JaLCDOI 10.18926/AMO/54981
フルテキストURL 71_2_127.pdf
著者 Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Tanabe, Shunsuke| Kuroda, Shinji| Kagawa, Shunsuke| Katsui, Kuniaki| Katayama, Norihisa| Kanazawa, Susumu| Fujiwara, Toshiyoshi|
抄録 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.
キーワード esophageal cancer radiation therapy high-risk patient
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 127
終了ページ 133
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420894
JaLCDOI 10.18926/AMO/53524
フルテキストURL 69_3_173.pdf
著者 Shirakawa, Yasuhiro| Noma, Kazuhiro| Ohara, Toshiaki| Kashima, Hajime| Maeda, Naoaki| Tanabe, Shunsuke| Kagawa, Shunsuke| Fujiwara, Toshiyoshi|
抄録 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.
キーワード chyle leak thoracic duct thoracoscopy prone position
Amo Type Case Report
発行日 2015-06
出版物タイトル Acta Medica Okayama
69巻
3号
出版者 Okayama University Medical School
開始ページ 173
終了ページ 176
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26101193
Web of Sience KeyUT 000356903000006
JaLCDOI 10.18926/AMO/52407
フルテキストURL 68_2_111.pdf
著者 Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Katsube, Ryoichi| Tanabe, Shunsuke| Ohara, Toshiaki| Sakurama, Kazufumi| Fujiwara, Toshiyoshi|
抄録 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.
キーワード thoracoscopic esophagectomy prone position standardization
Amo Type Original Article
発行日 2014-04
出版物タイトル Acta Medica Okayama
68巻
2号
出版者 Okayama University Medical School
開始ページ 111
終了ページ 117
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24743786
Web of Sience KeyUT 000334652700006
JaLCDOI 10.18926/AMO/49672
フルテキストURL 67_2_123.pdf
著者 Tanabe, Shunsuke| Shirakawa, Yasuhiro| Takehara, Yuko| Maeda, Naoaki| Katsube, Ryoichi| Ohara, Toshiaki| Sakurama, Kazufumi| Noma, Kazuhiro| Fujiwara, Toshiyoshi|
抄録 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.
キーワード pneumatosis cystoides intestinalis pneumoperitoneum α-glucosidase inhibitor
Amo Type Case Report
発行日 2013-04
出版物タイトル Acta Medica Okayama
67巻
2号
出版者 Okayama University Medical School
開始ページ 123
終了ページ 128
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23603930
Web of Sience KeyUT 000317801700008