JaLCDOI 10.18926/AMO/54981
フルテキストURL 71_2_127.pdf
著者 Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Tanabe, Shunsuke| Kuroda, Shinji| Kagawa, Shunsuke| Katsui, Kuniaki| Katayama, Norihisa| Kanazawa, Susumu| Fujiwara, Toshiyoshi|
抄録 Currently, chemoradiation is the most widely used nonsurgical treatment for esophageal cancer. However, some patients, particularly the very elderly or those with severe vital organ dysfunction, face difficulty with the chemotherapy component. We therefore examined the outcome of radiation therapy (RT) alone for patients with esophageal cancer at our facility. Between January 2005 and December 2014, 84 patients underwent RT at our hospital, and 78 of these patients received concomitant chemotherapy. The remaining 6 patients underwent RT alone; these patients were considered to be high-risk and to have no lymph node metastasis (stage I). Five of them received irradiation up to a curative dose: 4 showed a complete response (CR) and 1 showed a partial response (PR). Of the patients exhibiting CR, 3 are currently living recurrence-free, whereas 1 patient underwent endoscopic submucosal dissection (ESD) as salvage therapy for local recurrence, with no subsequent recurrence. High-risk stage I esophageal cancer patients can be treated radically with RT alone under certain conditions. In the future, to broaden the indications for RT monotherapy to include some degree of advanced cancers, a novel concurrent therapy should be identified.
キーワード esophageal cancer radiation therapy high-risk patient
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 127
終了ページ 133
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420894
Sort Key 8
タイトル(別表記) Thoracoscopic esophagectomy was effective in a case of lower esophageal stenosis due to recurrence of achalasia after myotomy 40 years previously
著者 桂 佑貴| 白川 靖博| 田邊 俊介| 前田 直見| 野間 和広| 藤原 俊義|
抄録 When planning surgery for achalasia, it is important to plan for adequate myotomy and prevention of reflux. However, achalasia may recur if the procedure was inadequate or in patients with a long-term course. The present case is a 68-year-old woman who underwent myotomy of the lower esophageal sphincter 40 years ago, but recently reported difficulty in swallowing. Dilatation of the thoracic esophagus and stenosis of the abdominal esophagus were identified by examination, and the patient was diagnosed with recurrence of achalasia. After percutaneous endoscopic gastrostomy was performed to recover nutritional status, thoracoscopic esophagectomy was carried out. The patient'spost-operative course was uneventful and oral intake was enabled. At the time of writing, there has been no re-recurrence. There is no standard therapy for post-operative recurrence of achalasia. We believe that thoracoscopic esophagectomy for the recurrence of achalasia is a safe and minimally invasive alternative to conventional surgery.
キーワード 食道アカラシア (achalasia) 再手術 (reoperation) 食道亜全摘 (esophagectomy)
備考 症例報告(Case Reports)
出版物タイトル 岡山医学会雑誌
発行日 2017-04-03
129巻
1号
出版者 岡山医学会
出版者(別表記) Okayama Medical Association
開始ページ 41
終了ページ 44
ISSN 0030-1558
NCID AN00032489
資料タイプ 学術雑誌論文
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
査読 有り
DOI 10.4044/joma.129.41
Eprints Journal Name joma
参考文献 1 ) 鬼丸 学, 井上晴洋 : 食道アカラシアに対する内視鏡的筋層切開術. Modern Physician ( 2014) 34, 478-480. 2 ) Herbella FA, Patti MG : Laparoscopic Heller Myotomy and Fundoplication in Patients with End-Stage Achalasia. World J Surg (2015) 39, 1631-1633. 3 ) Thomas J Watson : Esophagectomy for End-Stage Achalasia. World J Surg ( 2015) 39, 1634-1641. 4 ) 島田英昭, 林 秀樹, 岡住慎一, 落合武徳 : 食道アカラシア手術の最近の進歩. 千葉医学 (2006) 82, 133-138. 5 ) 阿久津泰典, 松原久裕 : 食道アカラシア. 消化器外科 (2009) 32, 1427-1434. 6 ) 小村伸朗, 矢野文章, 坪井一人, 星野真人, 柏木秀幸, 矢永勝彦 : 良性疾患の手術 1 . 食道アカラシアの手術. 手術 (2014) 68, 765-770. 7 ) Mercer CD, Hill LD : Reoperation after failed esophagomyotomy for acharasia. Can J Surg ( 1986) 29, 177-180. 8 ) 太田正穂, 井出博子, 江口礼紀, 中村 努, 菊池哲也, 谷川啓司, 高崎 健 : アカラシア再手術症例の検討. 日臨外会誌 (1998) 59, 1484-1490. 9 ) Loviscek MF, Wright AS, Hinojosa MW, Petersen R, Pajitnov D, Oelschlager BK, Pellegrini CA : Recurrent Dysphagia after Heller Myotomy : Is Esophageactomy Always the Answer? J Am Coll Surg ( 2013) 216, 736-743. 10) Shirakawa Y, Noma K, Maeda N, Katsube R, Tanabe S, Ohara T, Sakurama K, Fujiwara T : Assistant-based standardization of prone position Thoracoscopic esophagectomy. Acta Med Okayama (2014) 68, 2, 111-117.
