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Asada Y, Chinen K, Yamataka K, Tokuyama J, Kurihara N, Iida S. Intramural cancer recurrence in the rectum after curative surgery for proximal sigmoid colon cancer: a case report. World J Surg Oncol 2022; 20:332. [PMID: 36192748 PMCID: PMC9528118 DOI: 10.1186/s12957-022-02794-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background Intramural metastasis distant from the primary tumor is rare in colorectal cancer. Here, we present a notably rare and probably the first case of asynchronous intramural recurrence in the rectum after curative surgery for proximal sigmoid colon cancer. Case presentation A 44-year-old man underwent curative sigmoidectomy for proximal sigmoid colon cancer with T3N0M0, Stage IIA tubular adenocarcinomas. After 15 months, the tumor marker level had increased, and positron emission tomography-computed tomography (PET-CT) revealed abnormal fluorodeoxyglucose uptake in the rectum; colonoscopy revealed a submucosal tumor (SMT)-like lesion in the upper rectum, and biopsy revealed a tubular adenocarcinoma. We performed curative low anterior resection with tumor-specific mesorectal excision (TSME). The SMT-like tumor was located approximately 20 cm from the initial sigmoid colon anastomosis (i.e., at least 20 cm distal to the initial sigmoid colon cancer). The pathological findings revealed cancer cells with the same features as the initial sigmoid colon cancer, only in the intestinal wall but not in the mucosa and extramural tissue. Therefore, the lesion was determined to be an intramural recurrence. After 24 months, lung recurrence, and local recurrence, which might have involved the lymph nodes in the preserved mesorectum after TSME at the bottom of the pelvis was detected on PET-CT. Hence, we started systemic chemotherapy. Conclusions This case report suggests that PET-CT and short-interval repeat colonoscopy may help detect a rare intramural recurrence. A long distal margin may be necessary to achieve local control in the rectal resection for intramural recurrence.
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Affiliation(s)
- Yusuke Asada
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan.
| | - Katsuya Chinen
- Department of Pathology, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan
| | - Ken Yamataka
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan
| | - Jo Tokuyama
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan
| | - Naoto Kurihara
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan
| | - Shuhei Iida
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo, 176-8530, Japan
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Asada Y, Chinen K, Yamataka K, Tokuyama J, Kurihara N, Iida S. Pathological complete response after neoadjuvant chemotherapy with FOLFOX for locally advanced sigmoid colon cancer with diverticulitis: A case report. Int J Surg Case Rep 2022; 90:106685. [PMID: 34952318 PMCID: PMC8714994 DOI: 10.1016/j.ijscr.2021.106685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction and importance The standard treatment for locally advanced colon cancer (LACC) without distant metastasis is curative surgery followed by adjuvant chemotherapy, but the long-term outcomes of this strategy are not satisfactory. Neoadjuvant chemotherapy (NAC) is a promising novel option to overcome this issue. Tumor regression is an expected effect of NAC for LACC, but pathological complete response (pCR) is rare. In this report, we present a rare case of pCR after NAC with FOLFOX for LACC in the sigmoid colon. Presentation of case A 66-year-old woman presented to our hospital with fever and abdominal pain. The diagnosis was LACC in the sigmoid colon with possible invasion of the uterus and pelvic wall, stage IIIC (T4bN1bM0). Furthermore, the tumor was complicated by diverticulitis. A colostomy was performed, followed by NAC with FOLFOX. Six cycles were completed without significant adverse events, and the lesion shrunk remarkably. We performed a curative sigmoidectomy without any postoperative complications. Pathological examination revealed no viable cancer cells, indicating pCR. Discussion To the best of our knowledge, this is the first report of pCR after NAC for LACC complicated by diverticulitis. Colostomy before NAC, regimen, and cycle of NAC may be the key to this favorable course. Conclusion We present a rare case of pathological complete after neoadjuvant chemotherapy with FOLFOX for locally advanced colon cancer in the sigmoid colon complicated by diverticulitis. Our experience may be valuable in determining the optimal treatment strategy for LACC complicated by diverticulitis. Neoadjuvant chemotherapy is a promising novel option for locally advanced colon cancer. Pathological complete response is rare. Indications for cases complicated with diverticulitis are unknown. We present a rare case of pCR after NAC for LACC complicated by diverticulitis.
