Publications by authors named "Aosasa S"

Article Synopsis
  • The study investigates the effectiveness of conversion surgery in patients with initially unresectable advanced pancreatic ductal adenocarcinoma (PDAC) by analyzing surgical resection rates and survival outcomes from 2013 to 2018.
  • In a sample of 211 patients classified as resectable (R), borderline resectable (BR), and unresectable (UR), resection rates were highest in the R group (99%) and lowest in the UR group (19%), with overall survival markedly differing across groups (31 months for R, 18 months for BR, and 11 months for UR).
  • Patients who underwent surgical resection showed similar relapse-free and overall survival rates regardless of their initial classification, suggesting that while conversion surgery is
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Introduction: Growing evidence indicates the prognostic importance of the crosstalk between cancer cells and stroma through the induction of epithelial-mesenchymal transition (EMT). This study aimed to clarify the prognostic value of evaluating primary tumor histology with the anatomical extent of disease in patients with colorectal liver metastasis (CRLM).

Methods: Prognostic analyses were performed in 411 CRLM patients who underwent hepatectomy at two institutions.

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Background: The TNM (Tumor, Node, Metastasis) classification of the 8th Union for International Cancer Control and the 6th Japanese classification of biliary tract cancer were made on the premise that the prognostic effect of each regional lymph node station is similar. However, some studies have reported different effects of lymph node metastasis location on post-resection prognosis. This study aimed to investigate outcome following radical resection of ampullary carcinoma according to station of lymph node metastasis.

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Background: Many patients undergoing hepatectomy for colorectal liver metastases (CRLM) experience recurrence. However, no criteria for screening candidates to undergo repeat hepatectomy (RH) for CRLM have been established. Budding, one form by which colorectal carcinoma malignancies are expressed, is a new pathologic index.

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Article Synopsis
  • The Japanese guidelines recommend everolimus or sunitinib as first-line treatments for unresectable pancreatic neuroendocrine tumors (PNETs), with streptozocin (STZ) as an alternative.
  • A 50-year-old patient with PNET and multiple liver metastases showed a significant response to third-line treatment with STZ after failing to respond to everolimus and sunitinib.
  • The situation highlights the need for further research to identify the optimal order of anti-cancer drugs and their effectiveness for treating PNET, as treatment responses can vary significantly.
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Purpose: The purpose of this paper was to identify the optimum-sized stapler cartridges for reducing the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).

Methods: The authors retrospectively analyzed 101 patients who underwent DP with a triple-row stapler to identify the clinicopathological factors that strongly influence POPF after DP. The height difference (HD) was defined as the difference between the pancreatic thickness and the height of the closed stapler.

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Neoadjuvant chemotherapy (NAC) confers a survival benefit in esophageal carcinoma, but it is difficult to perform in patients who cannot receive enteral feeding due to an esophageal obstruction. In the current study, the nutritional benefit of laparoscopic jejunostomy (Lap-J) was evaluated in patients with NAC for obstructing esophageal cancer. A total of 91 patients with esophageal cancer who received NAC between 2009 and 2017 were included in the present study.

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Granulocyte colony-stimulating factor (G-CSF) is a naturally occurring glycoprotein that stimulates the proliferation of precursor cells in the bone marrow and their maturation into fully differentiated neutrophils. G-CSF-producing cancers rarely occur in the digestive system, particularly the pancreas. Herein we report the rare case of a G-CSF-producing pancreatic carcinoma associated with severe anemia due to bleeding in the duodenum, which was successfully treated with surgery.

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Background: Non-parasitic splenic cysts are associated with elevated serum carbohydrate antigen (CA) 19-9 levels. We report a case in which a 23-year-old female exhibited a large ruptured splenic cyst and an elevated serum CA19-9 level.

Case Presentation: The patient, who experienced postprandial abdominal pain and vomiting, was transferred to our hospital and was found to have a large splenic cyst during an abdominal computed tomography (CT) scan.

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Desmoplastic reaction (DR) involves the growth of fibrous or connective tissues around a tumor and has recently attracted attention as an indicator of malignant potential. Previous studies have confirmed that histological categorization of DR in the primary tumor is an independent prognostic factor in patients with colorectal liver metastases (CRLM). However, it remains unclear whether the DR status of the metastatic liver lesion (DR) is a useful prognostic factor.

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Introduction: A postoperative clinically relevant pancreatic fistula can cause severe sequelae. We aimed to describe our minimally invasive procedure (rendezvous technique) for the treatment of a pancreatic fistula resulting from pancreaticojejunal anastomosis dehiscence involving a dislodged main pancreatic duct tube.

Methods: In our rendezvous technique, a guidewire is advanced into the jejunal lumen from the access site of the drainage tube and is caught by a snare catheter, which is used to replace the dislodged main pancreatic duct tube.

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Sentinel node navigation surgery (SNNS) has become a standard procedure for early-stage melanoma and breast cancer. However, very few studies have evaluated the long-term clinical outcomes following SNNS for gastric cancer. The present study analyzed 51 patients with cT1 gastric cancer who underwent SNNS at our hospital.

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To investigate the pathological features of metastatic lymph nodes (LN) in pancreatic ductal adenocarcinoma (PDAC) and to determine factors with prognostic implications.Metastatic LN status is a proven significant factor for predicting postoperative prognosis in pancreatic cancer patients. However, the effective prognostic criteria regarding metastatic LNs for such disease remain unknown.

