A5028944983- Pancreatic and Hepatic Oncology Research
- Neuroendocrine Tumor Research Advances
- Gastric Cancer Management and Outcomes
- Colorectal Cancer Surgical Treatments
- Pancreatitis Pathology and Treatment
- Intraperitoneal and Appendiceal Malignancies
- Renal cell carcinoma treatment
- Colorectal and Anal Carcinomas
- Esophageal and GI Pathology
- Colorectal Cancer Screening and Detection
- Gastrointestinal disorders and treatments
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Glioma Diagnosis and Treatment
- Trauma Management and Diagnosis
- Cancer, Stress, Anesthesia, and Immune Response
- Diverticular Disease and Complications
- Appendicitis Diagnosis and Management
- Amoebic Infections and Treatments
- Foreign Body Medical Cases
- Cancer Genomics and Diagnostics
- Genetic factors in colorectal cancer
- Biliary and Gastrointestinal Fistulas
- Cancer Diagnosis and Treatment
- Pleural and Pulmonary Diseases
- Cancer Immunotherapy and Biomarkers
Higashi Osaka City General Hospital
2019-2023
Osaka City General Hospital
2020-2022
Nagoya Central Hospital
2017-2021
Nagoya University
2017
Ichinomiya Municipal City Hospital
2014
Gastric venous congestion and bleeding in association with total pancreatectomy (TP) were evaluated.Thirty-eight patients of TP retrospectively analyzed. was classified as distal gastrectomy (TPDG), pylorus-preserving (PPTP), subtotal stomach-preserving (SSPTP), segmental duodenectomy (TPSD).Portal vein or superior mesenteric resection reconstruction performed 24 (62.2%). occurred immediately after tumor one eight who underwent SSPTP, urgent anastomosis between the right gastroepiploic left...
Objective Second-line (2L) chemotherapy is important for improved survival in patients with advanced pancreatic cancer (APC). However, approximately half of APC do not receive 2L because disease progression or adverse events. Baseline factors predictive the receipt remain unknown. Therefore, we investigated APC. Methods Between January 2015 and March 2020, 53 received nab-paclitaxel plus gemcitabine (AG) as first-line at our institute. Of these patients, 29 chemotherapy, 23 best supportive...
Early ligation of the inferior pancreatoduodenal artery has been advocated to reduce blood loss during pancreatoduodenectomy. However, impact early dorsal pancreatic (DPA) remains unclear. This study was performed investigate clinical implications DPA.From October 2014 April 2017, 34 consecutive patients underwent pancreatoduodenectomy using a mesenteric approach. The were divided into DPA group (n = 15) and late 19). features retrospectively compared between two groups...
Abstract Background Second‐line (2 L) chemotherapy is important for improved survival. However, the efficacy of S‐1 after nab‐paclitaxel plus gemcitabine (AG) advanced pancreatic cancer (APC) remains unclear. Aim We retrospectively investigated clinical impact AG. Methods and results From January 2015 to July 2018, 37 patients with APC underwent AG as first‐line at our institute. Of these patients, 14 (38%) 2 L (S‐1 group), five (14%) received another agent AG, 18 (49%) no (best supportive...
Abstract Background Second‐line (2L) chemotherapy after nab‐paclitaxel plus gemcitabine (AG) is important for improving the survival of patients with advanced pancreatic cancer (APC). However, many fail to receive 2L because rapid disease progression. Therefore, early recognition any ineffectiveness during AG might lead an increased induction rate chemotherapy. Aim We investigated significance treatment response at 8 weeks as a predictive factor AG. Methods and results From January 2015...
Although the antitumor effects of antihypertensive drugs for patients with advanced pancreatic cancer (APC) have been investigated, their efficacy remains unclear. Previous studies suggest that hypertensive (HT) APC are significantly older than non-HT APC, and other major baseline differences in patient characteristics which may affect prognosis exist between HT patients. It is also possible lack activity. Therefore, we herein retrospectively investigated APC. From January 2015 to April...
Abstract Background Bridge to surgery (BTS) using a self-expandable metallic stent (SEMS) for the treatment of obstructive colorectal cancer improves patient’s quality life. This study aimed examine prognostic factors cancer. Methods We analyzed stage II-III resectable colon cases (Cur A) retrospectively registered between January 2005 and December 2017. Overall, 117 patients with Cur A were evaluated: 67 them underwent emergency (ES Group) 50 after BTS SEMS placement (BTS group). compared...
