Three-step esophagojejunal anastomosis with atraumatic anvil insertion technique after laparoscopic total gastrectomy.

Background: Esophagojejunostomy during laparoscopic total gastrectomy (LATG) using a circular stapler is a difficult procedure for which there remains no widely accepted standard technique. Based upon our experience with esophagogastrostomy during laparoscopic proximal gastrectomy, we have applied a modified lift-up method to LATG.

Material And Methods: Esophagojejunostomy using a modified lift-up method was performed during LATG in 41 patients with early gastric cancer, from July 2005 to June 2010.

Outcome after surgical resection of isolated metastases to the pancreas.

Background/aims: The pancreas is an unusual site for metastases. Thus, the efficacy of pancreatic resection in patients with metastatic pancreas cancer remains unclear. This study examined the result of surgical resection for patients with pancreatic metastases.

Outcome of surgical treatment for patients with locoregional recurrence of gastric cancer.

Purpose: Locoregional recurrent gastric cancer is commonly treated by systemic chemotherapy. The effectiveness of surgical treatment, in terms of complete tumor resection, is unknown.

Methods: We reviewed the case histories of 36 patients with locoregional recurrent gastric cancer, selected for surgical treatment by careful preoperative assessment.

Endoscopic ultrasonography is valuable for identifying early gastric cancers meeting expanded-indication criteria for endoscopic submucosal dissection.

Background: Endoscopic ultrasonography (EUS) has become a reliable method for predicting the invasion depth of early gastric cancer (EGC). This study evaluated the accuracy of EUS in identifying lesions meeting expanded-indication criteria for endoscopic submucosal dissection (ESD) and analyzed clinicopathologic factors influencing the diagnostic accuracy of EUS in assessing tumor invasion depth.

Methods: This study investigated 542 EGCs of 515 patients who underwent EUS pretreatment.

[The anti EGFR antibody indication between the Japanese and overseas guidelines].

The revised version of the Japanese colorectal cancer treatment guidelines by the Japanese Society for Cancer of the Colon and Rectum published in July 2009 showed remarkable changes in the field of systemic chemotherapy compared with the 2005 edition. Bevacizumab was approved in 2004 in United States, in 2005 in Europe, and in 2007 in Japan. On the other hand, cetuximab was approved in 2004 in Europe and United States, and in July 2008 in Japan.

Complications of loop ileostomy closure in patients with rectal tumor.

Background: Loop ileostomy is customary after very low rectal anastomosis to reduce the rate of pelvic sepsis that can result from anastomotic leakage. To evaluate complications of stoma closure is important to maximize the benefit of making the defunctioning stoma. The aim of this study was to examine possible risk factors associated with complications, especially wound infections, after loop ileostomy closure in patients with rectal tumor.

[Diagnosis and treatment for bone metastases--multidisciplinary team medicine by cancer board].

With the recent progress in cancer treatment making longer survival possible, the need of treatment for bone metastases has become indispensable to assure patient QOL(quality of life). Treatment and prevention of fracture and spinal cord injury are very important not only to maintain good QOL but also to improve survival. Early diagnosis of the risks and the prevention and treatment of fracture and spinal cord injury are necessary.

Laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery: initial experience.

Background/aims: Although laparoscopy is accepted for treatment of colon cancer, its use for rectal cancer still has technical limitations. Whether a laparoscopic approach for rectal cancer is safe and beneficial remains unknown when simultaneous open upper major abdominal surgery is planned.

Methodology: Eight patients underwent laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery.

Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial?

Purpose: The role of laparoscopic resection in management of rectal cancer is still controversial. The purpose of this study was to evaluate whether laparoscopic rectal resection for rectal cancer could be safely performed in elderly patients.

Methods: Forty-four elderly patients (> or =75 years) undergoing laparoscopic rectal resection (group A) were compared with 228 younger patients (<75 years) undergoing laparoscopic rectal resection (group B) and 43 elderly patients (> or =75 years) undergoing open rectal resection (group C).

[Rituximab resistance in B-cell lymphoma and its elimination].

Rituximab is commonly incorporated into CD20-positive B-cell lymphoma therapy to improve response and prognosis. With increasing use, resistance to rituximab is a continuing concern, but CD20 mutation as a cause of resistance has not previously been reported. Freshly collected lymphoma cells from 50 patients with previously untreated or relapsed/resistant non-Hodgkin's B-cell lymphomas(diffuse large B cell, n=22; follicular, n=7; mucosa associated lymphoid tissue, n=16; chronic lymphocytic leukemia, n=2; small lymphocytic lymphoma, n=1; lymphoplasmacytic, n =1; mantle cell lymphoma, n=1)were assessed for CD20 expression by flow cytometry, and CD20 gene sequencing was performed on extracted DNA.

[Biomarker for chemotherapy in patients with colorectal cancer].

Prognostic, predictive and safety biomarkers of chemotherapy for colorectal cancer have been reported. Recently, it was reported that KRAS mutation was present in 27-43% of patients, was associated with resistance to antibody against the epidermal growth factor receptor(EGFR), and showed a poorer survival in metastatic colorectal cancer. The search for biomarkers is therefore being conducted vigorously in parallel with a number of clinical trials that are currently being conducted for new drugs.

Increased fat content and body shape have little effect on the accuracy of lymph node retrieval and blood loss in laparoscopic distal gastrectomy for gastric cancer.

Background: Fat volume and large abdominal shape are known to disrupt the procedures of lymph node retrieval used in gastric cancer surgery. The present study examined the effect of increasing fat content on surgical outcomes, including estimated blood loss and the number of lymph nodes retrieved during gastrectomy.

