Publications by authors named "Hideki Nagano"
Article Synopsis
- The study reviewed cases of Toxic Megacolon (TM) treated at a single center from 1985 to 2020, focusing on surgical timing and techniques.
- Key diagnostic criteria, including Narabayashi's guidelines and SIRS, were validated, revealing that many patients met these indicators for toxemia and sepsis.
- Results showed a high mortality rate (50%) for patients with intestinal perforation, emphasizing the need for early recognition and surgical intervention in TM cases.
Background/aim: Self-expandable metallic stent (SEMS) placement is becoming the standard bridge-to-surgery (BTS) strategy for potentially curable left-sided obstructive colorectal cancer (OCRC). The study objective was to evaluate the effectiveness of SEMS placement as a BTS strategy for both right- and left-sided OCRC.
Patients And Methods: We retrospectively compared the short- and long-term outcomes of patients with OCRC who underwent placement of a SEMS versus a trans-nasal/anal decompression tube (DCT).
Background: Loop ileostomy is a common surgical procedure but is associated with complications such as outlet obstruction (OO), parastomal hernia (PH), and high-output stoma (HOS). This study aimed to identify risk factors for these complications, as well as their causal relationships.
Methods: The study included 188 consecutive patients who underwent loop ileostomy between April 2016 and September 2021.
Background Accurate lymph node evaluation is essential for staging colon cancer and guiding postoperative treatment decisions. In this study, we compared the efficacy of a simple enzymatic fat dissolution method with the conventional method for lymph node sampling from specimens after colon cancer surgery. Methods We enrolled 58 patients who underwent elective laparoscopic surgery for colon adenocarcinoma between May 2018 and May 2021 at Fukuoka University Hospital in Fukuoka, Japan.
View Article and Find Full Text PDFThe AirSeal system (CONMED, NY, USA) can outstandingly keep pneumoperitoneum stable. However, water droplets form on the access port, impairing the performance of comfortable surgical procedures because of the resultant wet surgical field. This study was performed to clarify the mechanism of water droplet formation and to prevent it.
View Article and Find Full Text PDFArticle Synopsis
- Neurofibromatosis type 1 (NF1) is often linked to gastrointestinal stromal tumors (GISTs), particularly in the small intestine, characterized by a tendency for multiple tumors, low growth activity, and generally good outcomes.
- A woman in her forties with a family history of NF1 presented with abdominal pain, leading to the discovery of a large cystic mass and a smaller solid mass in her abdomen, confirmed via various imaging techniques.
- Surgical exploration revealed a multicystic tumor in the jejunum along with a solid tumor, both showing benign characteristics under microscopic examination and confirming a diagnosis of multiple GISTs in the context of NF1.
Background: Alteration of chemosensitivity or tumor aggressiveness in response to chemotherapy has been reported, and liquid biopsy assessment during chemotherapy for colorectal cancers has confirmed the acquisition of mutations in various oncogenes. However, the occurrence of histological transformation seems to be extremely rare in colorectal cancers, and the few existing case reports of this transformation are from lung cancer and breast cancer. In this report, we describe the histological transformation of clinically aggressive scirrhous-type poorly differentiated adenocarcinoma of the ascending colon to signet-ring cell carcinoma in almost all recurrent tumors that were confirmed by autopsy after response to chemotherapy plus cetuximab.
View Article and Find Full Text PDFThe transanal/perineal (ta/tp) endoscopic approach has been widely used for anorectal surgery in recent years, but carbon dioxide embolism is a possible lethal complication. The frequency of this complication in this approach is not known. In this study, we investigated the frequency of intraoperative (including occult) carbon dioxide embolism using transesophageal echocardiography.
View Article and Find Full Text PDFArticle Synopsis
- - The study analyzed data from 2533 rectal cancer patients who underwent either abdominoperineal resection (APR) or sphincter-saving surgery (SSS) to determine the impact of surgical type on patient outcomes in Japan.
- - While univariate analysis indicated worse oncological outcomes for APR compared to SSS, multivariate analysis revealed no significant differences in overall survival (OS) or relapse-free survival (RFS) between the two procedures.
- - The study concluded that while APR did have a higher risk of positive pathological radial margin (pRM), both surgical methods yielded similar oncological outcomes, highlighting the importance of achieving negative pRM in APR to enhance patient prognosis.
Article Synopsis
- This study investigates the potential of using circulating tumor DNA (ctDNA) from colorectal cancer patients to predict tumor recurrence, focusing on mutations in the KRAS gene.
- It involved analyzing blood samples from 84 patients with specific KRAS mutations, although no direct link was found between KRAS mutation levels and tumor recurrence.
- The findings indicate correlations between tumor characteristics (like size and stage) and preoperative KRAS mutation levels, but suggest that ctDNA detection for predicting recurrence isn't reliable post-surgery.
Article Synopsis
- - Total pelvic exenteration (TPE) is a complex surgical procedure often needed for advanced or recurrent gynecologic cancer, particularly challenging in patients with prior surgeries and treatments.
- - The study presents a new combined surgical technique using laparoscopic and transperineal endoscopic TPE (TpTPE), which was successfully performed on a 42-year-old woman with recurrent cervical cancer affecting multiple pelvic organs.
- - The procedure took approximately 887 minutes with minimal blood loss, and the patient had a smooth recovery, highlighting TpTPE as a viable option for treating locally advanced pelvic tumors.
Background: Several serious complications are associated with the lithotomy position, including well-leg compartment syndrome and peroneal nerve paralysis. The aims of this study were to identify risk factors for the intraoperative elevation of lower leg pressure and to evaluate the effectiveness of monitoring external pressure during surgery for preventing these complications.
