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Yoshida T, Homma S, Ichikawa N, Fujiyoshi S, Shibata K, Imaizumi K, Taketomi A. Feasibility of Laparoscopic and Robotic Total Proctocolectomy for Ulcerative Colitis-related Colorectal Cancer. Anticancer Res 2023; 43:5245-5252. [PMID: 37909995 DOI: 10.21873/anticanres.16726] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM To evaluate the feasibility of laparoscopic and robotic total proctocolectomy (TPC) for ulcerative colitis-associated colorectal cancer (UC-CRC). PATIENTS AND METHODS We retrospectively analyzed the postoperative outcomes of TPC in 13 patients with UC-CRC between January 2011 and December 2021. Laparoscopic TPC was performed in 10 patients. TPC consisted of two procedures: ileal pouch-anal anastomosis (IAA) and TPC with end ileostomy. Using the da Vinci Xi platform with six ports, robotic TPC and abdominal perineal resection (APR) were performed in two and one patients, respectively. Transanal total mesorectal excision (TaTME) was performed using the perineal approach in five patients. RESULTS UC-CRC was located in the transverse colon, sigmoid colon, rectum, and anal canal in 1, 1, 10, and 1 patients, respectively. IAA, TPC with end ileostomy, and APR were performed in nine, three, and one patients, respectively. Postoperative complications included colitis, portal vein thrombosis, and liver dysfunction, without mortality. The pathological stages were 0, I, IIa, IIIb, and IIIc in five, four, one, two, and one patients, respectively. The tumors were completely resected in all cases. Eleven patients with pStages 0, I, and II survived without recurrence; however, two patients with pStage III died of cancer recurrence. CONCLUSION This study demonstrated the feasibility of laparoscopic and robotic TPC in patients with UC-CRC. However, long-term outcomes in terms of oncology and patient quality of life must be investigated in future large-scale studies.
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Affiliation(s)
- Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Sunao Fujiyoshi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Kengo Shibata
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
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Yoshida T, Homma S, Ichikawa N, Ohno Y, Miyaoka Y, Matsui H, Imaizumi K, Ishizu H, Funakoshi T, Koike M, Kon H, Kamiizumi Y, Tani Y, Ito YM, Okada K, Taketomi A. Preoperative mechanical bowel preparation using conventional versus hyperosmolar polyethylene glycol-electrolyte lavage solution before laparoscopic resection for colorectal cancer (TLUMP test): a phase III, multicenter randomized controlled non-inferiority trial. J Gastroenterol 2023; 58:883-893. [PMID: 37462794 DOI: 10.1007/s00535-023-02019-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/02/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND A hyperosmolar ascorbic acid-enriched polyethylene glycol-electrolyte (ASC-PEG) lavage solution ensures excellent bowel preparation before colonoscopy; however, no study has demonstrated the efficacy of this lavage solution before surgery. This study aimed to establish the non-inferiority of ASC-PEG to the standard polyethylene glycol-electrolyte solution (PEG-ELS) in patients undergoing laparoscopic resection for colorectal cancer. METHODS This was a prospective, single-blind, multicenter, randomized, controlled, non-inferiority clinical trial. Overall, 188 patients scheduled for laparoscopic colorectal resection for single colorectal adenocarcinomas were randomly assigned to undergo preparation with different PEG solutions between August 2017 and April 2020 at four hospitals in Japan. Participants received ASC-PEG (Group A) or PEG-ELS (Group B) preoperatively. The primary endpoint was the ratio of successful bowel preparations using the modified Aronchick scale, defined as "excellent" or "good." RESULTS After exclusion, 86 and 87 patients in Groups A and B, respectively, completed the study, and their data were analyzed. ASC-PEG was not inferior to PEG-ELS in terms of effective bowel preparation prior to laparoscopic colorectal resection (0.93 vs. 0.92; 95% confidence interval, - 0.078 to 0.099, p = 0.007). The total volume of cleansing solution intake was lower in Group A than in Group B (1757.0 vs. 1970.1 mL). Two and three severe postoperative adverse events occurred in Groups A and B, respectively. Patient tolerance of the two solutions was almost equal. CONCLUSIONS ASC-PEG is effective for preoperative bowel preparation in patients undergoing laparoscopic resection for colorectal cancer and is non-inferior to PEG-ELS.
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Affiliation(s)
- Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan.
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Yosuke Ohno
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
- Department of Surgery, Sapporo-Kosei General Hospital, N3, E8, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Yoichi Miyaoka
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Hiroki Matsui
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Hiroyuki Ishizu
- Department of Surgery, Sapporo-Kosei General Hospital, N3, E8, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Tohru Funakoshi
- Department of Surgery, Sapporo-Kosei General Hospital, N3, E8, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Masahiko Koike
- Department of Surgery, KKR Sapporo Medical Center, Hiragishi 1-jo, 6-chome, Toyohira-ku, Sapporo, Hokkaido, Japan
| | - Hirofumi Kon
- Department of Surgery, KKR Sapporo Medical Center, Hiragishi 1-jo, 6-chome, Toyohira-ku, Sapporo, Hokkaido, Japan
| | - Yo Kamiizumi
- Department of Surgery, Iwamizawa Municipal General Hospital, 9-jo, W7, Iwamizawa, Hokkaido, Japan
| | - Yasuhiro Tani
- Department of Surgery, Iwamizawa Municipal General Hospital, 9-jo, W7, Iwamizawa, Hokkaido, Japan
| | - Yoichi Minagawa Ito
- Biostatistics Division, Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, Japan
| | - Kazufumi Okada
- Biostatistics Division, Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
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Ichimura K, Imaizumi K, Kasajima H, Sato A, Sato K, Yamana D, Tsuruga Y, Umehara M, Kurushima M, Nakanishi K. Chemical Bowel Preparation Exerts an Independent Preventive Effect Against Surgical Site Infection Following Elective Laparoscopic Colorectal Surgery. Surg Laparosc Endosc Percutan Tech 2023; 33:256-264. [PMID: 37184268 DOI: 10.1097/sle.0000000000001175] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/20/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND We investigated the independent clinical value of mechanical bowel preparations (MBP) and chemical bowel preparations (CBP) for preventing surgical site infection (SSI) in patients undergoing elective laparoscopic colorectal surgery. MATERIALS AND METHODS This retrospective cohort study included 475 patients who underwent elective laparoscopic colorectal surgery between January 2018 and March 2022. CBP was introduced in January 2021 and included kanamycin (1 g) and metronidazole (1 g) 2 times a day, the day before surgery. In some cases, MBP was omitted in patients who planned to undergo right-sided colectomy, those with tumor obstruction, and those with poor general conditions, depending on the judgment of the physician. The primary endpoint was the overall SSI incidence, while the secondary endpoints were the incidences of incisional SSI and organ-space SSI, culture from the surgical site, and length of postoperative hospital stay. RESULTS In total, 136 patients underwent CBP. MBP was omitted in 53 patients. Overall, SSI occurred in 80 patients (16.8%), including 61 cases of incisional SSI (12.8%) and 36 cases of organ-space SSI (7.6%). Multivariate logistic regression revealed that CBP exerted an independent preventive effect on overall and incisional SSI, whereas MBP did not. However, CBP was not associated with a decreased risk of overall SSI in patients who had undergone preoperative therapy, those with benign disease, and those with stoma formation in the subgroup analysis. Levels of Bacteroides species at the surgical site were significantly lower in the CBP group than in the non-CBP group. Postoperative hospital stay was significantly longer in the incisional SSI group than in the non-SSI group and was significantly longer in the organ-space SSI group than in the other groups. CONCLUSIONS CBP, but not MBP, exerts an independent preventive effect on SSI, especially incisional SSI, in patients undergoing elective laparoscopic colorectal surgery.
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Affiliation(s)
- Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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Imaizumi K, Kasajima H, Ito K, Fukasawa T, Odagiri M, Yamana D, Tsuruga Y, Umehara M, Kurushima M, Munakata S, Shimoyama N, Nakanishi K. Hybrid robot-assisted abdominoperineal resection supported by simultaneous trans-perineal approach for anal gland adenocarcinoma with vaginal invasion: a case report. J Surg Case Rep 2023; 2023:rjad334. [PMID: 37309548 PMCID: PMC10257794 DOI: 10.1093/jscr/rjad334] [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: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023] Open
Abstract
Hybrid surgery (abdominal robotic approach with a trans-anal approach) has been reported to improve oncological outcomes in cases involving advanced cancer or technical difficulties. A 74-year-old woman presented with anal pain and stenosis. Examination revealed palpable sclerosis on the anterior wall at the anal verge with possible vaginal invasion. A biopsy revealed an adenocarcinoma. We performed a two-team robot-assisted abdominoperineal resection combined with resection of the vagina supported by a simultaneous trans-perineal approach. After rendezvous at the posterior side, the abdominal team cut the posterior wall of the vaginal vault while the perineal team confirmed the surgical margin. Histopathological findings identified the tumour as an anal gland adenocarcinoma (pT4b [vagina] N0M0 pathological stage IIC) with a negative circumferential resection margin. Hybrid surgery combined with resection of the posterior wall of the vagina may be performed safely and is a valuable surgical option for multimodal treatment of anal adenocarcinomas.
