus Medical Systems. The visualization and usefulness of its real-time image viewer for gastric transit abnormality were evaluated by using this new device. Thirty-seven consecutive patients were enrolled. In cases of gastric transit abnormality (gastric transit > 60 min, detected by the real-time viewer), intramuscular metoclopramide (10 mg) was administered. Diagnostic yield and gastric and small bowel transit times in ten patients receiving (group A) and 27 not receiving (group B) metoclopramide were analyzed. Median gastric transit time was longer in group A than in group B (110 vs. 24 min; P < 0.0001). Conversely, median small bowel transit time was shorter in group A than in group B (270 vs. 347 min; P < 0.05). Further, small bowel transit was complete in 9/10 patients (90%) in group A, and in 23/27 patients (85%) in group B, but the difference was not significant. Overall diagnostic yield was 78% (29/37 patients), and there was no significant difference in the ratio of abnormal findings documented between group A (8/10, 80%) and group B (21/27, 78%) patients. This new technology allowed clear image interpretation, and the real-time viewer was useful for detecting gastric transit abnormalities and determining a need for metoclopramide administration in patients undergoing capsule endoscopy.Journal of Gastroenterology 02/2008; 43(3):186-92. · 4.16 Impact Factor -
Article: Intravenous injection of micafungin counteracts Candida albicans-induced aggravation of duodenal ulcers caused by cysteamine in rats.
[show abstract] [hide abstract]
ABSTRACT: We have reported previously that Candida albicans is involved in the pathogenesis of peptic ulcer perforation; it was shown that C. albicans aggravated the severity of duodenal ulceration and increased the rate of perforation. We considered it incumbent upon us to ascertain whether C. albicans is a virulence factor involved in peptic ulcer perforation. In the present study, we administered an antifungal drug (micafungin) intravenously to rats that had received intragastric (i.g.) administration of C. albicans and cysteamine, in order to examine that micafungin could counteract the C. albicans-aggravation of duodenal ulcers. Cysteamine was administered thrice on day 1 to male Wistar rats. C. albicans was administered to the animals 1 h before, and 12 and 24 h after the first administration of cysteamine. Micafungin (n = 22) or saline (n = 24) was administered 12, 24, and 48 h after the administration of cysteamine. The area of the duodenal ulcers was also significantly smaller in the micafungin group (P < 0.05). In addition, the survival rate of the rats was significantly higher in the micafungin group (P < 0.05). While in the control group, the ulcer base was found to be colonized by C. albicans, there was no evidence of the presence of C. albicans in the micafungin group. It was shown that intravenous injection of micafungin counteracted the aggravation by C. albicans of cysteamine-induced duodenal ulcers in rats. This finding supports the concept that C. albicans is an aggravating factor for peptic ulcers.Digestive Diseases and Sciences 02/2008; 53(9):2422-8. · 2.12 Impact Factor -
Article: [Retrospective analysis of treatment for advanced gastric cancer with peritoneal dissemination].
[show abstract] [hide abstract]
ABSTRACT: Recent development and clinical application of novel anticancer agents like S-1 have been reported to show a good outcome against gastric cancer (GC) with peritoneal dissemination (P). In our study, a retrospective analysis of the treatment for GC with P was performed. Since 1989, a chemosensitivity test with MTT assay (MTTA) using surgical specimen was performed to choose chemotherapy after surgery, resulting in good prognosis in patients who received drugs which were determined effective by the MTTA. Since 1999, S-1 was introduced as adjuvant chemotherapy, and, since 2002, initial treatment with S-1/CDDP was used for GC with P, suggesting a better prognostic outcome compared with previous results with ineffective chemotherapy or surgery alone. In conclusion, prognosis of GC with P has been improving by effective regimens with novel anticancer agents like S-1. Further research and clinical trials will be necessary to achieve a more satisfactory outcome with the treatment of GC with P.Gan to kagaku ryoho. Cancer & chemotherapy 12/2007; 34(11):1827-31. -
Article: [Expectation of video capsule endoscopy for diagnosis of NSAID induced enteropathy].
[show abstract] [hide abstract]
ABSTRACT: Video capsule endoscopy (VCE) is a major advance in visualization of the small intestine and has been widely used for small intestinal involvement. We have developed a new capsule endoscope in collaboration with Olympus Medical Systems. Its features are, upgrade resolution, depth of the field, and brightness of the image, by improving the optical system, contained with the new function to adjust the level of lighting automatically coordinate with the brightness around, and original handy displayed real-time viewer. VCE is a new device which contributes to the diagnosis of nonsteroidal anti-inflammatory drug (NSAID) induced enteropathy, however, attention should be paid to retention of the capsule due to the stenosis of diaphragm induced by NSAID.Nippon rinsho. Japanese journal of clinical medicine 11/2007; 65(10):1896-901. -
Article: A patient with gastric cancer and liver metastases successfully treated with combination chemotherapy including S-1.
