Takushi Monden

Nguyen Tat Thanh University | NTT · Department of Surgery

A therapeutic guideline for sigmoid volvulus (SV) has not been established, and the most recommended surgical procedure for SV has not been determined. Our objective is to assess the usability of elective laparoscopic sigmoidectomy and the feasibility of single-incision laparoscopic surgery for SV following endoscopic reduction. SV typically affect...

A 67-year-old-man came to our hospital for further evaluation of a liver tumor detected by abdominal ultrasonography at another hospital. Abdominal computed tomography showed a tumor(8 cm in diameter)in the left lobe of the liver, with invasion of the left and middle hepatic veins, and multiple lymph node metastases. Liver biopsy examination reveal...

A 64-year-old man presented with a chief complaint of abdominal pain. An abdominal computed tomography(CT)scan showed a mass 30-mm in diameter at the splenic flexure, and we diagnosed a retroperitoneal abscess. Conservative therapy was successful, and the patient was discharged. However, 1 month later, he again experienced abdominal pain. To reasse...

Fibrin glue injection is used for treating postoperative digestive fistulas; however, this method is not always successful, especiallyin cases of complicated fistulas. Generally, the fibrin glue coagulates immediatelyafter application before it reaches the end of the fistulas. Based on the results of an in vitro studyof tensile strength and coagula...

A 66-year-old woman was diagnosed with pancreatic tail cancer, and she was referred to our hospital. Abdominal computed tomography(CT)revealed a tumor(2.5 cm in diameter)in the pancreatic tail, with invasion to the spleen and splenic vein. In February 2013, we performed distal pancreatectomy with splenectomy, left adrenal gland resection, and D2 ly...

Twenty patients( 30 nodules) with metastatic liver cancer( MLC) and 10 cases with hepatocellular carcinoma( HCC) treated by stereotactic radiotherapy (SRT) were analyzed. SRT was administered at 48.0 or 52.8 Gy/4 Fr/1 wk. The response rate (RR) in MLC patients was 78%, and 11 patients survived longer than 1 year and 9 patients survived as long as 2...

Background: In this retrospective study, we investigated the clinical outcomes of endoscopic gastroduodenal stenting (EGDS) for gastric outlet obstruction( GOO) caused by unresectable gastric cancer( UGC). Methods: A retrospective study was performed on 20 UGC patients with GOO between 2007 and 2012. We compared the clinical outcomes of EGDS usi...

The Japanese gastric cancer treatment guidelines(published as a web supplement for version 3)recommend the implementation of HER2 testing prior to the selection of chemotherapy. Since we had not yet implemented HER2 immunohistochemistry(IHC)methods for gastric cancer, we tried to compare the HER2 testing results from a reference laboratory(ref lab)...

A 76-year-old woman underwent mastectomy and axially lymph node dissection for primary right breast cancer in May 2003. Histological examination revealed invasive ductal carcinoma (papillotubular type), ER 71%, PgR 33%, HER2 (-), pT4bN1M0, and Stage IIIB. After adjuvant chemotherapy with CMF regimen and PMRT CT scan revealed mediastinal, cervical a...

Twenty cases (27 therapeutic sites/30 nodules) of metastatic liver cancer treated with stereotactic radiotherapy (SRT)were analyzed. The original sites of cancer were colorectal(8 cases), breast(4 cases), stomach(3 cases), esophagus(2 cases), and other organs (3 cases). SRT was performed with 52.8 Gy·4 fr·-1·wk-1. The response rate was 78%, includi...

We report the effects of stereotactic radiotherapy (SRT) targeting for distant solitary metastases from gastric cancer that were uncontrollable with chemotherapy. SRT(52.8 Gy per 4 fractions) was performed in 3 patients with liver metastasis and 1 patient with lung metastasis. Although SRT showed no effect in the patient with lung metastasis, compl...

We report a case of recurrent gastric cancer with paraaortic lymph nodes (No.16LNs) that was effectively controlled with chemoradiation therapy. A 63-year-old man underwent distal gastrectomy, cholecystectomy, and D2 dissection in July 2004 for advanced gastric cancer in the lower third area that was diagnosed as moderately differentiated stage II...