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Affiliation(s)
- Ken Imaizumi
- Correspondence address. Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido 041-8680, Japan. Tel: +81 138 43 4434; Fax: +81 138 43 4434; E-mail:
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Keiichiro Ito
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Takumu Fukasawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Makoto Odagiri
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Satoru Munakata
- Department of Pathology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Norihiko Shimoyama
- Department of Pathology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
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Sato K, Kasajima H, Imaizumi K, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Sato A, Ichimura K, Fukasawa T, Ito K, Isokawa M, Nakanishi K. Visualization of Anorectal Lymphatic Flow Using Indocyanine Green Fluorescence Imaging: An Observational Study. Anticancer Res 2023; 43:1591-1598. [PMID: 36974820 DOI: 10.21873/anticanres.16309] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND/AIM Currently, only a small part of functional lymphatic flow around the anorectal region has been anatomically analyzed. Despite the fact that local recurrence is often experienced in the pelvic floor, the functional lymphatic network in this region has rarely been studied due to difficulties in observation. This prospective observational study aimed to observe anorectal lymphatic flow around the pelvic floor using intraoperative indocyanine green fluorescence imaging during laparoscopic or robot-assisted rectal surgery. PATIENTS AND METHODS Fourteen patients who underwent laparoscopic (n=7) or robot-assisted (n=7) surgery without any preoperative therapy between April and December 2022 were enrolled. Indocyanine green solution (0.25 mg) was injected into the submucosa at the dentate line of the anterior, posterior, and bilateral walls prior to surgery. During and after total mesorectal excision, lymphatic flow was observed using a near-infrared camera system. RESULTS Lymphatic flow visualized by indocyanine green was detected not only in the already-known route from the low rectum to the lateral pelvic lymph nodes via the lateral ligament, but also in the novel route from the low rectum to the surface of the levator ani muscle and hiatal ligament. Fluorescence was widely spread in the pelvic floor between the longitudinal muscle of the low rectum and the surface of the levator ani muscle. CONCLUSION Even though the results are preliminary since histological analyses were not performed, a novel widespread lymphatic network on the surface of the levator ani muscle originating from the longitudinal muscle fibers of the low rectum was revealed.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan;
- Department of Gastroenterological Surgery, Hirosaki University, Graduate School of Medicine, Aomori, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Takumu Fukasawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Keiichiro Ito
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Marina Isokawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hokkaido, Japan
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Matsuzawa R, Morise M, Ito K, Hataji O, Takahashi K, Kuwatsuka Y, Goto Y, Imaizumi K, Itani H, Yamaguchi T, Zenke Y, Oki M, Ishii M. 46P Multi-center, phase II study of docetaxel (DTX) plus ramucirumab (RAM) following platinum-based chemotherapy plus ICIs in patients with NSCLC: SCORPION study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00300-3] [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: 04/04/2023]
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Sato A, Imaizumi K, Kasajima H, Ichimura K, Sato K, Yamana D, Tsuruga Y, Umehara M, Kurushima M, Nakanishi K. Short- and long-term outcomes of preservation versus ligation of the inferior mesenteric artery in laparoscopic D3 lymph node dissection for descending colon cancer: a propensity score-matched analysis. Langenbecks Arch Surg 2023; 408:23. [PMID: 36637543 DOI: 10.1007/s00423-023-02771-1] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/09/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE This study aimed to compare the short- and long-term outcomes of laparoscopic D3 lymph node (LN) dissection between ligation of the inferior mesenteric artery (IMA) (LIMA) and preservation of the IMA (PIMA) for descending colon cancer using propensity score-matched analysis. METHODS This retrospective study included 101 patients with stage I-III descending colon cancer who underwent laparoscopic D3 LN dissection with LIMA (n = 60) or PIMA (n = 41) at a single center between January 2005 and March 2022. After propensity score matching, 64 patients (LIMA, n = 32; PIMA, n = 32) were included in the analysis. The primary endpoint was the long-term outcomes, and the secondary endpoint was the surgical outcomes. RESULTS In the matched cohort, no significant difference was noted in the surgical outcomes, including the operative time, estimated blood loss, number of harvested LNs, number of harvested LN 253, and complication rate. The long-term outcomes were also not significantly different between the LIMA and PIMA groups (3-year recurrence-free survival, 72.2% vs. 75.6%, P = 0.862; 5-year overall survival, 69.8% vs. 63.4%, P = 0.888; 5-year cancer-specific survival, 84.2% vs. 82.8%, P = 0.607). No recurrence of LN metastasis was observed around the IMA root. CONCLUSION Laparoscopic D3 dissection in PIMA was comparable to that in LIMA regarding both short- and long-term outcomes. The optimal LN dissection for descending colon cancer should be investigated in future large-scale studies.
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Affiliation(s)
- Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan.
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
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Sato K, Kasajima H, Yamana D, Imaizumi K, Nakanishi K. Technique of the single-port laparoscopic Hartmann's reversal via the colostomy site-A Video Vignette. Colorectal Dis 2022; 25:1050-1051. [PMID: 36408686 DOI: 10.1111/codi.16425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/22/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
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Sato K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Sato A, Ichimura K, Isokawa M, Nakanishi K. Comparison of Short-term Outcomes of a Self-expandable Metallic Stent as a Bridge to Laparoscopic Surgery between Right- and Left-sided Obstructive Colorectal Cancers: A Retrospective Observational Study. J Anus Rectum Colon 2022; 6:239-248. [PMID: 36348950 PMCID: PMC9613414 DOI: 10.23922/jarc.2022-019] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/07/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Few studies have compared the tumor-site-based postoperative short-term outcomes of a bridge to surgery using self-expandable metallic stents. This study compared the perioperative outcomes following stent placement between right- and left-sided obstructive colorectal cancers, focusing on patients undergoing laparoscopic surgery. METHODS This study included 127 patients with stage I-IV obstructive colorectal cancer (right-sided, n = 25 [19.7%]; left-sided, n = 102 [80.3%]) who underwent laparoscopic-assisted surgery following stent placement between May 2012 and September 2021. We compared the postoperative complication rates and the success rates of stent placement. RESULTS The clinical success rate was not significantly different (92% vs. 97.1%, P = 0.254). The rates of all-grade complications (36% vs. 16.7%, P = 0.05) and postoperative ileus or small-bowel obstruction (20% vs. 2%, P = 0.003) were significantly higher in the right-sided group. The rates of the Clavien-Dindo classification ≥ III complications (8% vs. 6.9%, P = 1) and the median durations of postoperative hospital stay (8 days vs. 8 days, P = 1) were not significantly different. On multivariate analysis, right-sided colon cancer was an independent risk factor for postoperative ileus or small-bowel obstruction (odds ratio [OR]: 16.5, 95% confidence interval [CI]: 2.42-112, P = 0.004) but not for all grades of complications (OR: 2.63, 95% CI: 0.976-7.09, P = 0.056). CONCLUSIONS Although the rates of clinical success, postoperative Clavien-Dindo classification ≥ III severe complications, and postoperative hospital stay were comparable, the bridge to surgery following stent placement for right-sided obstructive colon cancer raises concerns about ileus or small-bowel obstruction.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Marina Isokawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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Sato K, Kasajima H, Imaizumi K, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Sato A, Ichimura K, Isokawa M, Nakanishi K. Postoperative colon perforation due to the tip of the transanal decompression tube after laparoscopic low anterior resection: A case report. Asian J Endosc Surg 2022; 15:820-823. [PMID: 35584793 DOI: 10.1111/ases.13078] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
A 66-year-old man underwent laparoscopic low anterior resection for rectal cancer. A transanal decompression tube (24Fr Nelaton catheter) was placed laparoscopically during the surgery. Contrast enema on postoperative day 5 showed perforation of the sigmoid colon around the tip of the tube, and emergency laparotomy was performed. Perforation of the posterior sigmoid colon located on the proximal side of the colorectal anastomosis at the level of the promontorium was identified. Closure of the perforation site, lavage drainage, and a diverting loop ileostomy were performed. Although a transanal decompression tube is useful in preventing anastomotic leakage, tube-related colon perforation should be noted, and controversies about the safety of laparoscopically transanal decompression tube placement should be resolved. Adequate management for tube placement should be discussed.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Marina Isokawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
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Tamiya M, Goto Y, Kenmotsu H, Kurata T, Murakami S, Yanagitani N, Taniguchi H, Kuyama S, Shimizu J, Yokoyama T, Shimada N, T. M, Tamiya A, Uchiyama A, Imaizumi K, Takahama T, Nishio M, Hayashi H, Shiraiwa N, Okura M, Kikkawa H, Thomaidou D, Kato T. EP08.02-115 A Retrospective, Multicenter, Observational Study to Evaluate Outcomes With Lorlatinib After Alectinib in ALK+ NSCLC in Japan. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.798] [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: 10/14/2022]
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Imaizumi K, Homma S, Miyaoka Y, Matsui H, Ichikawa N, Yoshida T, Takahashi N, Taketomi A. Exploration of the advantages of minimally invasive surgery for clinical T4 colorectal cancer compared with open surgery: A matched-pair analysis. Medicine (Baltimore) 2022; 101:e29869. [PMID: 35960060 PMCID: PMC9371553 DOI: 10.1097/md.0000000000029869] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The indications of minimally invasive surgery (MIS) for T4 colorectal cancer are controversial because the advantages of MIS are unclear. Therefore, we compared overall survival (OS) and recurrence-free survival (RFS) as the primary endpoint, and short-term outcome, alteration in perioperative laboratory data, and the interval of postoperative chemotherapy from operation as secondary endpoints, between MIS and open surgery (OPEN) using a matched-pair analysis. We explored the advantages of MIS for T4 colorectal cancer. In this retrospective single-institution study, we included 125 patients with clinical T4 colorectal cancer who underwent curative-intent surgery of the primary tumor between October 2010 and September 2019. Conversion cases were excluded. MIS patients were matched to OPEN patients (ratio of 1:2) according to tumor location, clinical T stage, and preoperative treatment. We identified 25 and 50 patients who underwent OPEN and MIS, respectively, including 31 with distant metastasis. Both groups had similar background characteristics. The rate of major morbidities (Clavien-Dindo grade > III) was comparable between the 2 groups (P = .597), and there was no mortality in either group. MIS tended to result in shorter postoperative hospitalization than OPEN (P = .073). Perioperative alterations in laboratory data revealed that MIS suppressed surgical invasiveness better compared to OPEN. Postoperative chemotherapy, especially for patients with distant metastasis who underwent primary tumor resection, tended to be started earlier in the MIS group than in the OPEN group (P = .075). OS and RFS were comparable between the 2 groups (P = .996 and .870, respectively). In the multivariate analyses, MIS was not a significant prognostic factor for poor OS and RFS. MIS was surgically safe and showed similar oncological outcomes to OPEN-with the potential of reduced invasiveness and enhanced recovery from surgery. Therefore, patients undergoing MIS might receive subsequent postoperative treatments earlier.
