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Volume 65, Issue 5
Displaying 1-9 of 9 articles from this issue
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Original Article
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Akira Iwaya, Yasumasa Takii2012 Volume 65 Issue 5 Pages 249-252
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSObjectives: We examined the clinical value of serum p53 antibody as a tumor marker by measuring serum p53 antibody levels in patients who underwent surgery for colon cancer. Subjects and Methods: The subjects were 450 patients in whom serum p53 antibody was measured before surgery for colon cancer from March 2002 to December 2004. Results: Among the patients, 20.7% were positive for p53 antibody, which was equivalent to the positive rate for CA19-9 and slightly lower than that for CEA. The p53 antibody prevalence in stages was 15.2% in I, 22.8% in II, 24.6% in III, and 31.7% in IV. In stage I, the prevalence was higher than that for CEA. There was no correlation between p53 antibody and CEA or CA19-9. The level of p53 antibody did not decrease in 10 patients after tumor resection, and 9 of these patients had a recurrence. Conclusion: We suggest that serum p53 antibody may be a new useful tumor marker for detecting early stage colon cancer and for postoperative monitoring.View full abstractDownload PDF (628K)
Clinical Study
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Amane Kanazawa, Tetsuo Yamana, Koji Morimoto, Yuki Kaneko, Satoshi Tak ...2012 Volume 65 Issue 5 Pages 253-258
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSThe aim of this study was to evaluate the surgical indication of colonic inertia and reveal the effectiveness of total colectomy with ileorectal anastomosis in the treatment of colonic inertia. The diagnosis of colonic inertia was performed based on clinical symptoms and colonic transit studies. Only when medical treatment was difficult, the decision of surgical indication was made by additional examinations. Four female patients underwent laparoscopic total colectomy for colonic inertia at our hospital. The mean age was 35 years. There were no patients with a past history of a mental disorder. Preoperatively, all patients had used laxatives heavily to manage their symptoms. After surgical treatment, all patients were able to have reasonable bowel movements without laxatives. After leaving the hospital, the number of stools was remarkably improved. The decision of surgical indication should be carefully made by adequate examinations. Total colectomy with ileorectal anastomosis provides satisfactory results in patients with colonic inertia.View full abstractDownload PDF (1103K)
Case Reports
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Masatsugu Kojima, Eiji Mekata, Tomoharu Shimizu, Hiromichi Sonoda, Kat ...2012 Volume 65 Issue 5 Pages 259-265
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSA 48-year-old menopausal woman, complaining of an abdominal tumor and hypogastric pain, visited our hospital. Colonoscopy revealed a 1cm Isp polyp at the sigmoid colon. A biopsy proved it to be adenocarcinoma. An abdominal CT showed large bilateral ovarian tumors composed of multilocular cysts and a liver cystic tumor similar to them. The CEA value was high. Laparotomy findings revealed a single dissemination near the sigmoid colon. Intraoperative pathological diagnosis revealed that the ovary and liver tumors were adenocarcinoma, so we thought these lesions were metastases from the colon cancer. Sigmoidectomy, D3 lymph node dissection, total hysterectomy, bilateral oophorectomy and resection of dissemination nodule were performed. The post-operative pathological findings revealed that the degree of penetration of the sigmoid colon cancer was the submucosal layer. Though chemotherapy and partial resection of the liver were performed, she died of cancer two years and 3 months after the operation. Metastatic ovarian cancer from the colorectum is not rare, and the prognosis is poor. Though primary colorectal cancers that metastatic to the ovaries are usually advanced, ovarian metastases from SM colorectal cancer can occur. When a SM colorectal cancer companies peritoneal dissemination and/or morphological change of the ovaries, bilateral oophorectomy is recommended.View full abstractDownload PDF (2820K) -
Tsuyoshi Hasegawa, Akiko Tachimori, Isao Kanehara, Naoyuki Taenaka2012 Volume 65 Issue 5 Pages 266-271