Objective: To clarify the complications associated with subcutaneous central venous access port devices, we investigated the patients who underwent placement of central venous access port devices in our hospital. Methods: Overall, 171 cancer patients who underwent placement of subcutaneous central venous access port devices (119 for chemotherapy...

A 75-year-old man was diagnosed as gall bladder carcinoma by postoperative histological examination following laparoscopic cholecystectomy. He underwent the second surgery of resection of liver bed and port sites with lymph node dissection. Isolated hepatic metastasis of 20 mm in diameter was found in S4/8 by MRI 18 months postoperatively, and ster...

We report a case of recurrent gastric cancer that was effectively controlled with radiation therapy. A 63-year-old man underwent total gastrectomy, cholecystectomy and D2 dissection in February 2006 for early gastric cancer in the upper third area that was diagnosed with papillary adenocarcinoma and Stage IA (T1 (SM), N0, H0, P0, CY0, M0). He under...

A 63-year-old male admitted for hematemesis was diagnosed with type 3 advanced gastric cancer located in the upper and middle body of the stomach in an endoscopic examination. Abdominal computed tomography demonstrated lymph nodes metastasis and a splenic vein thrombus. Since curative resection was not deemed possible, we performed neoadjuvant chem...

A 70-year-old female suffered from jaundice was admitted to our hospital for a tumor in the pancreas head. CA19-9 and DUPAN-2 levels were increased in laboratory test. Enhanced abdominal computed tomography (CT) scan revealed a low density area of pancreas head. Cytology of pancreatic juice was performed by ERCP, and malignant cells were detected....

Liver metastases from breast cancer are generally treated with systemic therapy such as chemotherapy or hormonotherapy. However, local treatment options such as resection, radiofrequency ablation (RFA), and radiotherapy can also be considered to treat oligometastases. We report the case of a 45-year-old female treated with stereotactic body radioth...

Although docetaxel is active against gastric cancer, Grade 3 or 4 neutropenia occurs in the majority of patients in Japan when administered at 60 mg/m(2) every 3 weeks. To determine a more convenient and tolerable schedule than the tri-weekly schedule, we conducted a dose-escalation study of bi-weekly docetaxel. In this study, we investigated the m...

Background: In our hospital, the starting dose of S-1 for patients over 75 years of age with advanced gastric cancer was determined by body surface of area, creatinine clearance, performance status(PS)and the presence of complications. The objective of this retrospective study was to investigate the proper administration of S-1 in elderly patients...

We present the case of a 58-year-old man who underwent distal gastrectomy for Stage III A advanced gastric cancer, identified as poorly-differentiated adenocarcinoma. He was diagnosed with recurrent peritoneal metastasis 11 months after surgery. S-1(80mg/m / 2)was administered as first-line chemotherapy, followed by weekly paclitaxel(80mg/m2)as sec...

We report a case ofa 76-year-old man suffering from advanced gastric cancer with lymph node recurrence. Distal gastrectomy was performed for gastric cancer with pylorus stenosis in April 2001. Pathological staging was III A(T3, N1, M0, Cur B). He underwent outpatient treatment with oral administration of UFT 400mg/day as postoperative adjuvant chem...

Background: Colorectal cancer (CRC) is the most common synchronous neoplasm associated with gastric cancer (GC). The objective of this study was to clarify the usefulness of preoperative colonoscopy and the clinicopathological characteristics of GC with CRC. Methods: We studied 293 GC patients who underwent colonoscopy before operation for their GC...

症例は82歳，男性．右下腹部痛のため，近医で抗生剤投与にて経過観察されていたが改善なく，消化管穿孔の疑いで当院に紹介された．腹部造影CTにて，小腸穿通による限局性腹膜炎を疑い緊急開腹手術を施行した．術中所見では空腸間膜は肥厚し，発赤を伴った硬結となっていたため腸間膜膿瘍と考え，小腸部分切除術を施行した．病理所見では空腸憩室炎穿通による腸間膜膿瘍と診断された．小腸憩室は，十二指腸憩室とMeckel憩室を除けば比較的稀な疾患とされ，空腸に多く発症し，そのほとんどが仮性憩室と考えられている．しかし自験例を含めた小腸憩室穿孔・穿通41例の報告例の検討では，仮性憩室が36例と多いものの発症部位は空腸が10例，回腸が31例と回腸に多く発生し，中でも回腸末端部に特に多く発生することが分かった．

