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61.
62.
Osamu Ikeda Yoshihisa Sakaguchi Yoshiro Aoki Norifumi Harimoto Jyunya Taomoto Takaaki Masuda Takefumi Ohga Eisuke Adachi Yasushi Toh Takeshi Okamura Hideo Baba 《Surgical endoscopy》2009,23(10):2374-2379
Background
Laparoscopic gastrectomy for gastric cancer has become common due to improvement of the surgical techniques and devices for laparoscopic surgery. Although laparoscopically assisted distal gastrectomy (LADG) has several advantages over open distal gastrectomy, little has been reported about the safety and feasibility of totally laparoscopic distal gastrectomy (TLDG).Methods
Between October 2005 and June 2007, 80 laparoscopic distal gastrectomies with regional lymphadenectomies were performed for patients with gastric cancer. After 24 patients underwent LADG and 56 patients underwent TLDG, the clinical data were compared between the two groups.Results
The groups were comparable in terms of age, gender, body mass index (BMI), tumor location, tumor size, macroscopic type, depth of invasion, histologic type, lymph node metastasis, and length of proximal margin. However, when only the patients with gastric cancer in the middle third of the stomach were compared between the two groups, the length of the proximal margin was significantly longer in the TLDG group (p < 0.05). The mean blood loss was significantly less in the TLDG group (p < 0.05). The patients in the TLDG group recovered earlier and thus had a significantly shorter postoperative hospital stay. Furthermore, the C-reactive protein level on postoperative day 7 was lower in the TLDG group than in the LADG group (p < 0.05). There was no significant difference in the postoperative complications between the two groups.Conclusion
This study demonstrated that TLDG has several advantages over LADG including smaller wounds, less invasiveness, and better feasibility of a secure ablation. The TLDG procedure yields safe anastomosis independently of the patient’s constitution or the location of the cancer. Therefore, TLDG is considered to be a useful technique for patients with gastric cancer. 相似文献63.
64.
Taomoto K Ohnishi H Kamada Y Kuga Y Kohaya N Nakashima K Ichioka T Tominaga T Nakamura M Nakazato Y 《Brain tumor pathology》2007,24(2):75-80
A 55-year-old woman presented with a right trigeminal dysfunction (dysesthesia) initially, followed by right oculomotor and
abducens paresis lasting 1 month. Neuroimaging studies showed an enhanced mass in the right cavernous sinus extending to the
trigeminal ganglion. The extraparenchymal tumor located around the right trigeminal ganglion was totally removed, except for
an intracavernous lesion, by the orbitozygomatic approach. The solid tumor was completely separated from the brainstem and
seemed to be a trigeminal schwannoma arising from the trigeminal ganglion or cavernous sinus at surgery. A histological examination,
however, found a typical malignant glioma that consisted primarily of astrocytic tumor cells. Immunohistochemical staining
showed the tumor cells stained intensely for GFAP, S-100 protein, and vimentin, but not for NFP, Schwann/2E, CD34, and CD68.
The mean MIB-1 index was 12.4%. The tumor recurred after a short time, and then it rapidly disseminated into the subarachnoid
space and left the cerebral hemisphere. The patient died 1 year after the initial symptoms in spite of aggressive surgery,
radiation, and chemotherapy with temozolomide. There are no previous reports of a malignant glioma arising from either the
cavernous sinus or the trigeminal ganglion. From the pathogenetic point of view, this malignant glioma is an extremely rare
case that developed clinically and neuroradiologically from the cavernous sinus and was suspected be being derived from ectopic
glial tissue. 相似文献
65.
66.
Masaru Mirukawa Kunihiko Hirose Tatsuhiko Mori Jyunya Kusukawa Nobuyoshi Tomioka Yutaka Watanabe 《Clinical cardiology》1996,19(10):831-833
Myocardial contusion is a rare type of sports injury. We report a case of myocardial contusion caused by a baseball. In this patient, arrhythmias were induced by an exercise test 1 week after injury. That patients with myocardial contusion but without arrhythmias at rest need to be treated carefully is emphasized. 相似文献
67.
