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Publications (6)4.61 Total impact

  • International Journal of Colorectal Disease 08/2014; · 2.24 Impact Factor
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    ABSTRACT: The diagnostic significance of single-balloon enteroscopy (SBE) in patients presenting with Crohn’s disease (CD)-like anorectal fistula is unknown. We experienced 11 cases undergoing SBE due to CD-like fistulas between December 2007 and April 2013. The mean interval from fistula onset to SBE was 19.2 months with a range of 1.3−44.7. Prior to SBE, all patients underwent anorectal examination under anesthesia (EUA), and 9 patients underwent total colonoscopy with terminal ileal cannulation (TCS-I). One of 7 patients undergoing upper gastrointestinal endoscopy had CD-like gastritis. EUA revealed CD fissures in 7 patients, 1 of whom had no intestinal lesion. Primary TCS-I identified early lesions, such as aphthes and small ulcers, in 4 patients. Among the other 5 patients without any intestinal lesions with TCS-I, SBE indicated early lesions in 3 patients. One of 2 patients who initially underwent SBE without TCS-I showed multiple aphthes. Of the 11 patients, only 4 patients fulfilled the definitive Japanese diagnostic criteria for CD and 7 remained ‘suspected CD’ cases. Intrinsic anorectal fistulas as a presenting symptom of CD may be an early predictor of bowel lesions. SBE has the potential to reveal incipient disease because an early ileal lesion is not rare for patients with anorectal fistulas.
    Clinical Journal of Gastroenterology 08/2013;
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    ABSTRACT: A 71-year-old man, whose chief complaint was a faecal occult blood, had gastrointestinal endoscopy and gastric cancer was diagnosed. CT scan and intraoperative findings revealed metastatic liver tumors. We performed total gastrectomy with D2 lymph dissection, partial hepatic resections and microwave coagulation therapy. Small cell carcinoma of the stomach was diagnosed by histopathological findings. We used combination chemotherapy consisting of carboplatin, epirubicin, etoposide and 5-FU was performed. After one course, he suffered from leucopenia and agranulocytosis of grade 3, thrombocytopenia of grade 4, so we reduced the dose and performed 6 courses in total. The patient remains alive without recurrence 48 months after operation. We conclude that adjuvant chemotherapy was effective for small cell carcinoma of the stomach, which was to be considered to have a poor prognosis.
    Gan to kagaku ryoho. Cancer & chemotherapy 10/2010; 37(10):1953-6.
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    ABSTRACT: Although an increasing number of reports and publications have dealt with the laparoscopic approach to liver resection, this procedure remains uncommon, and its feasibility, safety and effectiveness are still not established. There are few reports of the advantages of this approach on postoperative recovery. From December 1997 to March 2007, laparoscopic hepatic resection were performed in 68 patients. There were 52 malignant tumors (36 hepatocellular carcinomas, three intrahepatic cholangiocarcinomas, one cystadenocarcinoma, liver metastases from ten colorectal carcinomas and two other organs) and 16 benign lesions among our 68 patients. Fifteen patients with hepatocellular carcinoma had cirrhosis. The mean tumor size was 3.1 +/- 1.8 cm (range 1.0-14.0 cm), and the tumors were located in every liver segment except segment I. Liver resection was anatomical in 17 patients and consisted of a lobectomy in four patients and a lateral segmentectomy in 13 patients. Non-anatomical resections were performed in 51 patients. The operative time was 214 +/- 93 min. Mean blood loss was 393 +/- 564 g. A hand-assisted laparoscopic method or mini-laparotomy method was required in 35 patients (51.4%). Operative complications occurred mainly in our early cases and included three patients (4.4%) with operative bleeding, 2 of whom (2.9%) requiring a conversion to open surgery. Postoperative complications occurred in seven patients (10.0%), and two of then eventually required a re-operation. The mean hospital stay was 17 days. There were no complications in the more recent cases. The laparoscopic approach for liver tumors is feasible, if the indication is carefully selected. The safety of this procedure depends on the surgical experience of the surgeon and team and the availability of the necessary technology.
    Journal of Hepato-Biliary-Pancreatic Surgery 01/2009; 16(1):64-8. · 1.60 Impact Factor
  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2008; 69(1):155-159.
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    ABSTRACT: In spite of recent advances in laparoscopic surgery, laparoscopic approach is still not a standard option for the tumors located in the posterior segment of the right hepatic lobe mainly due to its technical difficulties and the risk for injuring major adjacent vessels. In order to evaluate the feasibility of laparoscopic posterior segment hepatectomy (LPSH) compared to open posterior segment hepatectomy (OPSH), we retrospectively reviewed a total of 46 laparoscopic hepatectomies and 169 open hepatectomies. Among them, three patients underwent LPSH and seven patients underwent OPSH for tumors located in the posterior segment of the right hepatic lobe. Although duration of operation showed a trend toward being longer in LPSH, LPSH was not accompanied by significant increase of blood loss. Furthermore, LPSH had a trend to result in earlier recovery of the patients, including shorter hospital stay and earlier start of walking or meal. In conclusion, our data suggested that LPSH could be as safe and feasible as OPSH for tumors located in the posterior segment.
    Hepato-gastroenterology 01/2008; 55(86-87):1695-8. · 0.77 Impact Factor