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Affiliation(s)
- Ken Imaizumi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- * Correspondence: Shigenori Homma, MD, PhD, Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-Ku, Sapporo, Hokkaido 060-8638, Japan (e-mail: )
| | - Yoichi Miyaoka
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroki Matsui
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Norihiko Takahashi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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13
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Obuchi K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Sato K, Sato A, Suzuki S, Nakanishi K. Safety of Insertion of Percutaneous Totally Implantable Central Venous Access Devices by Surgical Residents. In Vivo 2022; 36:985-993. [PMID: 35241560 DOI: 10.21873/invivo.12791] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To compare the outcomes of totally implantable central venous access device (TIVAD) insertions by surgical residents (SRs) with those by experienced surgeons (ESs) and establish the safety of percutaneous TIVAD insertion by SRs. PATIENTS AND METHODS A total of 700 insertions were successfully performed between January 2015 and December 2019 in our Department. The puncture site conversion and complication rates were compared, and risk factors related to complications were analysed. RESULTS In total, 84 and 616 insertions were performed in the SR and ES groups, respectively. SRs mainly punctured the internal jugular vein (IJV), and ESs punctured the subclavian vein (SV). The conversion rate from the IJV to SV was similar, whereas that from the SV to IJV was higher by SRs than ESs. Overall, early, and delayed complications were similar between the two groups. CONCLUSION Percutaneous TIVAD inserted into the IJV by an SR was demonstrated to be safe.
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Affiliation(s)
- Keisuke Obuchi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan;
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Yousuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Shinsaku Suzuki
- Department of Breast Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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Sato A, Imaizumi K, Kasajima H, Ichimura K, Sato K, Nakanishi K. Step-by-step approach to laparoscopic D3 lymph node dissection while preserving the inferior mesenteric artery for advanced descending colon cancer - a video vignette. Colorectal Dis 2022; 24:337. [PMID: 34821451 DOI: 10.1111/codi.16003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/15/2021] [Accepted: 11/21/2021] [Indexed: 01/14/2023]
Affiliation(s)
- Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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15
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Imaizumi K, Homma S, Nishida M, Soyama T, Shimura R, Kudo Y, Omotehara S, Yokota I, Takagi R, Matsui H, Miyaoka Y, Ichikawa N, Yoshida T, Takahashi N, Taketomi A. Transabdominal Ultrasonography for Preoperative Diagnosis of Lymph Node Metastasis in Colon Cancer: A Retrospective Cohort Study. Cancer Diagn Progn 2022; 2:173-183. [PMID: 35399166 DOI: 10.21873/cdp.10092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/31/2022] [Indexed: 02/06/2023]
Abstract
Background/Aim Although computed tomography (CT) is the standard modality for diagnosing lymph node metastasis (LNM), transabdominal ultrasonography (US) can be useful due to its high spatial resolution and use of Doppler signals to precisely analyse lymph nodes. This study aimed to evaluate the accuracy of US for lymph node assessment, establish US-based diagnostic criteria for LNM, and compare the capability of US with that of CT for the diagnosis of LNM. Patients and Methods This retrospective, single-institution, cohort study included patients who underwent radical surgery for clinical stage 0-III colon cancer, between March 2012 and February 2019. Results Overall, 34.9% (66/189) of patients had pathological LNM. The optimal US diagnostic criteria were 1) short axis ≥7 mm and short/long ratio ≥0.75 and 2) at least two of the following: the absence of hilar echoes, expansive appearance, or peripheral/mixed vascularity by the colour Doppler and/or contrast-enhanced method. Compared to CT, US showed a higher diagnostic sensitivity (54.5% vs. 43.9%; p=0.296), higher concordance with the number of pathological LNM (correlation coefficient: US, 0.42; CT, 0.27) and pathological N diagnosis (weighted ĸ: US, 0.35; CT, 0.18), and higher sensitivity for advanced LNM, including multiple LNMs (47.4% vs. 18.4%; p=0.014) and N2 stage (27.8% vs. 5.6%; p=0.177). Conclusion US has higher sensitivity than CT for diagnosing LNM in colon cancer, along with a more accurate preoperative diagnosis of the N stage. Additionally, US may be more helpful than CT alone for preoperatively deciding the appropriateness of neoadjuvant treatment in colon cancer with advanced LNM.
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Affiliation(s)
- Ken Imaizumi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Mutsumi Nishida
- Division of Laboratory and Transfusion Medicine, Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Takeshi Soyama
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Ryosuke Shimura
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Yusuke Kudo
- Division of Laboratory and Transfusion Medicine, Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Satomi Omotehara
- Division of Laboratory and Transfusion Medicine, Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryo Takagi
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroki Matsui
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoichi Miyaoka
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norihiko Takahashi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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16
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Imaizumi K, Kasajima H, Terashima K, Furukawa N, Nakanishi K. Diagnosis and Treatment Difficulty in Early-Onset Peristomal Pyoderma Gangrenosum Associated With Ulcerative Colitis: A Case Report. Cureus 2022; 14:e22405. [PMID: 35371835 PMCID: PMC8942041 DOI: 10.7759/cureus.22405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/06/2022] Open
Abstract
Peristomal pyoderma gangrenosum (PPG) is a rare dermatological condition associated with gastroenterological disease. Most gastrointestinal surgeons find it difficult to suspect and treat PPG, especially at early onset. The patient was an 18-year-old female. The patient underwent three-stage restorative proctocolectomy for refractory ulcerative colitis. On postoperative day (POD) 9, the trocar wound near the ileostomy site dehisced. Because the wound culture was positive, the wound was treated with an antibacterial agent as an infection. However, the wound worsened. The patient was referred to a dermatologist for diagnosis. PPG was diagnosed on POD 37. Wound management was initiated using topical steroids. The wound caused difficulties in pain and dressing management. Although infliximab was administered as a systemic therapy, it was discontinued because of allergic symptoms. Sealing therapy with hydrofiber dressing and adequate stoma pouching with stoma paste provided good exudate absorption and a clean environment by protecting the wound from stoma excretion. Oral prednisone was initiated on POD 82. Improvement in the wound condition was observed with a prednisone dose of 30 mg/day. Complete remission was achieved seven months after onset. Twelve months after the surgery, stoma closure was performed. The local cutaneous condition remained in remission without exacerbation. Suspicion of PPG can be difficult when it develops early after stoma creation. We never forget that PPG should be suspected when a progressive ulcerative lesion is found around the stoma, even early after operation. If PPG is suspected, a multidisciplinary team plays an essential role in its diagnosis and management.