[show abstract] [hide abstract]
ABSTRACT: We report the case of a 62-year-old man with advanced gastric cancer and multiple liver metastases who was successfully treated with combined chemotherapy including S-1. The patient was clinically diagnosed with stage IV (T3 N2 H1 P0) disease and was initially treated with 100 mg/body per day S-1 administered orally for 21 days and 10 mg/body per day cisplatin (CDDP) infused on days 1-5, 8-12, and 15-19. This chemotherapy resulted in significant reduction of the liver and gastric tumors. After receiving additional CDDP/S-1 administration as an outpatient, the patient's liver masses disappeared as shown on abdominal computed tomography (CT). With the patient's desire and informed consent, he underwent curative surgery with total gastrectomy, D1+alpha lymph node dissection, and partial resection of liver S4. After discharge without any surgical complication, CT revealed regrowth of the S4 liver mass, and combined docetaxel and CDDP was selected as second-line chemotherapy with local radiation therapy against the hepatic metastasis. Additionally, a third regimen with irinotecan and S-1 was given. At 2 years 7 months after the initial treatment, no sign of cancer (including liver metastasis and peritoneal dissemination) has been identified by radiological follow-up examinations.International Journal of Clinical Oncology 09/2007; 12(4):295-9. · 1.41 Impact Factor -
Article: Retrospective analysis of prognosis for scirrhous-type gastric cancer: one institution's experience.
[show abstract] [hide abstract]
ABSTRACT: Scirrhous gastric cancer is biologically aggressive, and the prognosis is poor even with curative surgery. We compared outcomes with different therapies in order to identify prognostic factors. Records for 83 patients, who were treated between 1991 and 2004, were evaluated for survival and stage, treatment, and clinicopathological factors. Cumulative 5-year overall survival was 10.2% for all 83 patients, including 27 (32.5%) patients with stage II/III disease and 56 (67.4%) with stage IV disease. The 5-year overall survival rate and median survival time for patients with stage II/III disease after curative surgery were 24.3% and 1150 days. For patients with stage IV disease, 2-year and 5-year survival rates after initial surgery were 13.7% and 0% and median survival was 250 days. In contrast, preoperative chemotherapy for advanced, unresectable disease produced 2-year and 3-year overall survival rates of 53.6% and 26.8% and medican survival was 910 days. Aggressive surgery alone does not seem to improve outcome, but preoperative chemotherapy might be beneficial and should be investigated further.International Journal of Clinical Oncology 09/2007; 12(4):291-4. · 1.41 Impact Factor -
Article: Predictive value of GADD153, p21 and c-Jun for chemotherapy response in gastric cancer.
[show abstract] [hide abstract]
ABSTRACT: We sought to determine whether changes in the expression of early response genes (GADD153, p21 and c-Jun) are indicators of chemotherapy response in gastric cancer. Three human gastric cancer cell lines were exposed to 5-fluorouracil or cisplatin in vitro. Xenografts of TMK-1 cells in nude mice were also treated with 5-fluorouracil or cisplatin in vivo. For each of these treatments, we tested for a correlation between early gene expression levels and inhibition ratios derived at a later time. A 5-fluorouracil derivative, S-1, and cisplatin were administered to 12 patients with advanced gastric cancer for 3 weeks. Gene expression levels were measured using biopsy specimens obtained by endoscopy soon after initiation of chemotherapy. There was a significant correlation between expression levels of these genes at 24 h and inhibition ratios at 72 h in vitro. Cut-off values determined from receiver-operating characteristic curves were 1.3 for GADD153, 1.8 for p21 and 2.1 for c-Jun There was also a significant correlation between gene expression levels at 2 days and inhibition ratios at 21 days in vivo. Cut-off values were 1.8 for GADD153, 1.9 for p21 and 2.2 for c-Jun. Levels of early response gene expression in patients showing progressive disease were significantly lower than those in patients with partial response. Changes in the expression of the three early response genes soon after drug administration could improve predictions of the final outcome of chemotherapy in gastric cancer.Cancer Science 06/2007; 98(5):707-15. · 3.33 Impact Factor -
Article: Candida albicans aggravates duodenal ulcer perforation induced by administration of cysteamine in rats.