Methods: The study included 106 patients with a diagnosis of sigmoid colon or rectal cancer who underwent elective laparoscopic surgery between June 2019 and December 2020.
Article Synopsis
- * Of the 362 patients studied, 11 had the BRAF V600E mutation, and though tumor size was linked to mutant allele frequency (MAF), no direct correlation was found between MAF and recurrence.
- * The research indicates that while MAF increases over time in some patients, using it for early recurrence prediction in colorectal cancer post-surgery remains challenging.
Purpose: Accurate preoperative T staging is important when determining the treatment strategy for advanced colorectal cancer. We have previously reported the usefulness of preoperative T staging based on the spatial relationship of tumors and "bordering vessels" by computed tomography colonography (CTC) with multiplanar reconstruction (MPR). The aims of this study were to evaluate the external validity of this method and to determine whether there is a difference in the accuracy of T staging between the mesenteric and antimesenteric sides.
View Article and Find Full Text PDFArticle Synopsis
- Laparoscopic pancreas-sparing distal duodenectomy is a minimally invasive surgical method for tumors in the duodenum, but it is technically challenging due to the organ's complex anatomy.
- The procedure was successfully performed on two patients with duodenal tumors, involving careful dissection and mobilization, with operative times of 326 and 370 minutes, and they experienced no complications post-surgery.
- This technique is becoming increasingly important as duodenal tumors are being diagnosed more frequently, and the approach proves to be a safe and effective option for excising such tumors without extensive organ mobilization.
Article Synopsis
- A 66-year-old woman with sigmoid colon cancer had a central venous port inserted for chemotherapy.
- During her second treatment cycle, she felt neck discomfort, leading to a CT scan that revealed the catheter had deviated and a thrombus formed in her internal jugular vein.
- The deviation was thought to be caused by breast displacement from gravity, which altered the catheter's position and led to the thrombus.
Background: Heterotopic ossification (HO) is the formation of osseous tissue outside the skeleton. HO in malignant tumors of the digestive tract is extremely rare, as is ossification in metastatic lesions from HO-negative digestive tract tumors. Regarding the pathogenesis of HO, two theories have been proposed.
View Article and Find Full Text PDFArticle Synopsis
- The transanal and transperineal endoscopic approaches are advanced surgical techniques for removing rectal and anorectal cancers, but they have risks, including CO2 embolisms which can be life-threatening.
- During a surgery involving these methods, a CO2 embolism was detected due to a sudden drop in end-tidal CO2 and arterial oxygen saturation, confirmed by transesophageal echocardiography.
- The surgical team promptly reversed the pneumopelvis and pneumoperitoneum, resolving the cardiopulmonary issues, and the surgery was successfully completed with the patient later discharged without serious complications aside from the embolism.
Background/aim: Chemoimmunotherapy is a promising treatment for various malignant diseases. In this study, we examined whether first-line chemoimmunotherapy using adoptive immune-cell therapy was effective for metastatic colorectal cancer (mCRC).
Patients And Methods: The therapeutic efficacy and safety of the standard first-line chemoimmunotherapy with adoptive αβ T cell therapy and bevacizumab were assessed using thirty-two patients with mCRC in our hospital.
Background: In abdominoperineal resection (APR) in male patients with rectal cancer, high margin involvement and urethral injury have been reported to result from difficulty in dissecting the anterior anorectum. Recently, the efficacy of an endoscopic down-to-up rectal dissection was reported. Here, we present a safe and simple technique for anterior dissection using a simultaneous laparoscopic and transperineal endoscopic approach.
View Article and Find Full Text PDFBackground: Complete mesocolic excision with central vascular ligation is a standard advanced technique for achieving favorable long-term oncological outcomes in colon cancer surgery. Clinical evidence abounds demonstrating the safety of high ligation of the inferior mesenteric artery (IMA) for sigmoid colon cancer but is scarce for descending colon cancer. A major concern is the blood supply to the remnant distal sigmoid colon, especially for cases with a long sigmoid colon.
View Article and Find Full Text PDFPurpose: The incidence and time of onset of acute chemotherapy-induced peripheral neuropathy (ACIPN) caused by oxaliplatin remain unclarified. Hence, we investigated the prevalence, onset time, and location of ACIPN symptoms in patients with colorectal cancer (CRC) receiving oxaliplatin without cold stimulation.
Methods: The study cohort comprised patients receiving oxaliplatin for CRC at our hospital between April 2017 and August 2018.
Background: Lymphoepithelioma-like carcinomas (LELCs), especially colorectal cancers (CRCs), are uncommon pathological phenotypes generally associated with poor aggressiveness and a preferable prognosis. However, PD-L1 overexpression in CRCs is associated with poor outcomes. We report a case of moderately differentiated adenocarcinoma with PD-L1 overexpression, an LELC component, and Crohn's-like lymphoid reaction (CLR) presenting with extreme locoregional aggression and complete remission with chemotherapy after noncurative excision.
View Article and Find Full Text PDFArticle Synopsis
- Capecitabine is converted to the anticancer drug 5-fluorouracil (5-FU) in tumors by an enzyme called thymidine phosphorylase (TP), and the study looked at how adding a TP inhibitor (5-nitrouracil or 5-NU) affects plasma 5-FU levels.
- After giving capecitabine, blood samples were tested for 5-FU concentrations at different times and conditions, revealing that samples stored at room temperature had significantly higher 5-FU levels compared to those stored at 4°C.
- The presence of 5-NU decreased 5-FU concentrations, with the most significant differences observed at room temperature, suggesting that both storage