Small bowel adenocarcinoma (SBA) is a relatively rare disease that is difficult to detect in the early stages; therefore, it often has a poor prognosis. We present a rare case of SBA and multiple liver metastases in a patient who underwent curative resection combined with neoadjuvant chemotherapy (NAC). A 70-year-old woman presented to the emergency department complaining of abdominal pain and bloating.
View Article and Find Full Text PDFA 25-year-old male received palliative total gastrectomy plus D1 dissection plus Roux-en-Y reconstruction for hemorrhagic gastric cancer with left Virchow lymph node metastasis in 2013. The final diagnosis was Type 2, pT4a(se), pap>tub2 >hepatoid adenocarcinoma, pN3b, sM1, fStage Ⅳ. Because AFP was as high as 11,000 ng/mL, he was diagnosed with AFP-producing gastric cancer and started S-1 plus CDDP therapy.
View Article and Find Full Text PDFBackground: Spontaneous regression (SR) of cancer is a rare condition in which the cancer partially or completely disappears without treatment. We report a case of breast cancer with tumor regression and spontaneously induced T-cell-mediated immunological responses in a surgical specimen obtained after core needle biopsy (CNB).
Case Description: A 52-year-old woman presented with a mass in the right breast.
The patient was a 57-year-old woman. She was referred to our hospital because severe anemia. Upper gastrointestinal endoscopy revealed polyposis throughout the stomach and lobulated polyps in cardia, greater curve of middle body of the stomach, and angulus.
View Article and Find Full Text PDFA 73‒year‒old man, living in the United States since 1985, visited the University of Minnesota Medical Center with a complaint of upper abdominal pain in December 2019. Gastroendoscopy revealed a depressed lesion in the U area of the stomach, and the biopsy results indicated a diagnosis of por/sig. On further examination, the condition was diagnosed as gastric cancer of cStage II/III.
View Article and Find Full Text PDFAnastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion.
View Article and Find Full Text PDFPurpose: The purpose of this study was to investigate the relationship between the fluorescence on indocyanine green fluorescent imaging (ICG-FI) and the histopathological findings of regional lymph node (LN) metastasis of splenic flexural colon cancer.
Methods: From July 2013 to December 2018, consecutive patients with splenic flexural colon cancer with a preoperative diagnosis of N0 who underwent laparoscopic surgery were enrolled. The distribution of cancer sites in metastatic LNs (completely/not completely occupied by metastatic foci) was evaluated with hematoxylin and eosin-stained preparations.
Purpose: Recently, several studies have suggested that near-infrared (NIR) imaging using indocyanine green (ICG) may contribute to the reduction of anastomotic leakage (AL) after colorectal cancer (CRC) surgery. However, few reports have focused on the usefulness of NIR imaging for AL after stapled functional end-to-end anastomosis (stapled FEEA). The purpose of this study was to clarify the frequency of fluorescence abnormalities on NIR imaging, in cases reconstructed with stapled FEEA.
View Article and Find Full Text PDFBackground: Mixed adenoneuroendocrine carcinoma of the colon and rectum is a very rare type of tumor.
Objective: The aim of the present study was to evaluate the clinicopathological characteristics and prognosis of mixed adenoneuroendocrine carcinomas of the colon and rectum.
Design: This was a retrospective case-matched analysis (from March 2007 to December 2013).
Background: The effects of subcutaneous closed-suction Blake drain for preventing incisional surgical site infections (SSIs) after colorectal surgery have never been evaluated in a randomized controlled trial (RCT). Thus, we performed a RCT to evaluate the clinical benefits of using a subcutaneous closed-suction Blake drain in patients undergoing colorectal surgery.
Method: Consecutive patients who underwent colorectal surgery were enrolled in this study.
Dis Colon Rectum
November 2016
Introduction: Single-incision laparoscopic colectomy is technically limited because of such factors as instrument crowding, in-line viewing, and insufficient countertraction. In particular, it is technically difficult to cut the distal rectum from the umbilicus using an articulating linear stapler in single-incision laparoscopic anterior resection.
Technique: After treating the mesorectum, the 5-mm trocar is replaced with a 12-mm trocar.
Purpose: The treatment of splenic flexural colon cancer is not standardized because the lymphatic drainage is variable. The aim of this study is to evaluate the lymph flow at the splenic flexure.
Methods: From July 2013 to January 2016, consecutive patients of the splenic flexural colon cancer with a preoperative diagnosis of N0 who underwent laparoscopic surgery were enrolled.
Introduction: Laparoscopic surgery for colon cancer located in the hepatic flexure or splenic flexure is not standardized, because lymphatic drainage at this site may vary and the precise site of lymphatic dissection is uncertain.
