Publications by authors named "Ishiyama Y"

Introduction: Clozapine is an atypical antipsychotic drug approved for treatment-resistant schizophrenia (TRS). Despite its high efficacy for TRS, clozapine is associated with several serious adverse effects, such as neutropenia and diabetes, so it requires vigilant monitoring. Severe anemia has also been documented as a rare but serious complication with an unclear mechanism.

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Purpose: To assess the efficacy and safety of PreserFlo MicroShunt (PMS) combined with mitomycin C in patients with medically treated primary open-angle glaucoma (POAG).

Study Design: A retrospective observational study.

Methods: The study examined 83 eyes from 83 patients with medically treated glaucoma surgery naive POAG.

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Introduction: The management of urinary tract stones, particularly kidney allograft stones, presents unique challenges for kidney transplant recipients because of their prevalence and specific clinical considerations. Here, we describe a case in which percutaneous nephrolithotomy was successfully used to fragment a large kidney allograft stone ≥20 mm in size.

Case Presentation: A 57-year-old woman who underwent ureteroureterostomy post simultaneous pancreas-kidney transplantation presented with gross hematuria after 15 years.

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Background: The Senhance digital laparoscopic system (Senhance) is a surgical robot approved for use in Japan after the da Vinci system. Our institution was the first to introduce this system, which has been used primarily for gastrointestinal surgery. Featuring tactile feedback, eye-movement-controlled camera operation, stereoscopic vision, and magnification, the short-term postoperative outcomes of the Senhance in abdominal surgery have been documented.

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Article Synopsis
  • This study investigated the use of amylase levels in drainage fluid (DFA) to detect anastomotic leakage (AL) early and non-invasively in patients undergoing low anterior resection (LAR) for rectal cancer.
  • The study analyzed drainage fluid samples from 120 patients post-surgery, finding that DFA levels were significantly higher in those with AL, particularly on postoperative days 3 and 5.
  • The results indicated that DFA levels on day 5 offered excellent diagnostic accuracy for detecting AL, with high sensitivity and specificity, suggesting that this method could be a simple and cost-effective way to detect complications early in these patients.
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  • Primary thyroid lymphoma, a rare cancer primarily consisting of large B-cell lymphomas (LBCLs), has a favorable prognosis and its underlying reasons are being studied.
  • Analysis of 21 cases revealed that most patients (71%) had limited-stage disease and a 5-year overall survival rate of 83%, with no central nervous system recurrences observed.
  • Factors linked to better clinical outcomes included a higher percentage of germinal center B-cell (GCB) phenotypes and an absence of MYD88 mutations among the cases.
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Purpose: To clarify specific factors associated with surgical outcomes in robot-assisted partial nephrectomy (RAPN) that require extended warm ischemia time (WIT), which may have a negative impact, but cannot always be avoided.

Methods: We included 1,182 patients who had RAPN performed between January 2016 and December 2022 from a prospectively generated multi-institutional RAPN database, divided into normal WIT (nWIT) (≤ 20 min; 843 patients) and extended WIT (eWIT) (> 20 min; 339 patients) groups. Primary outcome measures were WIT and the Surface-Intermediate-Base (SIB) margin score, which contribute to postoperative trifecta achievement.

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Background: Severe obesity greatly influences the difficulty of colorectal cancer surgery and has been reported to prolong operative time, increase the rate of laparotomy, and elevate increase postoperative complications. We investigated the efficacy of laparoscopic sleeve gastrectomy (LSG) for preoperative weight loss to ensure safe colorectal cancer surgery.

Case Presentation: A 51 year-old female with a body mass index of 43.

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  • Short bowel syndrome (SBS) is a serious condition that can be life-threatening, often requiring surgery and leading to significant complications, with this study reviewing 27 patients treated from 2018 to 2022.
  • Most patients were older adults, and common causes of SBS included superior mesenteric artery stenosis and nonocclusive mesenteric ischemia; on average, patients had a short remaining bowel length and long hospital stays.
  • The study found that over half of the patients died within 209 days, with a correlation between higher rates of jejunostomy and prolonged parenteral nutrition (PN) impacting survival rates significantly.
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  • The study compared the effectiveness and safety of new anemia treatments (HIF-PHis) in chronic kidney disease (CKD) patients who have received kidney transplants (KTRs) versus those who have not (non-KTRs).
  • Researchers analyzed data from 82 patients before and after starting treatment with roxadustat or daprodustat, focusing on hemoglobin (Hb) levels and adverse events.
  • Findings showed both groups had significant increases in Hb levels, but KTRs had a higher rate of thrombotic events, indicating that while the treatments are similarly effective, KTRs require careful monitoring for blood clot risks.
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Background: Most adult cases of intussusception are caused by colorectal cancer, and emergency surgery is performed when symptoms such as abdominal pain and vomiting are present. The patient must customarily undergo both bowel decompression and radical surgery for colorectal cancer at the same time, and laparotomy is generally the procedure of choice.

Case Presentation: An 86-year-old woman presented to our hospital with diarrhea and bloody stools.

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Background/aim: There is limited evidence regarding the systemic treatment of retroperitoneal soft-tissue sarcoma, and the current Japanese guidelines fail to make definitive suggestions. Here, we report our experience with combination chemotherapy of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) in this population.

Patients And Methods: We retrospectively reviewed the records of eight patients (three male and five female) who received MAID for pathologically diagnosed metastatic unresectable retroperitoneal sarcoma (either leiomyosarcoma or pleomorphic sarcoma) between October 2019 and January 2022.

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Background: According to several clinical trials for patients with rectal cancer, laparoscopic surgery significantly reduces intraoperative complications and bleeding compared with laparotomy and demonstrated comparable long-term results. However, obesity is considered one of the risk factors for increased surgical difficulty, including complication rate, prolonged operation time, and bleeding.

Methods: Patients with clinical pathological stage II/III rectal cancer and a body mass index of ≥25 kg/m who underwent laparotomy or laparoscopic surgery between January 2009 and December 2013 at 51 institutions participating in the Japan Society of Laparoscopic Colorectal Surgery were included.

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With emerging options in immediate postoperative settings for high-risk renal cell carcinoma (hrRCC), further risk stratification may be relevant for informed decision making. Balancing the benefits and drawbacks of adjuvant immunotherapy is recommended. We aimed to evaluate the effects of the lung immune prognostic index (LIPI) in this setting.

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Background: Considering the reported greater benefits of immunotherapy and its unignorable adverse events in adjuvant therapy for high-risk renal cell carcinoma (hrRCC), accurate prediction may optimize drug use.

Methods: The primary objective of this study was to generate a score-based prognostic model of recurrence-free survival in hrRCC. The study retrospectively evaluated 456 patients at two institutions who underwent radical surgery for nonmetastatic pT3-4 and/or N1-2 or pT2 and G4 disease.

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A 65-year-old man presented to our hospital with complaints of diarrhea. Computed tomography showed a fistula with the small intestine, and a single incision laparoscopic low anterior resection for rectum with D3 dissection and partial resection of the small intestine were performed. Lymph node dissection, including a part of the inflow vessel area, was also performed because lymph node swelling was observed in the mesentery of the small intestine around the fistula.

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Hypertension is a risk factor for cardiovascular disease (CVD). However, the association between blood pressure (BP) and CVD events has been based on mean BP alone. BP variability (BPV) is associated with increased organ damage and CVD events independently or beyond average home BP.

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