Publications by authors named "Taro Munechika"
Article Synopsis
- - Colonic varices, often linked to portal hypertension, are rare, and the presence of an arteriovenous fistula (AVF) in the inferior mesenteric artery (IMA) is even more uncommon, presenting unique diagnosis and treatment challenges.
- - A 48-year-old man with a positive fecal occult blood test was found to have varices and suspected AVF in the IMA region; due to the risks of other interventions, a laparoscopic sigmoidectomy was performed successfully.
- - This case highlights the need for surgical intervention in managing AVF and colonic varices in the IMA, especially when other treatments are risky and less effective, demonstrating a positive postoperative outcome through proper surgical techniques.
Background Accurate lymph node evaluation is essential for staging colon cancer and guiding postoperative treatment decisions. In this study, we compared the efficacy of a simple enzymatic fat dissolution method with the conventional method for lymph node sampling from specimens after colon cancer surgery. Methods We enrolled 58 patients who underwent elective laparoscopic surgery for colon adenocarcinoma between May 2018 and May 2021 at Fukuoka University Hospital in Fukuoka, Japan.
View Article and Find Full Text PDFThe AirSeal system (CONMED, NY, USA) can outstandingly keep pneumoperitoneum stable. However, water droplets form on the access port, impairing the performance of comfortable surgical procedures because of the resultant wet surgical field. This study was performed to clarify the mechanism of water droplet formation and to prevent it.
View Article and Find Full Text PDFPurpose: Elderly people are thought to be more likely than their non-elderly counterparts to experience a decline in activities of daily living (ADL) and quality of life (QOL) due to the onset and treatment of disease. In this study, we investigated whether there was an age-related difference in changes in health-related QOL indices after surgical resection of colorectal cancer (CRC).
Methods: Patients who underwent elective surgery for primary CRC at our hospital between September 2017 and November 2021 were enrolled.
The transanal/perineal (ta/tp) endoscopic approach has been widely used for anorectal surgery in recent years, but carbon dioxide embolism is a possible lethal complication. The frequency of this complication in this approach is not known. In this study, we investigated the frequency of intraoperative (including occult) carbon dioxide embolism using transesophageal echocardiography.
View Article and Find Full Text PDFArticle Synopsis
- - The study analyzed data from 2533 rectal cancer patients who underwent either abdominoperineal resection (APR) or sphincter-saving surgery (SSS) to determine the impact of surgical type on patient outcomes in Japan.
- - While univariate analysis indicated worse oncological outcomes for APR compared to SSS, multivariate analysis revealed no significant differences in overall survival (OS) or relapse-free survival (RFS) between the two procedures.
- - The study concluded that while APR did have a higher risk of positive pathological radial margin (pRM), both surgical methods yielded similar oncological outcomes, highlighting the importance of achieving negative pRM in APR to enhance patient prognosis.
Article Synopsis
- This study investigates the potential of using circulating tumor DNA (ctDNA) from colorectal cancer patients to predict tumor recurrence, focusing on mutations in the KRAS gene.
- It involved analyzing blood samples from 84 patients with specific KRAS mutations, although no direct link was found between KRAS mutation levels and tumor recurrence.
- The findings indicate correlations between tumor characteristics (like size and stage) and preoperative KRAS mutation levels, but suggest that ctDNA detection for predicting recurrence isn't reliable post-surgery.
Article Synopsis
- * Of the 362 patients studied, 11 had the BRAF V600E mutation, and though tumor size was linked to mutant allele frequency (MAF), no direct correlation was found between MAF and recurrence.
- * The research indicates that while MAF increases over time in some patients, using it for early recurrence prediction in colorectal cancer post-surgery remains challenging.
Article Synopsis
- The transanal and transperineal endoscopic approaches are advanced surgical techniques for removing rectal and anorectal cancers, but they have risks, including CO2 embolisms which can be life-threatening.
- During a surgery involving these methods, a CO2 embolism was detected due to a sudden drop in end-tidal CO2 and arterial oxygen saturation, confirmed by transesophageal echocardiography.
- The surgical team promptly reversed the pneumopelvis and pneumoperitoneum, resolving the cardiopulmonary issues, and the surgery was successfully completed with the patient later discharged without serious complications aside from the embolism.
Background: In abdominoperineal resection (APR) in male patients with rectal cancer, high margin involvement and urethral injury have been reported to result from difficulty in dissecting the anterior anorectum. Recently, the efficacy of an endoscopic down-to-up rectal dissection was reported. Here, we present a safe and simple technique for anterior dissection using a simultaneous laparoscopic and transperineal endoscopic approach.