症例は29歳，女性．左乳腺腫瘤を主訴に当科を受診した．左乳房D領域に2cm大で弾性硬，可動性良好の腫瘤を触知．乳腺超音波検査にて内部に微細石灰化集族を含む低エコー域をみとめた．マンモグラフィでは，左Lに多形性石灰化の集族および背景濃度の上昇を認めカテゴリ4と診断した．穿刺吸引細胞診で確定診断に至らず，左乳腺腫瘤摘出術を施行．病理結果にて海綿状血管腫と診断された．現在術後2年6カ月経過したが，再発の徴候はない．本邦報告で検索しえた限りでは，病変内に石灰化を有する乳腺血管腫は自験例を含めて3例で，うち20代の若年発症は自験例のみであり，極めてまれな症例と考えられた．

The authors analyzed the 62 patients who underwent hepatic arterial infusion (HAI) chemotherapy using W-spiral (WS) catheter. The catheter was successfully inserted into the hepatic artery without a coil fixation in 57 cases. After cessation of chemotherapy, the catheter was removed in 32 cases without difficulty, which resulted in improved patient...

The patient was a 75-year-old male, who was diagnosed with type 3 advanced gastric cancer and bulky lymph node metastasis. Two courses of neoadjuvant chemotherapy (S-1, CDDP) which showed a partial remission and distal gastrectomy were performed. Although he received S-1 medication as adjuvant chemotherapy, lymph node recurrence appeared 6 months a...

We report a case of liver metastasis from gastric cancer that was effectively controlled with stereotactic radiation therapy (SRT). A 77-year-old man underwent total gastrectomy, splenectomy, cholecystectomy and D2 dissection in February 2007 for type 3 gastric cancer in the upper third area that was diagnosed well to moderately differentiated aden...

Only a partial benefit of adjuvant chemotherapy administered after curative resection of colorectal cancer (CRC) metastases has been demonstrated. We report here our experience of 7 cases that were administered FOLFOX4 regimen as adjuvant chemotherapy after a curative resection of liver metastases from CRC. Five patients received 6 cycles of FOLFOX...

We report a case of successfully treated lower rectal cancer with both inguinal lymph nodes by chemoradiotherapy. A 59-year-old man presented with anal pain. A colonoscopy revealed primary rectal cancer. The histological diagnosis was well to moderately differentiated adenocarcinoma. A computed tomography showed metastases to pararectal, both ingui...

71歳，女性．C型肝炎，肝硬変，肝癌に対し治療中，2008年7月下旬から多量の右胸水による呼吸困難のため当院内科に入院，数回の癒着療法が無効のため同10月外科に紹介となった．腹腔造影CT，99mTc-macro aggregated albumin（MAA）シンチにて腹腔と胸腔の交通が確認されたため，同年11月胸腔鏡手術を行った．横隔膜に最大径10mmの薄壁嚢胞を数個認め，その他筋束に沿った数mmの小孔を数ヵ所に認めた．胸腔内を生理食塩水で満たしてから腹腔内に留置したカニューレから10mmHgで気腹を行ったところ，嚢胞内にエアの流入を認め，さらに横隔膜小孔の1カ所から気泡の発生を認めたため，同部と近接する嚢胞を含めた横隔膜を自動縫合器で切除した．術後2日目にOK-432による癒着療法を行い同...

A 63-year-old man found in gastrointestinal endoscopy screening to have type 0 lie early gastric cancer of the lower third of the stomach was also found to have a celiac artery aneurysm in abdominal CT staging. Abdominal angiography showed that the common hepatic artery, splenic artery, and left gastric artery branched from a celiac artery aneurysm...

The injection of the biological adhesive fibrin glue is often performed to treat postoperative digestive fistulas. However, it is not always effective especially in case of complex fistulas with large cavities, because the fibrin glue will coagulate before the mixed solutions fill the cavity, creating dead space. We report the results of fibrin glu...

An 88-year-old woman, who had undergone distal gastrectomy for Stage IIIA gastric cancer, was diagnosed with recurrent abdominal lymph node metastasis 11 months after surgery. Creatinine clearance of this patient calculated by Cockcroft-Gault method was 44 mL/min and renal function was impaired, so we reduced the administration dosage to 50 mg/day....

