[Advanced Gastric Cancer with Virchow's Lymph Node Metastasis-A Long-Term Survival Case].

A 36-year-old woman presented to our hospital with a complaint of melena. Examinations revealed type 3 gastric cancer with left supraclavicular lymph node(Virchow's node)and para-aortic lymph node(PAN)metastases. The patient was treated with S-1 and CDDP combination chemotherapy.

Oral rehydration solution normalizes plasma renin and aldosterone levels in patients with ulcerative colitis after proctocolectomy.

Objectives: The possible effects and benefits of oral rehydration solution (ORS) on chronic dehydration after total proctocolectomy.

Methods: To evaluate the effect of ORS on the renin-angiotensin system after remnant proctocolectomy in patients with ulcerative colitis (UC), we selected 20 patients after remnant proctocolectomy, ileal J pouch-anal anastomosis, and construction of a diverting ileostomy for UC. Patients were randomly divided into two groups, A (n=9) or B (n=11), 2 weeks after the surgery.

The functional outcome and factors influencing the quality of life after ileal pouch anal anastomosis in patients with ulcerative colitis.

Purpose: The aim of this study was to assess the bowel function and quality of life (QOL) in patients with ulcerative colitis (UC) after total proctocolectomy with ileal pouch anal anastomosis (IPAA).

Methods: Two questionnaires ["Questionnaire sheet on the bowel function" and "Inflammatory bowel disease questionnaire (Japanese IBDQ)"] were sent to 121 patients with UC who underwent IPAA at Tohoku University Hospital. Seventy-nine patients (65%) participated in the study.

Pouch functional outcomes after restorative proctocolectomy with ileal-pouch reconstruction in patients with ulcerative colitis: Japanese multi-center nationwide cohort study.

Background: Although several complications capable of causing pouch failure may develop after restorative proctocolectomy (RPC) for ulcerative colitis (UC), the incidences and causes are conflicting and vary according to country, race and institution. To avoid pouch failure, this study aimed to evaluate the rate of pouch failure and its risk factors in UC patients over the past decade via a nationwide cohort study.

Methods: We conducted a retrospective, observational, multicenter study that included 13 institutions in Japan.

Current State of and Problems Related to Cancer of the Intestinal Tract Associated with Crohn's Disease in Japan.

Background/aim: Cancer of the intestinal tract (small and large intestine) associated with Crohn's disease has a low incidence but can be fatal if it develops. Thus, the key question is how to deal with this type of cancer. The current study surveyed major medical facilities that treat inflammatory bowel disease (IBD) surgically in Japan in order to examine the clinical features of cancer of the intestinal tract associated with Crohn's disease and explore ways to deal with this cancer in the future.

[Surgical management of intestinal Crohn's disease].

Various intestinal conditions such as stricture, fistula, abscess, perforation, and hemorrhage are complications of Crohn's disease. Surgical intervention remains important, even in the era of biologic therapy. Limited surgical resection is essential to avoid short bowel syndrome after massive resection or multiple operations.

Parastomal hernia repair with the Sugarbaker technique using e-PTFE mesh.

Purposes: Although surgery is commonly used to treat parastomal hernia, it is very difficult and has shown poor results. Recently, repair with prosthetic materials has been thought to be a more promising method.

Methods: The Sugarbaker technique with e-PTFE mesh (Dualmesh) performed via open surgery was adopted for seven patients with parastomal hernia.

Risk factors for surgical site infection in Japanese patients with ulcerative colitis: a multicenter prospective study.

Purpose: A prospective, multicenter, observational study was performed to investigate the risk factors of surgical site infection (SSI) in patients with ulcerative colitis (UC).

Methods: From 2009 to 2010, perioperative clinicopathological data were collected from patients who had undergone surgery for UC within the research period, for up to 6 consecutive months in 13 hospitals in Japan. The primary outcome was the development of SSI.

Long-term incidence and characteristics of intestinal failure in Crohn's disease: a multicenter study.

Background: The aim of this study was to clarify the risk and characteristics of intestinal failure (IF) in patients with Crohn's disease (CD).

Methods: The present study was a retrospective study in 12 hospitals. CD patients who underwent initial surgery at any of the 12 hospitals between 1970 and 2009 were collected (n = 1,703).

A shift from colon- to ileum-predominant bacteria in ileal-pouch feces following total proctocolectomy.

Background: We previously investigated fecal flora of the pouch after total proctocolectomy using terminal restriction fragment polymorphism analysis. Although the results of the cluster analysis demonstrated clearly that bacterial populations, including an unidentified bacteria generating a 213-bp PCR fragment, moved toward a colon-like community in the pouch, it did not track changes in the individual species of fecal bacteria.

Aims: The aim of the present study was to estimate genome copy number of ten bacterial species, clusters, groups, or subgroups (including the bacteria generating 213-bp fragment in the previous study) in feces samples from pouches at various times following ileostomy closure.

The long-term clinical course of pouchitis after total proctocolectomy and IPAA for ulcerative colitis.

Background: Pouchitis is the most common long-term complication after restorative total proctocolectomy and IPAA for ulcerative colitis.

Objective: We examined the incidence, clinical aspects, and long-term outcome of patients with idiopathic pouchitis.

Design: This study was a retrospective review of medical records.

[A case with local recurrence of rectal cancer that responded to S-1 and PSK with long-term complete response].

The patient was a 65-year-old male, who underwent low anterior resection for rectal cancer. The pathological diagnosis showed mucinous adenocarcinoma, pSS, and pN0. He complained of diarrhea and melena 4 months after the surgery.

[A case of anal cancer with rapidly rising CEA in longstanding perianal Crohn disease after infliximab administration].

Infliximab is effective in the treatment of steroid-resistant Crohn disease. However, there is clinical concern about a possible correlation between an increased risk of anorectal cancer and infliximab treatment. We report a case of anorectal cancer in long-standing perianal Crohn disease.

[A case of multiple metachronous metastases of colon cancer to the small intestine preoperatively diagnosed by double balloon enteroscopy and radically resected].

The patient was a 75-year-old woman who had undergone resection of a transverse colon cancer two years before. She had anemia and intestinal obstruction, and a diagnosis of multiple metastases to the small intestine was made by double balloon enteroscopy. Eleven metastatic foci were resected by partial resection of the jejunum and ileum.

Surgical management in intestinal Crohn's disease.

The main strategy in surgical treatment of Crohn's disease is resection of the diseased segment, despite possible development of postoperative nutritional impairment and lowered quality of life (QOL) caused by short bowel syndrome and early postoperative relapse. To overcome postoperative short bowel syndrome, minimal resection is highly recommended, and furthermore strictureplasty is now used in many institutions. Many reports have shown that strictureplasty is safe, has a low rate of surgical complications, and displays identical surgical results as intestinal resection.

Ileal J-pouch perforation at the blind end: report of a case.

A 34-year-old woman presented with severe abdominal pain 8 years after undergoing ileal J-pouch anal anastomosis for ulcerative colitis (UC). Computed tomography (CT) showed free air and ascites in the abdomen, so she underwent laparotomy. A perforation was found at the ileal J-pouch blind end, which was remarkably enlarged.

The effect of a total colectomy on the motor inhibition of the upper gut induced by intraileal stimuli in conscious dogs.

Purpose: The administration of stimuli to the ileum inhibits upper gastrointestinal motility. The aim of this study was to determine whether a total colectomy can alter this motor inhibitory effect.

Methods: Beagle dogs were each equipped with four strain gauge force transducers on the upper gastrointestinal tract.