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31.
Camille Togo Ana Paula Zidorio Vivian Gonalves Patrícia Botelho Kenia de Carvalho Eliane Dutra 《Nutrients》2022,14(1)
The use of probiotics is one of the emerging lines of treatment for wound healing. This systematic review aimed to summarize currently available evidence on the effect of oral or enteral probiotic therapy on skin or oral mucosal wound healing in humans. To verify the developments in this field and the level of available scientific evidence, we applied a broad search strategy with no restrictions on wound type, target population, probiotic strain, or intervention protocol used. This review included seven studies involving 348 individuals. Four studies reported positive outcomes for healing improvement after probiotic therapy, and none of the studies reported adverse effects or a marked increase in wound healing time. The positive or neutral results observed do not generate strong evidence regarding the effectiveness of probiotics for wound healing. However, they suggest a promising field for future clinical research where the probiotic strains used, type of wounds, and target population are controlled for. 相似文献
32.
Togo Peraza JM Ayala Castellanos Mde L López Sandoval R 《Ginecología y obstetricia de México》2008,76(4):224-227
Pyometra is a pus accumulation in the endometrium cavity, with an incidence from 0.02% to 1.5%. The benign senile pyometra is a disease mainly reported in elder women, with an average age of 74 years. We present the case of a 59-year-old woman with the diagnosis of benign senile pyometra. The patient came to our service presenting purulent vaginal discharge, in bad condition with pelvic pain and altered hematic cytology. In the physical examination a pelvic mass was found, in the vaginal examination, the cervix was found estenotic, and the hysterometer could not be introduced. The image studies revealed an increased size of the uterus was liquid collection in its interior, compatible with blood or pus. We performed exploratory laparotomy, founding two abscecess in the uterin fundus which suffered rupture during the procedure. Abdominal hysterectomy with bilateral salpigooforectomy was performed, there were not other complications. Post surgical period was managed with antibiotics and close surveillance. The patient was discharged four days later with good response to the treatment. In the anatomophatological study no evidence of cervical or endometrial neoplasia was found. 相似文献
33.
Kuniya Tanaka M.D. Hiroshi Shimada M.D. Shinji Togo M.D. Yasuhiko Nagano M.D. Itaru Endo M.D. Hitoshi Sekido M.D. 《Journal of gastrointestinal surgery》2006,10(7):980-986
Consensus is lacking concerning how to manage afferent vessels during hepatectomy, particularly as to the Pringle maneuver
vs. selective hemihepatic clamping. Data for 81 hepatocellular carcinoma patients with chronic hepatitis or liver cirrhosis
whose liver resection was limited to one section or less, including intraoperative data and postoperative liver function data,
were analyzed retrospectively to compare two strategies. No significant differences of intraoperative data or postoperative
clinical course were seen between the two groups, even in patients with chronic hepatitis or liver cirrhosis whose postoperative
deterioration of liver function could be expected to be more than patients with a normal liver. The difference was evident
only in serum alanine aminotransferase level on postoperative day 10 (mean ± SEM, 64.5±5.1 IU in the Pringle group vs. 51.6±4.4
IU in the selective clamping group; P<0.05). During liver resection limited to one section or less, even with underlying chronic hepatitis or cirrhosis, intermittent
use of the Pringle maneuver preserved liver function to the same extent as selective clamping. 相似文献
34.
Applicability of the Milan Criteria for Determining Liver Transplantation as a First-Line Treatment for Hepatocellular Carcinoma 总被引:1,自引:0,他引:1
Morioka D Tanaka K Matsuo K Takeda K Ueda M Sugita M Nagano Y Endo I Sekido H Togo S Shimada H 《Annals of surgical oncology》2006,13(11):1500-1510
Background To determine whether or not the Milan criteria (MC) should be used to determine the applicability of liver transplantation (LT) as a first-line treatment for patients with cirrhosis with hepatocellular carcinoma (HCC) who are able to endure hepatectomy.Methods Retrospective analysis of 82 patients with cirrhosis with HCC who were treated by hepatectomy without LT at our institution between 1990 and 2003.Results Of these 82 patients, 48 met the MC. Proportional hazard regression analyses to determine the independent prognostic factors for postoperative cumulative patient and disease-free survival showed that meeting the MC is the strongest prognostic factor for both patient and disease-free survival. The cumulative patient and disease-free survival rates were 76.7% and 28.9%, respectively, at 5 years in patients who met the MC. The cumulative disease-free survival was markedly inferior to those in previously reported series of LT for HCC who met the MC, but the cumulative patient survival was comparable to those in the previously reported series. A comparison of cumulative postoperative survival between patients who met the MC and fulfilled all five factors listed below and patients who met the MC but did not fulfill any of the five factors demonstrated that the latter patients showed statistically significantly worse postoperative patient survival than the former. The five factors included: Model for End-Stage Liver Disease score <10, indocyanine green retention rate at 15 minutes <20%, absence of microscopic fibrous capsular invasion and microscopic intrahepatic metastases, and earlier grade (T1 or T2) of American Joint Committee on Cancer tumor classification.Conclusions The MC should not be used to determine the applicability of LT as a first-line treatment for patients with HCC considered able to endure hepatectomy. However, modifying MC with some clinicopathological factors could satisfy the appropriate criteria for applying LT as a first-line treatment for these patients. 相似文献
35.
