Title Alternative Achalasia treated with per-oral endoscopic myotomy (POEM)
Author Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Takashima, Shiho| Takei, Daisuke| Inokuchia, Toshihiro| Takahara, Masahiro| Kawano, Seiji| Hiraoka, Sakiko| Tanabe, Shunsuke| Noma, Kazuhiro| Shirakawa, Yasuhiro| Manabe, Noriaki| Inoue, Haruhiro| Okada, Hiroyuki|
Abstract Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Patients present with dysphagia, chest pain, vomiting, and aspiration. Esophageal achalasia had traditionally been treated with esophageal achalasia balloon dilatation and the Heller-Dor method, but in recent years, the use of per-oral endoscopic myotomy (POEM) has increased. Our patient, a 39-yr-old male, began experiencing dysphagia 4 years prior to his referral to our hospital. Based on the results of esophagogastroduodenoscopy, esophageal radiography and high-resolution manometry, we made the diagnosis of esophageal achalasia (Chicago classification type I) . After informed consent from the patient and his family and approval from our hospital's ethics committee were obtained, we performed a POEM. The patient was discharged on the 4th day post-surgery. At the 1-year post-operative examination, no worsening of symptoms and no relapse were observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect and prevention of invasion. We recommend that it be considered as the first-choice treatment for achalasia. However, accessibility to the procedure itself is limited due to the few adequately trained operators worldwide. POEM should thus be performed by an expert operator at a high-volume center.
Keywords POEM 食道アカラシア (esophageal achalasia)
Publication Title Journal of Okayama Medical Association
Published Date 2017-08-01
Volume volume129
Issue issue2
Start Page 115
End Page 121
ISSN 0030-1558
Related Url https://doi.org/10.4044/joma.129.115
language 日本語
Copyright Holders Copyright (c) 2017 岡山医学会
File Version publisher
DOI 10.4044/joma.129.115
Title Alternative Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis
Author Sugihara, Yuusaku| Kawano, Seiji| Harada, Keita| Takashima, Shiho| Takei, Daisuke| Inokuchi, Toshihiro| Takahara, Masahiro| Hiraoka, Sakiko| Mori, Yoshiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Okada, Hiroyuki|
Abstract A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.
Keywords 家族性大腸腺腫症 (familial adenomatous polyposis) 小腸癌 (jejunal cancer) 小腸内視鏡検査 (small intestine endoscope)
Publication Title Journal of Okayama Medical Association
Published Date 2017-08-01
Volume volume129
Issue issue2
Start Page 111
End Page 114
ISSN 0030-1558
Related Url https://doi.org/10.4044/joma.129.111
language 日本語
Copyright Holders Copyright (c) 2017 岡山医学会
File Version publisher
DOI 10.4044/joma.129.111
Author Iwamuro, Masaya| Okada, Hiroyuki| Harada, Keita| Kanzaki, Hiromitsu| Hori, Keisuke| Kita, Masahide| Kawano, Seiji| Kawahara, Yoshiro| Tanaka, Takehiro| Yamamoto, Kazuhide|
Published Date 2016-12-01
Publication Title Journal of Okayama Medical Association
Volume volume128
Issue issue3
Content Type Journal Article
Author Nakarai, Asuka| Kato, Jun| Hiraoka, Sakiko| Kuriyama, Motoaki| Inokuchi, Toshihiro| Takei, Daisuke| Moritou, Yuki| Akita, Mitsuhiro| Takahashi, Sakuma| Harada, Keita| Okada, Hiroyuki| Yamamoto, Kazuhide|
Published Date 2013-12-02
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue3
Content Type Journal Article