著者 Takagi, Kosei| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Watanabe, Nobuyuki| Kuise, Takashi| Fuji, Tomokazu| Araki, Hiroyuki| Fujiwara, Toshiyoshi|
発行日 2017-02
出版物タイトル Acta Medica Okayama
71巻
1号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/54830
JaLCDOI 10.18926/AMO/54601
フルテキストURL 70_5_401.pdf
著者 Kuroda, Shinji| Kikuchi, Satoru| Nishizaki, Masahiko| Kagawa, Shunsuke| Hinotsu, Shiro| Fujiwara, Toshiyoshi|
抄録 Although intermittent pneumatic compression (IPC) has become common as perioperative prophylaxis for venous thromboembolism (VTE) consisting of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), the prophylactic effect against VTE, especially lethal PE, is not yet satisfactory. Therefore, pharmacologic prophylaxis, such as with enoxaparin, is desirable. While the efficacy and safety of enoxaparin have been proven in several clinical trials, concern about bleeding with longterm (at least 7 days) use have potentially decreased its widespread adoption. We have launched a phase II study to evaluate the efficacy and safety of short-term (3 days) enoxaparin, in which a total of 70 gastric cancer patients undergoing gastrectomy will be recruited, and the primary endpoint is the incidence of DVT. This study could contribute to making pharmacologic prophylaxis for VTE more common.
キーワード venous thromboembolism enoxaparin short-term use gastric cancer surgery
Amo Type Clinical Study Protocols
発行日 2016-10
出版物タイトル Acta Medica Okayama
70巻
5号
出版者 Okayama University Medical School
開始ページ 401
終了ページ 404
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27777435
Web of Sience KeyUT 000388098700012
JaLCDOI 10.18926/AMO/54594
フルテキストURL 70_5_363.pdf
著者 Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Fujiwara, Toshiyoshi|
抄録 Sarcopenia following liver surgery has been reported as a predictor of poor prognosis. Here we investigated predictors of outcomes in patients with hepatocellular carcinoma (HCC) and attempted to establish a new comprehensive preoperative assessment protocol. We retrospectively analyzed the cases of 254 patients who underwent curative hepatectomy for HCC with Child-Pugh classification A at our hospital between January 2007 and December 2013. Sarcopenia was evaluated by computed tomography measurement. The influence of sarcopenia on outcomes was evaluated. We used multivariate analyses to assess the impact of prognostic factors associated with outcomes, including sarcopenia. Of the 254 patients, 118 (46.5%) met the criteria for sarcopenia, and 32 had an American Society of Anesthesiologists (ASA) physical status ≥3. The sarcopenic group had a significantly lower 5-year overall survival rate than the non-sarcopenic group (58.2% vs. 82.4% , p=0.0002). In multivariate analyses of prognostic factors, sarcopenia was an independent predictor of poor survival (hazard ratio [HR]=2.28, p=0.002) and poor ASA status (HR=3.17, p=0.001). Sarcopenia and poor ASA status are independent preoperative predictors for poor outcomes after hepatectomy. The preoperative identification of sarcopenia and ASA status might enable the development of comprehensive approaches to assess surgical eligibility.