Iede, Kiyotsugu MD; Yamada, Terumasa MD, PhD; Kato, Ryo Ueda, Masami Tsuda, Yujiro Nakashima, Shinsuke Ohta, Katsuya Matsuyama, Jin Ikenaga, Masakazu Tominaga, Shusei PhD Author Information
症例は60歳代の女性で,既往歴に高度の便秘症がある.左下腹部痛を主訴に,当院へ救急搬送された.左下腹部に限局した圧痛を認めたが,腹膜刺激症状は認めなかった.腹部CTで結腸全体に硬便を認めた.糞便性イレウスと診断し保存的加療を開始した.翌朝,中下腹部に腹膜刺激症状が出現し,炎症所見の上昇を認めた.腹部造影CTで直腸周囲から下腸間膜動脈の分枝に沿って遊離ガスを認め,直腸穿孔の診断で緊急手術を施行した.大腸全体に亘り,硬便が充満していた.上部直腸間膜内への便貯留を認めた.術式はハルトマン手術とし,大腸内の硬便を可及的に排出した後,結腸断端をストマとした.切除標本では,上部直腸の腸間膜側に22×14mmの楕円形の穿孔を認め,腸間膜内への宿便性直腸穿通症と診断した.宿便性大腸穿孔は硬便により大腸壁が圧迫壊死に陥る比較的稀な急性腹症の一つである.今回,腸間膜内への宿便性直腸穿通症の1例を経験したので文献的考察を加えて報告する.
症例は80歳台女性で,パーキンソン病で入院加療中に突然の心窩部痛が出現した.顔面冷汗著明,腹部は平坦・軟で心窩部に著明な圧痛を認めた.血液検査所見で炎症反応の上昇を認めた.腹部造影CTで,上行結腸周囲に腹腔内遊離ガス像と腸間膜内ガス像を認めた.臨床症状と画像所見より上行結腸穿孔と診断し,緊急手術を行った.開腹時,汚染腹水や腸管の虚血性変化は認めず,盲腸から上行結腸にかけて漿膜下気腫を認めた.気腫を伴う部位に微小穿孔をきたした可能性を否定できず同部位を切除し,一期的に吻合した.病理組織学的所見では上行結腸の固有筋層内に気腫状の腔を認め,腸管囊胞気腫症(pneumatosis cystoides intestinalis,以下,PCI)と診断した.PCIは腸管気腫像に加えて腹腔内遊離ガス像を認める場合があり,保存的加療が可能な疾患である.今回,術中にPCIと診断できずに術式判断に苦渋したため,文献的考察を加え報告する.
症例は77歳,女性.13年前に右腎細胞癌の既往がある.嘔気の精査目的に施行した腹部CTで膵腫瘤を指摘された.造影CTでは膵体尾部に早期濃染される多血性腫瘤を2箇所認めた(40mm/9mm).40mmの腫瘤内部は不均一で内部壊死が疑われた.MRIでは被膜様構造を有し,T1強調像で低信号,T2強調像で高信号を呈していた.他臓器転移を疑う所見は認めなかった.腎癌の既往があり画像所見から腎細胞癌膵転移が疑われた.年齢と術後のQOLを考慮し脾合併膵体尾部切除術を施行した.術後はISGPF Grade Aの膵液漏と残膵膵炎を併発したが,30日目に退院を許可した.病理所見では淡明細胞型腎細胞癌の膵転移と診断した.また術前画像で指摘されていた病変の他に2mm大の微小転移巣も有していた.腎癌の転移巣としては膵転移は稀である.今回腎細胞癌摘出後13年目に膵転移をきたした症例を経験したので,文献的考察を加えて報告する.
血管塞栓術が有効であった自然血気胸の1例を経験した。症例は20歳の女性で，誘因なく右背部痛を自覚した。呼吸苦・疼痛が増強し，近医を受診して当院救急外来を紹介となり，転院搬送となった。胸部X線検査で右胸腔内の貯留液と肺の虚脱を認め，CTで縦隔のシフトを伴っていた。胸腔ドレーンを挿入すると約700mLの血性の排液を認め，自然血気胸と診断した。持続する出血を認め，翌日当科紹介となったが，バイタルサインが比較的安定していたこともあり血管撮影を施行した。右気管支動脈造影を行うと気管支動脈から第2・3肋間動脈が分岐しており，この末梢に異常血管を認めたため，n-butyl-2-cyanoacrylateで塞栓を行った。以後胸腔ドレーンからの血性排液は停止したものの，胸腔内に残留した血腫の除去に難渋し，塞栓術の3日後に胸腔鏡下血腫除去を行った。術中血腫以外に新たな出血は認めなかった。肺尖部付近の肋骨下縁から連続する索状構造がみられ異常血管と考えられた。右肺は全体に凝血塊に被われていたが，良好な視野のもと掻破・吸引により約400mLの血腫を除去した。術後経過は良好で第8病日に退院となり，以後血気胸...
Objectives The clinical significance of increased skeletal muscle mass during nab-paclitaxel plus gemcitabine (AG) treatment in patients with advanced pancreatic cancer (APC) remains unknown. Therefore, we retrospectively investigated the characteristics after AG to evaluate treatment. Methods From January 2015 August 2021, 67 APC received as first-line chemotherapy at Higashiosaka City Medical Center. Of these patients, 39 second-line (2L) therapy, and 28 best supportive care. Patients' end...