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Mimatsu K.,Social Insurance Yokohama Central Hospital | Oida T.,Social Insurance Yokohama Central Hospital | Fukino N.,Social Insurance Yokohama Central Hospital | Kano H.,Social Insurance Yokohama Central Hospital | And 4 more authors.
Anticancer Research | Year: 2014

Background/Aim: The Glasgow prognostic score (GPS) is a predictor of outcome for several cancer types. The present study examined the significance of modified GPS (mGPS) in the prognosis of patients undergoing palliative surgery for stage IV gastric cancer. Patients and Methods: A total of 42 patients with stage IV gastric cancer treated with palliative gastrectomy and gastrojejunostomy were included in the study. Univariate and multivariate analyses were performed to evaluate the relationship between clinicopathological factors and cancer-specific survival (CS). Results: Among patients who underwent palliative surgery including gastrectomy and gastrojejunostomy, univariate analysis of CS identified the following significant risk factors: surgical treatment, chemotherapy and mGPS, and multivariate analysis revealed that mGPS was independentlyassociated with CS. In particular, among patients who underwent palliative gastrectomy, mGPS was shown to be the strongest independent predictive factor for CS. Conclusion: The mGPS was an independent predictive factor for survival in patients who underwent palliative surgery for stage IV incurable gastric cancer, especially for those who underwent palliative gastrectomy.


Oida T.,Social Insurance Yokohama Central Hospital | Mimatsu K.,Social Insurance Yokohama Central Hospital | Kano H.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | And 3 more authors.
World Journal of Gastroenterology | Year: 2010

AIM: To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. METHODS: We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. After pericardiocentesis, we performed catheterization of the pericardial space under ultrasonogram guidance. Malignant etiology of the pericardial fluid was confirmed by cytological examination. Subsequently, cisplatin (10 mg in 20 mL normal saline) was instilled into the pericardial space. RESULTS: The mean total volume of the aspirated effusion fluid was 782 ± 264 mL (range, 400-1200 mL). The drainage catheter was successfully removed in all patients, and the mean duration of pericardial drainage was 7.7 ± 2.7 d (range, 5-13 d). No fluid reaccumulation was observed. Mean survival time was 120 ± 71 d (range, 68-268 d). CONCLUSION: Pericardiocentesis along with catheter drainage appears to be a safe and effective for pericardial malignant effusion and tamponade, and cisplatin instillation prevents recurrence. © 2010 Baishideng. All rights reserved.


Oida T.,Social Insurance Yokohama Central Hospital | Mimatsu K.,Social Insurance Yokohama Central Hospital | Kano H.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | And 4 more authors.
Hepato-Gastroenterology | Year: 2012

Background/Aims: Previously, we developed a modified subtotal stomach-preserving pancreaticoduodenectomy for preventing delayed gastric emptying and achieved a decrease in the incidence of delayed gastric emptying. In this study, we compared the antecolic and retrocolic routes to determine which reconstruction route is better for decreasing the incidence of delayed gastric emptying in modified subtotal stomach-preserving pancreaticoduodenectomy. Methodology: We retrospectively analyzed 42 patients who underwent modified subtotal stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy. The patients were divided into 2 groups based on type of reconstruction: the antecolic reconstruction group and the retrocolic reconstruction group. The incidence of delayed gastric emptying was determined and compared between the 2 groups. Results: The mean time during nasogastric suction and before initiation of a diet after surgery was shorter in the retrocolic reconstruction group (without significant difference); however, the mean time before oral ingestion of solid food could be safely resumed was significantly shorter in the retrocolic reconstruction group (9.7±1.2 days) than in the antecolic reconstruction group AC group (11.4±3.0 days; p<0.0112). Conclusions: We consider retrocolic reconstruction preferable to antecolic reconstruction for preventing delayed gastric emptying in patients who have undergone modified subtotal-stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy. © H.G.E. Update Medical Publishing S.A.


Mimatsu K.,Social Insurance Yokohama Central Hospital | Oida T.,Social Insurance Yokohama Central Hospital | Kano H.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | And 4 more authors.
Surgical and Radiologic Anatomy | Year: 2012

Purpose Anatomical anomalies of visceral organs associated with gastric cancer are extremely rare. Here, we report a case of preduodenal portal vein (PDPV), intestinal malrotation, interruption of the inferior vena cava (IVC), and polysplenia associated with gastric cancer in an adult patient, together with a review of the literature on the anomalies of visceral organs associated with gastric cancer. Methods We describe the diagnosis and surgical treatment in a 63 year-old man who had a preoperative diagnosis of PDPV, intestinal malrotation, interruption of the IVC with azygos continuation, and polysplenia associated with gastric cancer. Fifteen reports, in the English literature up to 2011, on visceral organ anomalies detected in gastric cancer patients were identified by searching Medline. Results All of the 15 cases of anomalies associated with gastric cancer, including the present case, were correctly diagnosed by preoperative imaging. Situs anomaly was the most frequent anatomical anomaly detected, and PDPV was observed in only four cases. In 12 cases, gastrectomy was performed, and gastrojejunostomy was done in 1 case. Conclusions Although embryological anomalies such as PDPV, intestinal malrotation, interruption of the IVC, and polysplenia are rarely encountered in abdominal surgery, surgeons must be aware of their possible existence and be able to recognize them to avoid major intraoperative injuries. © 2011 Springer-Verlag.


