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1.
Clin Case Rep ; 10(2): e05320, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35140943

ABSTRACT

This clinical image presents an unusual report of simultaneous laparoscopic resection of a hydrocele of the canal of Nuck and an ovarian tumor. Laparoscopic treatment with a proper approach is a useful technique in some cases.

2.
Gastric Cancer ; 22(2): 377-385, 2019 03.
Article in English | MEDLINE | ID: mdl-30506394

ABSTRACT

BACKGROUND: Robotic gastrectomy (RG) for gastric cancer (GC) has been increasingly performed for a decade; however, evidence for its use as a standard treatment has not yet been established. The present study aimed to determine the safety, feasibility, and effectiveness of RG for GC. METHODS: This multi-institutional, single-arm prospective study, which included 330 patients from 15 institutions, was designed to compare morbidity rate of RG with that of a historical control (conventional laparoscopic gastrectomy, LG). This trial was approved for Advanced Medical Technology ("Senshiniryo") B. The included patients were operable patients with cStage I/II GC. The primary endpoint was morbidity (Clavien-Dindo Grade ≥ IIIa). The specific hypothesis was that RG could reduce the morbidity rate to less than half of that with LG (6.4%). A sample size of 330 was considered sufficient (one-sided alpha 0.05, power 80%). RESULTS: Among the 330 study patients, the protocol treatment was suspended in 4 patients. Thus, 326 patients fully enrolled and completed the study. The median patient age and BMI were 66 years and 22.4 kg/m2, respectively. Distal gastrectomy was performed in 253 (77.6%) patients. The median operative time and estimated blood loss were 313 min and 20 mL, respectively. No 30-day mortality was seen, and morbidity showed a significant reduction to 2.45% with RG (p = 0.0018). CONCLUSIONS: RG for cStage I/II GC is safe and feasible. It may be effective in reducing morbidity with LG.


Subject(s)
Adenocarcinoma/surgery , Gastrectomy/instrumentation , Robotic Surgical Procedures , Stomach Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Female , Gastrectomy/adverse effects , Gastrectomy/methods , Humans , Male , Middle Aged , Operative Time , Postoperative Complications/epidemiology , Robotic Surgical Procedures/adverse effects , Robotic Surgical Procedures/instrumentation , Robotic Surgical Procedures/methods
3.
Jpn J Clin Oncol ; 42(2): 131-3, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22167664

ABSTRACT

The standard treatment for T4 locally advanced gastric cancer is gastrectomy with D2 lymph node dissection followed by adjuvant chemotherapy with S-1 for 12 months; however, prognostic outcome in Stage IIIb has been insufficient. It is expected that survival is improved by preoperative treatment with a triplet regimen of docetaxel, cisplatin and S-1 (divided DCS therapy). A multicenter Phase II study has been conducted to evaluate the safety and efficacy of two courses of preoperative chemotherapy followed by gastrectomy. Fifty-five patients are required for this study. The primary endpoint of the study is pathological response rate of primary lesions. Secondary endpoints are overall survival, disease-free survival, R0 resection rate and adverse events.


Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Gastrectomy , Neoadjuvant Therapy/methods , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Adenocarcinoma/surgery , Adult , Aged , Antimetabolites, Antineoplastic/administration & dosage , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Disease-Free Survival , Docetaxel , Drug Administration Schedule , Drug Combinations , Feasibility Studies , Female , Gastrectomy/methods , Humans , Infusions, Intravenous , Lymph Node Excision , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Oxonic Acid/administration & dosage , Patient Selection , Stomach Neoplasms/surgery , Survival Analysis , Taxoids/administration & dosage , Tegafur/administration & dosage , Treatment Outcome
4.
Gan To Kagaku Ryoho ; 33(8): 1151-4, 2006 Aug.
Article in Japanese | MEDLINE | ID: mdl-16912538

ABSTRACT

Here we report a case of gastric cancer with diffuse abdominal wall invasion treated with weekly low-dose paclitaxel therapy. A 62-year-old male visited our hospital because of abdominal distention, prepubic tumor,and testicular hydrocele. Computed tomography revealed diffuse swelling of the abdominal wall and hydronephrosis of the right kidney. Upper gastrointestinal endoscopy demonstrated type 3' advanced gastric cancer. Pathological diagnosis of both gastric tumor and abdominal wall biopsy specimens was poorly-differentiated adenocarcinoma containing signet ring cell carcinoma. Low-dose paclitaxel (90 mg/body) was given once a week for 3 weeks. Abdominal wall swelling like cuirass disappeared after 2 courses of low-dose paclitaxel therapy. Nine repeated courses of this regimen have been given until now; the relapse of the abdominal wall invasion has not become apparent, and primary gastric lesion has been a stable disease. Diffuse abdominal wall invasion of gastric cancer like cuirass without ascites is a rare condition, and low-dose paclitaxel was very effective for this condition.


Subject(s)
Abdominal Wall/pathology , Adenocarcinoma/drug therapy , Antineoplastic Agents, Phytogenic/administration & dosage , Paclitaxel/administration & dosage , Stomach Neoplasms/drug therapy , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Carcinoma, Signet Ring Cell/pathology , Drug Administration Schedule , Humans , Male , Middle Aged , Neoplasm Invasiveness , Radiography, Abdominal , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/pathology , Tomography, X-Ray Computed
5.
Surg Today ; 36(8): 737-40, 2006.
Article in English | MEDLINE | ID: mdl-16865520

ABSTRACT

We report a case of jejunal loop obstruction by a large gallstone caused by Roux-en-Y hepaticojejunostomy-induced acute cholangitis. The patient was admitted with sepsis as well as abdominal and back pain. Abdominal computed tomography showed a dilated jejunal loop and an obstructing large mass. After his clinical condition and laboratory values improved, we performed laparotomy, which revealed a dilated jejunal loop with a palpable mass, and a gallstone was removed via enterotomy. After the disimpaction of the stone and control of the infection, his clinical condition and laboratory values continued to improve. Gallstone formation is rare after hepaticojejunostomy and to our knowledge, no other cases of acute cholangitis caused by a stone obstructing the jejunal loop have ever been reported. As with other major complications, early diagnosis and prompt initiation of surgical treatment are important to prevent any deterioration in the patient's general condition.


Subject(s)
Cholangitis/complications , Gallstones/complications , Hepatic Duct, Common/surgery , Intestinal Obstruction/etiology , Jejunal Diseases/etiology , Jejunostomy/methods , Acute Disease , Aged , Anastomosis, Roux-en-Y , Humans , Male , Postoperative Complications
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