Publications by authors named "Shigeo Tokumaru"

Introduction: Ovarian metastasis of colorectal cancer is known to have a poor prognosis. This study aimed to elucidate the characteristics of patients who underwent oophorectomy for ovarian metastasis from colorectal cancer.

Methods: This retrospective study included 16 patients who underwent oophorectomy for colorectal cancer metastasis to the ovary from January 2004 to December 2017.

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Background: Advanced esophageal cancer is occasionally accompanied by difficulty swallowing owing to esophageal stenosis or tracheoesophageal fistula formation. Esophageal bypass surgery and stent insertion are considered feasible palliative management options. The aim of this study was to evaluate the short-term outcomes of these palliative treatments.

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Article Synopsis
  • A patient with an adenoma in the horizontal duodenum was successfully treated using a transmesenteric laparoscopic endoscopic cooperative surgery (LECS) approach.
  • This method involved cutting into the colon's mesentery, allowing better laparoscopic access while keeping other parts of the duodenum stable and fixed.
  • Benefits of the LECS approach include improved visibility during surgery, reduced risk of damaging major blood vessels, and minimized intestinal incision damage.
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The Kirsten rat sarcoma (KRAS) oncogene was "undruggable" until sotorasib, a KRAS selective inhibitor, was developed with promising efficacy. However, inhibition of mutant KRAS in colorectal cancer cells (CRC) is ineffective due to feedback activation of MEK/ERK downstream of KRAS. In this study, we screened for combination therapies of simultaneous inhibition to overcome sotorasib resistance using our previously developed Mix Culture Assay.

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Introduction And Importance: Appendiceal goblet cell adenocarcinoma is in 0.3-0.9 % of appendectomy specimens.

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Background: Non-obstructive intestinal ischemia (NOMI) is caused by intestinal vascular spasm and has a poor prognosis if not diagnosed and treated early. Indocyanine green (ICG) fluorescence imaging has been reported to be useful for the intraoperative assessment of the extent of intestinal resection required for NOMI. Few reports have described massive intestinal bleeding after conservative management of NOMI.

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  • Germline pathogenic variants in the CDH1 gene are responsible for hereditary diffuse gastric cancer (HDGC), a rare condition that contributes to a small percentage of gastric cancer cases, particularly noted to be uncommon in Japan.
  • The study follows a Japanese family with HDGC, where one member had advanced gastric cancer linked to a specific CDH1 variant, and genetic testing identified three at-risk relatives with the same mutation.
  • The findings emphasize the importance of genetic screening for HDGC, advocating for a multidisciplinary approach in managing patients and their families to enhance early detection and treatment strategies.
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Background: RAS homolog family member A (RhoA), a member of the Rho family of small GTPases, and Vav1, a guanine nucleotide exchange factor for Rho family GTPases, have been reported to activate pathways related to the actin cytoskeleton and regulation of cell shape, attachment, and motility. The interaction between these molecules in lymphoma is involved in malignant signaling, but its function in epithelial malignancy is unknown. Here, we investigated the malignant signal of mutant RhoA in gastric cancer and demonstrated the potential of RhoA G17E/Vav1 as a therapeutic target for diffuse gastric cancer.

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Gastric glomus tumors are rare submucosal mesenchymal neoplasms that are difficult to diagnose preoperatively. We present a case of a 60-year-old woman who was diagnosed with a gastric glomus tumor using endoscopic ultrasonography-guided fine-needle aspiration biopsy. The tumor was successfully resected with laparoscopic endoscopic cooperative surgery (LECS).

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CD8αα+ intestinal intraepithelial lymphocytes (iIELs) are known for their unique role in keeping the integrity of the intestinal epithelial barrier, but factors affecting the development of these cells have not been thoroughly understood. Here, we found that the transcriptional regulator interferon regulatory factor-2 (IRF-2) plays a cell-intrinsic, indispensable role in establishing iIEL populations. CD8αα+, but not CD8αβ+, iIELs bearing TCRαβ or TCRγδ were severely reduced in numbers in mice lacking this factor (Irf2-/- mice).

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To prevent chylothorax after esophageal cancer surgery, it is important to recognize morphological patterns of the thoracic duct intraoperatively. The present study aimed to evaluate the safety and usefulness of near-infrared (NIR) fluorescence imaging with subcutaneous inguinal injection of indocyanine green (SII-ICG) to detect the thoracic duct during thoracoscopic esophagectomy for esophageal cancer. Patients (n = 16) who underwent thoracoscopic esophagectomy in the prone position with SII-ICG at Shinshu University Hospital between June 2020 and January 2022 were enrolled in the present study and retrospectively reviewed.

