フルテキストURL K0005585_abstract_review.pdf K0005585_summary.pdf K0005585_fulltext.pdf
著者 竹井 大介|
発行日 2017-09-29
資料タイプ 学位論文
学位授与番号 甲第5585号
学位授与年月日 2017-09-29
学位・専攻分野 博士(医学)
授与大学 岡山大学
言語 English
タイトル(別表記) Achalasia treated with per-oral endoscopic myotomy (POEM)
著者 杉原 雄策| 原田 馨太| 加藤 諒| 山内 健司| 高嶋 志保| 竹井 大介| 井口 俊博| 高原 政宏| 川野 誠司| 平岡 佐規子| 田辺 俊介| 野間 和宏| 白川 靖博| 眞部 紀明| 井上 晴洋| 岡田 裕之|
抄録 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.
キーワード POEM 食道アカラシア (esophageal achalasia)
出版物タイトル 岡山医学会雑誌
発行日 2017-08-01
129巻
2号
開始ページ 115
終了ページ 121
ISSN 0030-1558
関連URL https://doi.org/10.4044/joma.129.115
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.129.115
タイトル(別表記) Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis
著者 杉原 雄策| 川野 誠司| 原田 馨太| 高嶋 志保| 竹井 大介| 井口 俊博| 高原 政宏| 平岡 佐規子| 母里 淑子| 岸本 浩行| 永坂 岳司| 岡田 裕之|
抄録 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.
キーワード 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)
出版物タイトル 岡山医学会雑誌
発行日 2017-08-01
129巻
2号
開始ページ 111
終了ページ 114
ISSN 0030-1558
関連URL https://doi.org/10.4044/joma.129.111
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.129.111
著者 半井 明日香| 加藤 順| 平岡 佐規子| 栗山 宗彰| 井口 俊博| 竹井 大介| 森藤 由記| 秋田 光洋| 高橋 索真| 原田 馨太| 岡田 裕之| 山本 和秀|
発行日 2013-12-02
出版物タイトル 岡山医学会雑誌
125巻
3号
資料タイプ 学術雑誌論文