Background : We clarified the benefits and diszdvantages of the evaluating of surgical morbidity using common terminology criteria for adverse events, version 3.0 (CTCAEv3.0), for gastric cancer. Patients and methods : Subjects were 154 patients who had undergone surgery for gastric cancer from December 2004 to December 2006. Surgery involved dista...

A 71-year-old woman with peri-anal pain and anal bleeding was found to have a tumor in lower rectum in colonoscopic examination, which was histologically diagnosed as poorly differentiated adenocarcinoma. Computed tomography and magnetic resonance imaging showed a tumor 5 cm in diameter deeply infiltrating mesorectum, and swelling of intra-pelvic l...

Orbital metastasis from breast cancer is relatively rare. We report a case of successfully treated orbital metastasis from breast cancer by radiation therapy. This 50-year-old female patient underwent a mastectomy (Bt+Ax) of her left breast in October 2000. The diagnosis was invasive lobular carcinoma, Stage IIB (T2N1M0). Retroperitoneal and bladde...

抄録 広範な側方発育を呈した十二指腸癌の1例を経験したので報告する．症例は53歳，女性．2006年8月右上腹部痛，発熱を主訴に受診．精査の結果，十二指腸に約8cm大の表面凹凸のある隆起性病変を認め，生検にて十二指腸癌と診断された．術前超音波内視鏡検査によりSM浸潤が疑われたため同年9月膵頭十二指腸切除術を施行した．側方発育型の十二指腸癌は本邦でも数例の報告があるのみである．治療は内視鏡的切除，局所切除，リンパ節郭清を伴った膵頭十二指腸切除などが報告されている．側方発育を呈する十二指腸癌は，術前に壁深達度を正確に診断することは難しいため，縮小手術の選択は慎重を期すべきであると考える．

The authors analyzed the 25-patient who underwent a removal of W-spiral (WS) catheter after cessation of hepatic arterial infusion (HAI) chemotherapy. The catheter was easily removed in all cases, which resulted in improved patients' quality of life as well as preserved patency of hepatic arteries. However, arterial bleeding was occurred postoperat...

Multiple regional metastases due to colon cancer usually show poor prognosis. Various treatments such as chemotherapy and radiation therapy are not sufficient, and the outcome is generally poor in many cases. We report here on a patient with multiple regional metastases who was successfully treated with several therapies and remains still alive. A...

A 68-year-old woman was on dialysis for the treatment of chronic renal failure. FOLFOX 4 therapy was performed following CPT-11+UFT+Leucovorin for liver metastasis after resection of cancer of the sigmoid colon. The dose of oxaliplatin was 40 mg/m2, while 5-FU was given as a bolus of 300 mg/m2, and a continuous intravenous infusion of 500 mg/m2. He...

An 85-year-old man, who had undergone right hemicolectomy and partial hepatectomy for caecum cancer with liver metastasis, was diagnosed with recurrent multiple liver metastasis 10 months after surgery. TS-1 administration at a dose of 80 mg/day induced grade 3 anorexia, and after complete recovery from the adverse reaction, it was converted to a l...

In order to establish a reasonable prophylactic hepatic arterial infusion (HAI) chemotherapy following curative resection of colorectal liver metastases, the authors performed a randomized control study comparing two regimen. A weekly 5 hour-administration of 5-FU (1500 mg) which was repeated for 8 weeks showed a comparable effect to a continuous i...

Sigmoidectomy was performed for a 69-year-old man with sigmoid colon cancer and unresectable multiple liver metastases. The histological diagnosis was undifferentiated carcinoma of sigmoid colon. Hepatic arterial infusion chemotherapy with 5 FU and systemic chemotherapy with CPT-11 were performed after the operation. A complete response (CR) was ac...

We report 2 cases of colonic neuroendocrine carcinoma. Case1 : A 62-year-old man diagnosed with ascending colon cancer and undergoing right hemicolectomy was histologically determined to have neuroendocrine carcinoma. Multiple liver metastasis was detected 2 months after surgery. Despite hepatic arterial infusion of 5-FU + CDDP, he died 11 months p...

