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Miyamoto R, Takahashi A, Ogura T, Kitamura K, Ishida H, Matsudaira S, Suzuki Y, Shimizu S, Kawashima Y. Impact of endoscopic ultrasound-guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery. DEN Open 2024; 4:e270. [PMID: 37404728 PMCID: PMC10315642 DOI: 10.1002/deo2.270] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023]
Abstract
Objectives Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreatic surgery. Recently, endoscopic ultrasound-guided transmural drainage (EUS-TD) has been widely used to manage pancreatic pseudocysts after acute pancreatitis. Several studies have reported the effectiveness of EUS-TD for POPF, although there is insufficient evidence regarding the performance of EUS-TD for POPF. We herein report on the safety, efficacy, and appropriate timing of EUS-TD for POPF compared with conventional percutaneous intervention. Methods Eight patients who underwent EUS-TD of POPF and 36 patients who underwent percutaneous intervention were retrospectively enrolled. Clinical outcomes, including technical success, clinical success, and complications, were analyzed among the two groups. Results In terms of clinical outcomes between the EUS-TD and percutaneous intervention groups, significant differences were observed in the number of interventions (1 vs. 4, p = 0.011), period of clinical success (6 days vs. 11 days, p = 0.001), incidence of complications (0 vs. 3, p = 0.021), postoperative hospital stays (27 days vs. 34 days, p = 0.027), and recurrence of POPF (0 vs. 5, p = 0.001). Conclusions EUS-TD for POPF appears to be safe and technically feasible. This approach should be considered a therapeutic option in patients with POPF after pancreatic surgery.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological SurgerySaitama Cancer CenterSaitamaJapan
- Department of Gastroenterological SurgeryTokyo Medical University Ibaraki Medical CenterIbarakiJapan
| | - Amane Takahashi
- Department of Gastroenterological SurgerySaitama Cancer CenterSaitamaJapan
| | - Toshiro Ogura
- Department of Gastroenterological SurgerySaitama Cancer CenterSaitamaJapan
| | - Kei Kitamura
- Department of Gastroenterological SurgerySaitama Cancer CenterSaitamaJapan
| | - Hiroyuki Ishida
- Department of Gastroenterological SurgerySaitama Cancer CenterSaitamaJapan
| | | | - Yuko Suzuki
- Department of GastroenterologySaitama Cancer CenterSaitamaJapan
| | - Satoshi Shimizu
- Department of GastroenterologySaitama Cancer CenterSaitamaJapan
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2
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Kitamura K, Ogura T, Miyamoto R, Ishida H, Matsudaira S, Takahashi A, Kanda H, Fukuda T. Splenic sarcoid reaction mimicking metastases in patients after uterine cancer surgery: a report of two cases. Surg Case Rep 2023; 9:167. [PMID: 37726529 PMCID: PMC10509101 DOI: 10.1186/s40792-023-01753-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Tumor-associated sarcoid reactions have been observed with various tumors; however, they have not been reported with uterine cancer. We present two cases of splenic sarcoid reactions that mimicked metastases a few years after uterine cancer surgery. CASE PRESENTATION Case 1 involved a 67-year-old female patient diagnosed with endometrial cancer (pT1aN0M0, pStage Ia, grade 1). The patient underwent open total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Three years after the initial surgery, computed tomography (CT) and positron emission tomography CT showed multiple splenic masses with increasing numbers and sizes. Splenic metastases were diagnosed, and laparoscopic splenectomy was performed. The histopathological analysis revealed sarcoid reactions in the spleen. Case 2 involved a 47-year-old female patient diagnosed with endometrial cancer (pT1aN0M0, pStage Ia, grade 1). The patient underwent laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Two years after the initial surgery, multiple splenic masses were observed. We performed laparoscopic splenectomy for the splenic metastases. Granuloma formations were identified in the splenic specimen and perisplenic lymph nodes that were removed simultaneously, resulting in a final diagnosis of sarcoid reaction. A review of the lymph nodes at the time of the previous uterine surgery revealed granuloma formation. Other than the presence of splenic masses, no findings suggestive of recurrence were observed in these cases. Uterine cancer and sarcoid reactions progressed without recurrence after splenectomy. CONCLUSIONS To the best of our knowledge, this is the first report of the late development of splenic sarcoid reactions after uterine cancer surgery. Sarcoid reactions and metastases are difficult to diagnose based on preoperative imaging results. However, reviewing the specimen at the time of the initial resection, the number of lesions, and the clinical findings (other than imaging findings) may aid in the determination of the correct diagnosis.
