Publications by authors named "Ken Yonemitsu"

Background/aim: Reduction in skeletal muscle mass during chemotherapy is associated with poor outcomes. This study investigated the impact of changes in the psoas muscle index (PMI) on the prognosis of patients with unresectable colorectal liver metastases (CRLM) undergoing chemotherapy, including subgroup analyses based on the initial treatment response assessment.

Patients And Methods: We evaluated 47 patients with unresectable CRLM who underwent systematic chemotherapy and assessed changes in PMI to determine their prognosis.

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Background: Rectal gastrointestinal stromal tumors (GISTs) complicate surgical approaches because of their anatomical position. We herein report a patient with rectal GIST on the anterior wall of the lower rectum, hat was successfully resected using a transperineal approach.

Case Presentation: This report describes a unique case of a 73-year-old man who was diagnosed with rectal GIST on the anterior wall of the lower rectum.

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Background/aim: In colorectal cancer surgery, the risk of surgical site infection (SSI) is relatively high. The development of SSI is related to longer and costlier hospitalization and reduced quality of life; therefore, perioperative prevention of SSI is important. Chemical bowel preparation (CBP) combined with mechanical bowel preparation (MBP) may be more effective in preventing surgical site infection (SSI) compared to MBP alone.

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Complete mesocolic excision (CME) with central vascular ligation (CVL) in laparoscopic surgery for right-sided colon cancer (RSCC) requires a precise understanding of the vascular anatomy. The efficacy of intraoperative ultrasound (IUS) in the identification of blood vessels for RSCC surgery was not evaluated. The aim of this study was to compare the intraoperative and short-term outcomes of CME with CVL with or without IUS by laparoscopic surgery for RSCC.

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Since April 2018, robot-assisted rectal resection has been approved as an insurance medical treatment, and robot- assisted rectal resection is rapidly becoming widespread. Even in robot-assisted laparoscopic surgery, mesorectal division is difficult in a narrow pelvic cavity. At the beginning of the operation, Vessel Sealer ExtendTM(price 89,250 yen)was used, but as the procedure became stable, the mesorectal division was started with bipolar forceps and monopolar scissors.

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Article Synopsis
  • A 35-year-old woman with advanced sigmoid cancer underwent laparoscopic surgery and received adjuvant chemotherapy, but a follow-up CT scan showed new intraabdominal nodules a year later.
  • After a second round of treatment with IRIS and bevacizumab, the nodules shrank in size.
  • The patient then had successful robotic-assisted laparoscopic surgery to remove the nodules and has since been doing well without any recurrence for 6 months post-operation.
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Background: This study investigated the impact and short-term surgical outcomes of two different main energy devices for robotic gastrectomy for gastric cancer. The outcomes of robotic gastrectomy with ultrasonic shears and those of robotic gastrectomy with conventional forceps were compared.

Methods: We retrospectively evaluated 171 patients who underwent robotic distal gastrectomy or total gastrectomy for gastric cancer.

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Article Synopsis
  • A 76-year-old man diagnosed with locally advanced pancreatic cancer underwent initial treatment with Gemcitabine and nab-paclitaxel, which was stopped due to pneumonia, leading to a switch to S-1 therapy that resulted in stable disease for 22 months.
  • Following stable disease, conversion surgery was planned, during which laparoscopic section of the median arcuate ligament (MAL) was performed to alleviate celiac artery stenosis, resulting in improved blood flow and no complications.
  • A second surgery, subtotal stomach-preserving pancreaticoduodenectomy with portal vein resection, was successfully completed, demonstrating that a two-staged surgical approach after MAL section allows for better evaluation and selection of surgical methods for patients with celiac
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A 70-year-old man previously underwent laparoscopic total gastrectomy for gastric cancer in 2010 and pathological diagnoses were pT4a, pN3, M0, pStage ⅢC. The postoperative adjuvant chemotherapy was interrupted due to nausea, but the patient had no apparent recurrence within 5 years after gastrectomy. In 2019, a swelling appeared from the left inguinal region to the scrotum, and MRI scan showed subcutaneous edematous changes in the same region.

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A 46-year-old man presented with right lower quadrant pain. Enhanced CT revealed a 30 mm sized irregular shaped mass originating from the appendix and invading the abdominal wall. We performed the laparoscopic appendectomy.

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We examined 22 cases who underwent preoperative chemotherapy in our hospital from 2013 April to 2018 December. Seven patients were treated as neoadjuvant chemotherapy(NAC). Out of 15 patients with unresectable diseases before chemotherapy, 6 patients were able to R0 resection after chemotherapy(conversion).

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Article Synopsis
  • Anastomotic leakage is a severe complication that can occur after upper GI surgeries, often requiring prolonged fasting and the use of a nasogastric tube (NGT) for management.
  • Two patients experienced anastomotic leakage after surgical treatment for cancer; both were successfully managed using a technique called percutaneous transesophageal gastro-tubing (PTEG).
  • In the first case, PTEG helped resolve leakage after a total gastrectomy, while in the second case, it effectively managed a mediastinal abscess and ongoing leakage following esophagogastrostomy.
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Case: A 76-year-old man was referred to our hospital for advanced hepatocellular carcinoma(HCC)with chronic hepatitis type B. Although he underwent right anterior sectionectomy and S3 segmentectomy, multiple recurrences were found in the hepatic remnant after 2 months. Transcatheter arterial chemoembolization(TACE)and transcatheter arterial infusion (TAI)were performed separately.

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