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1.
Kosuke Nomura Toshiro Iizuka Daisuke Kaji Hisashi Yamamoto Yasutaka Kuribayashi Ryusuke Kimura Akihiro Yamada Tsukasa Furuhata Satoshi Yamashita Daisuke Kikuchi Akira Matsui Toshifumi Mitani Osamu Ogawa Shu Hoteya Yasunori Ota Shuichi Taniguchi Mitsuru Kaise 《Journal of gastroenterology and hepatology》2014,29(11):1867-1872
2.
Yorinari Ochiai Akira Matsui Shinji Ito Yutaka Takazawa Daisuke Kikuchi Shu Hoteya 《Internal medicine (Tokyo, Japan)》2021,60(4):533
A 45-year-old man visited our institution due to the onset of hematochezia. He had a previous episode nine years earlier and colonoscopy at that time revealed multiple polyps, which were consistent with inflammatory cloacogenic polyps (ICPs) on the dentate line. Colonoscopy was performed again and two of the ICPs had grown. Both lesions were pathologically diagnosed as adenocarcinomas based on biopsies. Endoscopic submucosal dissection (ESD) was performed and the two lesions were diagnosed as double well-differentiated adenocarcinomas arising from ICPs. To our knowledge, this is the first reported case of double early rectal cancer in ICPs, which were followed endoscopically and successfully resected with ESD. 相似文献
3.
Matsui A Nomura K Odagiri H Yamada A Domon K Yamashita S Furuhata T Kikuchi D Nakamura M Mitani T Ogawa O Iizuka T Hoteya S Kaise M Matoba S Fujii T 《Nihon Shokakibyo Gakkai zasshi》2012,109(5):788-794
A 75-year-old man was admitted because of watery diarrhea, hematochezia and right lower abdominal pain. Many deep undermining colonic ulcers were found by colonoscopy, and we detected trophozoite amoeba pathologically. Metronidazole was administered orally from 3 days after admission. However, since CT demonstrated a huge abscess in the abdominal cavity, we performed percutaneous drainage from 17 days after admission. On day 157, the patient was discharged, because the colonic ulcers had almost healed, and trophozoite amoebas were not recognized pathologically. 相似文献
4.
Kikuchi D Iizuka T Hashimoto M Hoteya S Yamashita S Nakamura M Yamada A Mitani T Fujimoto A Matsui A Arase Y Kaise M 《Digestive endoscopy》2012,24(1):16-20
Aim: Owing to carelessness of endoscopists, invasive procedures, such as biopsy, are sometimes carried out inadvertently in patients receiving antithrombotic therapy. The aim of the present study was to retrospectively evaluate the actual status of such careless mistakes and the efficacy of new safety measures. Methods: A questionnaire survey was conducted in 34 endoscopists at Toranomon Hospital about experiences of careless mistakes and experiences of anxiety before and after the procedure. ‘Anxiety before procedure’ was defined as the experience of discontinuing a given procedure because endoscopists remembered that the patient was receiving antithrombotic therapy, and ‘anxiety after procedure’ was defined as the experience of feeling anxious about the status of medication after the invasive procedure. A new measure was introduced at Health Management Center in August 2009. In this measure, endoscopists directly interview each patient about the status of medication just before examination, and attach forceps valves of one of two colors depending on the status of medication. A blue forceps valve is attached for patients undergoing antithrombotic therapy, and a conventional black forceps valve is attached for patients not undergoing antithrombotic therapy. Six months after introduction, a questionnaire survey was conducted in 10 endoscopists in this center. Results: Approximately half of endoscopists (18/34) experienced such careless mistakes. ‘Anxiety’ had been experienced by approximately 80%. After introduction, there was no report of careless mistakes and frequency of ‘anxiety’ evaluated by visual analog scale score decreased significantly. Conclusion: This new safety measure is expected to facilitate safer gastrointestinal endoscopy in patients receiving antithrombotic therapy. 相似文献
5.
Junnosuke Hayasaka Daisuke Kikuchi Hiroyuki Odagiri Kosuke Nomura Yorinari Ochiai Takayuki Okamura Yugo Suzuki Yutaka Mitsunaga Nobuhiro Dan Masami Tanaka Satoshi Yamashita Akira Matsui Shu Hoteya 《Internal medicine (Tokyo, Japan)》2022,61(4):451
Objective Clipping is a common technique for managing colonic diverticular bleeding (CDB), despite the lack of published evidence regarding its effectiveness. We aimed to evaluate the effectiveness of clipping for CDB in preventing early recurrent bleeding. Methods This dual-center retrospective study included 93 patients who underwent emergency hospitalization for bloody stool, diagnosed with definitive CDB, and treated with clipping or conservative treatment. The primary outcome was early recurrent bleeding. A logistic regression analysis was performed to assess the association between the occurrence of early recurrent bleeding and clipping with adjustment for propensity scores. Secondary outcomes included death, transfusion, length of hospitalization, need for transcatheter arterial embolization or surgery, and adverse events. Results The patient characteristics were similar between the clipping (n=85) and conservative treatment (n=8) groups. The rate of early recurrent bleeding was significantly lower in the clipping group than in the conservative treatment group [23.5% (20 cases) vs. 75% (6 cases), p=0.005]. In the propensity score-adjusted logistic regression analysis, the odds ratio for early recurrent bleeding in the clipping group was 0.094 (95% confidence interval, 0.008-0.633, p=0.026). Secondary outcomes were not significantly different between the two groups. Stigmata of recent hemorrhage (SRH) at the time of recurrent bleeding was identified in 79.2% of patients (19/24). In the clipping group, recurrent bleeding was observed in 62.5% of cases (10/16) from the same diverticulum. However, early recurrent bleeding tended to be less likely with direct clipping (p=0.072). Conclusion Clipping for definite CDB was more effective in preventing early recurrent bleeding than conservative treatment. 相似文献
6.
