Title Alternative Video capsule endoscopy usage: Intra-hospital consultations before and after the expansion of indications
Author Kawano, Seiji| Iwamuro, Masaya| Inokuchi, Toshihiro| Sugihara, Yuusaku| Harada, Keita| Hiraoka, Sakiko| Okada, Hiroyuki|
Abstract Approximately 10 years have passed since video capsule endoscopy (VCE)was introduced in routine clinical practice in Japan. We started using VCE in January 2009. Here we investigated the contribution of VCE and its level of recognition at our 855-bed hospital. We compared the clinical characteristics of intra-hospital consultation cases with non-consultation cases, and the details of the cases from each of our hospital’s departments. The number of intra-hospital consultations was notably increased by our expansion of the indications for non-obscure gastrointestinal bleeding (OGIB)cases. However, most of our hospital’s departments are sub-departments of internal medicine, in which almost no change in indications has been made. We found that the percentage of OGIB cases was higher among the intra-hospital consultations than non-consultations, and that the OGIB percentages differed markedly among the departments. Especially for OGIB cases, all hospital departments should be better informed regarding the indications for and efficacy of VCE.
Keywords カプセル内視鏡(video capsule endoscopy) 適応拡大(expansion of indication) 院内紹介(intra-hospital consultation)
Publication Title Journal of Okayama Medical Association
Published Date 2018-12-03
Volume volume130
Issue issue3
Start Page 155
End Page 159
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.130.147
language 日本語
Copyright Holders Copyright (c) 2018 岡山医学会
File Version publisher
DOI 10.4044/joma.130.147
NAID 130007542857
Title Alternative An effective case of peroral endoscopic myotomy for esophageal abnormal peristalsis after Heller-Dor myotomy
Author Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Takashima, Shiho| Yamasaki, Yasushi| Inokuchi, Toshihiro| Takahara, Masahiro| Kawano, Seiji| Hiraoka, Sakiko| Manabe, Noriaki| Otsuka, Fumio| Okada, Hiroyuki|
Abstract Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Our patient, a Japanese male in his 80's, had been experiencing dysphagia for almost 60 years. He was treated with balloon dilations and Heller-Dor 5 years prior to his present admission. Esophagogastroduodenoscopy, esophageal radiography, and high-myotomy manometry indicated that the symptoms were likely due to abnormal peristalsis. With the patient’s informed consent, we performed a peroral endoscopic myotomy(POEM). The patient was discharged 4 days post-surgery. At the 6-month postoperative examination, no worsening of symptoms or relapse was observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect. We recommend that POEM be considered as the first-choice treatment for abnormal peristalsis after a Heller-Dor myotomy.
Keywords POEM(peroral endoscopic myotomy) 食道アカラシア(esophageal achalasia)
Publication Title Journal of Okayama Medical Association
Published Date 2018-08-01
Volume volume130
Issue issue2
Start Page 67
End Page 71
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.130.67
language 日本語
Copyright Holders Copyright (c) 2018 岡山医学会
File Version publisher
DOI 10.4044/joma.130.67
NAID 130007481050
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 Hiraoka, Sakiko| Kato, Jun| Fujiki, Shigeatsu| Kaji, Eisuke| Morikawa, Tamiya| Murakami, Takatoshi| Nawa, Toru| Kuriyama, Motoaki| Uraoka, Toshio| Ohara, Nobuya| Yamamoto, Kazuhide|
Published Date 2011-08-01
Publication Title 岡山医学会雑誌
Volume volume123
Issue issue2
Content Type Journal Article
Author Hiraoka, Sakiko|
Published Date 2004-06-30
Publication Title
Content Type Thesis or Dissertation