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSOvarian metastasis from colorectal cancer, while rare, has recently been increasing. From January 1999 to July 2009, 272 female patients were managed by resection for primary colorectal cancer at our hospital. Four patients had heterochronous metastasis of the ovaries after curative resection of colorectal cancer. Case 1; A 73-year-old woman underwent bilateral oophorectomy 28 months after transverse colon cancer. She died of cancer 59 months after ovarian surgery. Case 2; A 66-year-old woman underwent bilateral oophorectomy 15 months after resection for rectal cancer. She died of hepatic metastasis 17 months after metastasectomy. Case 3; A 35-year-old woman underwent bilateral oophorectomy 6 months after transverse colon cancer. She died of lung metastasis 45 months after resection of the ovaries. Case 4; A 60-year-old woman underwent left oophorectomy 13 months after resection of sigmoid colon cancer. She was still alive 49 months after ovarian resection. There were 36 cases of heterochronous ovarian metastasis in Japanese reports. Though they have poor prognosis, combination therapy with operation and chemotherapy could be important for long-term survival.View full abstractDownload PDF (3375K) -
Kazuhide Iwakawa, Naoyuki Tokunaga, Yosuke Tsunemitsu, Kenta Isoda, Ry ...2012 Volume 65 Issue 5 Pages 272-276
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSAnaplastic surgical reconstruction is needed after the removal of highly invasive tumors on the abdominal wall. We used a myocutaneous flap to reconstruct the abdominal wall after resection of a locally recurrent tumor. A 78-year-old woman had undergone laparotomies for appendicitis, ileus, and an abdominal wall hernia, as well as an extended right hemicolectomy with partial abdominal wall resection to treat cecal cancer. Three years later, a local recurrent tumor became exposed at the skin and obstructed the sigmoid colon. We performed an emergency extended abdominal wall excision with sigmoidectomy and partial resection of the small intestine, urinary bladder, and uterus due to direct invasion. An abdominal wall defect of 11×7cm was repaired using a tensor fascia lata myocutaneous island flap. The postoperative course was uneventful and the patient's quality of life was satisfactory.View full abstractDownload PDF (2751K) -
Narihiro Shibukawa, Tsutomu Nishida, Takuya Yamada, Shinichiro Shinzak ...2012 Volume 65 Issue 5 Pages 277-282
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSA 20s-year-old man suffered from rectal-type ulcerative colitis developed total colitis in spite of aggressive therapies using corticosteroid, azathioprine, tacrolimus, and granulocyte and monocyte apheresis. In addition to the extensive inflammation in the colon, he developed peripheral arthritis as the extraintestinal manifestation of ulcerative colitis. Because previous treatments were not effective for the improvement of arthritis, we decided to treat him with Infliximab (IFX). One day after the initial infusion of IFX, the peripheral arthritis was much improved and activities of daily living were also dramatically improved.View full abstractDownload PDF (1512K) -
Shinsuke Suzuki, Hideaki Kimura, Reiko Kunisaki, Itaru Endo2012 Volume 65 Issue 5 Pages 283-287
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSAn 84-year-old woman who had been followed for Crohn's Disease was admitted due to lower abdominal pain and a fever. A CT scan on admission showed a thickened wall of the terminal ileum, and extraluminal air in the mesenterium. A subsequent CT scan revealed ileal penetration due to a Press Through Package (PTP), and we performed ileocecal resection. The patient had a good postoperative course. This is the first report of patient penetration or perforation by PTP with Crohn's Disease, and we report this case and review the relevant literature. Although this is a rare cause of intestinal perforation, multi-planar exams using MDCT may help precise diagnosis, especially in elderly patients with intestinal stenosis.View full abstractDownload PDF (1219K) -
Daisuke Ito, Shintaro Nakajima, Naoko Iida, Masahisa Ohkuma, Takenori ...2012 Volume 65 Issue 5 Pages 288-293
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSPagetoid spread (PS) is a rare phenomenon where the cancer of a neighboring organ infiltrates in the circumference epidermis. It is often accompanied with a dermatological change such as eruption, redness, and erosion. Rectal or anal canal carcinoma, accompanied by PS, is a rare case. Herein we present a case of anal canal carcinoma accompanied by PS lacking dermatological change, and review the literature. A 77-year-old man visited our hospital because of anal bleeding. A digital rectal examination and colonoscopy revealed an elevated lesion-like submucosal tumor, 1.5cm in diameter in the anal canal in the vicinity of the dentate line. There were no erythematous lesions or any skin lesion in the perianal region. We had a diagnosis of anal canal cancer as a result of biopsy and performed laparoscopic abdominoperineal resection with D2 lymphadenectomy. Pathology showed the Pagetoid cells which infiltrated in squamous epithelium of the perianal skin from the anal canal. Rectal or anal canal adenocarcinoma accompanied by Pagetoid spread is rare, and preoperative diagnosis is very difficult when an abnormality is not found in the perianal skin.View full abstractDownload PDF (2155K)
How I do it
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2012 Volume 65 Issue 5 Pages 294-296
Published: 2012
Released on J-STAGE: April 28, 2012
JOURNAL FREE ACCESSDownload PDF (967K)
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