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Affiliation(s)
- Kei Kitamura
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
| | - Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, Kita-Adachi-Gun, Saitama, Japan
| | - Takashi Fukuda
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806 Japan
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Nimura Y, Madeda Y, Tamura E, Kouyama Y, Matsudaira S, Nakamura H, Misawa M, Miyachi H, Baba T, Mukai S, Sawada N, Ishida F, Nemoto T, Kudo SE. Gastrointestinal: Real-time observation of rectal malignant lymphoma using endocytoscopy for differentiation from adenocarcinoma. J Gastroenterol Hepatol 2023; 38:1456. [PMID: 36863707 DOI: 10.1111/jgh.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Y Nimura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Madeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - E Tamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Kouyama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Matsudaira
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Nakamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - M Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Miyachi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Baba
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Mukai
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - N Sawada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - F Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Nemoto
- Department of Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S-E Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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Ishida H, Ogura T, Takahashi A, Kitamura K, Miyamoto R, Matsudaira S, Tanabe M, Kanda H, Kawashima Y. Prognostic Value of Peritoneal Lavage Cytology in Potentially Resectable Pancreatic Cancer Stratified by Cytologic Status. Cancer Diagn Progn 2023; 3:338-346. [PMID: 37168974 PMCID: PMC10165367 DOI: 10.21873/cdp.10221] [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] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND/AIM Patients with pancreatic ductal adenocarcinoma (PDAC) with positive peritoneal lavage cytology (CY) reportedly have poor prognoses. However, the value of diagnosis of suspicious for malignancy on CY is unknown. This study aimed to elucidate the prognostic impact of CY by focusing on CY subgroups. PATIENTS AND METHODS Data were collected from 231 resectable PDAC patients who underwent curative-intent resection. Patients were divided into three CY-based groups: negative (CY0), suspicious for malignancy (CY-S), and positive (CY1). Clinicopathological characteristics and prognostic factors were analyzed. RESULTS CY1 and CY-S were diagnosed in 7.8% and 3.9% of the patients, respectively. The CY1 group had significantly larger tumors and higher frequencies of distal tumors, anterior pancreatic tissue invasion, retropancreatic tissue invasion, and R1 resection than the CY0 group. Patient characteristics did not differ between the CY0 and CY-S groups. The CY1 group exhibited worse survival than the CY0 and CY-S groups (median survival time: 18.8 vs. 39.6 months, p=0.0021 and vs. 62.2 months, p=0.018). Multivariate analysis for survival indicated that a tumor size >2 cm, preoperative CA19-9 value >100 U/ml, CY1, lymph node metastasis, R1 resection, and lack of adjuvant chemotherapy were associated with poor prognosis. Both the CY1 and CY-S groups had higher frequencies of peritoneal recurrence than the CY0 group (50% vs. 11.8%, p<0.001 and 44.4% vs. 11.8%, p=0.019). CONCLUSION The prognosis of the CY1 group was poor. Although CY-S was associated with a higher frequency of peritoneal recurrence than CY0, the long-term outcomes of patients with surgical treatment were acceptable.