Shu Hoteya Satoshi Yamashita Daisuke Kikuchi Masanori Nakamura Ai Fujimoto Akira Matsui Noriko Nishida Toshihumi Mitani Yuichiro Kuroki Toshiro Iizuka Naohisa Yahagi 《Digestive endoscopy》2011,23(1):30-36
Aims: The aims of the present study were to evaluate the feasibility of endoscopic submucosal dissection (ESD) as curative treatment for node‐negative submucosal invasive early gastric cancer (EGC) and to consider further expansion of the curability criteria for submucosal invasive EGC. Methods: A total of 977 EGC in 855 patients treated by ESD were enrolled. They were divided into intramucosal cancer (M); minimally submucosal invasive cancer (<500 µm from the muscularis mucosa) (SM1); and deeper submucosal invasive cancer (>500 µm from the muscularis mucosa) (SM2). The technical feasibility of ESD for SM1 and M were compared, and the clinical prognosis of SM1 was evaluated. Furthermore, the volume of carcinoma invading to the submucosal layer, which we called the SM volume index, was calculated virtually to analyze its correlation with lymphatic‐vascular invasion. Results: There were no statistical differences in technical outcomes and complications between M and SM1. Curative resection rates were significantly better in M than in SM1 (M, 92.6%; SM1, 63.8%). No local recurrences and distant metastases were found in 48 SM1 patients declared to have undergone curative resections. Most cases (72.0%) with successful ESD but non‐curative resection exceeded 30 mm in maximum size, and no local recurrences and metastases were found in these patients. The SM volume index of these cases was comparatively small. Conclusion: The technical and theoretical validity of ESD for SM1 was validated. The possibility of further expansion of the curability criteria for submucosal invasive cancers was suggested by the evaluation of the SM volume index. 相似文献
7.
Iizuka T Hoshihara Y Hoteya O Yamamoto T Yahagi N Udagawa H 《Gan to kagaku ryoho. Cancer & chemotherapy》2006,33(5):659-661
A 74-year-old man was suffering from Borrmann type 2 advanced gastric cancer with abdominal lymph node metastases and multiple lung metastases. He started to undergo outpatient treatment with oral administration of TS-1. But pyloric stenosis was found after 6 courses of TS-1 chemotherapy, so he underwent palliative distal gastrectomy. TS-1 chemotherapy was continued afterwards, however obstructive jaundice was found. So combination chemotherapy of CPT-11 60 mg/m(2)and CDDP 30 mg/m(2)biweekly was selected as a second-line therapy after PTCD. As no side effects were found, he could be treated on an outpatient basis by CPT-11 60 mg/body and CDDP 30 mg/body biweekly. Four months has passed since the palliative operation, and the PTCD tube was successfully removed. The abdominal lymph nodes had decreased in size and the patient has maintained good QOL. Thus, combination CPT-11 and CDDP therapy could well be a new candidate for a second-line chemotherapy in outpatients. 相似文献
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9.
Waku Hatta Takuji Gotoda Tsuneo Oyama Noboru Kawata Akiko Takahashi Yoshikazu Yoshifuku Shu Hoteya Masahiro Nakagawa Masaaki Hirano Mitsuru Esaki Mitsuru Matsuda Ken Ohnita Kohei Yamanouchi Motoyuki Yoshida Osamu Dohi Jun Takada Keiko Tanaka Shinya Yamada Tsuyotoshi Tsuji Hirotaka Ito Yoshiaki Hayashi Tomohiro Nakamura Naoki Nakaya Tooru Shimosegawa 《Gastric cancer》2018,21(3):481-489
Background
We have established a risk-scoring system, termed the “eCura system,” for the risk stratification of lymph node metastasis in patients who have received noncurative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to clarify whether this system contributes to the selection of patients requiring radical surgery after ESD.Methods
Between 2000 and 2011, 1,969 patients with noncurative ESD for EGC were included in this multicenter study. Depending on the treatment strategy after ESD, we had patients with no additional treatment (n = 905) and those with radical surgery after ESD (n = 1,064). After the application of the eCura system to these patients, cancer recurrence and cancer-specific mortality in each risk category of the system were compared between the two patient groups.Results
Multivariate Cox analysis revealed that in the high-risk category, cancer recurrence was significantly higher (hazard ratio = 3.13, p = 0.024) and cancer-specific mortality tended to be higher (hazard ratio = 2.66, p = 0.063) in patients with no additional treatment than in those with radical surgery after ESD, whereas no significant differences were observed in the intermediate-risk and low-risk categories. In addition, cancer-specific survival in the low-risk category was high in both patient groups (99.6 and 99.7%). A limitation of this study is that it included a small number of cases with undifferentiated-type EGC (292 cases).Conclusions
The eCura system is a useful aid for selecting the appropriate treatment strategy after noncurative ESD for EGC. However, caution is needed when applying this system to patients with undifferentiated-type EGC.10.
Shinya Kodashima Kiyohito Tanaka Koji Matsuda Mitsuhiro Fujishiro Yutaka Saito Kazuo Ohtsuka Ichiro Oda Chikatoshi Katada Masayuki Kato Mitsuhiro Kida Kiyonori Kobayashi Shu Hoteya Takahiro Horimatsu Takahisa Matsuda Manabu Muto Hironori Yamamoto Shomei Ryozawa Ryuichi Iwakiri Hiromu Kutsumi Hiroaki Miyata Mototsugu Kato Ken Haruma Kazuma Fujimoto Naomi Uemura Michio Kaminishi Hisao Tajiri 《Digestive endoscopy》2018,30(1):20-28