Umbilical single incisional approach plus one port for partial transverse colectomy: initial operative experience.

Background/aims: Although single incision laparoscopy surgery (SILS) has recently been applied to various kinds of disease, there are few reports on partial transverse colectomy by SILS. We have been performing SILS plus one port procedure, SILS plus One.

Surgical Procedure: After placing 3cm incision in the umbilical fossa, a SILS portTM was introduced, and a 5-mm port was inserted in the upper left quadrant of the abdomen, and laparoscopic procedure was started.

Radical Resection of a Primarily Unresectable Pancreatic Cancer After Neoadjuvant Chemotherapy Using Gemcitabine, TS-1, and Nafamostat Mesilate; Report of a Case.

A 58-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a hypovascular pancreatic tumor measuring 17 × 11 mm in the uncinate process of the pancreas extending into the superior mesenteric plexus for greater than 180°. With a diagnosis of unresectable pancreatic cancer, the patient received gemcitabine and TS-1 with arterial infusion of nafamostat mesilate.

Effect of NF-κB inhibition on chemoresistance in biliary-pancreatic cancer.

Biliary cancer and pancreatic cancer are considered to be difficult diseases to cure. Although complete resection provides the only means of curing these cancers, the rate of resectability is not high. Therefore, chemotherapy is often selected in patients with advanced unresectable biliary-pancreatic cancer.

A comparison of laparoscopic energy devices on charges in thermal power after application to porcine mesentery.

Introduction: Advances in energy devices have played a major role in the rapid expansion of laparoscopic surgery. However, complications due to these energy devices are occasionally reported, and if the characteristics of these devices are not well understood, serious complications may occur. This study evaluated various typical energy devices and measured temperature rises in the adjacent tissue and in the devices themselves.

Laparoscopic repair for intraoperative injury of the right hepatic artery during cholecystectomy.

Right hepatic artery (RHA) injury is a complication that occurs during laparoscopic cholecystectomy, which can sometimes cause hepatic artery pseudoaneurysm or ischemic hepatic necrosis. Therefore, RHA should be managed carefully. Herein, we report a case of intraoperative RHA injury that was successfully repaired during laparoscopic cholecystectomy.

Additional gastrectomy after endoscopic mucosal resection for early gastric cancer.

The aim of this study was to examine the clinicopathological characteristics of cases undergoing additional gastrectomy after endoscopic mucosal resection (EMR) for early gastric cancer (EGC) and the appropriate strategy for treating those after incomplete EMR. We studied 16 patients who underwent additional gastrectomy after EMR for EGC. The reasons for additional gastrectomy were positive horizontal margin (8 cases), indeterminate horizontal margin (2 cases), positive vertical margin (4 cases), submucosal invasion (7 cases), lymphatic invasion (4 cases), venous invasion (1 case), and local recurrence (2 cases, including overlapped cases).

Short-term surgical outcomes of reduced port surgery for esophageal achalasia.

Purpose: To clarify the feasibility and utility of reduced port surgery (RPS) for achalasia.

Methods: Between September 2005 and June 2013, 359 patients with esophageal achalasia, excluding cases of reoperation, underwent laparoscopic Heller myotomy and Dor fundoplication (LHD) according to our clinical pathway. Three-hundred and twenty-seven patients underwent LHD with five incisions (conventional approach), while the other 32 patients underwent RPS, including eight via SILS.

Perioperative serum albumin correlates with postoperative pancreatic fistula after pancreaticoduodenectomy.

Objectives: Despite improvements in surgical techniques, instruments and perioperative management, postoperative pancreatic fistula (POPF) remains a serious complication after pancreaticoduodenectomy. The aim of the present study was to characterize a high-risk group for POPF after pancreaticoduodenectomy using perioperative clinical variables of patients.

Patients And Methods: This retrospective study comprised of 247 patients who had undergone pancreaticoduodenectomy between May 2000 and May 2013.

Mechanisms of Overcoming Intrinsic Resistance to Gemcitabine in Pancreatic Ductal Adenocarcinoma through the Redox Modulation.

Pancreatic ductal adenocarcinoma (PDAC) frequently develops therapeutic resistances, which can be divided into extrinsic and intrinsic resistance. The extrinsic resistance that arises from the surrounding dense tumor stroma is much better understood. However, the mechanisms of intrinsic resistance are not well understood.

Local excision of rectal schwannoma using transanal endoscopic microsurgery: A case report.

Introduction: Schwannoma is a neoplasm originating from the neural crest cells (schwann cells) that form nerve sheaths. These tumors are thought to be benign with little risk of malignant transformation. They rarely affect the gastrointestinal tract, and primary rectal involvement is extremely rare.

Phase I trial of S-1 every other day in combination with gemcitabine/cisplatin for inoperable biliary tract cancer.

Purpose: To date, gemcitabine-based or fluoropyrimidine-based regimens are recommended for unresectable advanced biliary tract cancer. Then, we conducted a phase I study of gemcitabine/cisplatin and S-1 that is an oral fluoropyrimidine. The aim of this study was to determine the dose-limiting toxicity (DLT), maximum-tolerated dose, and a recommended phase II dose of S-1.

