Site-specific risk factors for local recurrence after rectal cancer surgery.

Background: Quite few studies examined risk factors for local recurrence after rectal cancer surgery with respect to local recurrence sites.

Methods: Local recurrence sites were categorized into axial, anterior, posterior, and lateral (pelvic sidewall), and axial, anterior, and posterior type were combined as the "other" type of local recurrence. Among 76 patients enrolled into our prospective randomized controlled trial to determine the indication for pelvic autonomic nerve preservation (PANP) in patients with advanced lower rectal cancer (UMIN000021353), multivariate analyses were conducted to elucidate risk factors for either lateral or the "other" type of local recurrence.

Changing Patterns of Distant Metastasis in Patients With Lower Rectal Cancer Undergoing Intraoperative Radiotherapy.

Background/aim: Local radiotherapy for primary tumors may increase the incidence of distant metastasis. However, the patterns of target organs have not been clarified yet.

Patients And Methods: In our randomized controlled trial examining the oncological efficacy of intraoperative radiotherapy (IORT) for advanced lower rectal cancer, the details of the metastatic organs were evaluated.

Intraoperative radiotherapy for resectable advanced lower rectal cancer-final results of a randomized controlled trial (UMIN000021353).

Aim: Pelvic autonomic nerve preservation (PANP) is useful to preserve voiding and sexual function after rectal cancer surgery. The aim of this study was to investigate the benefit of intraoperative radiotherapy (IORT) to have complete PANP without affecting oncological outcomes.

Methods: Patients undergoing potentially curative resection of the rectum were included.

The impact of tumor location on the biological and oncological differences of colon cancer: Multi-institutional propensity score-matched study.

Background: Several studies have reported some differences between right-sided and left-sided colon cancer. The aim was to analyze the differences in clinical and pathological features, recurrence, and prognostic impact of tumor location in patients with tumors truly located in the right and left side of the colon.

Patients: The study included 6790 stage I-III colon cancer patients who underwent curative resection.

Recent trends (2016-2017) in the treatment of inflammatory bowel disease.

Prevalence of inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease has dramatically increased in Asian countries in the last three decades. In this period, many new medical therapies were introduced for the treatment of IBD, such as immunosuppressants, anti-tumor necrosis factor agents, leukocyte apheresis, anti-integrin antibody, and so on, which have contributed to induce remission and to reduce complications in IBD. As for surgical techniques for Crohn's disease, a stapled functional end-to-end anastomosis and conventional end-to-end anastomosis have similar perianastomotic recurrence rate and reoperation rate.

Optimal Surveillance Protocols After Curative Resection in Patients With Stage IV Colorectal Cancer: A Multicenter Retrospective Study.

Background: After patients with stage IV colorectal cancer undergo curative surgical resection, there is a large risk for recurrence. To establish optimal surveillance guidelines, an understanding of the temporal risk factors for recurrence is necessary.

Objective: The primary aim of our study was to determine predictors for early (within 1 year), middle (1-2 years), and late (2 years or later) recurrence following curative resection in patients with stage IV colorectal cancer.

Efficacy of Gum Chewing on Bowel Movement After Open Colectomy for Left-Sided Colorectal Cancer: A Randomized Clinical Trial.

Background: Prolonged intestinal paralysis can be a problem after gastrointestinal surgery. Several systematic reviews and meta-analyses have suggested the efficacy of gum chewing for the prevention of postoperative ileus.

Objective: The purpose of this study was to examine the efficacy of gum chewing for the recovery of bowel function after surgery for left-sided colorectal cancer and to determine the physiological mechanism underlying the effect of gum chewing on bowel function.

Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon.

Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity. Case Presentation.

Clinical pharmacology of daikenchuto assessed by transit analysis using radiopaque markers in patients with colon cancer undergoing open surgery: a multicenter double-blind randomized placebo-controlled study (JFMC39-0902 additional study).

Background: This exploratory trial was conducted to investigate whether daikenchuto accelerates the recovery of gastrointestinal function in patients undergoing open surgery for sigmoid or rectosigmoid cancer.

Methods: Eighty-eight patients who underwent colectomy at one of the 11 clinical trial sites in Japan from January 2009 to June 2011 were registered in the study. Patients received either placebo or daikenchuto (15.

Hemoptysis and acute respiratory syndrome (ARDS) as delayed-type hypersensitivity after FOLFOX4 plus bevacizumab treatment.

As there have been many multidrug regimens introduced in colorectal cancer treatment, hypersensitivity is more often encountered than in the past. Though most allergic adverse events of oxaliplatin are mainly classified as type I reaction, a limited number of case reports of type IV reaction (delayed-type hypersensitivity) have been reported. A 73-year-old man was hospitalized for receiving the third cycle of FOLFOX4 plus bevacizumab.

Modified Glasgow prognostic score in patients with incurable stage IV colorectal cancer.

Background: The modified Glasgow prognostic score is an inflammation-based prognostic score. This study examined whether this score, measured before surgical procedures, could predict postoperative cancer-specific survival.

Methods: We retrospectively studied 79 colorectal cancer patients who underwent a surgical procedure for incurable stage IV disease.

Inflammatory mass formation caused by gastric ectopic pancreas: report of a case.

Ectopic pancreas is a relatively rare condition that only occasionally causes the development of symptoms. This report presents a case of ectopic pancreas presenting as an inflammatory mass that formed in the gastric wall, which was successfully treated by surgical resection. A 32-year-old female was admitted due to a 3-year history of recurrent episodes of upper abdominal pain.