Sequential resection of lung metastasis following partial hepatectomy for colorectal cancer 总被引:4,自引:0,他引:4
Ike H Shimada H Togo S Yamaguchi S Ichikawa Y Tanaka K 《The British journal of surgery》2002,89(9):1164-1168
BACKGROUND: Multiple organ metastases from colorectal carcinoma may be considered incurable, but long survival after both liver and lung resection for metastases has been reported. METHODS: A retrospective analysis of 48 patients who underwent lung resection for metastatic colorectal cancer between 1992 and 1999 was undertaken. Twenty-seven patients had lung metastasis alone, 15 had previous partial hepatectomy, and six had previous resection of local or lymph node recurrence. The relationship of clinical variables to survival was assessed. Survival was calculated from the time of first pulmonary resection. RESULTS: Five-year survival rates after resection of lung metastasis were 73 per cent in patients without preceding recurrence, 50 per cent following previous partial hepatectomy and zero after resection of previous local recurrence. Independent prognostic variables that significantly affected survival after thoracotomy were primary tumour histology and type of preceding recurrence. There was no significant difference in survival after lung resection between patients who had sequential liver and lung resection versus those who had lung resection alone. CONCLUSION: Sequential lung resection after partial hepatectomy for metastatic colorectal cancer may lead to long-term survival. 相似文献
36.
Itaru Endo Mitsutaka Sugita Hideki Masunari Kenichi Yoshida Kazuhisa Takeda Hitoshi Sekido Shinji Togo Hiroshi Shimada 《Journal of gastrointestinal surgery》2008,12(5):962-965
High hepatic duct resection sometimes is unavoidable in achieving curative resection of hilar cholangiocarcinoma, as tumor
cells can extend further than expected along the bile ducts from the macroscopically evident cancer. In patients undergoing
left hemihepatectomy with caudate lobectomy whose bile duct must be severed at the subsegmental bile duct levels, the orifices
of the posterior bile ducts would lie behind the right portal vein. Conventional hepaticojejunostomy would be risky in such
cases because an anastomosis performed in the usual manner would be subjected to strain. Instead, between 2002 and 2004, three
patients underwent retroportal hepaticojejunostomy using a jejunal limb mobilized and positioned behind the hepatoduodenal
ligament. Primary tumors were classified as type IV in the Bismuth–Corlette classification. Tension-free hepaticojejunal anastomosis
was performed successfully in all three patients; insufficiency of the hepaticojejunostomy did not develop. Neither early
nor late complications directly related to this method occurred. Retroportal hepaticojejunostomy, thus, permits more peripheral
resection of the hepatic duct while providing a sufficient operative field for safe, tension-free anastomosis. This technique
is very useful for patients undergoing left hemihepatectomy requiring high hilar resection of the bile duct. 相似文献
37.
Hiroshi Shimada Kuniya Tanaka Kenichi Matsuo Shinji Togo 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2006,391(2):130-142
Background Recent advances have extended indications for hepatectomy to include multiple bilobar colorectal liver metastases (CLM). Staging
systems based on the biological malignancy of primary and metastatic tumors provide appropriate indications for hepatectomy
in CLM. However, suitability for resection in patients with complex and extensive hepatic metastases is controversial.
Methods A medline search was performed to identify papers reporting the resection for CLM. Techniques, indication, and results were
reviewed.
Results If the anticipated remnant liver volume is small (25–40% of total), suggesting a high risk of postoperative liver failure,
portal vein embolization (PVE) is recommended prior to hepatectomy. However, curative resections are not always possible.
Specifically in synchronous multiple bilobar CLM, two-stage hepatectomy, comprising bilateral hepatectomy and primary resection
with or without PVE, can prevent growth of ipsilateral metastatic nodules in the remnant liver and reduce surgical risk. Several
local ablation techniques can complement surgery if hepatic resection alone increases the risk of postoperative liver failure
or is not curative. Chemotherapy combined with targeted treatment can suppress recurrence and extend indications for hepatectomy
by reducing the size and number of primary irresectable tumors.
Conclusion PVE or staged procedure combining with local ablation or neoadjuvant, downstaging or adjuvant therapies extends indications
for hepatectomy to include multiple bilobar CLM. The 5-year survival rate for multiple bilobar CLM treated with alternating
hepatectomy and chemotherapy is comparable to the values reported for single and hemilateral CLM. 相似文献
38.