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Sato K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Sato A, Ichimura K, Nakanishi K. Short-term outcomes of extracorporeal colo-colonic triangular anastomosis versus functional end-to-end anastomosis in laparoscopic-assisted surgery for left-sided colon cancer: a propensity score matching analysis. Langenbecks Arch Surg 2022; 407:747-757. [PMID: 35034190 DOI: 10.1007/s00423-021-02403-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To the best of our knowledge, no studies have compared the short-term outcomes between colo-colonic extracorporeal triangular anastomosis (TA) and functional end-to-end anastomosis (FEEA), with a focus on laparoscopic-assisted surgery for left-sided colon cancer. Therefore, this study compared the short-term outcomes of these anastomoses using propensity score matching analysis. METHODS This retrospective study included 129 patients with stage I-IV left-sided colon cancer who underwent laparoscopic-assisted surgery with colo-colonic extracorporeal TA (n = 75) or FEEA (n = 54) between May 2009 and March 2021. After propensity score matching, 84 patients (TA, n = 42; FEEA, n = 42) were included in the analysis. The primary endpoint was the complication rate for all grades, and the secondary endpoints were the rates of Clavien - Dindo grade ≥ 3 complications and anastomotic leakage. RESULTS In the matched cohort, there were no significant differences in the complication rates for all grades (35.7% vs. 26.2%, p = 0.479), Clavien - Dindo grade ≥ 3 complications (11.9% vs. 11.9%, p = 1), and anastomotic leakage (0% vs. 4.8%, p = 0.494) between the TA and FEEA groups. In the univariate logistic regression analysis, TA did not increase the frequency of complications for any grades compared with FEEA (odds ratio: 1.570, 95% confidence interval: 0.616-3.980, p = 0.347). CONCLUSION Extracorporeal TA demonstrated equivalent short-term outcomes compared with FEEA in cases of laparoscopic-assisted surgery for left-sided colon cancer. TA can be an alternative anastomosis technique in cases wherein FEEA is difficult to perform.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan.
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Kentaro Ichimura
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, 041-8680, Japan
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Sato A, Imaizumi K, Kasajima H, Obuchi K, Sato K, Yamana D, Tsuruga Y, Umehara M, Kurushima M, Nakanishi K. Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single-center retrospective study in Japan. Asian J Endosc Surg 2022; 15:137-146. [PMID: 34463037 DOI: 10.1111/ases.12982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Laparoscopic Hartmann's reversal (LHR) has recently been reported to be safer and more feasible than open Hartmann's reversal (OHR); however, there is limited data on the outcomes of LHR compared with those of OHR from Asian countries. Therefore, we aimed to clarify the postoperative outcomes of LHR compared with OHR, and additionally compare the patient outcomes post-LHR according to the previous Hartmann's procedure (HP) approach. METHODS Patients who underwent OHR and LHR between January 2006 and September 2020 in a single center in Japan, were retrospectively evaluated. Patient characteristics and perioperative data were collected from the medical and surgical records and assessed. RESULTS Overall, 15 and 19 patients underwent OHR and LHR, respectively, between January 2006 and September 2020. LHR was associated with less blood loss (median: 15 mL vs 185 mL; P < .001) and shorter hospital stays (9 days vs 14 days; P = .023) than OHR. There was no significant difference in postoperative complications between LHR and OHR (26.3% vs 40.0%, P = .475). However, two severe anastomotic complications in LHR were observed in patients with the stump below the peritoneal reflection. No significant difference in outcomes was observed between LHR patients who underwent open and laparoscopic HP. CONCLUSION LHR resulted in positive outcomes regarding estimated blood loss and postoperative hospitalization, compared with OHR. Although the postoperative complications between LHR and OHR were not significant, patients with the stump below the peritoneal reflection may be at a high risk of anastomotic complications.
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Affiliation(s)
- Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Keisuke Obuchi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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Matsuzawa R, Morise M, Ito K, Hataji O, Takahashi K, Hara T, Goto Y, Imaizumi K, Itani H, Yamaguchi T, Zenke Y, Oki M, Kogure Y, Hashimoto N. P47.14 Study Design of SCORPION: Multi-Center, Phase II Study Following Platinum-Based Chemotherapy Plus ICIs in Patients with NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.507] [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: 10/20/2022]
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20
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Matsui H, Ichikawa N, Homma S, Yoshida T, Emoto S, Imaizumi K, Miyaoka Y, Taketomi A. Combined Laparoscopic and Transperineal Endoscopic Pelvic Tumor Resection with Sacrectomy for Locally Recurrent Rectal Cancer. J Anus Rectum Colon 2021; 5:327-333. [PMID: 34395947 PMCID: PMC8321584 DOI: 10.23922/jarc.2020-050] [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] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
Pelvic tumor resection with sacrectomy for locally recurrent rectal cancer is a challenging operation with a high complication rate and poor prognosis. We report a case of pelvic tumor resection with sacrectomy by transperineal endoscopy following laparoscopic dissection for locally recurrent rectal cancer. A 70-year-old man underwent laparoscopic abdominoperineal resection for rectal cancer and was diagnosed with local pelvic recurrence on follow-up computed tomography (CT) three years postoperatively. As the recurrence was in contact with the front of the sacrum, we concluded that distal sacrectomy was necessary to ensure a surgical margin. We safely performed combined laparoscopic and transperineal endoscopic pelvic tumor resection with sacrectomy by exposing the surface of the sacrum from both abdominal and transperineal approach. The operative time was 200 minutes, with minimal blood loss. There was no tumor exposure on the surgically dissected surface, and the patient was discharged without complications 14 days postoperatively. Transperineal endoscopy may be useful for pelvic tumor resection with sacrectomy for locally recurrent rectal cancer.
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Affiliation(s)
- Hiroki Matsui
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shin Emoto
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoichi Miyaoka
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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21
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Sato K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Obuchi K, Sato A, Nakanishi K. Short- and long-term outcomes of a self-expandable metallic stent versus a transanal decompression tube for pathological stage II and III left-sided obstructive colorectal cancer: a retrospective observational study. Surg Today 2021; 52:268-277. [PMID: 34272601 DOI: 10.1007/s00595-021-02341-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/09/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Few studies have investigated the long-term oncological outcomes of the self-expandable metallic stent (SEMS) as a bridge to surgery (BTS) for obstructive colorectal cancer (OCRC). We conducted this study to compare the short- and long-term outcomes of the SEMS with those of the traditional transanal decompression tube (TDT) in patients with stage II and III left-sided OCRC. METHODS The subjects of this retrospective study were 78 patients with pathological stage II and III left-sided OCRC who underwent radical surgery after SEMS or TDT placement, between April, 2005 and September, 2019. We compared perioperative data, including decompression success rates and 3-year relapse-free survival (RFS), between the SEMS and TDT groups. RESULTS A SEMS was placed in 60 (76.9%) patients and a TDT was placed in 18 (23.1%) patients, achieving a clinical success rate of decompression of 98.3% in the SEMS group and 77.8% in the TDT group (P = 0.009). The 3-year RFS of the overall cohort was better in the SEMS group than in the TDT group (74.9% vs. 40.9%, respectively; P = 0.003). CONCLUSIONS Decompression using a SEMS as the BTS may improve oncological outcomes over those achieved by a TDT in patients with left-sided stage II and III OCRC.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan.
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Keisuke Obuchi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, Hokkaido, 041-8680, Japan
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22
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Matsui H, Homma S, Hatanaka KC, Sawada A, Imaizumi K, Yoshida T, Ichikawa N, Emoto S, Miyaoka Y, Takahashi N, Matsuno Y, Hatanaka Y, Taketomi A. Novel Prognostic Stratification Factor Based on the Pathological Profile of the Invasive Front in Colorectal Cancer. Anticancer Res 2021; 41:3429-3438. [PMID: 34230138 DOI: 10.21873/anticanres.15130] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to develop a new pathological finding, namely, invasion front grade and verify its clinical usefulness. MATERIALS AND METHODS We re-examined haematoxylin-eosin-stained specimens in 162 stage II-III colorectal cancer patients who underwent radical resection. We assessed the desmoplastic reaction, Klintrup grade, and poorly differentiated cluster. These three findings were combined to form the invasion front grade (good prognosis group; Grade A, poor prognosis group; Grade B), and its reproducibility and prognostic stratification ability were statistically analysed. RESULTS Invasion front grade was Grade A in 116 cases and Grade B in 46 cases, and its kappa coefficient was 0.81 for interobserver and 0.74 for intraobserver variability. The 3-year recurrence-free survival rates of Grade A and Grade B were 90.4% and 55.9%. Multivariate analysis showed that invasion front grade was an independent prognostic factor. CONCLUSION Invasion front grade is useful as a prognostic stratification factor for stage II-III colorectal cancer.
