Tomoyuki Wakahara
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View article: A Case of Food Retention in the Distal Part of the Stomach after Stomach-Partitioning Gastrojejunostomy
A Case of Food Retention in the Distal Part of the Stomach after Stomach-Partitioning Gastrojejunostomy Open
View article: A case of pulmonary leiomyosarcoma achieving long-term survival after multiple metastasectomies
A case of pulmonary leiomyosarcoma achieving long-term survival after multiple metastasectomies Open
View article: A Case of Glioblastoma with Severe Anemia and Laparoscopic Colectomy
A Case of Glioblastoma with Severe Anemia and Laparoscopic Colectomy Open
77歳，女性．下血を主訴に外来を受診．初診時の血液検査でHb 6.5g/dLと高度な貧血を認め，輸血が施行された．下血精査目的で施行の下部消化管内視鏡検査で横行結腸に，頂部に潰瘍を伴う有茎性の粘膜下腫瘍を認め，出血源と考えられた．潰瘍部の生検では炎症性組織の所見であり，診断には至らなかった．有茎性の腫瘍であり内視鏡的切除が検討されたが，最大径40mmと大きく悪性腫瘍を否定できなかったため適応外と判断され，切除術目的に外科へ紹介となった．悪性腫瘍の可能性も考慮して，リンパ節郭…
View article: The Amount and Concentration of Drain Amylase Together Predict Postoperative Pancreatic Fistula after Gastric Cancer Surgery More Accurately than the Concentration Alone
The Amount and Concentration of Drain Amylase Together Predict Postoperative Pancreatic Fistula after Gastric Cancer Surgery More Accurately than the Concentration Alone Open
Introduction: The drain amylase concentration (dAmy-C) is a useful marker for predicting pancreatic fistula after gastric cancer surgery. However, dAmy-C might be reduced in cases of high drainage volume. Therefore, we hypoth…
View article: A Case of Small Intestinal Perforation due to Small Bowel Metastasis of Cervical Cancer
A Case of Small Intestinal Perforation due to Small Bowel Metastasis of Cervical Cancer Open
症例は70歳，女性．腹痛を主訴に救急搬送された．腹部CTにて腹腔内遊離ガスと腹水貯留を認め，消化管穿孔による腹膜炎と診断し，緊急試験開腹術を施行した．既往歴として8カ月前に子宮頸癌cStage II B期の扁平上皮癌と診断されていたが，強皮症・肺高血圧症・慢性閉塞性肺疾患の併存疾患のため手術や化学療法は適応なく，姑息的放射線治療のみ施行されていた．手術所見ではTreitz靱帯より約80cm肛門側の小腸に腫瘍穿孔を認めたため，同部位を中心に約15cmの小腸を切除して吻合した．…
View article: Optimal Timing to Assess Drain Amylase Concentration after Elective Gastrectomy
Optimal Timing to Assess Drain Amylase Concentration after Elective Gastrectomy Open
dAmy1 was more useful than dAmy3 in predicting PPRC. The combination of dAmy1 and sCRP3 may be a useful criterion for the removal of drains on postoperative day 3.
View article: Authors’ reply
Authors’ reply Open
We are grateful to Dr. Talukdar et al for their comments on our article, which we fully agree with.The accumulation of data from studies investigating the risk factors of postoperative morbidity or mortality helps clinicians identify which…
View article: Two Cases of Incarcerated Hiatal Hernia of the Broad Ligament of the Uterus after Diagnosis and Surgery Performed Laparoscopically before Surgery
Two Cases of Incarcerated Hiatal Hernia of the Broad Ligament of the Uterus after Diagnosis and Surgery Performed Laparoscopically before Surgery Open
腸閉塞の成因のうち,内ヘルニアによるものは1%前後といわれており,その中でも子宮広間膜裂孔ヘルニア嵌頓は比較的稀な疾患である.本疾患は長らく術前診断が困難とされてきた.しかし,本疾患に対しての認識が広まると共に,画像検査技術の発達に伴い術前診断が可能であった症例が多数報告されている.今回われわれは,術前にCTで診断し,手術を施行した子宮広間膜裂孔ヘルニア嵌頓の2例を経験した.2例とも腹腔鏡下手術を施行し,術後経過良好であった.本邦報告115例に自験例を加えた117例について…
View article: Postoperative morbidity in elderly patients after gastric cancer surgery
Postoperative morbidity in elderly patients after gastric cancer surgery Open
The overall morbidity rate was significantly higher among elderly patients and an intraoperative blood loss of ≥320 mL was a significant predictive factor. In particular, anastomotic leakage and cardiovascular complications were seen with …
View article: Is the Glasgow Prognostic Score Applicable to Both Early- and Advanced-Stage Gastric Cancers?
Is the Glasgow Prognostic Score Applicable to Both Early- and Advanced-Stage Gastric Cancers? Open
GPS is a simple and useful prognostic score for patients with advanced-stage, but is not applicable to early-stage patients.
View article: Granulomatosis with Polyangiitis Complicated with Gastrointestinal Perforation: A Case Report and Review of Literature
Granulomatosis with Polyangiitis Complicated with Gastrointestinal Perforation: A Case Report and Review of Literature Open
A 51-year-old man was detected nasal bleeding, multiple pulmonary nodule and mass, urinalysis abnormality, renal involvement and high titer of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), and was suspected of granulomatosi…
View article: Intestinal perforation management using T-tube drainage
Intestinal perforation management using T-tube drainage Open
In cases of small bowel perforation with gross contamination, enterostomy has traditionally been the treatment of choice. An 86-year-old woman was diagnosed with perforative peritonitis. Emergency laparotomy revealed a small bowel perforat…
View article: Successful Treatment of Recurrent Multiple Hepatolithiasis after Choledochectomy and Hepaticojejunostomy for Congenital Bile Duct Dilatation: Left Hepatectomy and Jejunostomy for Endoscopic Lithotomy
Successful Treatment of Recurrent Multiple Hepatolithiasis after Choledochectomy and Hepaticojejunostomy for Congenital Bile Duct Dilatation: Left Hepatectomy and Jejunostomy for Endoscopic Lithotomy Open
症例は49歳の男性で，20歳時に先天性胆道拡張症に対する分流手術（肝外胆管切除，総肝管空腸吻合術）を受け，37歳時より肝内結石を生じ胆管炎を反復するようになった．最大径35 mmの両葉多発肝内結石と肝左葉の萎縮を認めたため，肝左葉切除術，切石用空腸瘻造設術を施行した．術後に経空腸瘻的内視鏡的切石術を追加し残肝結石を全て切石することが可能であった．術後19か月目に肝内結石再発による胆管炎を来したが，ガストロボタンにて瘻孔を確保していたため，再び経空腸瘻的内視鏡的切石術が施行可…