Oncological Impact of the Level of Inferior Mesenteric Artery Ligation in Low Rectal Cancer Surgery.

Background/aim: This study aimed to evaluate the clinical impact of the level of inferior mesenteric artery (IMA) ligation in patients with advanced low rectal cancer.

Patients And Methods: All enrolled patients (n=350) underwent curative resection of rectal cancer with D3 lymph node dissection, with either IMA (high-tie) or superior rectal artery (SRA) (low-tie) ligation.

Results: There were 27 and 65 patients in the high-tie and low-tie groups, respectively.

Surgical outcomes of totally extraperitoneal repair for inguinal hernia: A retrospective multicenter propensity score-matched study.

Background: Laparoscopic surgical approaches, including total extraperitoneal repair (TEP), have been widely accepted for inguinal hernia repair in Japan. However, there are limited data regarding recurrence after TEP in Japan, given the limited versatility of this procedure. This study retrospectively evaluated the rates of hernia recurrence after TEP and open mesh repair at multiple Japanese centers.

A phase I/II study of S-1 and irinotecan (IRIS) combined with cetuximab in patients with RAS wild-type metastatic colorectal cancer (KSCC1401).

Purpose: This study was designed to assess the tolerability, efficacy, and safety of tri-weekly irinotecan plus S-1 (IRIS) and weekly cetuximab in patients with metastatic colorectal cancer (mCRC).

Methods: The main eligibility criteria were RAS wild-type mCRC with no prior chemotherapy. S-1 was given orally at a dose of 40 mg/m (40-60 mg) twice for 2 weeks, followed by a 1-week rest.

Successful Conversion Surgery Following Chylous Ascites After Nivolumab for Advanced Gastric Cancer.

Case Report: A 75-year-old man who underwent nivolumab as the third-line chemotherapy for advanced gastric cancer had chylous ascites (CA) after the primary tumor shrank remarkably. Total parenteral nutrition and subcutaneous octreotide were initiated, and CA disappeared. Nivolumab was continued for a total of 23 courses.

Mesenteric venous thrombosis as a rare complication of decompression sickness.

Background: Decompression sickness (DCS) induced by extravascular and intravascular gas bubbles during decompression can present with varying manifestations, such as joint pain, numbness, cutaneous symptoms, and cardiopulmonary dysfunction. However, mesenteric venous thrombosis (MVT) is a rare complication of DCS. To the best of our knowledge, only a few cases have been reported, and surgical cases of MVT secondary to DCS have not yet been reported.

A prospective study of XELIRI plus bevacizumab as a first-line therapy in Japanese patients with unresectable or recurrent colorectal cancer (KSCC1101).

Background: This study was designed to evaluate the efficacy and toxicity of XELIRI plus bevacizumab for the treatment of Japanese patients with unresectable or recurrent colorectal cancer (CRC).

Methods: This was a multicenter, single-arm, open-label prospective study. The major inclusion criteria were previously untreated unresectable or recurrent CRC, presence of measurable lesions, ≥20 years of age, Eastern Cooperative Oncology Group performance status 0 or 1, and adequate organ function.

Initial Japanese experience with the LAP-BAND system.

Introduction: Laparoscopic bariatric surgery has gradually spread in Japan since it was introduced in 2000. In 2005, we introduced laparoscopic adjustable gastric banding (LAGB) with the LAP-BAND system into Japan. Here, we evaluate our intermediate-term results with the LAP-BAND system.

Operative timing of laparoscopic cholecystectomy for acute cholecystitis in a Japanese institute.

Background And Objectives: In patients with acute cholecystitis who cannot undergo early laparoscopic cholecystectomy (within 72 hours), 6 weeks to 12 weeks after onset is widely considered the optimal timing for delayed laparoscopic cholecystectomy. However, there has been no clear consensus about it. We aimed to determine optimal timing for delayed laparoscopic cholecystectomy for acute cholecystitis.

Implications of portal vein thrombosis after splenectomy for patients with idiopathic portal hypertension.

Purpose: Idiopathic portal hypertension (IPH) is considered to be closely related to portal vein thrombosis (PVT). The aim of this study was to clarify the incidence, clinical characteristics, and outcomes of PVT in patients with IPH after splenectomy.

Methods: We investigated the rates, clinical characteristics, and outcomes of PVT in 18 patients who underwent splenectomy for IPH, during a mean follow-up period of 152 ± 83 months.

Long-term surviving patient with inferior vena cava tumor thrombus and extrahepatic metastasis after spontaneous ruptured hepatocellular carcinoma.

We present a case of long-term survival in a patient with inferior vena cava tumor thrombus (IVCTT) and extrahepatic metastasis after resection for spontaneous ruptured hepatocellular carcinoma (HCC). The patient was a 73-year-old Japanese man previously diagnosed with chronic hepatitis B. He was referred to our emergency room and diagnosed with spontaneous ruptured HCC.

[Current status of laparoscopic bariatric surgery].

During recent years, obesity has emerged as a major public health problem in the world. It is generally agreed that non-surgical therapies do not solve the problem of morbid obesity (BMI > or =35 kg/m). Therefore, bariatric surgery has been frequently performed for treatments of morbid obesity in American and European countries.

A comparative study of the long-term outcomes after laparoscopy-assisted and open left lateral hepatectomy for hepatocellular carcinoma.

Background: Laparoscopic hepatectomy was initially reported in 1992. However, the reported experiences are scarce, and this operation has not been a standard procedure until now. The aims of this study were to assess our results of laparoscopy-assisted left lateral hepatectomy for hepatocellular carcinoma (HCC) and to compare them with those of open conventional procedures.

Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery.

