Kiyoka Hara

Small Intestinal Perforation Due to Press Through Package Sheet Ingestion, with Subsequent Rectal Extraction

Michitaka Ogura, Shinnosuke Yamamoto, Hiroto Kawabata, Kiyoka Hara et autres

症例は72歳女性．便秘薬服用後の腹痛の精査目的に紹介受診した．単純CTで腹腔内に遊離ガスと腹水を認め，消化管穿孔および汎発性腹膜炎の診断で緊急手術を施行した．腹腔内には黄色の混濁腹水を認め，性状から上部消化管穿孔を疑ったが，腹腔鏡下では穿孔部位を特定できなかった．臍の小開腹創から小腸を引き出すと回腸末端から約30 cm口側に腸管の短軸方向に並ぶ2つの微小な穿孔を認め縫合閉鎖した．術後7病日の単純CTで直腸の周囲に空気を伴う高吸収を認め，形状からpress through package包装シート（以下，PTP）が疑われた．内視鏡を施行し直腸内のPTPを摘出した．PTPの誤飲による消化管穿孔は食道，十二指腸，小腸，大腸などで複数の報告があるが，本症例のように，PTPが小腸穿孔後に直腸まで到達し摘出に至った例は極めて稀である．

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Internal and External Inguinal Hernias Coexisting with a Femoral Hernia-like Lesion in an Older Male—A Case Report—

Shinnosuke YAMAMOTO, Kiyoka Hara, Michitaka Ogura, Haruo HOSOYA et autres

84歳，男性．来院3カ月前から右鼠径部膨隆を自覚していた．健康診断のCTで右内鼠径ヘルニアを疑われたため，紹介受診した．立位で右鼠径部に手拳大の膨隆を認め，CT所見より，新Japan Hernia Society （JHS）分類M2相当の右内鼠径ヘルニアと診断し，待機的に腹腔鏡下鼠径ヘルニア修復術（Trans-Abdominal Pre-Peritoneal repair;TAPP）を行った．腹腔内を観察すると，下腹壁血管の内外側にそれぞれ2.5cm大と2.0cm大のヘルニア門を認め，新JHS分類右M2型と右L2型と診断した．また，腹膜前腔を剥離すると大腿輪に1.5cm大のヘルニア門が存在したため，大腿ヘルニア類似病変と追加診断した．自験例のような内鼠径ヘルニア・外鼠径ヘルニアに大腿ヘルニア類似病変が併存した例は報告がない．腹腔鏡手術でなければ診断困難な稀な症例を経験した．

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Laparoscopic Surgery for Colorectal Cancer in Patients on Hemodialysis: A Propensity Score-matched Analysis

Nao Obara, Yasumitsu Hirano, Toshimasa Ishii, Hiroka Kondo et autres

BACKGROUND/AIM: Surgery on hemodialysis patients requires special attention, as the tissue of these patients is vulnerable and hemorrhagic. This study explored the feasibility of laparoscopic surgery for colorectal cancer in hemodialysis patients. PATIENTS AND METHODS: This was a retrospective study of patients …

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The short and mid-term outcome of Laparoscopic surgery for the Transverse Colon Cancer.

Takuya Kato, Obara Nao, Tetsuyoshi Takayama, Wang Liming et autres

The Significance of Lateral Lymph Node Metastasis in Low Rectal Cancer: a Propensity Score Matching Study

Liming Wang, Yasumitsu Hirano, Gregory Kang Ee Heng, Toshimasa Ishii et autres

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E-PASS Scoring System May Be Useful for Prediction of Postoperative Complications in Super Elderly Colorectal Cancer Surgery Patients

Hiroka Kondo, Yasumitsu Hirano, Toshimasa Ishii, Kiyoka Hara et autres

OBJECTIVES: Japan is facing an aging society. Elderly individuals are generally more prone to comorbidities and have weaker immune defenses, with ominous prognostic implications if postoperative complications arise. The aim of this study was to explore scoring systems for predicting postoperative morbidity …

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Better Cancer-specific Survival in Younger Patients With Stage III Colorectal Cancer: A Propensity Score Matching Study From Japan

Liming Wang, Yasumitsu Hirano, Gregory Kang Ee Heng, Toshimasa Ishii et autres

BACKGROUND/AIM: The purpose of this study was to explore the perioperative, short-term, and long-term prognostic differences in colorectal cancer (CRC) between young and older patients. PATIENTS AND METHODS: A total of 3095 patients were divided into young (≤45 years; n=139) and older …

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Does signet ring cell carcinoma component signify worse outcomes for patients with colorectal cancer?

Liming Wang, Yasumitsu Hirano, Gregory Kang Ee Heng, Toshimasa Ishii et autres

AIM: The purpose of this study was to elucidate the differences in clinical pathology and prognosis between signet ring cell carcinoma component and adenocarcinoma in colorectal cancer. MATERIALS AND METHODS: From April 2007 to December 2016, a total of 4348 patients with …

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Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer

Liming Wang, Yasumitsu Hirano, Toshimasa Ishii, Hiroka Kondo et autres

BACKGROUND: It is not clear whether stage II colon and rectal cancer have the same risk factors for recurrence. Thus, the purpose of this study was to identify the risk factors for postoperative recurrence in stage II colorectal cancer. PATIENTS AND METHODS: …

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Intestinal endometriosis treated by laparoscopic surgery: case series of 5 patients

Hiroka Kondo, Yasumitsu Hirano, Toshimasa Ishii, Kiyoka Hara et autres

BACKGROUND: Intestinal endometriosis is rare and most frequently involves the rectum and sigmoid colon. CASE PRESENTATION: Here, we report a case series of 5 patients who underwent laparoscopic resection for intestinal endometriosis. None of the patients developed postoperative complications, and all were …

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Mucinous Adenocarcinoma as a High-risk Factor in Stage II Colorectal Cancer: A Propensity Score-matched Study from Japan

Liming Wang, Yasumitsu Hirano, Gregory Kang Ee Heng, Toshimasa Ishii et autres

BACKGROUND/AIM: The purpose of this study was to investigate the clinical, pathological, and prognostic differences between adenocarcinoma (ADC) and mucinous adenocarcinoma (MUC) in colorectal cancer (CRC). PATIENTS AND METHODS: This was a retrospective study of a Japanese high-volume cancer Center over a …

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[A Case of Laparoscopic Ileocecal Resection for Ascending Colon Cancer with Portosystemic Shunt].

Kenichi Takemoto, Shigeki Yamaguchi, Toshimasa Ishii, Hiroka Kondo et autres

A 72-year-old woman who underwent colorectal endoscopy because of positive fecal occult blood test results was diagnosed with ascending colon cancer.Preoperative CT revealed advanced ascending colon cancer and portosystemic shunt between the ileocecal vein and inferior vena cava.It was necessary to cut …

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