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Affiliation(s)
- Hiroki Matsui
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan;
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kanako C Hatanaka
- Research Division of Genome Companion Diagnostics, Hokkaido University Hospital, Sapporo, Japan.,Center for Development of Advanced Diagnostics, Hokkaido University Hospital, Sapporo, Japan
| | - Akifumi Sawada
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Shin Emoto
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoichi Miyaoka
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Norihiko Takahashi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Yutaka Hatanaka
- Research Division of Genome Companion Diagnostics, Hokkaido University Hospital, Sapporo, Japan.,Center for Development of Advanced Diagnostics, Hokkaido University Hospital, Sapporo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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23
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Imaizumi K, Kasajima H, Yamana D, Sato A, Nakanishi K. Laparoscopic repair supplemented with the perineal approach for perineal hernia after abdominoperineal resection - a video vignette. Colorectal Dis 2021; 23:1937. [PMID: 33794034 DOI: 10.1111/codi.15661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
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24
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Sato K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y, Yamana D, Obuchi K, Sato A, Nakanishi K. Comparison of prognostic impact between positive intraoperative peritoneal and lavage cytologies in colorectal cancer. Int J Clin Oncol 2021; 26:1272-1284. [PMID: 33844111 DOI: 10.1007/s10147-021-01918-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prognostic value of positive intraoperative peritoneal cytology and lavage cytology, including the differences in their prognostic impact, in colorectal cancer is controversial. We aimed to investigate the prognostic values of positive peritoneal cytology and lavage cytology findings for colorectal cancer and compare their prognostic impact. METHODS We retrospectively evaluated 592 clinical stage II-IV colorectal cancer patients who underwent peritoneal cytology (n = 225) or lavage cytology (n = 367) between November 1993 and December 2018. The prognostic factors for cancer-specific survival were identified, and the differences in cancer-specific survival were examined between the patients. RESULTS The cytology-positive rate was 10.8% (64/592), 17.8% (40/225), and 6.5% (24/367) in the overall, peritoneal cytology, and lavage cytology groups, respectively. Both positive peritoneal cytology (hazard ratio: 2.196) and lavage cytology (hazard ratio: 2.319) were independent prognostic factors. The peritoneal cytology-positive group showed significantly poorer cancer-specific survival than the cytology-negative group (5-year: 3.5% vs. 59.5%; 10-year: 3.5% vs. 46.1%, p < 0.001). Similar results were obtained for lavage cytology (5-year: 14.1% vs. 73.9%; 10-year: 4.7% vs. 63.5%, p < 0.001). The cancer-specific survival was not significantly different between the peritoneal cytology-positive and lavage cytology-positive groups (p = 0.058). Both positive peritoneal and lavage cytology were associated with poorer cancer-specific survival across all colorectal cancer stages. CONCLUSIONS Positive peritoneal and lavage cytology are associated with worse cancer-specific survival in colorectal cancer. The prognostic impact was comparable between positive lavage and peritoneal cytology. Thus, cytology should be a standard assessment modality for colorectal cancer.
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Affiliation(s)
- Kentaro Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Ken Imaizumi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan.
| | - Hiroyuki Kasajima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Michihiro Kurushima
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Minoru Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Yosuke Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Daisuke Yamana
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Keisuke Obuchi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Aya Sato
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
| | - Kazuaki Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan
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25
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Imaizumi K, Nishizawa Y, Ikeda K, Tsukada Y, Sasaki T, Ito M. Prognostic Impact of Curative Resection for Peritoneal Recurrence of Colorectal Cancer. Ann Surg Oncol 2020; 27:2487-2497. [PMID: 32052301 DOI: 10.1245/s10434-020-08242-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Peritoneal recurrence (PR) of colorectal cancer is a poor prognostic factor but may be treatable by curative resection. We investigated the efficacy of this treatment and identified risk factors for postoperative recurrence. METHODS The subjects were patients who underwent radical surgery for colorectal cancer between January 2006 and March 2014. Those with PR were retrospectively reviewed. Prognostic factors for overall survival (OS) and risk factors for postoperative recurrence were identified. RESULTS Among 2256 patients, 66 had PR (2.9%). Surgical resection of PR was performed in 41 patients. Curative resection was achieved macroscopically in 38 cases without diffuse metastases in the peritoneum distant from the primary tumor and with a peritoneal cancer index < 10. In multivariate analysis, curative resection was a significant prognostic factor [hazard ratio (HR) 0.198] for better 5-year OS compared with cases without curative resection (68.7% vs. 6.3%, P < 0.001). In 28 cases with concurrent metastasis, curative resection significantly improved 5-year OS compared with no curative resection (78.7% vs. 0%, P = 0.008). In the 38 patients with curative resection, the 3-year recurrence-free survival rate was 21.4%. In multivariate analysis, concurrent metastasis was a significant risk factor [HR 3.394] for postoperative recurrence, and cases with concurrent metastasis more frequently had recurrence within 2 years after curative resection. CONCLUSIONS Curative resection improved the prognosis in patients with limited and resectable PR of colorectal cancer with or without concurrent metastasis. However, recurrence after curative resection was common and concurrent metastasis was a risk factor for this recurrence.
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Affiliation(s)
- Ken Imaizumi
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yuji Nishizawa
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
| | - Koji Ikeda
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yuichiro Tsukada
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Takeshi Sasaki
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
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26
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Imaizumi K, Suzuki T, Kojima M, Shimomura M, Sakuyama N, Tsukada Y, Sasaki T, Nishizawa Y, Taketomi A, Ito M, Nakatsura T. Ki67 expression and localization of T cells after neoadjuvant therapies as reliable predictive markers in rectal cancer. Cancer Sci 2019; 111:23-35. [PMID: 31660687 PMCID: PMC6942445 DOI: 10.1111/cas.14223] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 06/10/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Chemoradiotherapy (CRT) is the standard neoadjuvant therapy for locally advanced rectal cancer (RC). However, neoadjuvant chemotherapy (NAC) also shows favorable outcomes. Although the immunological environment of RC has been thoroughly discussed, the effect of NAC on it is less clear. Here, we investigated the immunological microenvironment, including T cell infiltration, activation, and topological distribution, of resected RC tissue after neoadjuvant therapies and evaluated the correlation between T cell subsets and patient prognosis. Rectal cancer patients (n = 188) were enrolled and categorized into 3 groups, namely CRT (n = 41), NAC (n = 46), and control (surgery alone; n = 101) groups. Characterization of residual carcinoma cells and T cell subsets in resected tissues was performed using multiplex fluorescence immunohistochemistry. The densities of total and activated (Ki67high) T cells in tissues after NAC, but not CRT, were higher than in control. In both CRT and NAC groups, patients presenting with higher treatment effects showed aggressive infiltration of T cell subsets into carcinomas. Multivariate analyses of pathological and immunological features and prognosis revealed that carcinoma Ki67highCD4+ T cells after CRT and stromal Ki67highCD8+ T cells after NAC are important prognostic factors, respectively. Our results suggest that evaluation of T cell activation with Ki67 expression and its tumor localization can be used to determine the prognosis of advanced RC after neoadjuvant therapies.
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Affiliation(s)
- Ken Imaizumi
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan.,Division of Cancer Immunotherapy, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan.,Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihiro Suzuki
- Division of Cancer Immunotherapy, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Motohiro Kojima
- Division of Pathology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Manami Shimomura
- Division of Cancer Immunotherapy, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Naoki Sakuyama
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuichiro Tsukada
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Sasaki
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuji Nishizawa
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaaki Ito
- Deparment of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuya Nakatsura
- Division of Cancer Immunotherapy, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
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Yamaguchi T, Morikawa S, Yuko O, Asada K, Oguri T, Inui N, Ito K, Kimura T, Kunii E, Matsui T, Kubo A, Kato T, Shindo J, Tsuda T, Okuno M, Hida T, Imaizumi K. P083 Efficacy of EGFR-TKIs in Patients Harboring EGFR Mutations with Non-Adenocartinoma Histology. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.10.096] [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: 11/17/2022]
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28
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Tanaka K, Inui N, Asada K, Abe T, Hataji O, Hayai S, Ito K, Imaizumi K, Kimura T, Kubo A, Kunii E, Murotani K, Okuno M, Oya Y, Shindoh J, Taniguchi H, Tsuda T, Yamaguchi T, Hida T, Suda T. Real-world data of EGFR minor mutated NSCLC treated with EGFR-TKI: Comparative analysis including compound mutation and de novo T790M mutation. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy425.032] [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: 11/12/2022] Open
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29
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Ito K, Murotani K, Kubo A, Kunii E, Taniguchi H, Shindo J, Asada K, Imaizumi K, Tanaka K, Inui N, Okuno M, Hataji O, Hayai S, Abe T, Kimura T, Tsuda T, Yamaguchi T, Oya Y, Yoshida T, Hida T. Comparative analysis of overall survival using propensity score between first- and second-generation EGFR-TKI: Real world data of 1354 patients with EGFR mutant NSCLC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Goto Y, Takahashi K, Saito H, Ogasawara T, Shindoh J, Kimura T, Sugino Y, Kojima E, Nomura F, Nakanishi T, Nozaki Y, Takeyama Y, Imaizumi K, Hasegawa Y. P1.01-25 Carboplatin and Pemetrexed Plus Bevacizumab After Failure of First-Line EGFR-TKI Therapy for NSCLC Harboring EGFR Mutation (CJLSG 0908). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.581] [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: 10/28/2022]
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31
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Imaizumi K, Nishizawa Y, Ikeda K, Tsukada Y, Sasaki T, Ito M. Extended pelvic resection for rectal and anal canal tumors is a significant risk factor for perineal wound infection: a retrospective cohort study. Surg Today 2018; 48:978-985. [PMID: 29858669 DOI: 10.1007/s00595-018-1680-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/21/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Perineal wound infection (PWI) rates are high after abdominoperineal resection (APR) and total pelvic exenteration (TPE). This study identified risk factors for PWI after surgery for anorectal tumors and examined the relationship between the surgical excision volume with the PWI degree. METHODS A retrospective review involving 135 patients who underwent surgical excision of anorectal tumors was performed. Superficial PWI included cellulitis and superficial dehiscence; deep PWI included major dehiscence, perineal abscess, and presacral abscess. The adjacent organ resection type was classified according to the dead space size formed by surgical excision. RESULTS Of the 135 patients, 119 underwent APR, and 16 underwent TPE. PWI occurred in 75 patients (superficial PWI, 44; deep PWI, 31). Adjacent organ resection was an independent risk factor for PWI. The cases with adjacent organ resection were classified into small-defect APR, large-defect APR, and TPE. Large-defect APR and TPE cases had significantly higher rates of deep PWI than APR cases without adjacent organ resection. CONCLUSIONS Adjacent organ resection involving the removal of one or more organs and that involving wide-range muscle resection are strong risk factors for deep PWI.