キーワード sarcopenia American Society of Anesthesiologists physical status hepatectomy hepatocellular carcinoma prognostic factor
Amo Type Original Articles
発行日 2016-10
出版物タイトル Acta Medica Okayama
70巻
5号
出版者 Okayama University Medical School
開始ページ 363
終了ページ 370
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27777428
Web of Sience KeyUT 000388098700005
JaLCDOI 10.18926/AMO/54514
フルテキストURL 70_4_327.pdf
著者 Watanabe, Mototsugu| Yamamoto, Hiromasa| Eikawa, Shingo| Shien, Kazuhiko| Shien, Tadahiko| Soh, Junichi| Hotta, Katsuyuki| Wada, Jun| Hinotsu, Shiro| Fujiwara, Toshiyoshi| Kiura, Katsuyuki| Doihara, Hiroyoshi| Miyoshi, Shinichiro| Udono, Heiichiro| Toyooka, Shinichi|
抄録 A study to evaluate the effect of metformin on the immune system was commenced in July 2014. Metformin is one of the most commonly prescribed drugs for type 2 diabetes, and previous studies have reported that metformin has an anti-tumor effect. The aim of this study is to evaluate the efficacy of metformin on the immune system in human cancer patients in vivo. The primary outcome parameter will be the rate change in the population of CD8+ T cells, which produce multiple cytokines.
キーワード metformin CD8+ T cells cancer immunology
Amo Type Clinical Study Protocols
発行日 2016-08
出版物タイトル Acta Medica Okayama
70巻
4号
出版者 Okayama University Medical School
開始ページ 327
終了ページ 330
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27549683
Web of Sience KeyUT 000384748600018
著者 佃 和憲| 浅野 博昭| 万代 康弘| 藤原 俊義|
発行日 2016-08-01
出版物タイトル 岡山医学会雑誌
128巻
2号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/54421
フルテキストURL 70_3_213.pdf
著者 Kikuchi, Satoru| Kagawa, Shunsuke| Ohara, Toshiaki| Kubota, Tetsushi| Kuwada, Kazuya| Kagawa, Tetsuya| Kuroda, Shinji| Shirakawa, Yasuhiro| Nishizaki, Masahiko| Fujiwara, Toshiyoshi|
抄録 A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called “dysplasia-like atypia” (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.
キーワード dysplasia-like atypia early gastric cancer endoscopic submucosal dissection local recurrence
Amo Type Case Report
発行日 2016-06
出版物タイトル Acta Medica Okayama
70巻
3号
出版者 Okayama University Medical School
開始ページ 213
終了ページ 216
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27339211
Web of Sience KeyUT 000379406100009
JaLCDOI 10.18926/AMO/54419
フルテキストURL 70_3_197.pdf
著者 Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi|
抄録 The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p<0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p<0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes.
キーワード pancreaticoduodenectomy surgical outcome mortality major complication length of stay
Amo Type Original Article
発行日 2016-06
出版物タイトル Acta Medica Okayama
70巻
3号
出版者 Okayama University Medical School
開始ページ 197
終了ページ 203
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27339209
Web of Sience KeyUT 000379406100007
著者 藤原 俊義|
発行日 2015-02
出版物タイトル Okayama University Medical Research Updates
7巻
資料タイプ その他
著者 藤原 俊義|
発行日 2014-07
出版物タイトル Okayama University Medical Research Updates
1巻
資料タイプ その他
JaLCDOI 10.18926/AMO/53675
フルテキストURL 69_5_291.pdf
著者 Sugiu, Kumi| Iwamoto, Takayuki| Kelly, Catherine M.| Watanabe, Naoki| Motoki, Takayuki| Itoh, Mitsuya| Ohtani, Shoichiro| Higaki, Kenji| Imada, Takako| Yuasa, Takeshi| Omori, Masako| Sonobe, Hiroshi| Fujiwara, Toshiyoshi| Matsuoka, Junji|
抄録 Although in the neoadjuvant setting for estrogen receptor (ER)-positive breast cancers, chemotherapy or hormone therapy alone does not result in satisfactory tumor response, it is unknown whether concurrent chemo-endocrine therapy is superior to chemotherapy alone in clinical outcomes. We conducted a randomized phase II trial to test the responses of ER-positive patients to concurrent administration of chemo-endocrine therapy in the neoadjuvant setting. Women with stage II-III, ER-positive, invasive breast cancer (n=28) received paclitaxel followed by fluorouracil, epirubicin, cyclophosphamide (T-FEC) and were randomized to receive concurrent chemo-endocrine therapy consisting of goserelin administered subcutaneously for premenopausal women or an aromatase inhibitor for postmenopausal women. The primary endpoint was the pathological complete response (pCR) rate after neoadjuvant therapy. Twenty-eight patients were randomized. There were no significant differences in pCR rate between the concurrent group (12.5%;2/16) and the chemotherapy alone group (8.3%;1/12). Tumor size after therapy was significantly reduced in the concurrent therapy group (p=0.035), but not in the chemotherapy-alone group (p=0.622). Neoadjuvant chemotherapy with concurrent hormone therapy provided no significant improvement in pCR rate in ER-positive breast cancers. These preliminary results should be followed up by further studies.