[show abstract] [hide abstract]
ABSTRACT: Candida sp are frequently isolated from the ascitic fluid of patients with perforated ulcers. The present study was performed to examine whether Candida infection may be involved in the process of ulcer perforation. Male Wistar rats were divided into a saline group (n = 15) and a Candida group (n = 17). Cysteamine-HCl (Sigma; 31 mg/100 g) was administered thrice on day 1 to both groups of animals. Candida albicans at a density of 10(8) in 0.5 mL of saline was administered 1 h before, and 12 h and 24 h after the first administration of cysteamine in the Candida group. Perforated duodenal ulcers were observed in 94.1% of the rats in the Candida group, but only 26.7% of the rats in the saline group (P < 0.01). The area of the duodenal ulcers in the Candida group was 40.89 +/- 33.07 mm2, whereas that in the saline group was 16.53 +/- 20.4 mm2 (P < 0.05). The mortality rate was significantly higher in the Candida group than in the saline group. In the Candida group, colonization by C. albicans was recognized at the ulcer base, surrounded by marked granulocytic infiltration. The number of eosinophils infiltrating the ulcer base was also significantly greater in the Candida group than in the saline group. Immunohistochemical analysis revealed the expression of secretory aspartyl protease (SAP) in the region of the ulcer showing colonization by C. albicans in the Candida group. Candida albicans aggravates duodenal ulcer perforation in the experimental model of cysteamine-induced duodenal ulcer perforation. The present findings suggest that SAP and host-parasite relationships, including granulocyte-dependent mechanisms, may be involved in the aggravation of ulcer perforation by C. albicans.Journal of Gastroenterology and Hepatology 05/2007; 22(5):749-56. · 2.87 Impact Factor -
Article: Mechanical-stapled versus hand-sutured anastomoses in billroth-I reconstruction with distal gastrectomy.
[show abstract] [hide abstract]
ABSTRACT: In June 2000, we started performing mechanical-stapled anastomosis (MSA) for Billroth-I reconstruction (B-I) in distal gastrectomy. Thus, we performed a retrospective study to compare the clinical outcome of MSA and conventional hand-sutured anastomosis (HA). We evaluated 103 patients who underwent a B-I reconstruction. The data we collected included operative time, operative blood loss, time until oral intake, postoperative hospital stay, and anastomotic and general complications. We also examined the remnant stomach by endoscopy and classified it according to the Residue, Gastritis, Bile (RGB) criteria. The operative time was significantly shorter with MSA than with HA, but there were no other significant differences between the two groups. The RGB classification showed that there was more residual stomach content after MSA than after HA. The incidence of gastritis and bile reflux was not significantly different between the two procedures. The operative time for B-I reconstruction with distal gastrectomy was significantly shorter with MSA than with HA. While there were no significant disadvantages in the incidence of complications associated with MSA compared with HA, MSA resulted in more residue in the remnant stomach. The findings of this study showed the advantages and disadvantages of MSA, and suggest that MSA and HA are equivalent as anastomotic procedures in B-I reconstruction.Surgery Today 02/2007; 37(2):122-6. · 1.22 Impact Factor -
Article: COLLAPSE‐SUBMERGENCE METHOD: SIMPLE COLONOSCOPIC TECHNIQUE COMBINING WATER INFUSION WITH COMPLETE AIR REMOVAL FROM THE RECTOSIGMOID COLON
[show abstract] [hide abstract]
ABSTRACT: Colonoscopy is a difficult examination to conduct for inexperienced examiners. In an attempt to improve the view, there is often a tendency to overinsufflate air, which causes elongation or acute angulations of the colon and makes passage of the scope difficult. Sakai et al. were the first to describe a simple colonoscopic technique using water infusion instead of air insufflation. We have modified this technique to simplify the procedure further by combining water infusion using disposable syringes with complete air suction from the rectum to the descending colon. With the resultant elimination of the boundary lines between water and air, a good view of the lumen is obtained though the transparent water. With the patient in the left lateral position, this procedure allows the water to flow straight down into the descending colon through the ‘collapsed’ lumen, and the scope to be easily negotiated through the straightened recto-sigmoid colon and sigmoid-descending colon junction with minimum discomfort. Measurements of the patients’ abdominal circumference during colonoscopy showed that colonic distension hardly occurred. Under supervision by the author, six complete novices were allowed to insert the colonoscope within 10 min by this method for one patient per week, as long as the patients did not complain of pain. The average trial number for the first cecal intubation within 10 min was 3.3, and the average success rate during the first 3 months was 58.6%. We believe that this ‘collapse-submergence method’ is easy to master, even for inexperienced examiners.Digestive Endoscopy 12/2006; 19(1):43 - 48. · 1.19 Impact Factor
Top co-authors
Top Journals
Institutions
-
1993–2010
-
Keio University
- • School of Medicine
- • Department of Surgery
- • Center for Diagnostic and Therapeutic Endoscopy
Tokyo, Tokyo-to, Japan
-
-
2009
-
Fujita Health University
- Department of General and Gastrointestinal Surgery
Toyohashi, Aichi-ken, Japan
-
-
2001
-
National and Kapodistrian University of Athens
- Division of Surgery V
Athens, Attiki, Greece
-
