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Volume 43, Issue 9
Displaying 1-11 of 11 articles from this issue
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Mikiko NOMURA, Naotaka FUJITA, Atsuo MATSUNAGA, Kiyoshi UCHIMI, Yutaka ...2001 Volume 43 Issue 9 Pages 1821-1827
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAim: To evaluate the effectiveness of the scratch-stick-method for endoscopic mucosal resection (EMR) of colorectal tumors (superficial type and nodule aggregating type) 20mm or more in size. Material and methods: Twenty lesions which were resected by the scratch-stick-method were reviewed as to the following points: 1) number of resections, 2) histological condition of the horizontal and vertical cut ends of resected specimens, 3) residue/recurrence of neoplasms at the site of resection, and 4) complications. Thirty-four lesions, resected by ordinary EMR, were also reviewed as a control. The scratch-stick-method is carried out as follows. First, a scratch is made by electrocautery in the normal mucosa oral to the lesion. After the tip of a snare has been stuck into the scratch to stabilize the snare, EMR is performed. Results: Complete resection in one session was achieved in 65% of the lesions which underwent EMR with the scratch-stick-method and in 35% of the lesions which underwent ordinary EMR. Neoplastic cells were observed at the horizontal cut end of the lesions in 5% of the group which underwent EMR with the scratch-stick-method and in 26% of the control group. No recurrence at the site of EMR was seen in the group which underwent EMR with the scratch-stick-method. No severe complications were observed in either group. Conclusion: The scratch-stick-method is a useful technique when performing EMR for large colorectal tumors.View full abstractDownload PDF (8559K) -
Tatsuro YAMAGUCHI, Misao YOSHIDA, Kumiko MOMMA, Tomoko HANASHI, Yuji K ...2001 Volume 43 Issue 9 Pages 1828-1833
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRecently large number of patients with mucosal cancer of the esophagus have been treated by endoscopic mucosal resection (EMR) with excellent results. At the same time, frequent esophageal stricture limited the mucosal defect after EMR to 3/4 the circumference. A circumferential and long segmental EMR was carried out for a 60-year-old man who had a superficial and spreading mucosal cancer. A self expandable metallic stent (EMS: covered type) was applied on the circumferential mucosal defect with axial dimension 12 cm immediately after the EMR, for prevention of esophageal stricture. He could take soft meals in five days and was discharged 21 days after EMR. The EMS was removed seven weeks after EMR. Two narrow segmental strictures were developed after 12 days and they were successfully dilated by repeated bougienages. These results strongly suggested that circumferential mucosal cancer of the esophagus could be treated with EMR by using EMS right after EMR.View full abstractDownload PDF (8133K) -
Takashi FUJISAWA, Yutaka ONISHI, Mitsuo MAEDA, Norikazu SAKAMOTO, [in ...2001 Volume 43 Issue 9 Pages 1834-1841
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 73-year-old man was admitted to our hospital with back pain. An upper gastrointestinal series showed Barrett's esophagus, sliding hernia, and a diffuse infiltrating cancer with defect of esophagogastric junction, measuring 2.5 cm in diameter. Biopsied specimen revealed signetring cell carcinoma. Lower esophageal resection and cardiac gastrectomy was performed. Histological examination of the resected specimen revealed poorly differentiated adenocarcinoma of the esophagogastric junctional region probably arising in Barrett's esophagus (pType 4ns, pT2(mp), por+sig, infβ, ly2⋅v0, pN1, EG, 10.5×6.5 cm). We reviewed cases of poorly differentiated adenocarcinoma of the esophagogastric junctional region and Barrett's esophagus.View full abstractDownload PDF (13149K) -
Ryutarou TORISHIMA, Takayuki NAGAI, Hiroshi NAKASHIMA, Hirokazu ISHITO ...2001 Volume 43 Issue 9 Pages 1842-1846
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported herein a 68-year-old male with primary early duodenal malignant lymphoma. Endoscopic examination revealed a flat protruted lesion which was covered with thick whitish mucosa in the second portion of the duodenum. Although the endoscopic finding of this tumor had not changed, a repeated histological examination of endoscopic biopsy speciemens revealed malignant lymphoma. Partial duodenectomy was performed and the resected tumor was diagnosed as follicular lymphoma limited within the submucosa. This was the 4th report in Japan as primary early duodenal malignant lymphoma.View full abstractDownload PDF (7794K) -
Tetsuya AOKI, Kiyotaka OKAWA, Ryuuta OISO, Hideto OIYA, Hiroko NEBIKI, ...2001 Volume 43 Issue 9 Pages 1847-1851
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 45-year-old man. He presented to our department with a small melena and right-sided abdominal pain. Colonoscopy and barium enema showed multiple diverticula and multiple smooth and reddened elevations of the mucosa from the cecum to the ascending colon. Since conservative therapy, including fasting and antibiotics, did not improve his symptoms, surgery was performed. Histopathologic examination of the resected colon showed an elongation of crypt and fibromuscular obliteration in the lamina propria. These lesions were considered to have developed secondarily to diverticula of the colon by the same mechanism as mucosal prolapse syndrome. This report was the third case in Japan.View full abstractDownload PDF (9467K) -
Satoshi YAO, Sumio TSUDA, Toshio HOHASHI, Masato MATSUMURA, Hiroaki MA ...2001 Volume 43 Issue 9 Pages 1852-1858