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Affiliation(s)
- Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Kei Kitamura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
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Miyamoto R, Takahashi A, Ogura T, Kitamura K, Ishida H, Matsudaira S, Kihara A, Kanda H, Kawashima Y. Transduodenal ampullectomy for early ampullary cancer: Clinical management, histopathological findings and long-term outcomes at a single center. Surgery 2023; 173:912-919. [PMID: 36697354 DOI: 10.1016/j.surg.2022.12.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Transduodenal ampullectomy has been attempted in ampullary tumors, including early ampullary cancer. However, the indication and extent of transduodenal ampullectomy with curative intent remain controversial. Herein, we address the perioperative and long-term outcomes of patients with early ampullary cancer who underwent transduodenal ampullectomy at a single center. METHODS We retrospectively enrolled 10 early ampullary cancer patients who underwent transduodenal ampullectomy and 11 early ampullary cancer patients who underwent subtotal stomach-preserving pancreatoduodenectomy at Saitama Cancer Center between October 2008 and May 2021. Among this cohort, we analyzed the perioperative outcomes and long-term outcomes. RESULTS In terms of the perioperative outcomes between the transduodenal ampullectomy and subtotal stomach-preserving pancreatoduodenectomy groups, the transduodenal ampullectomy group exhibited a shorter operating time (244 minutes vs 390 minutes, P = .003), less intraoperative blood loss (67.5 grams vs 774 grams, P = .006) and shorter length of postoperative hospital stay (15 days vs 33 days). With respect to the postoperative nutrition status, the transduodenal ampullectomy group exhibited less postoperative weight loss (0.67% vs 8.95%, P = .021), a better Controlling Nutritional Status score (1.0 vs 2.1, P = .011) and a better Prognostic Nutritional Index score (42.9 vs 40.9, P = .018). The 5-year survival in the adenoma with high-grade dysplasia and T1 ampullary cancer which invaded the mucosal layer groups was 100%, whereas the median survival time in the T1 ampullary cancer which invaded the sphincter of Oddi group was 20.7 months (P = .0028). CONCLUSION Transduodenal ampullectomy is assumed to be a feasible and effective surgical procedure for the treatment of selected patients with early ampullary cancer, including patients with adenoma with high-grade dysplasia or T1 ampullary cancer which invaded the mucosal layer ampullary cancer.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan.
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Kei Kitamura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Atsushi Kihara
- Department of Pathology, Jichi Medical University, Tochigi, Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
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Miyamoto R, Takahashi A, Ogasawara A, Ogura T, Kitamura K, Ishida H, Matsudaira S, Nozu S, Kawashima Y. Three-dimensional simulation of the pancreatic parenchyma, pancreatic duct and vascular arrangement in pancreatic surgery using a deep learning algorithm. PLoS One 2022; 17:e0276600. [PMID: 36306322 PMCID: PMC9616217 DOI: 10.1371/journal.pone.0276600] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022] Open
Abstract
Three-dimensional surgical simulation, already in use for hepatic surgery, can be used in pancreatic surgery. However, some problems still need to be overcome to achieve more precise pancreatic surgical simulation. The present study evaluates the performance of SYNAPSE VINCENT® (version 6.6, Fujifilm Medical Co., Ltd., Tokyo, Japan) in the semiautomated surgical simulation of the pancreatic parenchyma, pancreatic ducts, and peripancreatic vessels using an artificial intelligence (AI) engine designed with deep learning algorithms. One-hundred pancreatic cancer patients and a control group of 100 nonpancreatic cancer patients were enrolled. The evaluation methods for visualizing the extraction were compared using the Dice coefficient (DC). In the pancreatic cancer patients, tumor size, position, and stagewise correlations with the pancreatic parenchymal DC were analyzed. The relationship between the pancreatic duct diameter and the DC, and between the manually and AI-measured diameters of the pancreatic duct were analyzed. In the pancreatic cancer/control groups, the pancreatic parenchymal DC and pancreatic duct extraction were 0.83/0.86 and 0.84/0.77. The DC of the arteries (portal veins/veins) and associated sensitivity and specificity were 0.89/0.88 (0.89/0.88), 0.85/0.83 (0.85/0.82), and 0.82/0.81 (0.84/0.81), respectively. No correlations were observed between pancreatic parenchymal DC and tumor size, position, or stage. No correlation was observed between the pancreatic duct diameter and the DC. A positive correlation (r = 0.61, p<0.001) was observed between the manually and AI-measured diameters of the pancreatic duct. Extraction of the pancreatic parenchyma, pancreatic duct, and surrounding vessels with the SYNAPSE VINCENT® AI engine assumed to be useful as surgical simulation.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
- * E-mail:
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Aya Ogasawara
- Imaging Technology Center, Fujifilm Corporation, Minato-ku, Tokyo, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Kei Kitamura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Satoshi Nozu
- Department of Radiology, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