Recovery of upper gastrointestinal bowel movement after rectosigmoid cancer surgery: a pilot transit analysis.

Postoperative gastrointestinal bowel transit right after colorectal resection has not yet been clarified. Thirty patients with rectosigmoid cancer were treated in this pilot study. The nasogastric tube was removed on the first postoperative day.

Which is the preference of choice either life with a stoma or evacuatory disorder following rectal cancer surgery?

Background/aims: Low anastomosis with covering stoma is the standard operation for low rectal carcinoma. Some patients experience severe anorectal disorder, which makes us consider whether stoma closure should be performed or not. There was no comparative study between life with a stoma and life with evacuatory disorder.

Peristalsis gap sign at cine magnetic resonance imaging for diagnosing strangulated small bowel obstruction: feasibility study.

Purpose: The aim of this study was to determine the feasibility of cine magnetic resonance imaging (MRI) for diagnosing strangulated small bowel obstruction (SBO).

Materials And Methods: This study included 38 patients with clinically confirmed SBO who had undergone cine MRI. Cine MRI scans were evaluated regarding the presence of the "peristalsis gap sign" (referring to an akinetic or severely hypokinetic closed loop), indicating strangulation.

Neurophysiologic investigation of anal function following double stapling anastomosis.

Background And Aim: Manual dilatation of the anal sphincter and transanal introduction of the circular stapling device are required for intraluminal stapling anastomosis. This procedure has been regarded as one of the causes of postoperative evacuatory disorder in low anterior resection. However, there has been no evidence of this matter.

Rationale of pelvic autonomic nerve preservation in rectal cancer surgery based on immunohistochemical study.

Purpose: Previous studies revealed that the incidence of cancer cell involvement along the pelvic autonomic nerves ranged from 4 to 14%. However, patients' profiles and methodologies differed among the studies. This study was conducted to clarify the incidence of cancer cell involvement in and around the pelvic autonomic nerves immunohistochemically.

Quality assurance of pelvic autonomic nerve-preserving surgery for advanced lower rectal cancer--preliminary results of a randomized controlled trial.

Background: Pelvic autonomic nerve-preserving (PANP) lateral node dissection (LLND) has been introduced in rectal cancer surgery in Japan, but quality assurance of this approach has not been tested by randomized controlled trials.

Methods: Patients with advanced lower rectal cancer were randomized either to complete PANP + LLND surgery combined with intraoperative radiotherapy (preserved group; n = 28) or to pelvic autonomic nerve resection + LLND surgery (resected group; n = 27). Operation-related parameters were compared statistically.

Comparison of functional and clinical outcomes: colonic J-pouch vs. coloplasty in patients with low rectal cancer.

Background/aims: Coloplasty has been reported as substitution to colonic J-pouch when it is difficult to fashion. However, previous studies showed conflicting results with reference to functional outcome.

Methodology: Forty-seven patients with low rectal cancer were involved in this study from July 2000 to December 2006.

Morphological criteria for metastatic mesorectal lymph nodes in rectal cancer.

Background/aims: Preoperative diagnostic criteria for mesorectal lymph node metastasis in rectal cancer patients were not consistent in previous reports. This study was conducted to get conclusions on this controversial issue by detailed histological examination.

Methodology: Fifty-eight patients with rectal carcinoma who underwent total mesorectal excision were studied.

Impact of intra-operative radiotherapy on evacuatory function following ultra-low anterior resection. A preliminary result of prospective randomized trial.

Background/aims: Preoperative radiotherapy and/or chemotherapy have been reported as effective treatment for locally advanced low rectal carcinoma. However, recent follow-up studies represented severe postoperative evacuatory disorder, which annoys patients' quality of life.

Methodology: The present study was a part of a randomized trial protocol comparing between intraoperative radiotherapy with pelvic autonomic nerve preservation and control group without radiation.

Secure placement of a peripancreatic drain after a distal pancreatectomy.

Background: A peripancreatic drain that is placed after a distal pancreatectomy sometimes migrates and becomes ineffective postoperatively. We devised a new drainage method with fixation of the tip of a peripancreatic drain using a loose loop of an absorbable suture.

Methods: This retrospective study was performed on 84 consecutive patients who underwent a distal pancreatectomy followed by peripancreatic drainage with (n = 31) or without (n = 53) fixation.

Cholecystectomy by a combined transgastric and transparietal approach using two flexible endoscopes.

Objective: This experimental study was designed to assess the technical feasibility and benefits of our novel approach for transgastric NOTES (natural orifice translumenal endoscopic surgery) cholecystectomy.

Methods: Four pigs were subjected to NOTES cholecystectomy by the combined transgastric and transparietal approach using two flexible endoscopes. Under the guidance of a transparietal endoscope inserted through a trocar placed in the right upper abdomen, a gastrotomy was constructed, and a peroral endoscope was advanced into the peritoneal cavity through the gastrotomy and moved on retroflexion toward the gallbladder.

Intraoperative radiotherapy for oncological and function-preserving surgery in patients with advanced lower rectal cancer.

Background: Pelvic autonomic nerve preservation (PANP) with lateral lymph node dissection (LLND) has been introduced in rectal cancer surgery in Japan; however, its indication has not been standardized yet.

Materials And Methods: Forty-four patients with advanced lower rectal cancer were randomized to either the standard treatment group (control group) or the intraoperative radiotherapy (IORT) group. All patients underwent potentially curative resection of the rectum with total mesorectal excision.