キーワード breast cancer neoadjuvant chemotherapy concurrent hormone therapy estrogen receptor positive tumor response
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 291
終了ページ 299
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 26490026
Web of Sience KeyUT 000365519600005
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
Sort Key 7
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)
備考 症例報告(Case Reports)
出版物タイトル 岡山医学会雑誌
発行日 2015-08-03
127巻
2号
出版者 岡山医学会
出版者(別表記) Okayama Medical Association
開始ページ 117
終了ページ 121
ISSN 0030-1558
NCID AN00032489
資料タイプ 学術雑誌論文
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
査読 有り
DOI 10.4044/joma.127.117
NAID 130005096253
Eprints Journal Name joma
参考文献 1) 大腸癌治療ガイドライン 医師用 2014年版, 大腸癌研究会編, 金原出版, 東京(2014). 2) Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H, Clinical Outcomes of Surgical Therapy Study Group : Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg (2007) 246, 655-662. 3) Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ : Survival after laparoscopic surgery versus open surgery for colon cancer : long-term outcome of a randomised clinical trial. Lancet Oncol (2009) 10, 44-52. 4) Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ : Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg (2010) 97, 1638-1645. 5) Kitano S, Inomata M, Sato A, Yoshimura K, Moriya Y, Japan Clinical Oncology Group Study : Randomized controlled trial to evaluate laparoscopic surgery for colorectal cancer : Japan Clinical Oncology Group Study JCOG 0404. Jpn J Clin Oncol (2005) 35, 475-477. 6) Lujan J, Valero G, Hernandez Q, Sanchez A, Frutos MD, Parrilla P : Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg (2009) 96, 982-989. 7) 永坂岳司, 稲田 涼, 藤原俊義 : 腸管損傷の修復法 : OGS NOW16合併症対策&知っておきたい他科の手術手技, メジカルビュー社, 東京(2013)pp74-81. 8) 大腸癌取り扱い規約 第8版, 大腸癌研究会編, 金原出版, 東京(2013). 9) 小澤平太, 固武健二郎 : 我が国の大腸癌 最新の基本統計(2) ―大腸癌全国登録1974~1999年症例のデータから―. 大腸癌Frontier(2010)3, 293-297. 10) Grailey K, Markar SR, Karthikesalingam A, Aboud R, Ziprin P, Faiz O : Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc (2013) 27, 19-30. 11) 藤井正一, 石部敦士, 大田貢由, 渡辺一輝, 渡邉 純, 辰巳健志, 山岸 茂, 市川靖史, 大木繁男, 國崎主税, 嶋田 紘, 遠藤 格 : 高齢者(80歳以上)大腸癌に対する手術成績の検討. 日本大腸肛門病会誌(2013)66, 221-228. 12) 須藤 剛, 佐藤敏彦 : 高齢者大腸癌患者における腹腔鏡補助下手術の検討. 日老医誌(2011)48, 665-671. 13) Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, et al. : The Clavien-Dindo classification of surgical complications : five-year experience. Ann Surg (2009) 96, 187-196.
JaLCDOI 10.18926/AMO/53524
フルテキストURL 69_3_173.pdf
著者 Shirakawa, Yasuhiro| Noma, Kazuhiro| Ohara, Toshiaki| Kashima, Hajime| Maeda, Naoaki| Tanabe, Shunsuke| Kagawa, Shunsuke| Fujiwara, Toshiyoshi|
抄録 A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (typeⅢB1 of Edwardʼs classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position.
キーワード chyle leak thoracic duct thoracoscopy prone position
Amo Type Case Report
発行日 2015-06
出版物タイトル Acta Medica Okayama
69巻
3号
出版者 Okayama University Medical School
開始ページ 173
終了ページ 176
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 26101193
Web of Sience KeyUT 000356903000006
JaLCDOI 10.18926/AMO/53340
フルテキストURL 69_2_113.pdf
著者 Inada, Ryo| Nagasaka, Takeshi| Toshima, Toshiaki| Mori, Yoshiko| Kondo, Yoshitaka| Kishimoto, Hiroyuki| Hiraki, Takao| Oshiro, Taihei| Kanemitsu, Yukihide| Fujiwara, Toshiyoshi|
抄録 A case of advanced rectal cancer treated by aggressive local and systemic treatment who has survived more than 7 years from initial recurrence is presented. A 55-year-old woman was diagnosed with advanced lower rectal cancer and underwent a low anterior resection with complete removal of all regional lymph nodes and total mesorectal excision. The tumor was diagnosed as a moderately differentiated adenocarcinoma, pStage IIIB (T3, N2a, M0). Twenty-six months after the initial surgery, local recurrence in the pelvis was detected by computed tomography, and total pelvic exenteration with distal sacrectomy (TPES) was performed after systemic chemotherapy with a molecular-targeted drug. Six months after the TPES, multiple lung metastases were detected. Consequently, the patient underwent radiofrequency ablation (RFA) and chemotherapy. The disease has since been controlled for 38 months. As volume control is essential for cancer treatment, it may be important to combine appropriate local therapy with systemic therapy to metastatic or recurrent sites in order to achieve much longer disease control.