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Ishida H, Ogura T, Takahashi A, Miyamoto R, Matsudaira S, Amikura K, Tanabe M, Kawashima Y. ASO Visual Abstract: Optimal Region of Lymph Node Dissection in Distal Pancreatectomy for Left-sided Pancreatic Cancer Based on Tumor Location. Ann Surg Oncol 2022. [PMID: 35099655 DOI: 10.1245/s10434-021-11215-3] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan.,Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan. .,Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
| | - Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
| | - Katsumi Amikura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
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8
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Ishida H, Ogura T, Takahashi A, Miyamoto R, Matsudaira S, Amikura K, Tanabe M, Kawashima Y. Optimal Region of Lymph Node Dissection in Distal Pancreatectomy for Left-Sided Pancreatic Cancer Based on Tumor Location. Ann Surg Oncol 2021; 29:2414-2424. [PMID: 34837132 DOI: 10.1245/s10434-021-11108-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The optimal lymph node (LN) dissection for left-sided pancreatic cancer based on tumor location has remained unknown. In particular, the efficacy of LN dissection around the common hepatic artery and the celiac axis for distal tumors has not been established. This study was designed to elucidate the frequency and prognostic impact of LN metastasis, focusing on tumor location. METHODS Data from 110 patients with invasive pancreatic cancer who underwent distal pancreatectomy between 2007 and 2020 were collected. We used a quantitative value-the distance between the left side of the portal vein and the right side of tumor (DPT)-to define the tumor location. LN stations were divided into two groups: peripancreatic lymph nodes (PLN) and non-PLN. We then analyzed the frequency of LN metastasis based on the tumor location and prognostic factors. RESULTS Non-PLN metastasis was observed in 7.3% of patients. Non-PLN metastasis was found only in patients with a DPT < 20 mm. Patients with non-PLN metastasis exhibited a significantly worse prognosis than those with only-PLN metastasis (median survival time: 20.3 vs. 42.5 months, p = 0.048). Multivariate analysis for survival indicated that tumor size > 4 cm (hazard ratio [HR]: 2.23, p = 0.012) and metastasis in the non-PLN region (HR: 3.02, p = 0.015), and inability to undergo adjuvant chemotherapy (HR: 2.81, p = 0.0018) were also associated with poor prognosis. CONCLUSIONS Dissection of the non-PLN region can be avoided in selected patients with DPT ≥ 20 mm.
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Affiliation(s)
- Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan.,Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo ku, Tokyo, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan. .,Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo ku, Tokyo, Japan.
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Katsumi Amikura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo ku, Tokyo, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
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Miyamoto R, Amikura K, Matsudaira S, Ishida H, Ogura T, Takahashi A, Kihara A, Kanda H, Kawashima Y. Colloid carcinoma derived from intraductal papillary mucinous neoplasm of the pancreatic head with calcification: A case report and literature review. Surg Case Rep 2021; 7:202. [PMID: 34487254 PMCID: PMC8421485 DOI: 10.1186/s40792-021-01286-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background Colloid carcinoma derived from intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head with prominent calcification is exceedingly rare. Only a few studies about this entity have been reported in the literature. Therefore, its biological behavior, appropriate treatment modalities, and overall patient prognosis remain largely unclear. In this report, we present a case of a resected colloid carcinoma derived from IPMN with prominent calcification. In addition, we review the relevant literature and discuss the clinical management of colloid carcinoma derived from IPMN with prominent calcification, including the histopathological features. Case presentation A 75-year-old man presented with a pancreatic tumor measuring 58 mm on the head of the pancreas that was incidentally detected by abdominal ultrasonography. Abdominal computed tomography and endosonography revealed a multilobular cystic lesion with a 17 mm mural nodule in the pancreatic head. Furthermore, prominent calcification was observed on part of the cyst wall. Magnetic resonance cholangiopancreatography showed a multilobular cyst in the branch duct lacking communication between the cystic lesion and the main pancreatic duct. Thus, the lesion was diagnosed as intraductal papillary mucinous carcinoma (IPMC) with a preoperative classification of T1N0M0 stage IA according to the 8th Union for International Cancer Control (UICC) guidelines, and the patient underwent conventional pancreatoduodenectomy. The resected specimen was microscopically found to contain colloid carcinoma, probably derived from IPMN. In addition, marked calcification was confirmed in the partition wall of the cystic mass. The postoperative course was uneventful, and no evidence of recurrence or metastasis was observed after 10 months of follow-up. Conclusions We consider that colloid carcinoma derived from IPMN should be differentially diagnosed as a pancreatic multilobular cystic lesion with prominent calcification that shows no sign of systemic chronic pancreatitis.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan.