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Article Synopsis
  • This study presents a case of intrahepatic cholangiocarcinoma (ICC) that initially appeared to be cholangiocellular carcinoma (CoCC) during imaging and biopsy assessments in a 51-year-old female patient.
  • Imaging techniques like CT and MRI showed distinct features of the tumor and affected lymph nodes, including non-homogeneous enhancement and low signal intensity during the hepatobiliary phase.
  • Ultimately, despite the initial diagnosis suggesting CoCC from the biopsy, surgical examination revealed poorly differentiated adenocarcinoma, leading to a confirmed diagnosis of ICC based on histopathological and immunohistochemical results.
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Hepatic portal venous gas (HPVG) is rare with high mortality. There are few reports on HPVG's association with appendicitis. Here we report a case of HPVG associated with appendicitis.

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Surgical injury can be a life-threatening complication, not only due to the injury itself, but also due to immune responses to the injury and subsequent development of infections, which readily result in sepsis. Sepsis remains the leading cause of death in most intensive care units. Unfavorable outcomes of several high-profile trials in the treatment of sepsis have led researchers to state that sepsis studies need a new direction.

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Background: It is reported that several systemic immunoinflammatory measures, including systemic immune-inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and C-reactive protein (CRP)-to-albumin ratio (CAR), are associated with survival in patients with various types of cancer.

Objective: The aim of the present study was to clear which systemic immunoinflammatory measures had the greatest prognostic values. In addition, we examined which component had the greatest prognostic power in patients with esophageal cancer.

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Background: Pulmonary complications after esophagectomy are often fatal. The prediction of postoperative pulmonary complications remains a challenge. Accumulating evidence demonstrates a physiological and pathological role for angiotensin-converting enzyme 2 (ACE2) in the respiratory system.

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Article Synopsis
  • Liver fibrosis, a severe condition with no approved treatments, is linked to increased free cholesterol (FC) in activated hepatic stellate cells (HSCs) due to enhanced signaling from SREBP2 and miR-33a.
  • Researchers found that FC accumulation in HSCs from patients with liver fibrosis is independent of serum cholesterol levels and promotes further activation of these cells, leading to worse fibrosis.
  • Targeting the molecules related to FC accumulation in HSCs, using a vitamin A-coupled liposomal delivery system, shows potential as a new therapeutic approach for treating liver fibrosis.
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Article Synopsis
  • Pneumatosis intestinalis (PI) is a rare condition that can occur following chemotherapy, as illustrated by a 70-year-old man who developed it after receiving cisplatin and 5-fluorouracil for esophageal cancer.
  • After experiencing acute abdominal pain, CT scans showed extensive PI in the colon but no signs of ischemia, leading to a decision for conservative treatment.
  • By Day 7, follow-up CT scans showed that the PI had resolved, allowing the patient to successfully undergo surgery without complications, highlighting the importance of recognizing and managing PI conservatively in patients undergoing CF therapy.
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A red-green-blue camera-based imaging method is proposed for estimating spatial maps of concentrations of oxyhemoglobin (), deoxyhemoglobin (), total hemoglobin (), tissue oxygen saturation (), and scattering power () in liver tissue. Hemodynamic responses to hepatic ischemia-reperfusion of rat liver tissues induced by portal triad occlusion were evaluated. Upon portal triad occlusion, this method yielded images of decreased , , , and , and increased followed by a progressive increase in and during reperfusion.

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A 57-year-old woman was admitted to National Defense Medical College hospital for treatment of gastric cancer with pyloric stenosis. She had been diagnosed with chronic kidney disease (CKD) 10 years prior, but received no hemodialysis. Because of peritoneal dissemination, a palliative distal gastrectomy was performed.

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Background: Nonalcoholic fatty liver disease (NAFLD) after pancreatoduodenectomy (PD) is increasingly being recognized as a late postoperative complication, but the main causes have not been fully investigated. This study aimed to clarify the relationship between NAFLD after PD and postoperative adjuvant chemotherapy, focusing particularly on the adjuvant chemotherapy regimens administered.

Materials And Methods: We retrospectively reviewed the medical records of 154 patients who underwent PD from April 2007 to December 2013, to identify the clinicopathologic factors most strongly influencing NAFLD development after PD.

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Article Synopsis
  • Elderly patients (aged ≥75 years) are considered high-risk for major abdominal surgeries due to health challenges but can benefit from a specific surgical technique.
  • A study compared totally laparoscopic distal gastrectomy (TLDG) with laparoscopy-assisted distal gastrectomy (LADG) in 102 gastric cancer patients, finding that while elderly patients had longer hospital stays, they did not experience more complications.
  • TLDG resulted in significantly lower pain medication use post-surgery for elderly patients, suggesting it may be a more effective option for managing postoperative pain in this high-risk group.
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Article Synopsis
  • Bochdalek hernia is a rare type of congenital diaphragmatic hernia in adults, with an incidence of 0.17%-6% among diaphragmatic hernias.
  • A 78-year-old man developed abdominal pain after using a blow gun, leading to a diagnosis of an incarcerated Bochdalek hernia, which was successfully treated with laparoscopic surgery.
  • Surgical repair is essential to prevent severe complications, and laparoscopic techniques are increasingly preferred due to their minimally invasive nature and shorter recovery times.
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