Publications by authors named "Hirotaka Miyai"
Background: Robot-assisted gastrectomy (RG) for gastric cancer is still not well standardized. This study aimed to explore the feasibility and effectiveness of solo surgery in robot-assisted gastrectomy (SRG) for gastric cancer compared to laparoscopic gastrectomy (LG).
Methods: This was a single-center retrospective comparative study between SRG and conventional LG.
Article Synopsis
- This study aimed to assess long-term chronic pain and complications after a specific hernia repair method (C-TAPP) and compare the outcomes of unilateral versus bilateral cases.
- A questionnaire was distributed to over 1500 patients to evaluate satisfaction, pain levels, and complications, with noteworthy return rates indicating strong participation.
- The results showed low frequencies of pain and complications for both groups, with no significant differences in long-term pain or complication rates, suggesting that both unilateral and bilateral repairs yield similar outcomes.
The optimal surgical indications for small rectal neuroendocrine tumors (NETs) are controversial. Generally, treatment guidelines for rectal NETs >2 cm or with potential lymph node (LN) metastasis recommend formal oncologic low anterior resection (LAR) with total mesorectal excision (TME). However, rectal NETs have the potential to metastasize to the lateral lymph nodes (LLNs).
View Article and Find Full Text PDFIntroduction: Despite increasing reports of laparoscopy for strangulated small bowel obstruction (SSBO), there is no consensus on outcomes in patients with SSBO. We evaluated the safety and utility of laparoscopy for SSBO and investigated the preoperative risk factors for laparotomy.
Methods: This retrospective study included 107 patients who underwent emergency surgery for SSBO over a period of 6 years.
Diffuse cavernous hemangioma of the rectum (DCHR) is a relatively rare benign vascular disease. DCHR is marked by recurrent bleeding and anemia, and it is difficult to diagnose correctly. Here, we report the case of a 34-year-old man diagnosed with DCHR by colonoscopy, CT, and endoscopic ultrasonography.
View Article and Find Full Text PDFIntroduction: Inguinal hernia repair and cholecystectomy are frequently performed in the field of gastrointestinal surgery. However, reports describing surgical procedures that involve simultaneous transabdominal preperitoneal hernia repair (TAPP) and laparoscopic cholecystectomy (LC), as well as the safety and usefulness of this combination, are limited. Herein, we report a surgical procedure involving simultaneous TAPP and LC (TAPP + LC) and present the outcomes of patients who have undergone this combined surgical procedure, with a particular focus on its safety and usefulness.
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- A 65-year-old man was diagnosed with gallstone ileus involving the sigmoid colon after experiencing abdominal pain and nausea, confirmed by a CT scan.
- The patient underwent a single surgery that included enterolithotomy, cholecystectomy, and fistula closure, after which he had a brief issue with biliary leakage that was managed conservatively.
- The case discussion suggests that one-stage surgery may be a viable approach for treating gallstone ileus, especially in patients with a cholecystocolonic fistula, despite ongoing debates about treatment methods.
Background: Secondary small bowel volvulus is a rare condition caused by adhesions after laparotomy or tumors. There are no clear guidelines for indication of laparoscopic surgery.
Case Presentation: A 69-year-old male visited our hospital complaining of epigastric pain.
Here, we report two patients with transomental hernia who were successfully treated with laparoscopic surgery. The first patient was a 58-year-old female who presented to our hospital with abdominal pain and vomiting; she had no history of abdominal surgery. Enhanced computed tomography revealed strangulation ileus due to an internal hernia.
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- * A 48-year-old male patient presented with symptoms of severe anemia, visible skin lesions, and notable gastrointestinal findings, leading to a diagnosis of Cowden disease.
- * The case highlighted the successful laparoscopic surgery for treating colon arteriovenous malformations, suggesting that this minimally invasive approach is effective for congenital vascular issues in the intestines.
Article Synopsis
- Mesenteric neuroendocrine tumors typically come from small intestine metastases, but primary cases are rare; this report details a unique instance of such a tumor changing from cystic to solid.
- A 72-year-old man with abdominal pain had a 25-mm cystic tumor near the duodenum that grew to 40 mm and transformed over two years.
- After being diagnosed through imaging and PET scans, the tumor was surgically removed without needing to resect the intestine and confirmed as a low-grade neuroendocrine tumor; the patient has shown no signs of recurrence one year post-surgery.*
Recent studies have shown constitutive activation of the Notch signaling pathway in various types of malignancies. However, it remains unclear whether this signaling pathway is activated in gastric cancer. In the present study, the aim was to investigate the role of Notch signaling in gastric cancer by investigating the subcellular localization of Notch-associated proteins in tissue samples from gastric cancer patients.
View Article and Find Full Text PDFBackground: The manifestations of non-alcoholic fatty liver disease in patients who have undergone pancreatoduodenectomy differ from those associated with obesity-related non-alcoholic fatty liver disease. This study aimed to identify factors that predicted the occurrence of and recovery from non-alcoholic fatty liver disease after pancreatoduodenectomy.
Methods: This retrospective study included 120 patients who underwent pancreatoduodenectomy between April 2004 and December 2013.
Introduction: Lymphangiomas are rare, benign tumors. An intra-abdominal location of these lesions is rarer still and there are only a few reports describing laparoscopic resection for retroperitoneal lymphangiomas, especially in tumors that mimic pancreatic tumors.
Case Presentation: We present the case of an asymptomatic 30-year-old Japanese woman in whom a cystic tumor was found incidentally in close approximation to the pancreas.
Article Synopsis
- - Primary gastric small cell carcinoma is a rare and aggressive cancer first identified in 1976, resembling small cell lung carcinoma, with a generally poor survival outlook.
- - A case study details a 71-year-old male who, after being diagnosed with the disease following surgery, received successful combination chemotherapy with irinotecan and cisplatin, resulting in over a year of survival.
- - The report includes a literature review on chemotherapy treatments for this type of cancer, highlighting its effectiveness in improving patient outcomes.
Article Synopsis
- - The study focuses on identifying predictive factors for postoperative pancreatic fistula (POPF) after laparoscopy-assisted gastrectomy (LAG) in gastric cancer patients, analyzing data from 277 cases over several years.
- - Key risk factors for POPF were identified through multivariate analysis, including patient age, amylase levels, number of retrieved lymph nodes, body mass index, and operating time, leading to the development of a scoring system.
- - The predictive scoring system effectively identifies high-risk patients, demonstrating a high negative predictive value and aiding clinicians in early interventions for those at greater risk for POPF.