[Re-Administration of Anti-EGFR Antibody Drugs for Unresectable Colorectal Cancer-Focusing on Tumor Markers].

The 2022 edition of the Guidelines for the Treatment of Colorectal Cancer described rechallenge therapy as a backward treatment for unresectable colorectal cancer, but currently, there is no evidence to support its benefit. We reviewed 6 cases of rechallenge therapy in which tumor marker trends could be followed in our department. Two cases had a rapid decline in tumor markers that was maintained for 7-8 months.

A Case Report of Primary Unresectable Hilar Cholangiocarcinoma Causing Colonic Obstruction Due to Peritoneal Dissemination.

Although surgical resection is the only available treatment to achieve long-term survival in biliary tract cancer, many cases are often identified at an advanced stage at the time of diagnosis. Radiotherapy may be an alternative option to prolong survival in cases with locally advanced unresectable disease. While there are some reports of long-term survival after radiotherapy for unresectable biliary tract cancer, it is rare that clinical symptoms are exhibited by peritoneal dissemination more than 8 years after radiotherapy and that resection can be performed.

[A Case of Ascending Colon Cancer with Skull Metastasis].

A 55-year-old woman became aware of a tumor on the left side of the head in July, 2020 and was referred to our hospital in September because of its rapid growth. A head CT showed a neoplastic lesion of the skull. A CT from the neck to the pelvis revealed an ascending colon tumor and multiple lesions in the liver, which was suspected as metastasis.

[Two Cases of Synchronous Double Primary Prostate Cancer Accompanying Bone Metastasis and Colon Cancer].

We report two cases of synchronous double primary cancers, which were composed of prostate cancer accompanied by bone metastasis and colon cancer, within only five months of each other. The first was a 77-year-old man whose ECOG PS was 0. He was referred to our hospital in March 2020 because abdominal CT scan, which was performed at a clinic for the purpose of close examination of poor control of diabetes, showed wall thickening of the sigmoid colon.

The prognostic significance of the expression of monocarboxylate transporter 4 in patients with right- or left-sided colorectal cancer.

Aim: Monocarboxylate transporter 4 (MCT4) is a proton pump that exchanges lactate through the plasma membrane. The present study investigated the clinical significance of the expression of MCT4 in patients with right- or left-sided colorectal cancer (CRC).

Methods: Surgical specimens from 237 CRC patients were immunohistochemically stained with polyclonal anti-MCT4 antibodies.

[A Review of 7 Cases of Laparoscopic Cholecystectomy for Pediatric Cholecystolithiasis].

Pediatric cholecystolithiasis is a relatively rare disease, but it is recently increasing in Japan. Laparoscopic cholecystectomy (LC) is a standard procedure for cholecystolithiasis not only in adults but also in children, and we are aggressively introducing single-incision laparoscopic cholecystectomy (SILC) at our hospital. We reviewed the patient characteristics, operation procedures and outcomes of 7 children (15 years old and under) with cholecystolithiasis who underwent LC in our hospital between August 1995 and December 2015.

[A Case of Retroperitoneal Paraganglioma].

We report a surgical case of retroperitoneal paraganglioma. A paraganglioma is a catecholamine-producing tumor originating in the chromaffin cells of the sympathetic ganglion. It is a kind of pheochromocytoma which occurs on the outside of the adrenal gland.

A novel epigenetic mechanism regulating hyaluronan production in pancreatic cancer cells.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an abundant stroma enriched with hyaluronan (HA), a major component of extracellular matrix known to play a critical role in tumor progression. The mechanisms that regulate HA synthesis in PDAC are poorly understood. To investigate whether DNA methylation and HA production from PDAC cells are associated, we studied the effect of 5-aza-2'-deoxycitidine (5-aza-dC), an inhibitor of DNA methylation, or DNA methyltransferase 1 (DNMT1) knockdown by small interfering RNA, on the HA production from PDAC cells.

Reduced Port Distal Gastrectomy With a Multichannel Port Plus One Puncture (POP).

Background: This report describes the techniques and outcomes of reduced port distal gastrectomy (RPDG) with a multichannel port plus one puncture (POP) for gastric cancer patients.

Patients And Methods: A total of eight patients underwent a RPDG using the E･Z Access™/LAPPROTECTOR™ (Hakko Co. Ltd.

Single-incision laparoscopic cholecystectomy for acute cholecystitis: A retrospective cohort study of 52 consecutive patients.

Background: Single-incision laparoscopic cholecystectomy (SILC) has become increasingly popular but its role in acute cholecystitis remains controversial.

Methods: We compared the clinical features and outcomes of SILC procedures between 52 patients with acute cholecystitis (the AC group) and 308 patients without acute cholecystitis (the NAC group). We also analyzed clinical variables to identify factors affecting difficulties associated with SILC for acute cholecystitis.

Rare combination of familial adenomatous polyposis and gallbladder polyps.