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Affiliation(s)
- Yusuke Asada
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan.
| | - Katsuya Chinen
- Department of Pathology, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan
| | - Ken Yamataka
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan
| | - Jo Tokuyama
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan
| | - Naoto Kurihara
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan
| | - Shuhei Iida
- Department of Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima, Tokyo 176-8530, Japan
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Sugawara K, Yamashita H, Yajima S, Oshima Y, Mitsumori N, Fujisaki M, Yamazaki K, Otsuka K, Futawatari N, Watanabe R, Satodate H, Yoshimoto Y, Nagaoka S, Tokuyama J, Sasaki S, Seto Y, Shimada H. Prognosis of hemodialysis patients undergoing surgery for gastric cancer: Results of a multicenter retrospective study. Surgery 2021; 170:249-256. [PMID: 33632543 DOI: 10.1016/j.surg.2021.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Little is known about the survival outcomes of and predictive factors for survival in hemodialysis patients undergoing surgery for gastric cancer. METHODS We performed a multicenter retrospective study from 9 institutions to investigate the survival outcomes of 75 hemodialysis patients with gastric cancer. Patient characteristics included demographic data, hemodialysis- and gastric cancer-related variables. Multivariate Cox hazards models were applied to determine independent predictors of poor overall survival and non-gastric cancer related death. RESULTS Stage I disease was predominant (58.7%) in our series. The overall morbidity and the 30-day mortality rates were 25.3% and 1.3%, respectively. The 5-year overall survival rates of patients with pStages I, II, III, and IV disease were 59.2%, 42.9%, 32.3%, and 0%, respectively. Eleven (14.7%) patients died of gastric cancer, whereas many more (40.0%) died owing to causes other than gastric cancer. Non-gastric cancer-related death was especially prevalent in patients with pStages I (95.2%) and II (75.0%) disease. Multivariable analysis revealed advanced age, long duration of hemodialysis (> 5 years), total gastrectomy, and pStage IV disease to be independently associated with poor overall survival. Notably, advanced age, long duration of hemodialysis, and the presence of cardiovascular disease were all independent predictors of non-gastric cancer-related death. Patients with all 3 factors had very poor survival outcomes (3-year overall survival; 14.3%). CONCLUSION The survival outcomes of hemodialysis patients with gastric cancer, especially those with early-stage gastric cancer, were clearly poor, largely owing to the increased risk of non-gastric cancer-related death. Preoperative comorbidities and hemodialytic features were useful for predicting long-term outcomes of this vulnerable population.
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Affiliation(s)
- Kotaro Sugawara
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo, Japan
| | - Hiroharu Yamashita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo, Japan.
| | - Satoshi Yajima
- Department of Surgery, Toho University Omori Medical Center, Tokyo, Japan
| | - Yoko Oshima
- Department of Surgery, Toho University Omori Medical Center, Tokyo, Japan
| | - Norio Mitsumori
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Muneharu Fujisaki
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Kimiyasu Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Koji Otsuka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Nobue Futawatari
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Ryohei Watanabe
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan; Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | | | | | - Sakae Nagaoka
- Department of Gastroesophageal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Jo Tokuyama
- National Hospital Organization Tokyo Medical Center, Japan
| | - Shin Sasaki
- Department of Surgery, Omori Red Cross Hospital, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo, Japan
| | - Hideaki Shimada
- Department of Surgery, Toho University Omori Medical Center, Tokyo, Japan; Department of Surgery, Toho University Graduate School of Medicine, Tokyo, Japan. https://twitter.com/twitterhandle
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Ochiai H, Ohishi T, Osumi K, Tokuyama J, Urakami H, Seki S, Shimada A, Matsui A, Isobe Y, Murata Y, Endo T, Ishii Y, Hasegawa H, Matsumoto S, Kitagawa Y. Reevaluation of serum p53 antibody as a tumor marker in colorectal cancer patients. Surg Today 2011; 42:164-8. [PMID: 22075664 DOI: 10.1007/s00595-011-0044-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 02/04/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE We reevaluated the serum p53 antibody (S-p53Ab) ELISA kit, which was approved as a tumor marker of colon cancer in the Japanese Health Insurance System in 2007. METHODS S-p53Ab was measured as a tumor marker in 154 colorectal cancer patients, and the results were categorized by clinical and pathological variables. We then compared the positive frequency of S-p53Ab, carcinoembryonic antigen (CEA), and carbohydrate 19-9 (CA19-9). RESULTS S-p53Ab was positive in 33.1% of the colorectal cancer patients. The positive rate was significantly higher in patients with lymph nodes metastasis (P = 0.025) and lymphatic invasion (P = 0.023). In patients with stage I colorectal cancer, the positive rate of S-p53Ab (23.7%) was significantly higher than that of CEA (5.3%) or CA19-9 (7.9%). CONCLUSION The approved kit for S-p53Ab testing was found to be an effective tumor marker of colorectal cancer. The positive rate of S-p53Ab was significantly higher in patients with cancer involvement of the lymphoid tissues. The positive rate of S-p53Ab was higher than that of CEA and CA19-9 in patients with stage I colorectal cancer, suggesting that the S-p53Ab is a useful tumor marker for patients with early-stage disease.