Background/aims: Obstructive jaundice is common symptom of carcinoma of the ampulla of Vater. In the present study we evaluated association between preoperative jaundice and prognosis and possible indication of the minimal surgery.

Methodology: Clinicopathological features of 50 patients who underwent curative resection were examined retrospectively and statistically analyzed.

Increased levels of both carbohydrate antigen 19-9 and duke pancreatic monoclonal antigen type 2 reflect postoperative prognosis in patients with pancreatic carcinoma.

Objectives: It is important to identify useful tumor markers for the prediction of postoperative outcomes in patients with pancreatic carcinoma (PC).

Methods: A retrospective study was performed in 87 patients who underwent surgical resection for PC. Preoperative levels of tumor markers such as carbohydrate antigen 19-9 (CA19-9) and duke pancreatic monoclonal antigen type 2 (DUPAN-2) were estimated and analyzed in relation to disease-specific survival (DSS).

Increased heat-shock protein 90 expression contributes to impaired adaptive cytoprotection in the gastric mucosa of portal hypertensive rats.

Background And Aims: Portal hypertensive (PHT) gastropathy results in an increased susceptibility to damage. Adaptive cytoprotection against ethanol-induced damage is impaired in the gastric mucosa of rats with portal hypertension. Excessive nitric oxide (NO) production occurs in portal hypertension and is mediated in part via heat-shock protein (Hsp)90 production.

Lymphatic invasion: an important prognostic factor for stages T1b-T3 gallbladder cancer and an indication for additional radical resection of incidental gallbladder cancer.

Background: Laparoscopic cholecystectomy is being performed with increasing frequency worldwide. This has led to more frequent discovery of incidental gallbladder cancer (IGBC) and in turn to the need for an independent prognostic factor for stages T1b-T3 gallbladder cancer so that is can be determined clinically which cases of IGBC are indicated for additional radical resection (ARR).

Methods: A retrospective study was conducted that included 72 patients who underwent macroscopically curative surgical resection (R0, R1) at our center for stages T1b-T3 GBC.

[Endoscopic and laparoscopic treatments for morbid obesity--endoscopic intragastric balloon placement and laparoscopic adjustable gastric banding].

We have introduced intragastric balloon placement (IGB) and laparoscopic adjustable gastric banding (LAGB) into Japan since 2004. We performed IGB in 23 morbidly obese patients with 40 +/- 9 kg/m2 (BMI). When the balloon were removed after 5 months, the averaged weight loss and percent excess weight loss (%EWL) were 12 kg and 27%, respectively.

Pylorus-preserving pancreaticoduodenectomy in patients undergoing chronic hemodialysis.

This report describes three patients who underwent a pylorus-preserving pancreaticoduodenectomy (PpPD) and received maintenance hemodialysis due to chronic renal failure. The three cases were diagnosed to have bile duct cancer, intraductal papillary mucinous neoplasm, and carcinoma of the ampulla of Vater, respectively. They underwent chronic hemodialysis for 7.

Splenectomy for hypersplenism caused by adult T-cell leukemia: report of a case.

A 45-year-old woman with previously diagnosed chronic type adult T-cell leukemia (ATL) presented with abdominal discomfort and red eruptions on her arms and legs. Anemia, thrombocytopenia, hypercalcemia, and splenomegaly indicated progression to acute-type ATL. Combined chemotherapy resulted in normalization of the serum calcium level and improvement in her symptoms.

Direct invasion to the colon by hepatocellular carcinoma: report of two cases.

Although hepatocellular carcinoma (HCC) is a common tumor, direct invasion of the gastrointestinal tract by HCC is uncommon. Recently, we encountered two cases of HCC with direct invasion to the colon. The first patient was a 79-year-old man who underwent transarterial chemo-embolization (TACE) for HCC 1.

Initial Japanese experience with intragastric balloon placement.

Background: We introduced intragastric balloon placement in Japan and evaluated the initial data.

Methods: Between December 2004 and March 2008, intragastric balloons [BioEnterics Intragastric Balloon (BIB) system] were placed in 21 Japanese patients with obesity [six women, 15 men; mean age 40+/-9 years; mean body mass index (BMI) 40+/-9 kg/m2]. The inclusion criteria were morbid obesity (BMI>or=35 kg/m2), the presence of obesity-related disorders, and failure with conventional treatments for at least 6 months.

Additional effect of visceral fat resection in an obese rat model of gastric banding.

Background: There is accumulating agreement that bariatric surgery is currently the most efficacious and enduring treatment for clinically severe obesity, and as a result, the number of bariatric surgeries performed worldwide has increased in recent years. Although the function of visceral fat has gradually become clear, the effect of visceral fat resection is still unknown. The aim of this study was to clarify the additional effect of visceral fat resection in an obese rat model of gastric banding.

Metastasis of hepatocellular carcinoma to spleen and small intestine.

Metastasis of cancer to the spleen or small intestine is rare. We encountered a case of hepatocellular carcinoma (HCC) with splenic and jejunal metastases. A 60-year-old man was referred to us in February 2005 with a diagnosis of splenic tumor.

Short- and long-term outcomes after hepatic resection for hepatocellular carcinoma with concomitant esophageal varices in patients with cirrhosis.

Background: Hepatic resection for hepatocellular carcinoma (HCC) in cirrhotic patients with esophageal varices (EV) is often avoided because of poor liver function reserve. Outcomes of resection in such cases have not been fully investigated.

Methods: We conducted a retrospective study of 134 cirrhotic patients (Child-Pugh class A or B) who underwent hepatic resection for HCC, comparing short- and long-term outcomes in patients with EV (n = 31) to those in patients without EV (n = 103).