| JaLCDOI | 10.18926/AMO/54981 |
|---|---|
| FullText URL | 71_2_127.pdf |
| Author | Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Tanabe, Shunsuke| Kuroda, Shinji| Kagawa, Shunsuke| Katsui, Kuniaki| Katayama, Norihisa| Kanazawa, Susumu| Fujiwara, Toshiyoshi| |
| Abstract | Currently, chemoradiation is the most widely used nonsurgical treatment for esophageal cancer. However, some patients, particularly the very elderly or those with severe vital organ dysfunction, face difficulty with the chemotherapy component. We therefore examined the outcome of radiation therapy (RT) alone for patients with esophageal cancer at our facility. Between January 2005 and December 2014, 84 patients underwent RT at our hospital, and 78 of these patients received concomitant chemotherapy. The remaining 6 patients underwent RT alone; these patients were considered to be high-risk and to have no lymph node metastasis (stage I). Five of them received irradiation up to a curative dose: 4 showed a complete response (CR) and 1 showed a partial response (PR). Of the patients exhibiting CR, 3 are currently living recurrence-free, whereas 1 patient underwent endoscopic submucosal dissection (ESD) as salvage therapy for local recurrence, with no subsequent recurrence. High-risk stage I esophageal cancer patients can be treated radically with RT alone under certain conditions. In the future, to broaden the indications for RT monotherapy to include some degree of advanced cancers, a novel concurrent therapy should be identified. |
| Keywords | esophageal cancer radiation therapy high-risk patient |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2017-04 |
| Volume | volume71 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 127 |
| End Page | 133 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2017 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 28420894 |
| Title Alternative | Thoracoscopic esophagectomy was effective in a case of lower esophageal stenosis due to recurrence of achalasia after myotomy 40 years previously |
|---|---|
| FullText URL | 129_41.pdf |
| Author | Katsura, Yuki| Shirakawa, Yasuhiro| Tanabe, Shunsuke| Maeda, Naomi| Noma, Kazuhiro| Fujiwara, Toshiyoshi| |
| Abstract | When planning surgery for achalasia, it is important to plan for adequate myotomy and prevention of reflux. However, achalasia may recur if the procedure was inadequate or in patients with a long-term course. The present case is a 68-year-old woman who underwent myotomy of the lower esophageal sphincter 40 years ago, but recently reported difficulty in swallowing. Dilatation of the thoracic esophagus and stenosis of the abdominal esophagus were identified by examination, and the patient was diagnosed with recurrence of achalasia. After percutaneous endoscopic gastrostomy was performed to recover nutritional status, thoracoscopic esophagectomy was carried out. The patient'spost-operative course was uneventful and oral intake was enabled. At the time of writing, there has been no re-recurrence. There is no standard therapy for post-operative recurrence of achalasia. We believe that thoracoscopic esophagectomy for the recurrence of achalasia is a safe and minimally invasive alternative to conventional surgery. |
| Keywords | 食道アカラシア (achalasia) 再手術 (reoperation) 食道亜全摘 (esophagectomy) |
| Publication Title | Journal of Okayama Medical Association |
| Published Date | 2017-04-03 |
| Volume | volume129 |
| Issue | issue1 |
| Start Page | 41 |
| End Page | 44 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2017 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.129.41 |
| NAID | 130005632071 |
| JaLCDOI | 10.18926/AMO/53524 |
|---|---|
| FullText URL | 69_3_173.pdf |
| Author | Shirakawa, Yasuhiro| Noma, Kazuhiro| Ohara, Toshiaki| Kashima, Hajime| Maeda, Naoaki| Tanabe, Shunsuke| Kagawa, Shunsuke| Fujiwara, Toshiyoshi| |
| Abstract | A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (typeⅢB1 of Edwardʼs classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position. |
| Keywords | chyle leak thoracic duct thoracoscopy prone position |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-06 |