Laparoscopic low anterior resection for rectal carcinoma has never been widely accepted among general surgeons because of the technical difficulties encountered during pelvic dissection. We describe our technique of hand-assisted laparoscopic low anterior resection (HAL-LAR) for rectal carcinoma using the Lapdisc abdominal wall sealing device (Hakk...

A 61-year-old woman was referred to our hospital due to a liver tumor discovered at a medical checkup. A hypervascular tumor located in liver segment I, measuring 45 mm in diameter, was visualized on ultrasonography. The tumor showed strong uniform enhancement from an early phase on computed tomography and angiography. Right hepatectomy with total...

The authors investigated the usefulness of W-Spiral (WS) catheters for hepatic arterial infusion (HAI) chemotherapy especially from the viewpoint of a removable catheter after cessation of chemotherapy. A WS catheter was successfully inserted into the hepatic artery without a coil fixation in 40 out of 47 patients with hepatic malignant disease. A...

Fibroblasts have been considered to play an important role in tumor progression. In order to evaluate the contribution of fibroblasts to tumor invasion, TE2-NS, an esophageal cancer cell line, was cultured on collagen gel containing primary fibroblasts derived from normal esophageal submucosa or cancerous tissues of seven esophageal cancer patients...

The cyclin-dependent kinase inhibitor p21cip1/waf1 negatively regulates the progression of cell cycle and the potential usefulness of p21cip1/waf1 gene is proposed in gene therapy. However, studies have demonstrated a protective role of p21cip1/waf1 against apoptosis and little is known about effects of ectopic expression of p21cip1/waf1 on differe...

Endoscopic mucosal resection (EMR) is a widely accepted technique for early gastric cancer because it is minimally invasive; however, incomplete resection with subsequent cancer recurrence in the remnant remains a difficult problem. Generally, the margins of the local recurrence lesions are unclear, and second EMR is difficult to perform because of...

Lipomas are found very rarely in the stomach, where they account for only 3% of benign gastric tumors. Here, we report a case of large gastric lipoma removed successfully by laparoscopic intragastric surgery. A 45-year-old woman with no symptoms was incidentally diagnosed with a yellowish submucosal gastric tumor, about 3 cm in diameter, in the pre...

It is known that p16(INK4) tumor suppressor gene expression in colon cancer cells is repressed by methylation at the CpG island of promoter, but in vivo silencing of p16 gene is not fully understood. Some studies showed that primary colorectal cancer (CRC) tissues often overexpress the p16 protein, while others showed the high incidence of p16 meth...

We report two cases of large gastrointestinal stromal tumor (GIST) of the stomach that were successfully treated by hand-assisted laparoscopic surgery (HALS). Two patients, a 56-year-old woman and a 60-year-old man, were admitted to our department for the treatment of a large submucosal tumor of the stomach. After gastrointestinal endoscopy, ultras...

A 31-year-old-man with selective IgA deficiency admitted for left-lower abdominal pain in February 2003 and diagnosed with transverse colon cancer, underwent partial transdescending colectomy on March 24, 2003. Histological examination showed moderately differentiated adenocarcinoma. Immunohystochemical examination showed that IgA producing plasma...

はじめに: 脾腫瘍に対する用手補助腹腔鏡下脾摘出術 (hand-assisted laparoscopic splenec- tomy; 以下, HALSと略記) の有効性については報告が少なく不明な点が多い. 対象・方法: HALSを施行した10例の脾腫瘍症例につきその術中, 術後経過, 術後回復をretrospectiveに検討した. 結果: 10例の脾腫瘍の内訳は5例が良性腫瘍, 5例が悪性腫瘍であった. 腹腔鏡手術から通常の開腹手術に移行した症例はなかった. 平均手術時間は170分 (100～310分), 平均術中出血量は105g (10～900). 摘出した脾臓の平均重量は478g, 平均長径は13cmであった. 脾臓の重量と大きさから, 50%の症例が脾腫症例であった. 術中術後...

Although there are some reports that adjuvant hepatic arterial infusion (HAI) chemotherapy reduces the hepatic recurrence following curative resection of colorectal liver metastases, problems of indwelling catheters after chemotherapy cessation remains unsolved. The usefulness of adjuvant HAI was investigated using a removable port-catheter system....