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Affiliation(s)
- Ken Imaizumi
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yuji Nishizawa
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Koji Ikeda
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yuichiro Tsukada
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takeshi Sasaki
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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32
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Imaizumi K, Tinwongger S, Kondo H, Hirono I. Disinfection of an EMS/AHPND strain of Vibrio parahaemolyticus using ozone nanobubbles. J Fish Dis 2018; 41:725-727. [PMID: 29399827 DOI: 10.1111/jfd.12783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 05/27/2023]
Affiliation(s)
- K Imaizumi
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - S Tinwongger
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
- Department of Fisheries Kasetklang Chatuchak, Coastal Fisheries Research and Development Bureau, Bangkok, Thailand
| | - H Kondo
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - I Hirono
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
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Yamaguchi T, Oya Y, Kagawa Y, Furuta H, Watanabe N, Shimizu J, Horio Y, Uemura T, Morikawa S, Imaizumi K, Hida T. P2.07-028 Efficacy and Safety of Nivolumab in Non-Small Cell Lung Cancer Patients Who Relapse after Thoracic Radiotherapy. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.11.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Imaizumi K, Suzuki T, Shimomura M, Tsukada Y, Sasaki T, Nishizawa Y, Kojima M, Ito M, Nakatsura T. Immunological features of resected tumor after neoadjuvant chemotherapy (NAC) and chemoradiotherapy (CRT) become the superior prediction markers for recurrence in rectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.035] [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: 11/13/2022] Open
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35
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Uygun DS, McNally JM, Yang L, Imaizumi K, Katsuki F, Brown RE, Mao X, Nicholson T, Sidor M, Zhang Q, Strecker RE, McCarley RW, Feng G, Pan JQ. 0017 ABNORMAL SLEEP SPINDLE RHYTHMOGENESIS IN MICE BEARING A SCHIZOPHRENIA ASSOCIATED CODING VARIANT IN THE CACNA1I GENE. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.016] [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: 11/14/2022] Open
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Ibáñez O, Vicente R, Navega D, Campomanes-Álvarez C, Cattaneo C, Jankauskas R, Huete MI, Navarro F, Hardiman R, Ruiz E, Imaizumi K, Cavalli F, Veselovskaya E, Humpire D, Cardoso J, Collini F, Mazzarelli D, Gibelli D, Damas S. MEPROCS framework for Craniofacial Superimposition: Validation study. Leg Med (Tokyo) 2016; 23:99-108. [PMID: 27890113 DOI: 10.1016/j.legalmed.2016.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/14/2016] [Accepted: 10/19/2016] [Indexed: 11/18/2022]
Abstract
Craniofacial Superimposition (CFS) involves the process of overlaying a skull with a number of ante-mortem images of an individual and the analysis of their morphological correspondence. The lack of unified working protocols and the absence of commonly accepted standards, led to contradictory consensus regarding its reliability. One of the more important aims of 'New Methodologies and Protocols of Forensic Identification by Craniofacial Superimposition (MEPROCS)' project was to propose a common framework for CFS, what can be considered the first international standard in the field. The framework aimed to serve as a roadmap for avoiding particular assumptions that could bias the process. At the same time, it provides some empirical support to certain practices, technological means, and morphological criteria expected to facilitate the application of the CFS task and to improve its reliability. In order to confirm the utility and potential benefits of the framework use, there is a need to empirically evaluate it in CFS identification scenarios as close as possible to the reality. Thus, the purpose of this study is to validate the CFS framework developed. For that aim 12 participants were asked to report about a variable number of CFS following all the recommendations of the framework. The results are analysed and discussed according to the framework understanding and fulfilment, the participants' performance, and the correlation between expected decisions and those given by the participants. In view of the quantitative results and qualitative examination criteria we can conclude that those who follow the MEPROCS recommendations improve their performance.
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Affiliation(s)
- O Ibáñez
- Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain.
| | - R Vicente
- Forensic Sciences Centre (CENCIFOR), Coimbra, Portugal; Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - D Navega
- Forensic Sciences Centre (CENCIFOR), Coimbra, Portugal; Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | | | - C Cattaneo
- Laboratorio di Antropología e Odontologia Forense, University of Milan, Milan, Italy
| | - R Jankauskas
- Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
| | - M I Huete
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - F Navarro
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - R Hardiman
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - E Ruiz
- Legal Medicine School, Complutense University of Madrid, Spain
| | - K Imaizumi
- National Research Institute of Police Science, Japan
| | - F Cavalli
- Research Unit of Paleoradiology and Allied Sciences, Ospedali Riuniti di Trieste, Trieste, Italy
| | - E Veselovskaya
- Institute of Ethnology and Anthropology, Russian Academy of Science, Moscow, Russia
| | | | - J Cardoso
- Crime Scene Investigation Section, Forensic Laboratory, Portuguese Criminal Police, Lisbon, Portugal
| | - F Collini
- Laboratorio di Antropología e Odontologia Forense, University of Milan, Milan, Italy
| | - D Mazzarelli
- Laboratorio di Antropología e Odontologia Forense, University of Milan, Milan, Italy
| | - D Gibelli
- Laboratorio di Antropología e Odontologia Forense, University of Milan, Milan, Italy
| | - S Damas
- Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain
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Imaizumi K, Homma S, Yoshida T, Shimokuni T, Sakihama H, Takahashi N, Kawamura H, Takakuwa E, Taketomi A. Solitary left axillary lymph node metastasis after curative resection of carcinoma at the colostomy site: a case report. Surg Case Rep 2016; 2:99. [PMID: 27651059 PMCID: PMC5030199 DOI: 10.1186/s40792-016-0229-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/31/2016] [Accepted: 09/15/2016] [Indexed: 11/25/2022] Open
Abstract
Background The incidence of axillary lymph node metastasis (ALNM) of colon cancer is very low, and there have been only a few reports of solitary ALNM. Neither the mechanism involved in solitary colon cancer ALNM nor the proper treatment has been elucidated. We encountered a case of solitary left ALNM after curative resection of carcinoma at the colostomy site. Case presentation A 53-year-old man underwent a Hartmann’s operation for Hirschsprung disease during his adolescence. He complained of a mass of the descending colon and was diagnosed with colon cancer at the colostomy site with pagetoid spread to the adjacent skin. The cancer at the stoma site was resected, and a transverse colostomy was performed. Nine years later, his carbohydrate antigen (CA) 19-9 level was high during a health screening. On physical examination, adenopathy was palpated in the left axilla. Computed tomography (CT) demonstrated a lymph node in the left axillary fossa that was 33 mm in diameter, and 18F-fluorodeoxyglucose positron emission tomography/CT showed high uptake in the lesion. We performed a curative resection of the left axillary lymph node. The lesion was pathologically diagnosed as left ALNM originating from the adenocarcinoma at the colostomy site. After lymph node resection, his serum CA19-9 level decreased compared to that observed at baseline. He has been receiving adjuvant chemotherapy (capecitabine plus oxaliplatin) without recurrence for 5 months after lymph node resection. Conclusions The present case report shows that carcinoma at the colostomy site with pagetoid spread can metastasize to the axillary lymph nodes through superficial abdominal lymphatic pathways, and surgical resection followed by adjuvant chemotherapy may be a potent strategy to treat solitary colon cancer ALNM.
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Affiliation(s)
- Ken Imaizumi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tatsushi Shimokuni
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideyasu Sakihama
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Norihiko Takahashi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.,Surgical Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hideki Kawamura
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Emi Takakuwa
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
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Murata T, Koshiishi H, Imaizumi K, Okuno K, Nakata T, Hirano T, Tokura M, Matsuyama T, Hoshino M, Kakimoto M, Goto H, Yoshimura T. [A Case of Surgical Resection of Isolated Pulmonary Metastasis from Gastric Cancer]. Gan To Kagaku Ryoho 2015; 42:1588-1590. [PMID: 26805105] [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: 06/05/2023]
Abstract
We report a rare case of surgical resection for pulmonary metastasis from gastric cancer. A 71-year-old man underwent total gastrectomy for gastric cancer in October 2012. After the operation, he received S-1 chemotherapy for 1 year. In January 2014, computed tomography of the chest showed a nodule shadow with a cavity at S3 in the right lung. Because it showed a tendency to gradually enlarge, we performed an operation in September 2014. The nodule was diagnosed as metastatic adenocarcinoma from gastric cancer on pathology. The patient is being treated with S-1 chemotherapy during follow-up. The pulmonary metastases of gastric cancer often develop along with carcinomatous lymphangiosis or carcinomatous pleurisy, and isolated pulmonary metastasis is rare. A consensus has not been reached about the usefulness of surgical resection, and the accumulation of further cases is required.