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Article Synopsis
  • Extrapulmonary neuroendocrine carcinoma (EPNEC) is a rare type of cancer distinct from lung neuroendocrine carcinoma, with a focus on clinical features, treatment options, and patient prognosis based on a review of 31 cases at a single hospital from 2013 to 2021. !* -
  • The study included 31 patients, primarily male (21 men, 10 women) with a median age of 65, and identified various primary tumor sites, such as the stomach and rectum, with many patients having locally advanced disease or distant metastases. !* -
  • The response to initial chemotherapy was around 56.5%, and the median overall survival for patients was
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Background: Laparoscopic colorectal surgery (LCRS) requires a small laparotomy at the umbilicus. The wound is small and inconspicuous, but if the patient develops an umbilical incisional hernia (UIH), the wound is visible and the patient suffers from symptoms of discomfort. However, the incidence of UIH after LCRS and its risk factors are not well understood.

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Aim: Whether seasonal and meteorological factors affect the incidence of adhesive small bowel obstruction (ASBO) remains unclear. This study aimed to clarify the impacts of seasonal and meteorological factors on the occurrence of ASBO.

Methods: Clinical data of patients with ASBO were acquired from 42 national university hospitals in Japan, using a national inpatient database, between April 2012 and March 2020.

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Introduction: The influence of air temperature on adhesive small bowel obstruction (ASBO) is unknown. This study aimed to investigate the relationship between air temperature and postoperative ASBO.

Methods: Overall, 312 patients with postoperative ASBO were included.

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Article Synopsis
  • The study aims to compare the effectiveness and safety of laparoscopic versus open surgery for adhesive small bowel obstruction (ASBO) based on data from 42 Japanese university hospitals.
  • The analysis involved matching 96 patients who underwent laparoscopic surgery with 96 who had open surgery, evaluating outcomes like morbidity, mortality, hospital stay length, and recurrence rates.
  • Results showed that while there were no significant differences in overall complications between the two methods, laparoscopic surgery resulted in a shorter hospital stay (10 days vs. 13 days) and allowed for earlier discharge than open surgery.
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  • Acute mesenteric ischemia, a serious complication after cardiovascular surgery, has a very high mortality rate, but its predictors post-treatment are not well studied.
  • This research analyzed 29 patients who had laparotomy for this condition after cardiovascular procedures, classifying them into survivor and nonsurvivor groups to identify clinical outcome predictors.
  • Findings indicated that higher serum creatinine levels before surgery were significantly associated with in-hospital mortality, suggesting that this lab value could be an important predictor for patient outcomes.
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Background: Tension-free repair using mesh has become the standard treatment for abdominal wall incisional hernias. However, its postoperative complications reportedly include mesh infection, adhesions, and fistula formation in other organs. Here, we report an extremely rare case of mesh migration into the neobladder and ileum with entero-neobladder and neobladder-cutaneous fistulas.

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Radical surgical procedures for malignant diseases of the pelvis result in a large pelvic defect that requires soft tissue reconstruction. The mesentery can be used for pelvic floor reconstruction when debridement with intestinal resection is required. A 75-year-old woman was diagnosed with sacral necrosis, infection and sepsis after carbon ion radiotherapy for sacral chordoma.

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Background: Neurofibromatosis type 1 is an autosomal dominant inherited disease associated with multiple skin neurofibromas or other neurogenic tumors, such as nodular plexiform neurinoma or cerebrospinal tumor. Gastrointestinal stromal tumors are often complicated in patients with neurofibromatosis type 1, although involvement of the appendix is rare, and there have been few reports of appendiceal ganglioneuroma.

Case Presentation: The patient was a 29-year-old man diagnosed with neurofibromatosis type 1 based on physical findings and his family history.

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Background: Adhesive small bowel obstruction (ASBO) is one of the major causes of postoperative morbidity. Non-surgical management is generally applied to non-strangulated ASBO. Several factors have been reported to affect the response to non-surgical management in patients with ASBO.

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Introduction: Patients with unresectable or recurrent gastric cancer who have an objective response (OR) to nivolumab monotherapy are expected to have a good long-term prognosis. However, the OR rate for nivolumab treatment is low at 11%, and there is a need for biomarkers to predict the treatment response. This study aimed to analyze the significance of systemic inflammation-related variables and clinicopathologic characteristics as predictive markers of response to nivolumab monotherapy in patients with advanced gastric cancer.

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Colorectal cancer with a Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) gene mutation is considered to be resistant to anti-EGFR agents. G12D is the most common KRAS mutation in colorectal cancer, followed by G12V and G13D. According to clinical and basic research data, patients with colorectal cancer exhibiting G12D and G12V KRAS mutations are resistant to anti-EGFR agents; however, this is not true of G13D and other minor mutations, which are still not well understood.

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KRAS‑mutant colorectal cancer (CRC) is a highly malignant cancer with a poor prognosis, however specific therapies targeting KRAS mutations do not yet exist. Anti‑epidermal growth factor receptor (EGFR) agents, including cetuximab and panitumumab, are effective for the treatment of certain patients with CRC. However, these anti‑EGFR treatments have no effect on KRAS‑mutant CRC.

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