[A Case of Rhabdomyolysis Caused by Oxaliplatin during Postoperative Adjuvant Chemotherapy].

The patient was a 50-year-old male. At the age of 48 years, he had undergone total gastrectomy and right hemicolectomy simultaneously for gastric and ascending colon cancers. Since adjuvant chemotherapy has become common practice for patients with ascending colon cancer, capecitabine was administered for 6 months.

[A Case of Transverse Colon Cancer Complicated by Eosinophilic Granulomatosis with Polyangiitis].

A man in his 50s had undergone steroid therapy for eosinophilic granulomatosis with polyangiitis(EGPA). Since an examination for malignant tumors revealed type 0-Ⅰsp(cT1aN0M0)and type 2(cT2N0M0)lesions in the proximal and mid- transverse colon, respectively, he was referred to our department. Endoscopic resection was performed on the proximal lesion.

[A Case of Extramural Growth-Type Ileocecal Colon Cancer].

A woman in her 80s was diagnosed with an abdominal mass during physical examination. Contrast-enhanced computed tomography(CT)revealed a tumor with contrast enhancement outside the ileocecal region of the intestine, and the ileocolic artery penetrated the tumor. No tumor was detected by colonoscopy.

Identification of patient subgroups with unfavorable long-term outcomes associated with laparoscopic surgery in a randomized controlled trial comparing open and laparoscopic surgery for colon cancer (Japan Clinical Oncology Group Study JCOG0404).

Background: Previously, we conducted a randomized controlled trial (JCOG0404) for stage II/III colon cancer patients and reported that the long-term survival after open surgery (OP) and laparoscopic surgery (LAP) were almost identical; however, JCOG0404 suggested that survival of patients after LAP with tumors located in the rectosigmoid colon, cT4 or cN2 tumors, and high body mass index (BMI) might be unfavorable.

Aim: To identify the patient subgroups associated with poor long-term survival in the LAP arm compared with the OP arm.

Methods: Patients aged 20-75, clinical T3 or deeper lesion without involvement of other organs, clinical N0-2 and M0 were included.

Usefulness of a Precursory Small Epigastric Midline Incision during Laparoscopic Right Hemicolectomy.

Objectives: During laparoscopic right hemicolectomy, many surgeons make a small incision near the umbilicus after the routine intraperitoneal operation. In this study, we created a precursory small epigastric incision at the center of a line connecting the xiphoid process and umbilicus (the M point, an empirically determined position) at the start of surgery prior to laparoscopic manipulation. This study aimed to determine whether the small incision at the center of the M point was a suitable position through which the right hemicolon is extracted.

Risk factors for anastomotic leakage after laparoscopic surgery with the double stapling technique for stage 0/I rectal carcinoma: a subgroup analysis of a multicenter, single-arm phase II trial.

Purpose: The aim of this study was to determine the risk factors for anastomotic leakage after laparoscopic rectal surgery.

Methods: We conducted a prospective trial involving 395 patients with stage 0/I rectal carcinoma who underwent laparoscopic low anterior resection using a double stapling technique. Data concerning variables related to patient background, tumors and surgical factors were evaluated.

Flattened tumor requires a more careful attention for residual distal cancer spread in locally advanced lower rectal carcinoma after chemoradiotherapy.

Background/aims: Limited data are available on distal resection margin (DRM) for lower rectal cancer (LRC) after preoperative chemoradiotherapy (pre-CRT); thus, we aimed to establish the criteria for DRMs as estimated by the macroscopic tumor appearance.

Methods: This was a pathological study using whole-mount sections that included the entire circumference of tumor. Residual cancer spread located most distally from the macroscopic tumor border was mainly evaluated.

Laparoscopic resection for colorectal cancer improves short-term outcomes in very elderly colorectal cancer patients.

Background: Laparoscopic-assisted colectomy (LAC) for colorectal cancer has been shown to improve short-term outcomes compared with open colectomy (OC) in colorectal cancer patients. However, there are a few reports that describe the efficacy of LAC in the very elderly population. We investigated whether LAC improves short-term outcomes in elderly patients, especially those 80 years of age or older.

