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Kenichi Okubo Masashi Kobayashi Hiromasa Morikawa Eiichi Hayatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(7):268-272
Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer
with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal
node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral
to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted
of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients
underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical
findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy
after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion
to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal
nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior
to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p<
0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea
and makes the node dissection easier after induction chemoradiotherapy. 相似文献
3.
Experience with dimethyl sulfoxide treatment for primary localized amyloidosis of the bladder 总被引:2,自引:0,他引:2
We report a case of primary localized amyloidosis of the bladder treated successfully with transurethral resection and intravesical dimethyl sulfoxide instillation. Dimethyl sulfoxide bladder instillation is useful for the treatment of primary localized amyloidosis of the bladder. 相似文献
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Hisato Takagi Toshiyuki Tanabashi Norikazu Kawai Takuya Umemoto 《European journal of cardio-thoracic surgery》2007,32(2):400; author reply 400-400; author reply 401
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M Asakawa S Wada N Hayahara R Yayumoto T Kishimoto M Maekawa Y Morikawa J Kawakita M Umeda A Horii 《Hinyokika kiyo. Acta urologica Japonica》1990,36(11):1361-1369
Estramustine phosphate disodium (Estracyt) was used in the treatment of 38 patients with prostatic carcinoma for at least 1 year. Of these patients 37 patients were treated with Estracyt as primary treatment and 1 patient had been treated with another antiandrogenic therapy before the Estracyt treatment. Estracyt was given orally in a dose of 560 mg/day in divided oral doses. The clinical evaluation was done for the change of PAP, the relapse rate, the survival rate and the side effect. Among 22 cases which had shown abnormally high PAP values before the treatment started, the values decreased or normalized in 21 cases (95.5%) in the first year of administration of Estracyt. In 6 cases, however, the values increased again in the second year or later. Relapse was observed in 10 (26.3%) out of 38 cases. Relapse rate was 2.6%, 51.7%, and 51.7%, at the first, third, and fifth year, respectively. Survival rate was 97.4% at the first year, 88.5% at the third year, and 68.8% at the fifth year for the follow-up study. Side effects were observed in 14 (36.8%) out of 38 cases. The main side effect was gynecomastia. Gastro-intestinal disturbance and edema were also observed. However, there were only 2 cases (5.2%) in which administration of Estracyt had to be discontinued. 相似文献
9.
A case of indirect carotid-cavernous sinus fistula treated by combined transarterial and transvenous embolization is described. A 49-year-old woman with a right indirect carotid-cavernous sinus fistula draining solely to the right superior ophthalmic vein was treated first by transarterial embolization with polyvinyl alcohol particles. Then, by approaching through the superior ophthalmic vein from the right external jugular vein, the cavernous sinus was embolized with platinum wire using a tracker microcatheter, which resulted in marked clinical improvement. Transvenous embolization by approaching from the external jugular vein through the superior ophthalmic vein represents a promising alternative when shunted blood drains anteriorly to the superior ophthalmic vein. 相似文献
10.
Nobuyuki Takemura Yasuhiko Sugawara Takuya Hashimoto Nobuhisa Akamatsu Yoji Kishi Sumihito Tamura Masatoshi Makuuchi 《Liver transplantation》2005,11(3):356-360
The incidence of hepatic venous stenosis is higher in partial liver transplantation. New methods for hepatic venous reconstruction in left liver transplantation, which secure wide anastomosis, were devised and are reported here. In the graft, the right side of the middle hepatic vein or the left side of the left hepatic vein was cut longitudinally and a rectangular-shaped vein patch was attached for venoplasty. In the recipient, after the left and middle hepatic veins were joined, the right side of the middle hepatic vein was cut toward the closed right hepatic vein, making a horizontal cavotomy for anastomosis. Of 92 patients who underwent conventional hepatic vein reconstruction, 3 were complicated by hepatic venous stenosis (median follow-up 43 months). By contrast, there were no hepatic vein complications in the 20 patients who underwent the new technique (7 months). The current method appears to be technically feasible for outflow reconstruction in left liver graft transplantation. 相似文献