[Consideration of Surgical Treatment for Ileus Symptoms Associated with Progressing Cancer in Our Hospital].

INTRODUCTION: Many cases of terminal cancer develop ileus symptoms such as vomiting and abdominal distension. The causes of ileus symptoms include peritoneal dissemination, localized recurrence, etc. The treatments include octreotide acetate, decompression measures such as ileus tube, and surgical treatment. We evaluated the results of cases that underwent surgical methods to reduce ileus symptoms. METHODS: The subjects were 31 patients comprising 38 cases with ileus symptoms between January 2013 and January 2018. The surgical procedures included bypass(17 cases), tumor extirpation(7 cases), stoma(11 cases), and other(3 cases). RESULTS: Dietary intake information was available for 27 of the 38 cases; in cases that underwent tumor excision, all meals were able to be ingested and there were many cases of long-term survival. DISCUSSION: Surgical procedures can allow patients to eat food and should be considered as dietary intake after treatment is associated with survival duration.

[Endoscopic Topical Therapy Using Mesh for Refractory Suture Failure after Rectal Cancer Surgery].

We reported a case that could be cured with endoscopic topical therapyusing mesh for refractorysuture failure after rectal cancer surgery. The patient was a 73-year-old man. He was diagnosed as lower rectal cancer, and underwent laparoscopic super law anterior rectum resection. On the 13th postoperative day, abdominal pain appeared, suspected ileal necrosis, emergencylaparoscopic examination laparotomywas performed. Upper gastrointestinal perforation was suspected from pus and food on the whole intraperitoneal cavity, and we moved laparotomy. But any perforations were not found, we resected ileum and inserted a drain tube to Douglas fossa. After second surgerydischarge of the juice from the drain was confirmed, diagnosis was made of suture failure of the anastomosis of the rectal cancer. He rejected artificial stomy, we chose conservative therapy. On 114th day after second surgerywe put a mesh for inguinal hernia in the puncture under the endoscope. On the next dayafter the treatment discharge of the juice from the drain was stopped. And finallyhe was discharged. This endoscopic treatment is considered to be useful for refractorysuture failure.

[A Case of Small Intestinal Gastrointestinal Stromal Tumor(GIST)with Synchronous Colonic Cancer and Gastric Cancer at a Different Time].

The patient was a 70-year-old woman with a gastrointestinalstromaltumor (GIST)of the small intestine and synchronous colonic cancer, who underwent laparoscopic right colectomy and resection of the small intestine. We started imatinib therapy because GIST belongs to a high-risk group, according to the modified Fletcher classification. Gastric cancer was diagnosed 2 years after the start of imatinib therapy. Only 4 of the 12 GIST cases seen at our institution over the last 5 years were complicated by another cancer. This is the first case of GIST in which 2 other cancers occurred at both the same and different times. We suggest that imatinib might be a factor in the development of gastric cancer.