Efficacy of 5-aminolevulinic acid-mediated photodynamic therapy using light-emitting diodes in human colon cancer cells.

5-Aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) (ALA-PDT) is a highly selective treatment for malignant cells. ALA-PDT has the potential to develop into a novel therapeutic strategy for various types of cancer. Recently, light-emitting diodes (LEDs), which are inexpensive, stable and easier to handle compared to lasers, have been used in PDT as a light source.

Incidentally Discovered Adenocarcinoma in situ of the Appendix in a Young Woman.

Primary appendiceal adenocarcinoma is an infrequent disease. This report presents a rare case of incidentally discovered carcinoma in situ of the appendix. A 35-year-old parturient female simultaneously underwent appendectomy and oophorectomy due to an ovarian abscess that adhered to the appendix during cesarean section.

[Operative problems during simultaneous laparoscopic surgery for gastric and colorectal cancer].

Recent technological advances in optical and surgical devices have resulted in laparoscopic surgery for gastric and colorectal cancer, gaining wider acceptance and becoming more common. Simultaneous laparoscopic surgery for gastric and colorectal cancer has many potential advantages, including a small incision, good cosmetic result, less postoperative pain, and less mobility. However, some problems have to be resolved.

[Diagnostic problems in gastric cancer patients with sarcoidosis-case report and literature review].

Sarcoidosis is an idiopathic systemic disease with non-caseating granuloma that is reported to occur concomitantly with various malignant tumors. We report here a case of advanced gastric cancer with sarcoidosis, for which precise preoperative diagnosis was difficult. A 69-year-old woman was diagnosed with a far-advanced gastric cancer because multiple intra-abdominal and intra-thoracic lymph node swellings and a tumorous lesion in the spleen were detected by multidetector computed tomography and fluorodeoxyglucose positron emission tomography.

[The clinical influence of double or multiple primary cancers on the prognosis of patients with gastric cancer].

Background: An aging population and advances in diagnostic technology have led to an increase in the incidence of double or multiple primary cancers(DMPC) in patients with gastric cancer(GC). This study was designed to evaluate the clinical influence of DMPC on the prognosis of patients with GC.

Methods: Between 1997 and 2009, 1,086 patients underwent curative gastrectomy for GC in our hospital.

[Diagnostic value of direct inspection and palpitation by surgeons in intra-operative nodal staging of gastric cancer].

Background And Purpose: Recent imaging modalities such as multi-detector computed tomography, fluorodeoxyglucose positron emission tomography/computed tomography, and magnetic resonance imaging have emerged as promising diagnostic and staging methods in various cancers. However, these modalities lack the diagnostic ability to evaluate tissue elasticity, which could instead be easily estimated by a surgeon through palpitation. To add tissue elasticity to future diagnostic methods, this study was designed to evaluate the ability of surgeons to estimate elasticity by direct inspection and palpitation during intra-operative nodal staging of gastric cancer.

[A case of advanced colon cancer resected successfully after neoadjuvant chemotherapy].

This case concerns a 54-year-old male patient who had been identified as having a type 2 tumor in the cecum, which subsequent pathologic examination revealed to be an adenocarcinoma. The results of a computed tomography (CT) scan suggested that the tumor had directly invaded the right iliopsoas. Neoadjuvant chemotherapy was performed to avoid a non-curative resection.

[A case of pancreaticoduodenectomy after the placement of an expandable metallic stent].

This is a case report of a 75-year-old man who underwent pancreaticoduodenectomy and received a placement of an expandable metallic stent (EMS) for palliation of the biliary stricture following diagnosis as middle bile duct carcinoma. At a local hospital, abdominal computed tomography revealed multiple low-density lesions with peripheral enhancement in the liver. After being diagnosed as metastatic liver tumor with cholangiocarcinoma, an EMS was inserted for palliation of the biliary stricture on the basis of the diagnosis as unresectable carcinoma due to the metastatic lesion.