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Kakimoto M, Nakata T, Imaizumi K, Hirano T, Murata T, Okuno K, Hoshino M, Matsuyama T, Goto H, Koshiishi H, Yoshimura T, Osanai T, Suzuki K. [Subclavian Artery Hemorrhage Related to Everolimus in a Patient with Recurrent Breast Cancer--A Case Report]. Gan To Kagaku Ryoho 2015; 42:1806-1808. [PMID: 26805179] [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: 06/05/2023]
Abstract
A 53-year-old woman underwent breast-conserving surgery for right breast cancer (invasive ductal carcinoma, T1cN0M0, ly+, stage ⅠA, ER+, PR+, HER2-) 5 years previously. During treatment with tamoxifen, massive recurrence in the axillary lymph nodes was found. First- through fourth-line chemotherapy were tried, but they all failed. Everolimus and exemestane were administered, resulting in rapid shrinking of the tumor, but the patient developed sudden severe bleeding from the subclavian artery. Hemostasis was achieved with artery stenting. The patient also developed a thoracic duct-cutaneous fistula. The patient died from tumor regrowth 6.5 months after her first everolimus treatment. Treating tumors involving major vessels with everolimus can cause severe bleeding after rapid shrinking of the tumor.
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Damas S, Wilkinson C, Kahana T, Veselovskaya E, Abramov A, Jankauskas R, Jayaprakash PT, Ruiz E, Navarro F, Huete MI, Cunha E, Cavalli F, Clement J, Lestón P, Molinero F, Briers T, Viegas F, Imaizumi K, Humpire D, Ibáñez O. Study on the performance of different craniofacial superimposition approaches (II): Best practices proposal. Forensic Sci Int 2015; 257:504-508. [PMID: 26482539 DOI: 10.1016/j.forsciint.2015.07.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 05/21/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022]
Abstract
Craniofacial superimposition, although existing for one century, is still a controversial technique within the scientific community. Objective and unbiased validation studies over a significant number of cases are required to establish a more solid picture on the reliability. However, there is lack of protocols and standards in the application of the technique leading to contradictory information concerning reliability. Instead of following a uniform methodology, every expert tends to apply his own approach to the problem, based on the available technology and deep knowledge on human craniofacial anatomy, soft tissues, and their relationships. The aim of this study was to assess the reliability of different craniofacial superimposition methodologies and the corresponding technical approaches to this type of identification. With all the data generated, some of the most representative experts in craniofacial identification joined in a discussion intended to identify and agree on the most important issues that have to be considered to properly employ the craniofacial superimposition technique. As a consequence, the consortium has produced the current manuscript, which can be considered the first standard in the field; including good and bad practices, sources of error and uncertainties, technological requirements and desirable features, and finally a common scale for the craniofacial matching evaluation. Such a document is intended to be part of a more complete framework for craniofacial superimposition, to be developed during the FP7-founded project MEPROCS, which will favour and standardize its proper application.
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Affiliation(s)
- S Damas
- European Centre for Soft Computing, Mieres, Spain.
| | - C Wilkinson
- Centre for Anatomy & Human Identification, University of Dundee, UK
| | - T Kahana
- Division of Identification and Forensic Sciences, Israel National Police, Jerusalem, Israel
| | - E Veselovskaya
- Institute of Ethnology and Anthropology Russian Academy of Science, Moscow, Russia
| | - A Abramov
- Main Department of Criminalistics Investigation Committee of Russia, Moscow, Russia
| | - R Jankauskas
- Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
| | - P T Jayaprakash
- Science Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - E Ruiz
- Legal Medicine School, Complutense University of Madrid, Spain
| | - F Navarro
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - M I Huete
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - E Cunha
- Forensic Sciences Centre (CENCIFOR), Coimbra, Portugal; Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - F Cavalli
- Research Unit of Paleoradiology and Allied Sciences, Ospedali Riuniti di Trieste, Trieste, Italy
| | - J Clement
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - P Lestón
- Department of Identification - Criminalist Services, Civil Guard, Madrid, Spain
| | - F Molinero
- Department of Identification - Criminalist Services, Civil Guard, Madrid, Spain
| | - T Briers
- South Africa Police Service, Pretoria, South Africa
| | - F Viegas
- Crime Scene Investigation Section, Forensic Laboratory, Portuguese Criminal Police, Lisbon, Portugal
| | - K Imaizumi
- National Research Institute of Police Science, Japan
| | | | - O Ibáñez
- European Centre for Soft Computing, Mieres, Spain; Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain
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41
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Nakada T, Koshiishi H, Imaizumi K, Murata T, Tokura M, Hoshino M, Goto H, Yoshimura T, Takahashi E, Otsuji M. [A case of resectable lung metastasis one year six months after surgery for pancreatic cancer]. Gan To Kagaku Ryoho 2014; 41:2160-2162. [PMID: 25731456] [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: 06/04/2023]
Abstract
The patient was a 68-year-old man who underwent pylorus-preserving pancreaticoduodenectomy for cancer of the pancreatic head in March 2012. Pre-operative chest computed tomography (CT) revealed a scar-like shade approximately 1.5 cm in length in the right middle lobe of the lung, but an active metastasis was not suspected. Adjuvant S-1 was initiated in June the same year at 100 mg/day and reduced to 50 mg/day in October because of neutropenia. The internal structure of the right middle lobe was observed to be uneven on a CT scan obtained in July 2013, and the shading increased to approximately 3 cm in length along with spicula. Brushing and transbronchial lung biopsy(TBLB)were performed. No other distant organ metastases were detected on a whole body search. Diagnosis was between a solitary lung metastasis of pancreatic cancer or cT2N0M0, StageIB primary lung cancer. The right middle lobe of the lung was resected via thoracoscopy along with lymph node dissection in September 2013. Histological examination revealed that the lesion was a well differentiated adenocarcinoma, with negative immunostaining for thyroid transcription factor-1(TTF-1) and Napsin A, and positive staining for cytokeratin (CK)7 and CK20, consistent with a solitary lung metastasis of pancreatic cancer. This report documents a rare case of pancreatic cancer with a solitary, resectable lung metastasis without involvement of other organs.
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Affiliation(s)
- Takuya Nakada
- Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital
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42
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Imaizumi K, Koshiishi H, Nakata T, Matsuyama T, Hirano T, Okuno K, Yoshimura T, Ebana H, Ikeda N. [Three cases of resected pulmonary metastasis from colorectal cancer after preoperative chemotherapy]. Gan To Kagaku Ryoho 2014; 41:2056-2058. [PMID: 25731421] [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: 06/04/2023]
Abstract
We describe three cases of resected pulmonary metastasis from postoperative colorectal cancer after preoperative 5-fluorouracil, Leucovorin, oxaliplatin (FOLFOX) chemotherapy. The first case is a 38-year-old man who underwent low anterior resection for rectal cancer in 2003. Subsequently, left lung metastasis occurred in February 2009. FOLFOX chemotherapy was administered, resulting in a partial response (PR) of tumor size. Post-chemotherapy, segmental resection of he S1+2 segments of the left lung was performed in May 2009. A pathological diagnosis of Grade 1b was made. The patient remained recurrence-free 5 years post-surgery. The second case is a 68-year-old man who underwent left half colon resection for descending colon cancer with left lung metastasis in March 2006. FOLFOX chemotherapy was administered, with a PR of lung metastasis size. Post-chemotherapy, a segmental resection of the S4 segment of the left lung was performed in September 2006. A pathological diagnosis of Grade 1b was made. The patient was alive 8 years post-surgery. The third case is a 64-year-old man who underwent low anterior resection for rectal cancer in November 2007. A year later, bilateral lung metastases were detected. FOLFOX+bevacizumab was administered, with a stable disease effect on tumor size. Post-chemotherapy, partial resection of both lungs was performed in March and April 2010. A pathological diagnosis of Grade 1a was made. The patient was recurrence-free at the 4-year follow up. We believe that preoperative FOLFOX chemotherapy may be effective in treating lung metastasis from colon cancer.
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Affiliation(s)
- Ken Imaizumi
- Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital
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43
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Kakimoto M, Nakata T, Imaizumi K, Hirano T, Yamamoto Y, Chikatani K, Hoshino M, Matsuyama T, Motoyama K, Goto H, Yoshimura T, Koshiishi H, Tsuruta K. [A case of locally recurrent breast cancer difficult to differentiate from nodular fasciitis]. Gan To Kagaku Ryoho 2014; 41:1881-1883. [PMID: 25731362] [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: 06/04/2023]
Abstract
Breast-conserving surgery was performed on a 78-year-old woman for left breast cancer 5 years previously (invasive ductal carcinoma, T1cN2M0, stage IIIA, ER[+], PR[-], HER2[-]). Chemotherapy, radiotherapy, and hormonal therapy were administered. A left subclavian tumor was detected, and an excisional biopsy was performed. Histological examination showed spindle cells, different from primary breast cancer histology, and nodular fasciitis was diagnosed negative cytokeratin and vimentin immunostaining results. After 12 months, a mass had developed in the same region, and reoperation was performed for resection. Similar spindle cells were observed, but they tested positive for cytokeratin. Carcinoma was diagnosed and thought to be locally recurrent breast cancer. Despite postoperative chemotherapy, the patient experienced bone and lung metastasis and a third local recurrence. She died 13 months following the last surgery. Recurrent breast cancer sometimes displays different histology from the initial cancer, and mimics stromal tumors in certain cases.