| Volume | volume69 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 173 |
| End Page | 176 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 26101193 |
| Web of Science KeyUT | 000356903000006 |
| Author | Yamada, Eiji| Shirakawa, Yasuhiro| Yamatsuji, Tomoki| Sakuma, Leon| Takaoka, Munenori| Yamada, Takako| Noma, Kazuhiro| Sakurama, Kazufumi| Fujiwara, Yasuhiro| Tanabe, Shunsuke| Nagasaka, Takeshi| Fujiwara, Toshiyoshi| Naomoto, Yoshio| |
|---|---|
| Published Date | 2012-12 |
| Publication Title | Journal of Surgical Research |
| Volume | volume178 |
| Issue | issue2 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/52407 |
|---|---|
| FullText URL | 68_2_111.pdf |
| Author | Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Katsube, Ryoichi| Tanabe, Shunsuke| Ohara, Toshiaki| Sakurama, Kazufumi| Fujiwara, Toshiyoshi| |
| Abstract | Thoracoscopic esophagectomy in the prone position (TEPP) might enable solo-surgery in cases requiring resection of the esophagus and the surrounding lymph nodes due to the associated advantages of good exposure of the surgical field and ergonomic considerations for the surgeon. However, no one approach can be for all patients requiring extensive lymphadenectomy. We recently developed an assistant-based procedure to standardize exposure of the surgical field. Patients were divided into 1 of 2 groups:a pre-standardization group (n＝37) and a post-standardization group (n＝28). The thoracoscopic operative time was significantly shorter (p＝0.0037) in the post-standardization group (n＝28; 267±31min) than in the pre-standardization group (n＝37;301±53min). Further, learning curve analysis using the moving average method showed stabilization of the thoracoscopic operative time after the standardization. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the 2 groups. There were also no significant differences in the complication rate. Assistant-based surgery and standardization of the procedure resulted in a well-exposed and safe surgical field. TEPP decreased the operative time, even in patients requiring extensive lymphadenectomy. |
| Keywords | thoracoscopic esophagectomy prone position standardization |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-04 |
| Volume | volume68 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 111 |
| End Page | 117 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24743786 |
| Web of Science KeyUT | 000334652700006 |
| Author | Fujiwara, Y.| Yamada, T.| Naomoto, Y.| Yamatsuji, T.| Shirakawa, Y.| Tanabe, S.| Noma, K.| Kimura, T.| Aoki, H.| Matsukawa, H.| Kimura, M.| Nonaka, Y.| Sasaki, H.| Onoda, T.| Otawa, Y.| Takaoka, M.| Fukazawa, T.| Ohno, Y.| Fujiwara, T.| |
|---|---|
| Published Date | 2013-12 |
| Publication Title | Journal of Hospital Infection |
| Volume | volume85 |
| Issue | issue4 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/49672 |
|---|---|
| FullText URL | 67_2_123.pdf |
| Author | Tanabe, Shunsuke| Shirakawa, Yasuhiro| Takehara, Yuko| Maeda, Naoaki| Katsube, Ryoichi| Ohara, Toshiaki| Sakurama, Kazufumi| Noma, Kazuhiro| Fujiwara, Toshiyoshi| |
| Abstract | An 80-year-old woman, who had been administered α-glucosidase inhibitor for diabetes, was brought to the hospital with the sensation of abdominal fullness and pain. Abdominal computed tomography indicated pneumatosis cystoides intestinalis (PCI) in the small intestinal wall, with free air within the abdomen. A blood examination showed no increases in white blood cells or C-reactive protein level. The patientʼs condition improved with conservative therapy. PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. In PCI with pneumoperitoneum, differentiation from gastrointestinal perforation is important and following the clinical symptoms over time is vital. |
| Keywords | pneumatosis cystoides intestinalis pneumoperitoneum α-glucosidase inhibitor |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-04 |
| Volume | volume67 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 123 |
| End Page | 128 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23603930 |
| Web of Science KeyUT | 000317801700008 |