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Affiliation(s)
- Hiroki Ochiai
- Department of Surgery, National Tokyo Medical Center, Tokyo, Japan.
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Ochiai H, Ohishi T, Seki S, Tokuyama J, Osumi K, Urakami H, Shimada A, Matsui A, Isobe Y, Murata Y, Endo T, Ishii Y, Hasegawa H, Matsumoto S, Kitagawa Y. Prolapse of Intussusception through the Anus as a Result of Sigmoid Colon Cancer. Case Rep Gastroenterol 2010; 4:346-350. [PMID: 21060698 PMCID: PMC2974997 DOI: 10.1159/000320770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Adult intussusception is rare and most often associated with cancer. We report a case of intussuscepted sigmoid colon into the rectum protruding from the anus of a 47-year-old woman. The cause of the intussusception was sigmoid colon cancer. We removed the intussuscepted part of the sigmoid colon as well as the rectum and regional lymph nodes. The patient recovered uneventfully and there has been no evidence of recurrence of the cancer.
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Affiliation(s)
- Hiroki Ochiai
- Department of Surgery, National Tokyo Medical Center, Tokyo, Japan
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Takeuchi H, Futamata K, Maeshima A, Hirose S, Shimada A, Kawaguchi Y, Tokuyama J, Osumi K, Kishi S, Hojo T, Kim S, Wada N, Oishi T, Isobe Y, Ikeuchi S, Kubochi K, Matsumoto S. A case of primary gastric small cell carcinoma with a rare pattern of lymph node metastasis. ACTA ACUST UNITED AC 2007; 36:99-104. [PMID: 16648660 DOI: 10.1385/ijgc:36:2:99] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 11/11/2022]
Abstract
We report a very rare case of primary gastric small cell carcinoma (GSCC) that was accompanied with gastric tubular adenocarcinoma. A male in his 60s had an elevated tumor with a central ulceration in the middle stomach. The patient underwent a distal gastrectomy with lymph node dissection. The pathological examination showed two separated lesions of the stomach, which contained the components of primary GSCC and primary gastric tubular adenocarcinoma. Immunohistochemical (IHC) examination demonstrated that the tumor cells in the small cell carcinoma stained positive for synaptophysin, chromogranin A, and neural cell adhesion molecule (NCAM). GSCC cells and adenocarcinoma cells independently metastasized to each regional lymph node. Further studies on the biological behavior of individual tumors may allow the development of new treatment strategies for GSCC.
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Affiliation(s)
- Hiroya Takeuchi
- Department of Surgery, National Tokyo Medical Center, 2-5-1 Higashigaoka, Tokyo, 152-8902, Japan.
