タイトル(別表記) Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis
著者 杉原 雄策| 川野 誠司| 原田 馨太| 高嶋 志保| 竹井 大介| 井口 俊博| 高原 政宏| 平岡 佐規子| 母里 淑子| 岸本 浩行| 永坂 岳司| 岡田 裕之|
抄録 A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.
キーワード 家族性大腸腺腫症 (familial adenomatous polyposis) 小腸癌 (jejunal cancer) 小腸内視鏡検査 (small intestine endoscope)
出版物タイトル 岡山医学会雑誌
発行日 2017-08-01
129巻
2号
開始ページ 111
終了ページ 114
ISSN 0030-1558
関連URL https://doi.org/10.4044/joma.129.111
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.129.111
JaLCDOI 10.18926/AMO/53672
フルテキストURL 69_5_267.pdf
著者 Inada, Ryo| Nagasaka, Takeshi| Kondo, Yoshitaka| Watanabe, Ayako| Toshima, Toshiaki| Kubota, Nobuhito| Kikuchi, Satoru| Ishida, Michihiro| Kuroda, Shinji| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
抄録 The aim of this single-institution, retrospective, observational case-control study was to evaluate the safety and feasibility of laparoscopic proctocolectomy (PC) for ulcerative colitis (UC), by comparing it with a case-control series of open PC. Twenty UC patients who underwent laparoscopic PC were retrospectively compared with the open PC group of 12 patients matched for age, sex, and urgency of the operation. In the laparoscopic PC group, the operative time was significantly longer, but the amount of blood loss was significantly smaller. The open PC patients underwent an intraoperative blood transfusion significantly more often, and the serum C-reactive protein level on the first postoperative day was significantly higher in the open PC group. In the laparoscopic PC group, the rate of severe postoperative morbidities, grades 3 and 4 on the Clavien-Dindo classification, was significantly lower, and the median length of hospital stay was significantly shorter. Laparoscopic PC for patients with UC showed superior perioperative outcomes to open PC, except for longer operative time.
キーワード laparoscopic surgery total proctocolectomy open proctocolectomy ulcerative colitis case-matched study
Amo Type Original Article
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 267
終了ページ 273
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490023
Web of Sience KeyUT 000365519600002
タイトル(別表記) Successful laparoscopic resection of a cecal tumor in a 95-year-old man
フルテキストURL 127_117.pdf
著者 渡邉 彩子| 稲田 涼| 永坂 岳司| 八木 朝彦| 松本 聖| 戸嶋 俊明| 菊池 覚次| 黒田 新士| 近藤 喜太| 母里 淑子| 岸本 浩行| 藤原 俊義|
抄録 We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.
キーワード 超高齢者(extremely elderly patient) 大腸癌(colorectal cancer) 腹腔鏡手術(laparoscopic surgery)
出版物タイトル 岡山医学会雑誌
発行日 2015-08-03
127巻
2号
開始ページ 117
終了ページ 121
ISSN 0030-1558
関連URL isVersionOf https://doi.org/10.4044/joma.127.117
言語 Japanese
著作権者 Copyright (c) 2015 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.127.117
NAID 130005096253