[A novel treatment strategy using trafermin, containing basic fibroblast growth factor, for intractable duodenal fistula following curative gastrectomy for gastric cancer-case report and literature review].

Despite recent perioperative technological advances in gastric cancer treatment, duodenal stump leakage and intractable duodenal fistula are still major critical complications following gastrectomy that should be specifically targeted in order to improve postoperative outcomes. Here, we provide a preliminary report of a case of intractable duodenal fistula successfully treated with Trafermin containing basic fibroblast growth factor. A 70-year-old man underwent distal gastrectomy with radical lymphadenectomy for early distal gastric cancer (pT1bN0M0).

[Neoadjuvant chemoradiotherapy for locally advanced rectal cancer].

A total of 37 patients treated with chemoradiotherapy between 2008 and 2011 were analyzed. Radiotherapy was administered in fractions of 1.8 Gy/day for 25 days.

HGF regulates VEGF expression via the c-Met receptor downstream pathways, PI3K/Akt, MAPK and STAT3, in CT26 murine cells.

In the present study, we assessed the involvement of hepatocyte growth factor (HGF)/c-Met signalling with vascular endothelial cell growth factor (VEGF) and hypoxia inducible factor (HIF)-1α expression in the downstream pathways phosphatidylinositol 3-kinase (PI3K)/Akt, mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) in CT26 cells, to determine the mechanisms of the potent anti-angiogenic effect of NK4. We established genetically modified CT26 cells to produce NK4 (CT26-NK4). VEGF expression in subcutaneous CT26 tumours in vivo and in culture supernatants in vitro was determined by ELISA.

Evaluation of lymph node metastasis in patients with gastric cancer: a comparison of the directionality of lymph node metastasis and the total number of metastatic lymph nodes.

Purpose: The clinical impact of the directionality of lymph node (LN) metastasis was assessed in comparison with the staging by the Japanese Classification of Gastric Carcinoma (JCGC), a numerical LN staging system.

Methods: Two hundred forty-one gastric cancer patients who were diagnosed pathologically to have LN metastasis, and 54 patients who underwent preoperative multidetector-row computed tomography (MDCT) with an image thickness of 1 mm were classified into three groups (unidirectional [Uni-], bidirectional [Bi-], and tridirectional [Tri-] groups) depending on the directionality of their LN metastasis.

Results: The prognosis of the Uni-group was better than that of the Bi- or the Tri-group when assessed on the basis of the pathological findings of metastatic LN and also the preoperative MDCT findings.

Staging fluorescence laparoscopy for gastric cancer by using 5-aminolevulinic acid.

Background: Precise staging of gastric cancer is essential when selecting for the appropriate treatment approach. 5-Aminolevulinic acid (5-ALA) is metabolized and accumulated as protoporphyrin IX (PpIX), which is a photosensitizer. In this study, we evaluated the diagnostic usefulness of 5-ALA for demonstrating peritoneal dissemination in patients with gastric cancer.

Case involving long-term survival after esophageal cancer with liver and lung metastases treated by multidisciplinary therapy: report of a case.

A 57-year-old male with lower esophageal cancer underwent subtotal esophagectomy with lymphadenectomy. The histopathological diagnosis was poorly differentiated squamous cell carcinoma, pT2N1M0 pStageIIB. After one course of postoperative adjuvant chemotherapy involving low-dose CDDP/5FU, a PET-CT scan obtained 12 months after surgery revealed a solitary liver metastasis in the S2 area.

Risk factors for postoperative respiratory complications following esophageal cancer resection.

The development of surgical and postoperative management techniques has improved the treatment outcomes of esophageal cancer resection. However, respiratory morbidity is still the most frequent complication after esophagectomy. The objective of the present study was to identify risk factors for respiratory complications following resection for esophageal cancer.

Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy.

Aim: To re-evaluate the recent clinicopathological features of remnant gastric cancer (RGC) and to develop desirable surveillance programs.

Methods: Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Japan. Of these, 33 patients underwent gastrectomy with lymphadenectomy for RGC.