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7
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Tokuyama J, Kubota T, Saikawa Y, Yoshida M, Furukawa T, Otani Y, Kumai K, Kitajima M. Tyrosine kinase inhibitor SU6668 inhibits peritoneal dissemination of gastric cancer via suppression of tumor angiogenesis. Anticancer Res 2005; 25:17-22. [PMID: 15816514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Peritoneal dissemination of cancer involves several steps, including tumor cell attachment, invasion and growth in the peritoneum. Tumor angiogenesis is a prerequisite for the growth of disseminated tumor. Vascular endothelial growth factor (VEGF) and its receptor are major regulators of angiogenesis. PURPOSE We examined the cytotoxic effects of SU6668, an inhibitor of VEGF tyrosine kinase receptors, on in vitro gastric cancer cell lines and human umbilical vascular endothelial cells (HUVEC); we also examined the antitumor effects of SU6668 on human gastric cancer cells administered intraperitoneally into nude mice. MATERIALS AND METHODS Direct cytotoxicity to gastric cancer cells (TMK-1, MKN-45 and MKN-74) and normal cells (HUVEC) was determined by the MTT assay and the bromodeoxyuridine (BrdU) incorporation assay, with and without VEGF-evoked growth stimulation in vitro. TMK-1 cells were transplanted intraperitoneally into nude mice, followed by twice daily oral administration of SU6668 (200 mg/kg/day) for two weeks starting on the first day after transplantation. Both the number and the wet weight of disseminated peritoneal tumor nodules were assessed. RESULTS In the MTT assay, SU6668 demonstrated low-grade cytotoxicity to the cell growth of three gastric cancer cells, with a 50% inhibitory concentration (IC50) of 22.6 microg/ml for TMK-1, 31.8 microg/ml for MKN-45 and 26.7 microg/ml for MKN-74; HUVEC was sensitive to SU6668 with an IC50 of 8.9 microg/ml. In the BrdU assay, VEGF stimulated DNA synthesis in HUVEC, while the incorporation of BrdU was not affected by VEGF in gastric cancer cell lines. SU6668 inhibited VEGF-induced DNA synthesis in HUVEC, while BrdU incorporation of gastric cancer cell lines was inhibited by SU6668 without correlation to VEGF stimulation. Peritoneal dissemination of cancer in nude mice was significantly suppressed by SU6668 compared with a control group at the p<0.05 level. CONCLUSION The mechanism of the antitumor activity of SU6668 may not involve direct toxicity to cancer cells, but may rather be an inhibitory effect on tumor angiogenesis, resulting in the inhibition of tumor dissemination in the peritoneum.
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Affiliation(s)
- Jo Tokuyama
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan
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Kato Y, Tsuyuki A, Kikuchi K, Tokuyama J, Kurihara N, Kumamoto Y, Fujishiro Y, Ebinuma H. Continuous hepatic arterial infusion chemotherapy for liver metastasis from biliary tract and pancreatic cancers. Anticancer Res 2005; 25:477-82. [PMID: 15816615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The efficacy of intrahepatic arterial chemotherapy for liver metastasis from biliary tract or pancreatic cancer remains uncertain. PATIENTS AND METHODS Five patients with bilio-pancreatic liver metastasis underwent continuous hepatic arterial infusion chemotherapy. One treatment course basically consisted of a 14-day infusion period during which continuous infusions of 5-fluorouracil and intermittent bolus injections of cisplatin were given, and a subsequent 14-day intermission. After two consecutive courses, these drugs were administered bi-weekly. RESULTS One complete and three partial responses were observed (response rate, 80%). In responders, the responses persisted until or even after the cessation of chemotherapy. The median survival was 15 months after the start of chemotherapy. The longest survivor has been disease-free for 46 months since a liver tumour remaining despite chemotherapy was eradicated by further treatment. Toxicity was acceptable. CONCLUSION 5-Fluorouracil and cisplatin-based continuous hepatic arterial infusion chemotherapy may serve as a promising treatment for bilio-pancreatic liver metastasis.
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Affiliation(s)
- Yutaro Kato
- Department of Surgery, Tokyo Denryoku Hospital, 9-2 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan.