キーワード colorectal cancer recurrence total pelvic exenteration radiofrequency ablation systemic chemotherapy
Amo Type Case Report
発行日 2015-04
出版物タイトル Acta Medica Okayama
69巻
2号
出版者 Okayama University Medical School
開始ページ 113
終了ページ 118
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 25899633
Web of Sience KeyUT 000353181700006
著者 Kikuchi, Satoru| Kishimoto, Hiroyuki| Tazawa, Hiroshi| Hashimoto, Yuuri| Kuroda, Shinji| Nishizaki, Masahiko| Nagasaka, Takeshi| Shirakawa, Yasuhiro| Kagawa, Shunsuke| Urata, Yasuo| Robert M Hoffman| Fujiwara, Toshiyoshi|
発行日 2014-12-19
出版物タイトル Molecular Therapy
資料タイプ 学術雑誌論文
著者 Kondo, Yoshitaka| Nagasaka, Takeshi| Kobayashi, Satoru| Kobayashi, Naoya| Fujiwara, Toshiyoshi|
発行日 2014-03
出版物タイトル Hepato-Gastroenterology
61巻
130号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/53024
フルテキストURL 68_6_349.pdf
著者 Yamamoto, Tsuyoshi| Kajikawa, Yutaka| Otani, Satoru| Yamada, Yuki| Takemoto, Syunji| Hirota, Minoru| Ikeda, Masae| Iwagaki, Hiromi| Saito, Shinya| Fujiwara, Toshiyoshi|
抄録 Accumulated studies have shown that ω-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have protective roles against inflammatory responses such as hyperlipidemia, diabetes mellitus (DM) and cardiovascular diseases. Here we examined the effects of administering EPA to hyperlipidemic patients and other patients undergoing cardiac surgery to determine whether this treatment would increase plasma EPA levels and to clarify the association between EPA treatment and adiponectin production in hyperlipidemic patients. We also assessed the effect of preoperative EPA administration on postoperative adverse events such as postoperative atrial fibrillation (POAF) and postoperative infection in the cardiac surgery patients. The EPA administration significantly increased the serum EPA concentrations in both patient populations (p<0.001). In the hyperlipidemic patients, the EPA administration significantly increased plasma adiponectin levels (p<0.05), accompanied by a decrease in insulin resistance designated by the HOMA-IR (homeostasis model assessment of insulin resistance) score (p<0.05) and Hs-CRP (high sensitivity C-reactive protein) value (p<0.05). In the cardiac surgery patients, no significant effect of EPA on cardiac adverse events such as POAF was observed. However, our results clearly demonstrated that both the neutrophil-to-lymphocyte ratio and the 2nd-line antibiotic requirement in the EPA group were significantly decreased compared to the untreated control group (p<0.05). We suggest that EPA administration may exert anti-inflammatory effects in patients with hyperlipidemia and in those undergoing cardiac surgery, possibly through an increase in plasma adiponectin levels.
キーワード eicosapentaenoic acid adiponectin hyperlipidemic patients cardiac surgery atrial fibrillation
Amo Type Original Article
発行日 2014-12
出版物タイトル Acta Medica Okayama
68巻
6号
出版者 Okayama University Medical School
開始ページ 349
終了ページ 361
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25519029
Web of Sience KeyUT 000346882200005
関連URL http://ousar.lib.okayama-u.ac.jp/metadata/53125
著者 Shigeyasu, Kunitoshi| Tazawa, Hiroshi| Hashimoto, Yuuri| Mori, Yoshiko| Nishizaki, Masahiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Kuroda, Shinji| Urata, Yasuo| Goel, Ajay| Kagawa, Shunsuke| Fujiwara, Toshiyoshi|
発行日 2014-05-28
出版物タイトル Gut
資料タイプ 学術雑誌論文