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 37-year old man who had been treated as total ulcerative colitis for 11 years, received colonoscopy for surveillance of colitic cancer. Colonoscopic findings revealed 4 flat elevated lesions in the rectum and an endoscopic mucosal resection was performed for these lesions. All of these resected specimens were diagnosed as well differentiated adenocarcinoma localized in the mucosal layer histologically. Scrutinizing colonoscopy for residual malignancy revealed no obvious lesion, but one of the biopsied specimens from the artificial ulcer scar of the previous mucosal cancer was histologically diagnosed as moderate dysplasia. Therefore, we performed total proctocolectomy. Histological examination of the resected colon showed widespread moderate dysplasia where multiple cancers had been located. We eventually diagnosed this case as multiple rectal cancers associated with long-standing ulcerative colitis.View full abstractDownload PDF (7487K) -
Yoshiaki EBUCHI, Akihiko HACHIYA, Tadashi IWASAKI, Naoki OKANO, Tomihi ...2001 Volume 43 Issue 9 Pages 1859-1864
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 85-year-old man underwent cholecystectomy due to gallbladder stone in 1980. He had fever and abdominal pain occasionally for 4months, then visited our out patient department on October, 1993. Laboratory data showed the elevation of CRP and biliary enzymes. After admission, the common bile duct (CBD) stones were recognized by abdominal ultrasonography (US). Endoscopic retrograde cholangiography (ERC) showed the dilatation of the CBD with three stones. There was a fistula in the duodenal bulb in which bile discharge was confirmed at endoscopy. Cholangiography from the fistula showed significant CBD and stones. We made a diagnosis of cystic duct remnant-duodenal fistula which is considered an extremely rare case from review of the literature.View full abstractDownload PDF (8007K) -
Hisafumi KITAGAWA, Teruyuki KANE, Masayuki CHIKAMORI, Tatsuhiko KITAMU ...2001 Volume 43 Issue 9 Pages 1865-1870
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground and Study Aims : The Song-type polyurethane-covered self-expandable metallic stent was first introduced in 1992 and widely used for palliative therapy of malignant strictures of the esophagus, however it is rarely employed for benign strictures. It is because it would cause ref lux esophagitis when the stent is placed in the lower esophagus. Patients and Methods : An 81-year-old male presented severe stricture of the lower esopha-gus due to reflux esophagitis with hiatal hernia. We employed the Song type polyurethane-covered self-expandable metallic stent with the anti-ref lux valve with the benign stricture. Anti -ref lux valve simply consisted of the polyurethane tube folded inwardly on the oral side of the stent. Results : The patient was relieved easily from dysphagia after the placement of the stent. No symptoms from reflux of the gastric juice occurred afterwards with the administration of a proton pump inhibitor. The stent was proved to be out of GI tract five months later. Conclusions : This case suggested that the stent with the anti-ref lux valve was safe and useful for the management of patients with benign strictures as well as malignant strictures who cannot tolerate surgical procedures.View full abstractDownload PDF (8596K) -
Hisafumi KITAGAWA, Masayuki CHIKAMORI, Tatsuhiko KITAMURA, Seirou SHIO ...2001 Volume 43 Issue 9 Pages 1871-1877
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground and Study Aims : Metallic stents are currently an established component of the endoluminal treatment of stenoses within the upper gastrointestinal tract. Although the development of newer stent designs and delivery systems, there still exist malignant strictures of high cervical esophagus that cannot be palliated by single use of metallic stent. High cervical strictures had been reported difficult to palliate for the reason that high stenting might cause dysphagia and foreign body sensation. Patients and Methods : We report a case of cervical gastric tube stricture caused by the cervical lymph node metastases after the esophageal cancer operation. The stricture is treated by the metallic stents (covered Wallstent) using "stent in stent" technique, which use multiple overlapping stents. In addition to multiple overlapping stents, the uncovered part of the metallic stents had to be removed since the uncovered part had not enough expansible strength and might protrude to the pharynx when stenting high cervical strictures. Results : The stricture is palliated by the metallic stents using "stent in stent" technique. Conclusions : We concludes that when stenting high cervical strictures it is one of the best way to use "stent in stent" technique with the removal of the uncovered part of the metallic stents.View full abstractDownload PDF (9225K) -
Koichi AIURA, Shinya KISHI, Minoru KITAGO, Keiichi SUZUKI, Hiroaki SEK ...2001 Volume 43 Issue 9 Pages 1878-1884
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe developed the simple and safe method of the endoscopic transpapillary biopsy for pancreato-biliary diseases by using the ERCP catheter-guided technique. A fine biopsy forceps with 1 mm in diameter was inserted to the bile duct or main pancreatic duct through the ERCP catheter to approach the focal lesion and biopsy was carried out repeatedly under viewing the image of fluoroscopy. The diagnostic sensitivity for pancreato-biliary carcinoma was 64.3 (18/28). There was no significant difference of positive rate of diagnosis among the location of the lesions. To biopsy specimens from the center of the obstructive lesion as well as to take at least five specimens from a lesion may improve the accuracy of the diagnosis. This technique allows us to perform the biopsy of the lesions located in the pancreato-biliary tract safely and repeatedly and was considered useful for the histologic diagnosis of pancreato-biliary diseases.View full abstractDownload PDF (5768K) -
2001 Volume 43 Issue 9 Pages 1889
Published: September 20, 2001
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1455K)
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