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Sakai, Japan

Chatani M.,Osaka Rosai Hospital
Japanese Journal of Clinical Radiology | Year: 2014

We compared treatment outcomes of stereotactic ablative body radiation therapy (SABR) in octogenarians with early (T1-2N0M0) lung cancer with the outcomes in younger patients. Fifty-three patients were octogenarians (Group A) and 127 patients were younger (Group B). The 3-year survival rates were 44% and 59%, and the 3-year cause specific survival rates were 59% and 71% in groups A and B, respectively (p = 0.70 and p = 054). The treatment outcomes of SABR in octogenarians were comparable to those observed in younger patients.

Hasegawa J.,Osaka Rosai Hospital
Asian journal of endoscopic surgery | Year: 2013

Fecal diversion may be performed using various techniques. Each technique has advantages that affect patient selection. In this report, we report our experience with 31 patients who underwent single-incision laparoscopic stoma creation using only a pre-selected stoma site as the point of port access. A 2.5-cm skin incision was made at a previously marked stoma site, and two 5-mm trocars were placed into the abdomen through the stoma site. An optional third trocar was inserted at the stoma site only if the bowel needed to be mobilized or if adhesions needed to be divided. After full intra-abdominal exploration, a selected intestinal loop was brought up to the stoma site, and the ostomy was then matured using standard techniques. Between April 2009 and March 2012, 31 patients (19 men) with a mean age of 68 years (range, 46-87 years) underwent single-incision laparoscopic stoma creation. Fecal diversion included ileostomy (n = 18) and colostomy (n = 13). There were no intraoperative complications. Two patients (6.5%) required additional port placement in the midline suprapubic area. Conversion to open laparotomy was required in two patients (6.5%) because of the presence of extensive adhesions. Postoperative complications were observed in two patients and included peristomal ileus and dehydration due to high ileostomy output. Single-incision laparoscopic stoma creation is an effective technique that allows full intra-abdominal visualization and bowel mobilization, while reducing the need for additional skin incisions beyond that of the stoma site. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

We report a case in which recurrent pancreatic metastasis of renal cell carcinoma( RCC) in the remnant pancreas was resected 6 years after subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). A 74-year-old man underwent right nephrectomy for RCC in 1991, left partial nephrectomy for left renal RCC metastasis in 1996, and SSPPD for pancreatic RCC metastasis in 2007. In November 2012, he was referred to our hospital with a tumor in the remnant pancreas, as seen on abdominal computed tomography (CT). Partial pancreatectomy for the recurrent metastatic RCC in the remnant pancreas was performed in January 2013. The tumor was histologically diagnosed as metastasis from clear cell RCC in the remnant pancreas. The postoperative course was uneventful, and the blood glucose level after surgery was well controlled using an oral hypoglycemic agent.

Fujimori T.,Osaka University | Iwasaki M.,Osaka University | Okuda S.,Osaka Rosai Hospital | Takenaka S.,Osaka Koseinenkin Hospital | And 3 more authors.
Spine | Year: 2014

STUDY DESIGN.: Retrospective study. OBJECTIVE.: We sought to determine the long-term outcomes of laminoplasty versus anterior decompression and fusion in the treatment of cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and to ascertain what factors should be considered in selecting appropriate surgical procedure. SUMMARY OF BACKGROUND DATA.: There are little data about long-term results of cervical myelopathy due to OPLL with an occupying ratio 60% or more. METHODS.: We retrospectively studied 27 patients having OPLL with an occupying ratio 60% or more and a follow-up period of at least 2 years. Clinical outcome was evaluated using Japanese Orthopaedic Association scores and recovery rates (≥75%, excellent; 50%-74%, good; 25%-50%, fair; and <25%, poor). RESULTS.: The mean age and the mean duration of follow-up were 57 years and 10.2 years. The mean Japanese Orthopaedic Association score was 9.3 before surgery and 12.4 at the final follow-up examination. There were 15 patients in the laminoplasty group (LAM group) and 12 patients in the anterior decompression and fusion group (ADF group). The ADF group had a significantly better recovery rate at final evaluation (53% vs. 30%; P = 0.04), a longer duration of surgery (314 vs. 128 min; P < 0.01), and greater blood loss (600 vs. 240 mL; P < 0.01) than did the LAM group. In the LAM group, 4 patients with excellent or good results had a significantly larger degree of cervical lordosis (30 vs. 10 ; P = 0.002) than others. CONCLUSION.: The ADF group had a significantly better recovery rate than the LAM group, although the degree of surgical invasiveness was high. ADF is generally recommended for OPLL with an occupying ratio 60% or more. © 2013, Lippincott Williams & Wilkins.

Fukushima M.,Head and Neck Surgery | Miyaguchi M.,Head and Neck Surgery | Kitahara T.,Osaka Rosai Hospital
Acta Oto-Laryngologica | Year: 2011

Conclusions: We performed extracapsular dissection (ECD) on 31 patients with pleomorphic adenoma, including 7 deep lobe cases. ECD is minimally invasive and has limited complications compared with other conventional parotidectomy procedures. This is the first report on performance of ECD in patients with deep lobe parotid pleomorphic adenomas. Surgeons who are capsule-conscious can perform ECD with good results. Objective: Pleomorphic adenoma, the most common benign neoplasm occurring in the parotid gland, has a constant frequency of recurrence and facial paralysis in patients after surgery. ECD is one of the surgical procedures performed on patients with these tumors, but its validity is still unclear because of its similarity to enucleation. Methods: We performed ECD in patients with untreated parotid neoplasms that were clinically diagnosed as benign before surgery. Of these, resected samples from 31 patients were histologically diagnosed as pleomorphic adenoma. Results: We achieved resection in patients with pleomorphic adenoma with no permanent facial paralysis or tumor recurrence, with a median follow-up time of 61 months (range 18-125 months). © 2011 Informa Healthcare.

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