Toranomon Hospital 2-2-2 Toranomon Minato city, Tokyo, Japan 105-8470
sasakikazunari1978@hotmail.com
2009- Staff Surgeon Department of Digestive Surgery, Hepato-Biliary-Pancreatic Surgery Unit, Toranomon Hospital, Tokyo, Japan Residency 2006-2008 Toranomon Hospital, Tokyo, Japan 2008-2009 Department of Transplant Surgery, National Center for Child Health and Development,Tokyo, Japan
Internship 2004-2006 Kyoto University Hospital, Kyoto, Japan Medical School 1998-2004 Shiga University of Medical Science, Shiga, Japan
Abstract: To investigate the safety and feasibility of our original single-incision laparoscopic cholecystectomy (SILC) for acute inflamed gallbladder (AIG).
Abstract: To maintain operative safety, patient selection criteria for single-incision laparoscopic cholecystectomy (SILC) are more stringent than that for traditional laparoscopic cholecystectomy (TLC). No other method could demonstrate the same feasibility and safety as TLC because the patient selection criteria were too restrictive for SILC to compare with TLC. In this study, we conducted a comparative study between our original SILC and TLC for demonstrating similar feasibility and safety among patients who had the same selection criteria as that for TLC. A statistical comparison between 114 patients of SILC and 201 patients of TLC was conducted during the same time period. The preoperative patient characteristics for SILC and TLC showed no statistical difference. In the operative result analysis, a significant disadvantage of SILC was the prolongation of operative time by only 15 minutes. The original SILC was as feasible and safe as TLC and virtually scarless cholecystectomy could be performed without any selection criteria. This was performed using only 2 trocars from an umbilical incision and 2 incisionless extracorporeal retraction devices.
Abstract: Classically defined cystic duct carcinoma is extremely rare owing to its strict diagnostic criteria, which are not suitable in actual clinical settings. Recently, several new classifications of cystic duct carcinoma were reported, which defined it as a tumor with its center located in the cystic duct. On the other hand, the incidence of cystic duct carcinoma, based on the new classifications, is not rare, but all reported cases are advanced. PRESENTATION OF CASE: A 77-year-old man with dilatation of the common bile duct, a stricture at the level of the cystic duct junction, and a filling defect of contrast medium into cystic duct in endoscopic retrograde cholangiopancreatography was diagnosed with cystic duct carcinoma. Radical cholecystectomy with bile duct resection was performed. In the resected specimen, we found that a 2Â cm tumor whose center was located in the cystic duct and vertically limited to the mucosal layer. Horizontally, the tumor was superficially spread in the gallbladder, which were also limited to the mucosal layer.
Abstract: BWS is one of the most well-known somatic overgrowth syndromes, which is characterized by macroglossia, organomegaly, abdominal wall defects, and predisposition to embryonal tumors, such as Wilms' tumor, hepatoblastoma, and adrenocortical carcinoma. We report a case of BWS in a girl with unresectable hepatoblastoma, who received a planned LVDT following neo-adjuvant chemotherapy. This is the first case report of liver transplantation for patients with BWS. Tumor surveillance after transplantation would be necessary to detect possible recurrence of the original disease and development of other malignancies.
Abstract: Schwannomas of the left recurrent nerve are rare and there is no agreement on how to manage them without causing recurrent nerve dysfunction. We present a 63-year-old male with unspecific clinical symptoms in whom a middle mediastinal mass with a diameter of 5 cm was found incidentally. At thoracoscopic surgery,we found that the encapsulated tumor originated from left recurrent nerve and we performed tumor enucleation without sacrificing the recurrent nerve. The patient did experience postoperative hoarseness and vocal cord paralysis even though we preserved the recurrent nerve. To our knowledge, thoracoscopic removal of a left recurrent nerve schwannoma has not been reported in the literature before.
Abstract: Angiogenesis is believed to be involved in the pathogenesis and progression of multiple myeloma (MM). In some young patients, the MM has been reported to be complicated with high-output cardiac failure (HOCF), in which an increase in the vascular bed may be involved in the pathogenesis; however, no throughput studies have been conducted to determine what angiogenic factors are associated with HOCF in MM patients. We experienced a 34-year-old MM patient with HOCF and used the cytokine array system to investigate the expression of angiogenic cytokines and related factors in his serum before and after treatment and to compare the results with those of a healthy volunteer. We treated the patient with chemotherapy in combination with autologous peripheral blood stem cell transplantation. Following the treatment, he showed a good partial response without any signs of cardiac failure. The patient had experienced dramatic increases in the expression levels of angiopoietin 2, insulin-like growth factor-binding protein 6, and glial cell line-derived neurotrophic factor. After treatment, the levels of these factors decreased remarkably in association with an improvement in the patient's clinical condition. We review previous case reports in our discussion of the significance of these findings in the pathogenesis of MM with HOCF.