| | - Katsumi Amikura
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Shinichi Matsudaira
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Hiroyuki Ishida
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Toshiro Ogura
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Atsushi Kihara
- Department of Pathology, Jichi Medical University, Tochigi, Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan
| | - Yoshiyuki Kawashima
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
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Matsudaira S, Yarita A, Fukumoto T, Hamada J, Hisada M, Fukumura Y, Fukushima J, Kawarabayashi N. [A case of granulocyte-colony stimulating factor-producing gallbladder adenosquamous carcinoma with rapidly-growing recurrence of liver metastasis in early postoperative period]. Nihon Shokakibyo Gakkai Zasshi 2020; 117:626-634. [PMID: 32655122 DOI: 10.11405/nisshoshi.117.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
An 82-year-old male with a gallbladder mass was diagnosed with gallbladder carcinoma through various examinations. Cholecystectomy, gallbladder bed resection, and lymph node dissection were performed. The histological examination revealed a gallbladder adenosquamous carcinoma, and this tumor showed positive staining for granulocyte-colony stimulating factor (G-CSF). Recurrence of multiple liver metastases was detected on 25th day postoperatively. Unfortunately, the patient died on 97th day postoperatively. Here, we report a case of G-CSF-producing adenosquamous carcinoma of the gallbladder with rapid recurrence of liver metastases in the early postoperative period.
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Affiliation(s)
| | - Akinaga Yarita
- Department of Digestive and General Surgery, Gyoda General Hospital
| | | | - Joji Hamada
- Department of Emergency and General Practice, Gyoda General Hospital
| | - Masayuki Hisada
- Department of Digestive and General Surgery, Gyoda General Hospital
| | - Yuki Fukumura
- Department of Diagnostic Pathology, Juntendo University School of Medicine
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11
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Matsudaira S, Fukumoto T, Yarita A, Hamada J, Hisada M, Fukushima J, Kawarabayashi N. A patient with cystic duct remnant calculus treated by laparoscopic surgery combined with near-infrared fluorescence cholangiography. Surg Case Rep 2020; 6:146. [PMID: 32577857 PMCID: PMC7311589 DOI: 10.1186/s40792-020-00909-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/30/2020] [Accepted: 06/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The recurrence of symptoms present before cholecystectomy may be caused by a cystic duct remnant. The resolution of cystic duct remnant syndrome may require surgical resection, but identification of the duct remnant during laparoscopic surgery may be difficult because of adhesions following the previous procedure. Open surgery, which is more invasive than laparoscopic surgery, is frequently chosen to avoid bile duct injury. CASE PRESENTATION The patient was a 24-year-old woman with previous laparoscopic cholecystectomy for chronic cholecystitis and repeated attacks of biliary colic. The postoperative course was uneventful, but computed tomography revealed a remnant cystic duct calculus. Ten months after surgery, the patient returned to our department for right hypochondriac pain. Laparoscopic remnant cystic duct resection was performed with intraoperative near-infrared (NIR) fluorescence cholangiography to visualize the common bile duct and remnant cystic duct. The postoperative course was uneventful and the patient was discharged on day 3 after surgery. At the 6-month follow-up, she had no recurrence of pain. CONCLUSION Laparoscopic surgery with NIR cholangiography is a safe and effective alternative for the removal of a cystic duct remnant calculus after cholecystectomy.