Indications for curative resection of advanced gallbladder cancer with hepatoduodenal ligament invasion 总被引:1,自引:0,他引:1
Endo I Shimada H Fujii Y Sugita M Masunari H Miura Y Tanaka K Misuta K Sekido H Togo S 《Journal of Hepato-Biliary-Pancreatic Surgery》2001,8(6):505-510
Abstract.
Purpose: Hepatoduodenal ligament invasion (HLI) is an inhibiting factor for the curative resection of advanced gallbladder cancer.
The aim of this study was to clarify the indications for surgical resection in patients with advanced gallbladder cancer with
and without HLI by analyzing outcomes.
Methods: The subjects were 58 patients with advanced gallbladder cancer who underwent aggressive resection, and 20 nonresected patients
diagnosed as haring HLI. The presence of stromal cancerous infiltration at six sites in the hepatoduodenal ligament was investigated.
The extent of cancer spread was classified into two grades by the number of sites where cancer cells detected: low grade,
one or two invasion sites; high grade, three or more sites.
Results: Pancreatoduodenectomy, vascular reconstruction, and extensive hepatectomy were frequently performed in the patients with
HLI. The cumulative 5-year-survival rate of the HLI patients was 10.9%, significantly worse than that of the resected patients
without HLI (46.6%; P < 0.01). Patients with paraaortic lymph node metastasis died within 1 year. The cumulative 5-year-survival rate after curative
resection was 38.1%, significantly better than that after noncurative resection (0%; P < 0.05). The survival was significantly worse in patients with high-grade invasion than in these with low-grade invasion
(P < 0.05), being equivalent to that in the nonresection patients. Of four factors, operative curability, hepatic lobectomy,
HLI grade, and paraaortic lymph node metastasis, the HLI grade and hepatic lobectomy were considered to be significant prognostic
factors by Cox's multivariate analysis (backward stepwise method).
Conclusions: Aggressive surgical resection for curative purposes should be limited to patients with low-grade HLI and metastasis-negative
paraaortic lymph nodes.
Received: January 9, 2001 / Accepted: May 11, 2001 相似文献
39.
Fujii Y Ueda M Yoshida K Matsuo K Takeda K Morioka D Tanaka K Endo I Togo S Shimada H 《Nihon Geka Gakkai zasshi》2006,107(4):177-181
Standardization of surgical procedure for pancreatic cancer has been recognized to be necessary and important these days. Recent studies appear to exhibit efficacy of the adjuvant chemoradiation therapy before or after pancreatic surgery. In this study, we examined the standard surgery as part of the multidisciplinary treatment for pancreatic cancer. Invasive ductal carcinoma of the pancreas was resected in 121 patients in our institution from 1992 through 2005. We stopped performing an extended lymphadenectomy with pancreatectomy in 2003, but the survival rates were not significantly different between the cases before and after 2003. We usually resect half of the nerve plexus around the superior mesenteric artery (SMA) as a standard procedure. When we achieved the microscopically curative resection (R0) even if the plexus around SMA or the portal vein was invaded, there were a few long survivors for more than five years. The R0 resection is the most important factor for prolonged survival. Pancreatectomy including removal of regional lymph nodes (D2) and half of the nerve plexus around SMA and combined resection of the infiltrated portal vein is thought to be a standard surgery from the viewpoint of decrease in morbidity and maintenance of curability. 相似文献
40.
the role of splenomesenteric vein anastomosis after division of the splenic vein in pancreatoduodenectomy 总被引:3,自引:0,他引:3
Koichiro?MisutaEmail author Hiroshi?Shimada Yasuhiko?Miura Osamu?Kunihiro Toru?Kubota Itaru?Endo Hitoshi?Sekido Shinji?Togo 《Journal of gastrointestinal surgery》2005,9(2):245-253
Division of the splenic vein was performed in 29 patients who underwent pancreatoduodenectomy to achieve lymph node dissection
and neural resection around the superior mesenteric artery. The basic protocol for the splenic vein reconstruction to reduce
congestion of the spleen and stomach is as follows. When the inferior mesenteric vein (IMV) drained into the splenic vein,
the confluence was preserved without reconstruction of the splenic vein. When the IMV drained into the superior mesenteric
vein (SMV) or the splenomesenteric angle, the division of the IMV and spleno-IMV anastomosis were performed. In postoperative
venography, nine patients showed downward flow (from the splenic vein to the IMV) and three patients showed upward flow (from
the IMV to the splenic vein). Postoperative computed tomography scans showed venous dilatation and splenomegaly in the upward
flow group; there were no patients in the downward flow group. In selected patients, splenic vein reconstruction is necessary
to reduce congestion of the spleen and stomach. When the flow is downward, spleno-IMV flow should be preserved. When the flow
is upward, spleno-SMV anastomosis is necessary instead of spleno-IMV anastomosis. 相似文献