68.
Yoshiro Aoki Jun Hihara Kenji Sakogawa Junya Taomoto Yoichi Hamai Manabu Emi Morihito Okada 《Surgery today》2012,42(11):1088-1090
Esophageal bypass surgery using a gastric tube prior to definitive chemoradiotherapy in preparation for the formation of esophago-tracheal or bronchial fistula is a possible strategy for esophageal cancer invading the airway. This report presents the case of a patient with esophageal cancer involving the left main bronchus who underwent esophageal bypass followed by definitive chemoradiotherapy and who has achieved long-term survival without deterioration of his quality of life, in spite of the development of a malignant esophago-bronchial fistula. 相似文献
69.
Y. Hamai J. Hihara J. Taomoto I. Yamakita Y. Ibuki M. Okada 《Diseases of the esophagus》2015,28(4):358-364
We compared the surgical outcomes between 114 patients who did not receive neoadjuvant therapy (group 1) and 92 others who received neoadjuvant chemoradiotherapy (nCRT) (group 2), and assessed the preoperative and surgical factors that influence postoperative morbidity to determine the impact of nCRT on morbidity and mortality after esophagectomy via cervical, right transthoracic, and abdominal approaches. The overall postoperative morbidity rates were 44.7% and 55.4% in groups 1 and 2, respectively (P = 0.13). Rates of anastomotic leak (8.8% vs. 16.3%; P = 0.10), pneumonia (9.6% vs. 13.0%; P = 0.44), recurrent nerve palsy (15.8% vs. 10.9%; P = 0.31), and all other complications did not significantly differ between the groups. Multivariable analysis revealed cervical lymph node dissection (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.01–3.84; P = 0.047) as the sole independent covariate for overall morbidity. Furthermore, a history of cardiovascular disease (OR, 2.90; 95% CI, 1.03–8.24; P = 0.045), the retrosternal reconstruction route (OR, 15.15; 95% CI, 3.56–62.50; P = 0.0002), and a longer surgical duration (OR, 1.01; 95% CI, 1.002–1.02; P = 0.01) were independent covariates for anastomotic leakage, and advanced age (OR, 1.08; 95% CI, 1.01–1.15; P = 0.02) and lower body mass index (OR, 1.16; 95% CI, 1.01–1.33; P = 0.04) were independent covariates for pneumonia. However, whether or not patients received nCRT was irrelevant. We found that nCRT is safe for three‐incision esophagectomy and it does not increase the incidence of postoperative morbidity and mortality relative to esophagectomy alone. 相似文献
70.
Toshio Takeuchi Daisuke Tanaka Noriko Saikawa Hiroyuki Satoh Jyunya Iwasaki Makoto Inoue Kenji Narui Yoji Iikura 《Pediatrics international》2001,43(2):128-133
BACKGROUND: Short stature and low bodyweight are commonly encountered problems in the clinical follow up of premature infants. However, details about the underlying pathophysiology are unknown in these cases. METHODS: Evaluations of growth and endocrine function were performed in 23 very low-birth weight (VLBW) infants between 11.3 and 14.3 years of age. RESULTS: The mean (+/-SD) scores for height and weight were -0.50+/-0.97 and -0.50+/-1.10 SD, respectively. Mean serum insulin-like growth factor (IGF)-I and urine growth hormone (GH) levels were 402+/-138 ng/mL and 18.0+/-17.5 pg/mg creatinine, respectively. Serum IGF-I and urine GH levels were within the normal range for all patients. The bone age values were consistent with the patient's true age. Physical signs of puberty were detected in 15 of 23 patients (65%). Using bone ages to predict final adult height yielded a score of -0.52+/-1.08 SD. CONCLUSIONS: Despite the almost normal results of serum IGF-I, urine GH levels and bone age, the physical growth of these VLBW infants was less than that of normal birth weight children, as was their predicted adult growth. 相似文献