Title Alternative Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis
Author Sugihara, Yuusaku| Kawano, Seiji| Harada, Keita| Takashima, Shiho| Takei, Daisuke| Inokuchi, Toshihiro| Takahara, Masahiro| Hiraoka, Sakiko| Mori, Yoshiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Okada, Hiroyuki|
Abstract A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.
Keywords 家族性大腸腺腫症 (familial adenomatous polyposis) 小腸癌 (jejunal cancer) 小腸内視鏡検査 (small intestine endoscope)
Publication Title Journal of Okayama Medical Association
Published Date 2017-08-01
Volume volume129
Issue issue2
Start Page 111
End Page 114
ISSN 0030-1558
Related Url https://doi.org/10.4044/joma.129.111
language 日本語
Copyright Holders Copyright (c) 2017 岡山医学会
File Version publisher
DOI 10.4044/joma.129.111
JaLCDOI 10.18926/AMO/53672
FullText URL 69_5_267.pdf
Author Inada, Ryo| Nagasaka, Takeshi| Kondo, Yoshitaka| Watanabe, Ayako| Toshima, Toshiaki| Kubota, Nobuhito| Kikuchi, Satoru| Ishida, Michihiro| Kuroda, Shinji| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract The aim of this single-institution, retrospective, observational case-control study was to evaluate the safety and feasibility of laparoscopic proctocolectomy (PC) for ulcerative colitis (UC), by comparing it with a case-control series of open PC. Twenty UC patients who underwent laparoscopic PC were retrospectively compared with the open PC group of 12 patients matched for age, sex, and urgency of the operation. In the laparoscopic PC group, the operative time was significantly longer, but the amount of blood loss was significantly smaller. The open PC patients underwent an intraoperative blood transfusion significantly more often, and the serum C-reactive protein level on the first postoperative day was significantly higher in the open PC group. In the laparoscopic PC group, the rate of severe postoperative morbidities, grades 3 and 4 on the Clavien-Dindo classification, was significantly lower, and the median length of hospital stay was significantly shorter. Laparoscopic PC for patients with UC showed superior perioperative outcomes to open PC, except for longer operative time.
Keywords laparoscopic surgery total proctocolectomy open proctocolectomy ulcerative colitis case-matched study
Amo Type Original Article
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 267
End Page 273
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490023
Web of Sience KeyUT 000365519600002
Title Alternative Successful laparoscopic resection of a cecal tumor in a 95-year-old man
FullText URL 127_117.pdf
Author Watanabe, Ayako| Inada, Ryo| Nagasaka, Takeshi| Yagi, Tomohiko| Matsumoto, Hijiri| Toshima, Toshiaki| Kikuchi, Satoru| Kuroda, Shinshi| Kondo, Yoshitaka| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.
Keywords 超高齢者(extremely elderly patient) 大腸癌(colorectal cancer) 腹腔鏡手術(laparoscopic surgery)
Publication Title 岡山医学会雑誌
Published Date 2015-08-03
Volume volume127
Issue issue2
Start Page 117
End Page 121
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.127.117
language 日本語
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.117
NAID 130005096253