Oida T.,Social Insurance Yokohama Central Hospital | Mimatsu K.,Social Insurance Yokohama Central Hospital | Kano H.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | And 3 more authors.
Hepato-Gastroenterology | Year: 2011

Background/Aims: Delayed gastric emptying (DGE) is one of the most troublesome complications of pylorus-preserving pancreaticoduodenectomy (PPPD). In Japan, since the 1990s, subtotal-stomach-preserving pancreaticoduodenectomy (SSPPD) has been performed as an alternative to PPPD. Here, we evaluated the efficacy of our modification of the original SSPPD technique as compared to PPPD with an aim to decrease the incidence of DGE. Methodology: We retrospectively analyzed 67 patients who underwent PD with pancreaticogastrostomy (PG). They were divided into 2 groups on their basis of the surgical treatment: the PPPD group and the modified SSPPPD (MSSPPD) group. The incidence of DGE was determined and compared between the 2 groups. Results: In the MSSPPD group, 98%, 2%, and 0% of the cases developed class A, class B, and class C DGE, respectively; the corresponding values in the PPPD group were 4%, 52%, and 44%, respectively. The incidence of DGE differed significantly between the 2 groups (p<0.0001). Conclusions: We consider that our reconstruction procedure is useful for preventing DGE in patients who have undergone SSPPD with PG. © H.G.E. Update Medical Publishing S.A.


PubMed | Nihon University and Social Insurance Yokohama Central Hospital
Type: Journal Article | Journal: Anticancer research | Year: 2014

The Glasgow prognostic score (GPS) is a predictor of outcome for several cancer types. The present study examined the significance of modified GPS (mGPS) in the prognosis of patients undergoing palliative surgery for stage IV gastric cancer.A total of 42 patients with stage IV gastric cancer treated with palliative gastrectomy and gastrojejunostomy were included in the study. Univariate and multivariate analyses were performed to evaluate the relationship between clinicopathological factors and cancer-specific survival (CS).Among patients who underwent palliative surgery including gastrectomy and gastrojejunostomy, univariate analysis of CS identified the following significant risk factors: surgical treatment, chemotherapy and mGPS, and multivariate analysis revealed that mGPS was independently-associated with CS. In particular, among patients who underwent palliative gastrectomy, mGPS was shown to be the strongest independent predictive factor for CS.The mGPS was an independent predictive factor for survival in patients who underwent palliative surgery for stage IV incurable gastric cancer, especially for those who underwent palliative gastrectomy.


PubMed | Nihon University and Social Insurance Yokohama Central Hospital
Type: Journal Article | Journal: Case reports in gastroenterology | Year: 2014

We report the rare case of an elderly patient with an advanced gastric cancer arising from an upside-down stomach through a paraesophageal hiatal hernia (PEH). An 82-year-old man presented with appetite loss and anemia. Upper gastrointestinal endoscopy revealed a type 1 tumor located in the middle body of the stomach. An upper gastrointestinal series and computed tomography showed organoaxial rotation of the stomach, which was located in the mediastinum, through a PEH, indicating an upside-down stomach. The preoperative diagnosis was gastric cancer arising from an upside-down stomach through a PEH. The patient underwent total gastrectomy with lymph node dissection and closure of the hernial orifice. Although a large PEH is a chronic disorder, gastric malignancies should be considered in patients with PEH manifested as an upside-down stomach due to its anatomical characteristics, and careful preoperative diagnosis is mandatory.


Fukino N.,Social Insurance Yokohama Central Hospital | Oida T.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | Mimatsu K.,Social Insurance Yokohama Central Hospital | And 3 more authors.
World Journal of Gastroenterology | Year: 2010

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-yearold woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted, and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone. © 2010 Baishideng. All rights reserved.


Oida T.,Social Insurance Yokohama Central Hospital | Mimatsu K.,Social Insurance Yokohama Central Hospital | Kawasaki A.,Social Insurance Yokohama Central Hospital | Kanou H.,Social Insurance Yokohama Central Hospital | And 2 more authors.
Langenbeck's Archives of Surgery | Year: 2010

Purpose Left-sided hepatectomy occasionally leads to early delayed gastric emptying (EDGE). We developed a new fixation procedure of the round ligament to the peritoneum to prevent EDGE after hepatic lateral segmentectomy and evaluated its efficacy. Methods We retrospectively studied 42 patients who underwent hepatic lateral segmentectomy. They were divided into two groups: a fixation group (N=15) and a nonfixation group (N=27). The round ligament of the liver was divided at the umbilicus and detached from the abdominal wall from the umbilicus to the liver. The cut surface of the liver was wrapped by the round ligament, and the distal part of the round ligament was then fixated to the peritoneum. Results EDGE was found to be 0% in the fixation group versus 15% in the nonfixation group. Conclusions Fixation of the round ligament to the peritoneum is a useful technique to prevent EDGE after hepatic lateral segmentectomy. © Springer-Verlag 2008.


PubMed | Social Insurance Yokohama Central Hospital
Type: Case Reports | Journal: Asian journal of endoscopic surgery | Year: 2014

Laparoscopic Nissen fundoplication (LNF) and gastrostomy are often performed in children with gastroesophageal reflux disease. With a population that is increasingly aging, the number of elderly patients with paraesophageal hernia who have a nutritional disorder due to dysphagia has increased. In these patients with feeding difficulties, LNF and percutaneous endoscopic gastrostomy (PEG) are effective procedures for providing nutritional support. Here, we describe the case of an 82-year-old woman with paraesophageal hernia and certain comorbidities. She was receiving enteral feeding through a nasogastric tube, which was discontinued because aspiration pneumonia occurred. Therefore, LNF and crural repair without mesh placement were performed. The PEG tube was placed using the Ponsky pull technique under direct visualization with a laparoscope and gastroscope. The patients nutritional status improved after she received enteral nutrition through the PEG tube. Thus, LNF and PEG may be useful techniques for nutritional support in elderly patients with a large paraesophageal hernia.

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