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Affiliation(s)
- Shinichi Matsudaira
- Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan.
| | - Tsuyoshi Fukumoto
- Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan
| | - Akinaga Yarita
- Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan
| | - Joji Hamada
- Department of Emergency and General Practice, Gyoda General Hospital, Saitama, Japan
| | - Masayuki Hisada
- Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan
| | - Junichi Fukushima
- Department of Diagnostic Pathology, Gyoda General Hospital, Saitama, Japan
| | - Nobuaki Kawarabayashi
- Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan
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12
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Fukumoto T, Hamada J, Matsudaira S, Yarita A, Sakano T, Kawarabayashi N, Fukushima J, Kamioka N, Nagumo H, Serizawa M, Osaka S, Hashimoto Y, Ogasawara A. [A Case of Primary Anal Fistula Cancer with Extensive Intrapelvic Spreading That Was Successfully Treated with Bevacizumab plus mFOLFOX6]. Gan To Kagaku Ryoho 2019; 46:717-720. [PMID: 31164514] [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: 06/09/2023]
Abstract
The patient was a 68-year-old man who had an anal fistula for>10 years. He was referred to our institution after visiting a local physician with left femoral pain as the main complaint and received a diagnosis of high inflammatory response. We then found discharge of pus in the perianal region during a medical examination. We also found an extensive intrapelvic tumor during a computed tomography(CT)/magnetic resonance imaging examination. In addition, the level ofa tumor marker and inflammatory response were high. To control the inflammation, we performed seton drainage and sigmoid colostomy. On the basis of the pathological findings from the mucus component, we confirmed a diagnosis of fistula cancer. Considering that the progressive lesion had extensively spread, we decided to initiate chemotherapy alone because ofthe absence ofan indication for radiotherapy. We administered bevacizumab plus mFOLFOX6, and partial response was observed on a CT scan. We could control the progression ofthe disease for>6 months. The present case suggests that bevacizumab plus mFOLFOX6 can be an effective regimen for unresectable advanced fistula cancers.
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13
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Nishiyama M, Matsudaira S, Kaketani M, Sugawara A, Numechika T, Ohashi M. [Detailed reproductions of impressions made with impression materials. 1. Products of test blocks duplicated by electroforming]. Shika Zairyo Kikai 1984; 3:588-604. [PMID: 6395402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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14
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Nishiyama M, Kaketani M, Matsudaira S, Ohashi M. Production of test blocks duplicated by electroforming for detail reproduction of impressions made with impression materials. J Nihon Univ Sch Dent 1984; 26:211-37. [PMID: 6394724 DOI: 10.2334/josnusd1959.26.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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15
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Nishiyama M, Kodaki T, Matsudaira S, Yoshimizu Y, Ogoshi H, Hidaka K, Ohashi M. Physical and bonding properties of opaque materials for thermo-setting facing resins. J Nihon Univ Sch Dent 1981; 23:18-26. [PMID: 7026741 DOI: 10.2334/josnusd1959.23.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Iwahashi I, Matsumoto K, Matsudaira S, Minami S, Yoshinaga H. Improved double beam, vacuum far infrared spectrophotometer. Appl Opt 1969; 8:583-588. [PMID: 20072263 DOI: 10.1364/ao.8.000583] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A double beam far ir spectrophotometer was improved in order to give more convenience and higher performance. The instrument is evacuable and the sample chamber alone can also be purged with dry air to remove water vapor. Three photometric systems, i.e., conventional double beam, double beam double chopping, and single beam systems can be selected for versatile measurements. The use of an efficient transmission filter system, not involving deliquescent crystals, results in many operational advantages. Accordingly, high resolution can be obtained through the entire spectral region from 400 cm(-1) to 30 cm(-1) Moreover, 30-min scan over the entire spectral region is achieved by completely automatic operation with a refined control system.
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