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Koshiishi H, Nakata T, Imaizumi K, Kakimoto M, Kato H, Tamura A, Tsutsui H, Ikeda N. [Thyroid carcinoma diagnosed by pathology during surgery]. Gan To Kagaku Ryoho 2014; 41:2509-2511. [PMID: 25731573] [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: 06/04/2023]
Abstract
We describe the pathological diagnosis of 4 resected cases of thyroid carcinoma made during surgery in comparison to that for 6 benign thyroid tumors. Preoperative computed tomography scanning and ultrasonography revealed 1 case of simple nodules, 3 cases of multiple nodules, 3 cases of solid cystic nodules, and 3 cases of calcification. Cytological examination of fine needle aspirates revealed 1 case to be Class II and 3 cases to be Class III. The diagnosis, which was made during the operation procedure on the basis of the frozen section and final operative methods, was papillary adenocarcinoma in 2 cases (total thyroidectomy + D1 and subtotal thyroidectomy+D1) and suspected papillary adenocarcinoma in 2 cases (hemithyroidectomy+ D1 and lobectomy of the thyroid+D1). The final pathological diagnosis of the 4 cases was papillary adenocarcinoma (pStage I: 3 cases, pStage II: 1 case). In the 6 cases of benign thyroid tumor, preoperative examinations revealed variegated tumor findings, and cytological examination of fine needle aspirates revealed 1 case to be ClassII and 5 cases to be ClassIII. Pathological diagnosis of the frozen sections of the 6 benign samples indicated 1 case of suspected malignancy and 5 cases of benign tumor. In all 10 cases, the pathological diagnosis based on frozen sections (with a sensitivity of 4/4 and specificity of 5/6) was more accurate than that established with preoperative imaging and cytological examination, and is therefore effective for the decision-making process when selecting the operative method.
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Abstract
AbstractA nine-year-old girl with short stature was referred to the department of pediatrics at Kyushu University. The clinical diagnosis was Turner syndrome; karyotypic analysis performed on peripheral blood, using GTG techniques, demonstrated a 45,X/47,XYY (17:83) mosaicism. Her twin brother, a phenotypically normal male, had the same karyotype; 45,X/47,XYY (3:97) on peripheral blood. Their skin fibroblast karyotypes showed the same mosaicism, ie. 45,X/47,XYY (41:59 and 31:69 respectively). On eleven biochemical genetic markers the twin pair were concordant, thus the likelihood of monozygosity was 0.99527034. In addition, the analysis of variable number of tandem repeat (VNTR) markers revealed the likelihood of monozygosity to be 0.99944386. The most plausible explanation of the X/XYY mosaicism was nondisjunction of the Y in the first cleavage division of the 46,XY zygote. A disproportionate rate of cell populations with 45,X and 47.XYY in the twinning process of the X/XYY embryo, especially in the germ lines, would result in discordant sex in twin pairs.
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Affiliation(s)
- K Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center, Japan
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46
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Omi T, Tanimukai H, Kanayama D, Sakagami Y, Tagami S, Okochi M, Morihara T, Sato M, Yanagida K, Kitasyoji A, Hara H, Imaizumi K, Maurice T, Chevallier N, Marchal S, Takeda M, Kudo T. Fluvoxamine alleviates ER stress via induction of Sigma-1 receptor. Cell Death Dis 2014; 5:e1332. [PMID: 25032855 PMCID: PMC4123092 DOI: 10.1038/cddis.2014.301] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 05/16/2014] [Accepted: 06/06/2014] [Indexed: 01/02/2023]
Abstract
We recently demonstrated that endoplasmic reticulum (ER) stress induces sigma-1 receptor (Sig-1R) expression through the PERK pathway, which is one of the cell's responses to ER stress. In addition, it has been demonstrated that induction of Sig-1R can repress cell death signaling. Fluvoxamine (Flv) is a selective serotonin reuptake inhibitor (SSRI) with a high affinity for Sig-1R. In the present study, we show that treatment of neuroblastoma cells with Flv induces Sig-1R expression by increasing ATF4 translation directly, through its own activation, without involvement of the PERK pathway. The Flv-mediated induction of Sig-1R prevents neuronal cell death resulting from ER stress. Moreover, Flv-induced ER stress resistance reduces the infarct area in mice after focal cerebral ischemia. Thus, Flv, which is used frequently in clinical practice, can alleviate ER stress. This suggests that Flv could be a feasible therapy for cerebral diseases caused by ER stress.
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Affiliation(s)
- T Omi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Psychiatry, Osaka General Medical center, Sumiyoshi-ku, Osaka, Japan
| | - H Tanimukai
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - D Kanayama
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Y Sakagami
- Department of Psychiatry, Osaka General Medical center, Sumiyoshi-ku, Osaka, Japan
| | - S Tagami
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - M Okochi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - T Morihara
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - M Sato
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - K Yanagida
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - A Kitasyoji
- Gifu Pharmaceutical University, Department of Biofunctional Molecules, Gifu, Japan
| | - H Hara
- Gifu Pharmaceutical University, Department of Biofunctional Molecules, Gifu, Japan
| | - K Imaizumi
- Department of Biochemistry, Graduate School of Biomedical & Health Sciences Hiroshima University, Hiroshima, Japan
| | - T Maurice
- Team II Endogenous Neuroprotection in Neurodegenerative Diseases INSERM U. 710, EPHE, University of Montpellier cc 105, place Eugene Bataillon, Montpellier cedex 5, France
| | - N Chevallier
- Team II Endogenous Neuroprotection in Neurodegenerative Diseases INSERM U. 710, EPHE, University of Montpellier cc 105, place Eugene Bataillon, Montpellier cedex 5, France
| | - S Marchal
- Team II Endogenous Neuroprotection in Neurodegenerative Diseases INSERM U. 710, EPHE, University of Montpellier cc 105, place Eugene Bataillon, Montpellier cedex 5, France
| | - M Takeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - T Kudo
- Department of Psychiatry, Osaka University Health Care Center, Toyonaka, Osaka, Japan
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Yamaguchi T, Imaizumi K, Morikawa S, Minezawa T, Okamura T, Morishita M, Uozu S, Hayashi M, Nakanishi T, Okazawa M. Hydration in Four Hours Around the Cisplatin Infusion May Be Critical for Preventing Cisplatin-Induced Nephrotoxicity. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.70] [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: 11/14/2022] Open
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48
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Koshiishi H, Nakata T, Imaizumi K, Kitayama S, Takazawa R, Tsuji T, Takahashi E, Ebana H, Ikeda N. [Clinicopathological analysis of 3 cases in which pulmonary metastasis from the urothelial carcinoma was resected]. Gan To Kagaku Ryoho 2013; 40:2342-2344. [PMID: 24394106] [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: 06/03/2023]
Abstract
We describe 3 cases in which the pulmonary metastasis from the urothelial carcinoma of the bladder and upper urinary tract was resected. The duration from the operation of the primary lesion to the occurrence of the pulmonary metastasis was 19, 11, and 4 years in each of the 3 cases. Repeated treatment of the local recurrence was performed in all the 3 cases. Local recurrence in the bladder membrane was observed in 1 case. In 2 cases, computed tomography( CT) scans revealed that the cavitation had penetrated the tumor. Histological findings of the surgical specimen obtained from the 3 cases revealed severe tumor necrosis. Immunostaining of the surgical specimen resulted in a definitive diagnosis of pulmonary metastasis from the urothelial carcinoma in 2 cases in which a differential diagnosis could not identify the primary lung cancer from the pulmonary metastasis. The prognoses in terms of survival in each of the 3 cases were shorter than 32, 19, and 6 months from the operation of the pulmonary metastasis. However, the prognoses could be improved by multidisciplinary treatment, including the resection of the pulmonary metastasis.
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Kawai M, Kirkness JP, Yamamura S, Imaizumi K, Yoshimine H, Oi K, Ayuse T. Increased phosphatidylcholine concentration in saliva reduces surface tension and improves airway patency in obstructive sleep apnoea. J Oral Rehabil 2013; 40:758-66. [DOI: 10.1111/joor.12094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M. Kawai
- Department of Clinical Physiology; Nagasaki University Graduate School of Biomedical Science; Nagasaki Japan
| | - J. P. Kirkness
- Division of Pulmonary and Critical Care Medicine; The Johns Hopkins School of Medicine; Johns Hopkins Sleep Disorders Center; Baltimore MD USA
| | | | | | - H. Yoshimine
- Department of Internal Medicine; Inoue Hospital; Nagasaki Japan
| | - K. Oi
- Department of Clinical Physiology; Nagasaki University Graduate School of Biomedical Science; Nagasaki Japan
| | - T. Ayuse
- Department of Clinical Physiology; Nagasaki University Graduate School of Biomedical Science; Nagasaki Japan
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Fukidome H, Takahashi R, Abe S, Imaizumi K, Handa H, Kang HC, Karasawa H, Suemitsu T, Otsuji T, Enta Y, Yoshigoe A, Teraoka Y, Kotsugi M, Ohkouchi T, Kinoshita T, Suemitsu M. Control of epitaxy of graphene by crystallographic orientation of a Si substrate toward device applications. ACTA ACUST UNITED AC 2011. [DOI: 10.1039/c1jm12921j] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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