Thymidine phosphorylase mRNA expression may be a predictor of response to post-operative adjuvant chemotherapy with S-1 in patients with stage III colorectal cancer.

The aim of the present study was to investigate markers in surgically resected specimens of colorectal cancer that can be used to predict the response to chemotherapy. The mRNA expression levels of enzymes involved in 5-fluorouracil (5-FU) metabolism and folate metabolism were measured in formalin-fixed, paraffin-embedded tumor sections obtained from the primary tumors of 54 patients with resected stage II or III colorectal cancer who received S-1 for one year. The 5-FU metabolizing enzymes studied were thymidylate synthase, dihydropyrimidine dehydrogenase and thymidine phosphorylase (TP).

Glasgow prognostic score predicts outcome after surgical resection of gallbladder cancer.

Background: Systemic inflammation as evidenced by the Glasgow prognostic score (GPS) predicts cancer-specific survival in various types of cancer. The aim of this study was to evaluate the significance of GPS in therapeutic outcome after surgical resection of gallbladder cancer.

Methods: The subjects were 51 patients who underwent surgical resection for gallbladder cancer.

Postoperative peripheral absolute blood lymphocyte-to-monocyte ratio predicts therapeutic outcome after pancreatic resection in patients with pancreatic adenocarcinoma.

Aim: The aim of this study was to evaluate the significance of postoperative peripheral absolute blood lymphocyte-to-monocyte (ALC/AMC) ratio in pancreatic resections for pancreatic carcinoma.

Patients And Methods: One hundred eleven patients who underwent pancreatic resection for pancreatic carcinoma were included in this study. We retrospectively examined perioperative findings as predictors of therapeutic outcome and the relation between postoperative ALC/AMC ratio and recurrence rate as well as overall survival of the patients with pancreatic carcinoma.

Prognostic significance of ZNF217 expression in gastric carcinoma.

Background: The zinc finger protein ZNF217 is a candidate oncogene in breast cancer and ovarian clear cell cancer. The purpose of the present study was to clarify the significance of this protein's expression in gastric carcinoma and to evaluate the outcome of these patients.

Materials And Methods: Using paraffin-embedded specimens from 84 patients with gastric cancer, ZNF217 protein was detected using an anti-ZNF217 goat polyclonal antibody.

Prediction of lymph node metastasis in patients with submucosa-invading early gastric cancer.

Background And Aim: Early gastric cancer (EGC), with wall invasion limited to the submucosa, has approximately 15 to 20% chance of lymph node metastasis. The purpose of this study is to clarify the parameters which affect lymph node metastasis and survey whether lymph node metastasis can be predicted preoperatively.

Patients And Methods: We retrospectively analyzed 145 consecutive patients with EGC using multivariate analysis and developed a formula which predicts lymph node metastasis by linear discriminant analysis.

Large gastrointestinal stromal tumor and advanced adenocarcinoma in the rectum coexistent with an incidental prostate carcinoma: A case report.

Introduction: Gastrointestinal stromal tumors (GISTs) are the leading mesenchymal neoplasia in the gastrointestinal tract, but GIST arising from the rectum is rare. When a secondary neoplasia coexists in the vicinity of a rectal GIST, more aggressive treatment strategies may be needed to cure the diseases.

Presentation Of Case: We herein describe a 76-year-old man with a large gastrointestinal stromal tumor along with an advanced adenocarcinoma in the rectum that coexisted with prostate carcinoma.

Mesothelial cyst with endometriosis mimicking a Nuck cyst.

We report a case of mesothelial cyst protruding from the right femoral ring with suspected endometriosis in a 35-year-old woman, who complained of a lump with a diameter of 6 cm in the right inguinal region. Although she had the hormone therapy during the next 8 months for the diagnosis of extragenital endometriosis, her symptoms did not improve. The clinical suspicion of a Nuck cyst with endometriosis, supported by ultrasonography and magnetic resonance imaging, was confirmed by histopathological examination of the surgical specimen.

Assessment of motor function of the remnant stomach by ¹³C breath test with special reference to gastric local resection.

Background: Indications for gastric local resection (LR) include gastrointestinal stromal tumors, neuroendocrine tumors, and early gastric cancer. LR is expected to preserve physiological function and ameliorate postgastrectomy syndrome.

Methods: Gastric emptying was assessed by the (13)C-acetate breath test in 20 healthy volunteers (HVs) and 60 gastrectomized patients [distal gastrectomy with Billroth I reconstruction (DGBI) in 26 patients, LR in 34 patients].

A single nucleotide polymorphism in fibronectin 1 determines tumor shape in colorectal cancer.

Depressed and flat surface lesions are not easy to identify with routine colonoscopies during screening for colorectal cancer (CRC). Identifying clinically relevant genes that influence tumor shape could be useful when screening for the presence of depressed lesions. Total RNA was extracted from tumor cells collected by laser microdissection from the primary lesions of 146 CRC cases.

Sentinel lymph node navigation surgery for early stage gastric cancer.

We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG). The sentinel lymph node (SLN) is defined as a first lymph node (LN) which receives cancer cells from a primary tumor. Reports on clinical application of SNNS for gastric cancers started to appear since early 2000s.