Technique: Indocyanine green was injected into the submucosal layer around the tumor at 2 points with a 23-gauge localized injection before lymph node dissection and the lymph flow was observed using a near-infrared camera system 30 minutes after injection. In addition, a complete mesocolic excision with central vascular ligation guided the region where the lymph flow was fluorescently observed.
Purpose: It has been reported that some patients do not have an anastomosis of a marginal artery near the rectosigmoid junction, but the frequency of this condition and its clinical significance so far remain unclear. The aim of this study was to evaluate the blood flow at the marginal artery near the rectosigmoid junction.
Methods: From January 2013 to January 2014, we enrolled consecutive patients with a preoperative diagnosis of left-sided colon cancer or rectal cancer who underwent surgery with lymph node dissection.
We retrospectively studied the clinical efficacy and safety of the combination therapy with low-dose cis-diamminedichloroplatinum ( CDDP) and irinotecan hydrochloride(CPT-11)as a second- or third-line chemotherapy in 41 patients with advanced and recurrent gastric cancer. Low-dose CDDP (20mg/m²) and CPT-11 (80 mg/m²) were administered intravenously once every 2 or 3 weeks. The patients comprised 31 men and 10 women, with ages ranging from 42 to 81 years (mean, 67.
View Article and Find Full Text PDFWe report the cases of 2 patients with clinical T4( cT4) esophageal cancer who achieved pathological complete response on treatment with neoadjuvant chemoradiation therapy. Case 1 involved a 68-year-old woman who was diagnosed as having cT4 advanced esophageal cancer( with involvement of the aorta and left pulmonary vein). Neoadjuvant chemoradiation therapy with 5-fluorouraci(l 5-FU)( 800 mg/m2, days 1-5 and days 29-33), cisplatin( CDDP 80 mg/m2, days 1 and 29), and radiation (39.
View Article and Find Full Text PDFWe report a case of consciousness disorder following the fourth course of chemotherapy with cisplatin (CDDP) and 5- fluorouracil (5-FU) in a patient with esophageal cancer. A 74-year-old man was admitted to our hospital to receive chemotherapy for esophageal cancer. Six days after chemotherapy, the patient showed impaired consciousness and his serum sodium concentration was found to be 125 mEq/L, but no edema or dehydration was noted.
View Article and Find Full Text PDFBackground: Preclinical studies have shown that irinotecan (CPT-11) and cisplatin (CDDP) can act synergistically. Several chemotherapy regimens combining CPT-11 and CDDP for advanced gastric cancer have been reported to demonstrate high response rates and high incidence of severe toxicity.
Purpose: We conducted a combination chemotherapy regimen of low-dose CDDP and CPT-11 to prolong the time to progression with less toxicity.
Follow-up colonoscopy of a 25-year-old Japanese man with ulcerative colitis (UC) who had undergone endoscopic mucosal resection twice for early colon cancers revealed the presence of a new 1.5-cm-diameter tumor in the sigmoid colon. It was diagnosed by preoperative biopsy as a poorly differentiated adenocarcinoma.
View Article and Find Full Text PDFTo improve the prognosis after hepatectomy for HCC, repeated postoperative transcatheter arterial infusions of anticancer drugs and lipiodol (TAI) were given. TAI may be effective as an adjuvant therapy for prevention of residual liver recurrence after hepatectomy, probably by suppression of the development of intrahepatic micrometastases rather than of multicentric carcinogenesis.
View Article and Find Full Text PDFHepatogastroenterology
December 2005
Background/aims: To determine an appropriate surgical treatment for patients with multiple liver metastases, we evaluated the efficacy of two-stage hepatectomy in patients with multiple bilobular liver metastases from colorectal carcinoma.
Methodology: Some patients with multiple liver metastases are not candidates for a complete resection by a single hepatectomy, even when downstaged by chemotherapy, after portal embolization. In two-stage hepatectomy, the highest possible number of tumors is resected in a first, noncurative intervention, and the remaining tumors are resected after a period of liver regeneration.
Background: The expression of genes thought to be related to 5-FU chemosensitivity has been extensively investigated. However, little data is available on the expression patterns of these genes after chemotherapy.
Patients And Methods: We investigated the expression of four genes, DPD, TS, p53 and p21, in the metastatic liver lesions obtained from colorectal cancer patients who had been treated with hepatic arterial infusions of 5-fluorouracil(5-FU)-based chemotherapy.
Background/aims: The aim of this study was to evaluate the effect and the toxicity of prophylactic adjuvant hepatic arterial infusion chemotherapy (HAIC) on liver metastases and on overall survival of Dukes C colorectal cancer patients.
Methodology: Ninety patients in whom Dukes C colorectal cancer was diagnosed and were treated with curative resection between 1993 and 1997 underwent HAIC. The HAIC regimen consisted of a 24-hour continuous infusion of 1500 mg of 5-fluorouracil, administered once a week for 8 weeks, utilizing a portable infusion drug delivery system to ambulatory patients.