The authors experienced a case with obstruction of the inferior vena cava (IVC) and the common bile duct due to a recurrent hepatocellular carcinoma. In order to improve severe edema of the lower extremities and obstructive jaundice, IVC metallic stent as well as biliary stent were applied. A Luminexx stent of 8 cm in length was placed in the bile...

Case 1:A 62-year-old man, who had undergone right upper lobectomy for lung squamous cell carcinoma (pT2pN2M0, stage IIA) 4 months earlier, was diagnosed as mediastinal lymph node recurrence by chest CT. Case 2: A 63-year-old woman, who had undergone right middle-lower lobectomy for lung squamous cell carcinoma (pT2pN1M0, stage IIB) 16 months earlie...

We performed laparoscopic appendectomy and drainage to treat panperitonitis due to perforated appendicitis that occurred in a 28-year-old woman. We believe this is an appropriate procedure to treat perforated appendicitis because it is safe and minimally invasive, and faster recovery can be expected than after conventional open appendectomy.

We report adult congenital bronchoesophageal fistula with both symptomatic fistula and asymptomatic one. A 56-year-old woman with a history of cough after drinking fluids was diagnosed as bronchoesophageal fistula by upper gastrointestinal series that showed a diverticulum in the middle portion of the esophagus with a fistula between the esophagus...

To detect patients with poor prognosis among those with estrogen receptor (ER)-positive breast cancer, who generally show good prognosis, we analyzed gene expression profiles of 35 ER-positive tumors by using a high through-put RT-PCR technique, iAFLP. High expression of six genes out of 7,508 was related to poor prognosis in this group. From these...

Solitary splenic metastasis is a rare condition. We performed hand-assisted laparoscopic splenectomy (HALS) for a solitary splenic metastasis from a uterine corpus carcinoma that had directly invaded the wall of the stomach. HALS is a superior technique that offers the advantages of both open and laparoscopic splenectomy, and it may become one of t...

Little is known about hepatic arterial infusion (HAI) of paclitaxel for hepatic malignancies. The authors administered paclitaxel via the HAI port in two patients with liver metastases from gastric cancer. Both patients were uneventfully treated without any serious complications, and its anti-tumor effect on 5-fluouracil resistant liver metastases...

The feasibility of hand-assisted laparoscopic splenectomy (HALS) for splenic tumors including benign or malignant neoplasms and the associated clinical outcome of the patients remain unclear. A total of 10 patients with splenic tumors undergoing HALS were retrospectively analyzed in this study. The intraoperative course, postoperative course, and p...

A 66-year-old man with bilateral leg edema and food passage failure was diagnosed with advanced gastric cancer with nephrotic syndrome (membranouse nephropathy). Although he was found during surgery to have liver metastases and peritoneum dissemination, he underwent total gastrectomy to improve anemia and food passage failure. Histology showed mode...

We report ileal malignant lymphoma causing ileocecal intussusception diagnosed before laparotomy. A 55 year-old man reporting constipation and dull lower abdominal pain from 1 month previously had moderate abdominal distension and a soft mass palpable in the right lower abdomen. USG showed a multiple concentric ring sign and hay-folk sign. CT showe...

症例は65歳男性.膵癌術後にgemcitabinを用いた補助化学療法を施行した. Gemcitabine 1,000mg/m2を週1回3週連続で投与し1週休薬するスケジュールで3クール施行し,総投与量は8,500mgに達した. 7回目の投与終了8日後より,発熱,呼吸困難,咳嗽,倦怠感を認め, Grade 4の呼吸器障害が出現.血液ガス検査ではPaO2 45mmHg, PaCO2 39mmHgと低酸素血症を呈し,胸部単純写真とCTでは両側下肺野を中心に間質性陰影を認めた. Gemcitabineに起因した薬剤性間質性肺炎と診断し,入院の上プレドニン60mg/日の静注を開始し,その後減量していった.治療開始1週間後には低酸素血症は改善し,画像上も著明な改善が得られ2週間後に退院となった.膵癌に対...

A 38-year-old man had multiple recurrence of hepatocellular carcinoma (HCC) with portal vein thrombosis after hepatectomy and postoperative transcatheter arterial chemotherapy with 5-fluorouracil (5-FU). He was treated by trans hepatic arterial embolization (TAE) with 100 mg of cisplatin (CDDP) and degrable starch microspheres (DSM). After 3 course...