Familial adenomatous polyposis is associated with a high incidence of malignancies in the upper gastrointestinal tract (particularly ampullary adenocarcinomas). However, few reports have described a correlation between familial adenomatous polyposis and gallbladder neoplasms. We present a case of a 60-year-old woman with familial adenomatous polyposis who presented with an elevated mass in the neck of the gallbladder (measuring 16 mm × 8 mm in diameter) and multiple small cholecystic polyps.

A new oval multichannel port to facilitate reduced port distal gastrectomy.

Background: This report describes the techniques and outcomes of reduced port distal gastrectomy (RPDG) using a new oval multichannel port.

Material And Methods: We performed reduced port distal gastrectomy through the E·Z Access™ oval type device with three trocars in the umbilical incision, plus the use of additional 5 mm and 2 mm ports. All routine procedures performed in conventional laparoscopic distal gastrectomy (CLDG) were achieved in RPDG.

Postoperative complications following single-incision laparoscopic cholecystectomy: a retrospective analysis in 360 consecutive patients.

Background: Single-incision laparoscopic cholecystectomy (SILC) is being increasingly performed based on recent evidence showing its cosmetic advantages. However, there is limited information on outcome data for SILC with respect to postoperative complications.

Methods: We retrospectively reviewed a consecutive series of 360 patients undergoing SILC to evaluate the rate, features, and risk factors of postoperative complications.

Intermittent negative pressure external drainage of the pancreatic duct reduces the incidence of postoperative pancreatic fistula after pancreaticojejunostomy.

Background/aims: The formation of a pancreatic fistula remains one of the serious morbidities after pancreaticojejunostomy. This study is focused on the efficacy of negative pressure external drainage of the main pancreatic duct in pancreaticojejunostomy.

Methodology: Fifty-eight consecutive patients who underwent pancreaticojejunostomy at our hospital from May 2008 to May 2012 were enrolled in this study.

Pancreatic somatostatinoma diagnosed preoperatively: report of a case.

Context: Somatostatinoma is a rare neoplasm of the pancreas. Preoperative diagnosis is often difficult.

Case Report: We report a 72-year-old woman with a pancreatic head tumor measuring 37 mm in diameter, and enlargement of the lymph nodes on the anterior surface of the pancreatic head and the posterior surface of the horizontal part of the duodenum.

Stapled gastro/duodenojejunostomy shortens reconstruction time during pylorus-preserving pancreaticoduodenectomy.

Aim: To investigate whether a stapled technique is superior to the conventional hand-sewn technique for gastro/duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy (PpPD).

Methods: In October 2010, we introduced a mechanical anastomotic technique of gastro- or duodenojejunostomy using staplers during PpPD. We compared clinical outcomes between 19 patients who underwent PpPD with a stapled gastro/duodenojejunostomy (stapled anastomosis group) and 19 patients who underwent PpPD with a conventional hand-sewn duodenojejunostomy (hand-sewn anastomosis group).

A newly developed oval-shaped port device (E•Z ACCESS Oval type) for use in reduced port surgery: initial clinical experiences with cholecystectomy.

We recently developed an oval-shaped E•Z Access device designed exclusively for use with the LAP PROTECTOR™ Oval type device (Hakko Co. Ltd., Tokyo, Japan).

Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy.

Background: A prolonged operative time is associated with adverse post-operative outcomes in laparoscopic surgery. Although a single-incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown.

Methods: A total of 20 clinical variables were retrospectively reviewed to identify factors for a prolonged operative time (longer than 3 h) in a total of 220 consecutive patients undergoing SILC.

Laparoendoscopic single-site common bile duct exploration using the manual manipulator.

Background: Laparoendoscopic single-site (LESS) surgery has developed as a new surgical modality that has increased cosmetic benefits over conventional endoscopic surgery. However, there are no reports about LESS surgery in common bile duct exploration. This report presents a LESS surgery to manage CBD stones by laparoscopic choledochotomy and C-tube placement with favorable outcomes.

Routine intraoperative cholangiography during single-incision laparoscopic cholecystectomy: a review of 196 consecutive patients.

Background: Single-incision laparoscopic cholecystectomy (SILC) has been increasingly performed as a potentially less invasive alternative to standard laparoscopic cholecystectomy. However, recent evidences suggest a higher incidence of complications, notably bile duct injuries, in SILC. We reviewed our experiences with routine intraoperative cholangiography (IOC) during SILC to investigate its feasibility and usefulness.

Enucleation of an Insulinoma of the Pancreas Using Reduced Port Surgery: Report of a Case.

Reduced port surgery (RPS) is a new surgical modality producing increased cosmetic benefits over conventional endoscopic surgery. We herein report the first case of insulinoma of the pancreas treated by RPS. RPS enucleation was performed for a 23-year-old Japanese female who was admitted to our hospital with repeated episodes of hypoglycemia attributable to an insulinoma.