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9
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Tokuyama J, Kubota T, Otani Y, Egawa T, Wada N, Kumai K, Sugino Y, Mashima Y, Nakamura Y, Mukai M, Ishii H, Kitajima M. Rare case of early mucosal gastric cancer presenting with metastasis to the bulbar conjunctiva. Gastric Cancer 2003; 5:102-6. [PMID: 12111586 DOI: 10.1007/s101200200017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early gastric cancer has an excellent outcome following surgical treatment. In particular, mucosal gastric cancer (m-cancer) very rarely results in metastatic dissemination and may be successfully treated by local surgical resection. We report a 64-year-old Japanese woman who presented with a recurrent cystic lesion on the left bulbar conjunctiva, with a biopsy specimen revealing metastatic signet-ring cell carcinoma. Gastrointestinal investigations revealed an early gastric cancer in the lesser curvature of the stomach. Biopsy specimen of the gastric lesion indicated poorly differentiated adenocarcinoma, which was identical to findings in the lesion in the bulbar conjunctiva. She underwent a distal gastrectomy and made an uneventful recovery. Histopathological analysis indicated a gastric signet-ring cell carcinoma that was limited to the mucosal layer, without evidence of lymphatic spread. Although the exact mechanism of metastatic dissemination to the bulbar conjunctiva is unclear, this case is very unusual, because ocular metastases almost invariably occur in the context of documented and established malignant disease. This is, to our knowledge, the first reported case of a patient with gastric mucosal cancer who presented with a conjunctival metastatic deposit and who subsequently received curative surgical treatment for both conditions.
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Affiliation(s)
- Jo Tokuyama
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Kimata M, Kubota T, Otani Y, Ohgami M, Ishikawa Y, Yokoyama T, Issiki S, Abe S, Egawa T, Tokuyama J, Wada N, Kumai K, Kitajima M, Mukai M. Gastrointestinal stromal tumors treated by laparoscopic surgery: report of three cases. Surg Today 2000; 30:177-80. [PMID: 10664344 DOI: 10.1007/s005950050038] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Three cases of gastrointestinal stromal tumors (GIST) were treated by a laparoscopic wedge resection of the stomach. The tumor characteristics were confirmed to be nonepithelial, nonlymphomatous, nonmyogenic, and nonneurogenic gastrointestinal neoplasms with an uncertain origin which were CD34-positive and actin- and S-100-negative. The malignant potential was estimated based on the mitotic figures and growth rates. The results suggest that laparoscopic surgery is an adequate strategy for gastric submucosal tumors including GIST, and also indicates this technique to be a curative, safe, and minimally invasive procedure for both diagnosis and treatment.
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Affiliation(s)
- M Kimata
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Kitajima M, Ohgami M, Furukawa T, Morikawa Y, Watanabe M, Kitagawa Y, Tokuyama J, Nakazawa K. [Fusion of medicine and technology in endoscopic surgery]. Nihon Geka Gakkai Zasshi 1999; 100:273-8. [PMID: 10412144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Although endoscopic surgery has become widespread and is currently used in a wide range of general, thoracic, urologic, gynecologic, and orthopedic procedures, many major difficulties remain because sensorial information is restricted to a two-dimensional image, and effector instruments have limited maneuverability due to the rigid shaft axis fixed to the abdominal wall by the entry trocar. To overcome these problems, advanced engineering technology has been introduced in laparoscopic surgery which includes three-dimensional video imaging, robotic laparoscopic cameraholders, telemanipulated flexible effector instruments, and tactile feedback. A voice-controlled robotic laparoscopic holder (AESOP200, Computer Motion Inc. USA) provides stable support for the laparoscope during laparoscopic surgery performed by a single surgeon. A new computer-assisted telemanipulation robot (Intuitive Surgical Inc. USA) permits the performance of completely endoscopic coronary artery bypass and Nissen fundoplication. Furthermore, price reductions and technological advances in telecommunications have made telementoring in endoscopic surgery available for routine clinical use, and intercontinental surgical video teleconferences fruitful opportunities for discussing technical details. The fusion of medicine and technology in endoscopic surgery would overcome difficulties in the conventional endoscopic approach.
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Affiliation(s)
- M Kitajima
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
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Ohyama H, Simoen E, Claeys C, Vanhellemont J, Hayama K, Tokuyama J, Takami Y, Sunaga H, Poortmans J, Caymax M. Radiation damage in Si1−x Ge x heteroepitaxial devices. J Radioanal Nucl Chem 1999. [DOI: 10.1007/bf02349510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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