The authors investigated the usefulness of W-Spiral Catheters for adjuvant hepatic arterial infusion (HAI) chemotherapy following curative resection of colorectal liver metastases. The catheter has a special shape-memory alloy in its tip, which allows preferable fixation without coils and removal of the catheter if desired. A W-spiral catheter was...

Background: The present study was conducted to evaluate the usefulness and safety of the non-powder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy. Methods: A total of 830 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder in our hospital were analyzed. Th...

A biliary stricture is one of the most serious complications of laparoscopic cholecystectomy and usually requires a laparotomy. A 50-year-old man was diagnosed with common bile duct stricture after laparoscopic cholecystectomy. Percutaneous transhepatic balloon dilatation was an effective and less invasive treatment for common bile duct stricture f...

We report 2 cases of splenic vascular tumors that were successfully treated by hand-assisted laparoscopic splenectomy. Two patients, a 41-year-old woman and a 33-year-old man, were admitted to our department for investigation of a splenic tumor. After ultrasonography, computed tomography, and magnetic resonance imaging, we suspected that the masses...

Background: Laparoscopic clolecystectomy is now the most appropriate treatment for most patients with symptomatic cholelithiasis (S-Chole). However, the management of patients with asymptomatic cholelithiasis (A-Chole) remains controversial. Our research is aimed at determining whether laparoscopic cholecystectomy for patients with A-Chole is safer...

We report the case of a huge splenic cyst that was successfully treated by hand-assisted laparoscopic splenectomy. A 17-year-old girl with a chief complaint of left-sided abdominal pain was admitted to our department for investigation of a splenic tumor. Ultrasonography, computed tomography, and magnetic resonance imaging revealed a huge cystic les...

A 34-year-old man with an umbilical urachal sinus underwent a voice-controlled robot-assisted laparoscopic excision. In the operational procedure, three trocars were inserted into the peritoneal cavity. Exploration with a laparoscope revealed a cystic lesion at the middle part of the lower abdomen that extended about 4 cm in the major axis just fro...

Although hepatic resections are performed with various access approaches according to the location of the tumor, the extent of resection and patient's physical constitution, the exposure of the root of the hepatic veins is not optimal in some patients by any conventional incision. An additional 5 cm of right parasternal skin incision followed by di...

This study was conducted to examine the usefulness and safety of absorbable clips in laparoscopic cholecystectomy (LC). We retrospectively compared the clinical data of 328 patients who underwent LC using absorbable clips for cystic duct ligation and 444 patients who underwent LC using metal clips for cystic duct ligation. The mean operative time i...

Although hepatic arterial infusion (HAI) is widely performed as a prophylactic chemotherapy for patients who have undergone a curative resection of a metastatic liver tumor from colorectal cancer, the optimal management of implantable ports and catheters after the cessation of such adjuvant therapy remains to be elucidated. The survival and recurre...

症例は26歳,女性.近医で心窩部痛のため精査した際,腹部超音波検査で左下腹部に径50mm大の腫瘤を指摘され当院へ紹介された. CTおよびMRIでは左腸骨筋にはまり込み,造影で壁とともに淡く濃染される部位を伴う多房性の嚢胞性腫瘤を認めた.後腹膜の充実性成分を伴う嚢胞性腫瘍と診断し,腹腔鏡下に完全摘出を施行した.摘出標本は境界明瞭で,内容は一部混濁した粘液成分であった.組織学的には悪性所見は認めず,後腹膜原発の粘液性嚢胞腺腫と診断された.術前に充実性成分が疑われた部位は無数の小嚢胞が蜂巣状に集合したもので,造影された壁が充実性成分として反映されたものと考えられた.後腹膜原発の嚢胞性腫瘍は稀であり,また術前に良悪性の鑑別は困難とされる.

A 70-year-old man underwent total gastrectomy for advanced gastric cancer in January 2000. He was treated with UFT of 300 mg/day after surgery. In December 2000, liver metastasis was detected. In January 2001, treatment was switched to oral administration of TS-1 at 100 mg/day. In April 2001, there were no extrahepatic lesions. However, the metasta...