Methods: Of 154 patients, 50 underwent the conventional open procedure (OPEN) and 104 underwent laparoscopy-assisted distal gastrectomy (LADG).

Safety of laparoscopic total mesorectal excision for low rectal cancer with preoperative chemoradiation therapy.

Introduction: Total mesorectal excision (TME) with preoperative chemoradiation therapy is an accepted standard treatment for low rectal cancer. Although the laparoscopic approach is accepted for the treatment of colon cancer, its value for low rectal cancer is unknown. The purpose of this study was to evaluate whether preoperative chemoradiation therapy exerted an adverse influence on laparoscopic TME for low rectal cancer.

[Relative dose intensity of FOLFOX4 regimen].

Purpose: Oxaliplatin (L-OHP) is one of the key drugs against advanced, recurrent colorectal cancer, and FOLFOX4 regimen combination of l-leucovorin (l-LV)and 5-fluorouracil (5-FU)with oxaliplatin is a standard therapy in colorectal cancer. We performed a retrospective study that researched adverse events and relative dose intensity(RDI)to evaluate safety and feasibility of FOLFOX4 regimen.

Patients And Methods: We administered 188 patients a FOLFOX4 regimen.

[Reconstruction after total gastrectomy].

Reconstruction after total gastrectomy should be assessed based on the simplicity and safety of the procedure and postoperative digestive function. A survey performed by the Japan Gastric Cancer Association showed that the Roux-en-Y and small bowel interposition are the most common reconstructive procedures after total gastrectomy. Laparoscopic total gastrectomy is not yet the standard procedure under the Japanese guidelines for the treatment of gastric cancer.

Liver transection using the LigaSure sealing system.

Background: The aim of the present study was to evaluate the feasibility and efficacy of the LigaSure vessel sealing system on a large scale when used for liver resection.

Methods: We retrospectively analyzed the short-term outcomes of 277 patients undergoing hepatectomies with the use of the LigaSure system.

Results: There were two hospital deaths (0.

Trastuzumab and vinorelbine as first-line therapy for HER2-overexpressing metastatic breast cancer: multicenter phase II and pharmacokinetic study in Japan.

Tolerability and response rate to weekly combination chemotherapy with trastuzumab and vinorelbine in Japanese women with HER2-overexpressing breast cancer not previously receiving either therapy were assessed. Tumor response was evaluated every 4 weeks and adverse events were graded. A total of 23 patients from six participating centers in Japan were enrolled.

[Safety and efficacy analysis of FOLFOX4 regimen in elderly compared to younger colorectal cancer patients].

The number of elderly patients with colorectal cancer is increasing in Japan. They have the opportunity to receive chemotherapy similar to non-elderly patients because of the development of new drug agents and improvement of supportive therapy. We analyzed retrospectively 184 patients (32 aged >or= 70, 75 View Article and Find Full Text PDF

[A case of splenic inflammatory pseudotumor].

A 51-year-old woman who had undergone gastrectomy for advanced gastric cancer was found to have a splenic tumor during the postoperative clinical observation. Abdominal computed tomography (CT) demonstrated solitary splenic tumor 15mm in diameter with delayed contrast enhancement. Abdominal ultrasonography (US) revealed low echoic mass with enhancement at vascular and perfusion image.

[Transcatheter arterial chemoembolization (TACE) using degradable starch microspheres (DSM) for metastatic liver tumors in patients with gastric cancer].

We reviewed the effects and complications of transcatheter arterial chemoembolization (TACE), using degradable starch microspheres (DSM) in eight patients with hepatic metastases from gastric cancer. The rate of complete remission (CR) +partial remission (PR) was 62.5%, and the actual survival rates at one and two years post-treatment were 87.

[Transcatheter arterial chemoembolization (TACE) using degradable starch microspheres (DSM) (DSM-TACE) for primary and metastatic liver neuroendocrine tumors from gastrointestinal neuroendocrine tumors].

We reviewed the efficacy and complications of transcatheter arterial chemoembolization using degradable starch microspheres (DSM) for primary neuroendocrine tumors of the liver or liver metastases from gastrointestinal neuroendocrine tumors in ten patients. The rate of complete and partial response was 70.0%.

Benefit of mediastinal and para-aortic lymph-node dissection for advanced gastric cancer with esophageal invasion.

Background And Objectives: Lymph-node dissection in gastric cancers with esophageal invasion (AGCE) is of current interest. This study examined the significance of inferior mediastinal lymph-node (IM) and para-aortic lymph-node (PA) dissection for this type of cancer.

Method: Two hundred and seventy cases of AGCE were clinicopathologically reviewed.

Standardized technique of laparoscopic intracorporeal rectal transection and anastomosis for low anterior resection.

Background: Rectal transection and anastomosis at the lower rectum is the most challenging part of laparoscopic low anterior resection. Therefore, some have demonstrated that rectal transection should be performed using instruments for open surgery with small laparotomy. In our institute, however, rectal transection using a currently available endostapler followed by anastomosis with a double stapling technique is usually performed.

[Prostate cancer].

Localized prostate cancer is generally treated with radical prostatectomy or radiation therapy (external beam or brathytherapy). However, the primary treatment failure rate is especially high in so-called high-risk patients. Therefore, many clinical trials of neoadjuvant therapy before radiation therapy or prostatectomy have been conducted.

Favourable long-term results after surgical removal of lung metastases of breast cancer.

We retrospectively evaluated whether a surgical strategy benefits patients with operable lung metastasis of breast cancer. Between 1960 and 2000, 90 patients (mean age 55.1; range 32-77) with lung metastasis (79 solitary, 11 multiple) underwent surgery as follows: wedge resection (n = 10), segmental resection (n = 11), lobectomy (n = 68) and pneumonectomy (n = 1).