View Article and Find Full Text PDFBackground: Complete mesocolic excision with central vascular ligation is a standard advanced technique for achieving favorable long-term oncological outcomes in colon cancer surgery. Clinical evidence abounds demonstrating the safety of high ligation of the inferior mesenteric artery (IMA) for sigmoid colon cancer but is scarce for descending colon cancer. A major concern is the blood supply to the remnant distal sigmoid colon, especially for cases with a long sigmoid colon.
View Article and Find Full Text PDFPurpose: The incidence and time of onset of acute chemotherapy-induced peripheral neuropathy (ACIPN) caused by oxaliplatin remain unclarified. Hence, we investigated the prevalence, onset time, and location of ACIPN symptoms in patients with colorectal cancer (CRC) receiving oxaliplatin without cold stimulation.
Methods: The study cohort comprised patients receiving oxaliplatin for CRC at our hospital between April 2017 and August 2018.
Article Synopsis
- Capecitabine is converted to the anticancer drug 5-fluorouracil (5-FU) in tumors by an enzyme called thymidine phosphorylase (TP), and the study looked at how adding a TP inhibitor (5-nitrouracil or 5-NU) affects plasma 5-FU levels.
- After giving capecitabine, blood samples were tested for 5-FU concentrations at different times and conditions, revealing that samples stored at room temperature had significantly higher 5-FU levels compared to those stored at 4°C.
- The presence of 5-NU decreased 5-FU concentrations, with the most significant differences observed at room temperature, suggesting that both storage
Numbness and pain are currently evaluated using subjective methods such as the visual analogue scale (VAS). PainVision (PV) is an analytical instrument that was designed to quantitatively assess sense perception and nociception in patients. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most important adverse events that renders prolonged chemotherapy difficult.
View Article and Find Full Text PDFTransanal total mesorectal excision (taTME) has been developed to overcome the difficulty of laparoscopic dissection and transection in the deep pelvis. TaTME has several clinical benefits over laparoscopic surgery, such as better exposure of the distal rectum and direct determination of distal resection margin. Although evidence demonstrating the true benefits of taTME over laparoscopic TME (LapTME) is still insufficient, accumulating data have revealed that, as compared with LapTME, taTME is associated with shorter operative time and a lower conversion rate without jeopardizing other short-term outcomes.
View Article and Find Full Text PDFArticle Synopsis
- TAS-102 significantly improves overall survival (OS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC), but is often linked to grade ≥3 neutropenia, a common side effect affecting treatment continuity.
- A study of 41 patients revealed that biweekly administration of TAS-102 reduces the incidence of neutropenia compared to standard dosing, while still maintaining comparable OS and enhancing PFS.
- Overall, the study indicates that the method of drug administration, nutritional status (measured by Onodera's index), and use of other medications can influence the efficacy and side effects of TAS-102 treatment in mCRC patients.
A 69-year-old man, who had undergone distal gastrectomy for duodenal ulcer, was diagnosed with remnant gastric cancer and jejunal mesenteric lymph node metastasis. To improve curability, we planned 2 courses of S-1 and cisplatin therapy. After chemotherapy, primary lesion and lymph node metastases reduced in size drastically.
View Article and Find Full Text PDFWe report a case of locally far-advanced colon cancer resected by laparoscopic surgery after colonic stent insertion and neoadjuvant chemotherapy. A 71-year-old man with obstructive symptoms was admitted to our hospital in July 2015. CT revealed a sigmoid colon tumor infiltrating the retroperitoneum and small intestine.
View Article and Find Full Text PDF[A Case of Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy].
Gan To Kagaku Ryoho
November 2015
A 60s male was admitted to our hospital because of appetite loss and nausea. After examination, he was diagnosed with type 3 advanced gastric cancer in the antrum. Abdominal computed tomography showed gastric cancer invasion to the left liver lobe.
View Article and Find Full Text PDF[New FP Therapy Was Effective for a Case of Massive Hepatocellular Carcinoma].
Gan To Kagaku Ryoho
November 2015
A 62 year-old woman was hospitalized with the diagnosis of pneumonia, and a huge mass was recognized in the right lobe of the liver during a CT scan. AFP and PIVKA-Ⅱ were elevated to 101.05 ng/mL and 2,177 mAU/mL.
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