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Predecessor
Volume 67, Issue 5
Displaying 1-9 of 9 articles from this issue
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Original Article
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Sho Sawazaki, Manabu Shiozawa, Teni Godai, Yusuke Katayama, Koji Numat ...2014 Volume 67 Issue 5 Pages 305-309
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSPurpose: The aim of this study was to identify the subgroup of patients at the greatest risk by investigating the clinicopathological features associated with poor survival in patients with Stage II rectal cancer.
Methods: A total of 133 patients with Stage II rectal cancer who underwent curative resection between January 1990 and September 2007 at Kanagawa Cancer Center were enrolled. The clinicopathological data of the patients were retrospectively evaluated.
Results: The 5-year disease-free survival rate was 86.3% in the study group as a whole. A univariate analysis of 5-year disease-free survival identified two factors: the preoperative serum CEA level and the distance from the tumor to the anal verge. A multivariate analysis of 5-year disease-free survival identified two independent factors: serum CEA level (HR: 3.351; 95% CI: 1.356-8.280; p=0.009) and the distance from the tumor to the anal verge (HR: 3.002; 95% CI: 1.214-7.420; p=0.017).
Conclusions: Patients with Stage II rectal cancer who exhibit a high preoperative serum CEA level and a short distance from the tumor to the anal verge are at a high risk of recurrence.View full abstractDownload PDF (729K)
Clinical Studies
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Junya Arakaki, Yasumi Araki, Toshiyuki Noake, Keiko Matono, Kentaro Na ...2014 Volume 67 Issue 5 Pages 310-316
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSPurpose: We report on cases of V-Y plasty for pilonidal disease. Method: Fourteen patients with pilonidal disease undergoing radical excision and reconstruction with V-Y plasty between 2006 and 2012 were examined retrospectively. Results: The mean age was 31.5 years old. All patients were men. The mean weight was 75.5 kg (63.4-92 kg). The mean Body Mass Index (BMI) was 26.0 kg/m2 and eight of the cases (57.1%) had a BMI of 25 kg/m2 or more. The mean operative time was 47.3 minutes. There were six cases with postoperative complications (42.9%). The postoperative complications were wound infection in five cases and wound defective granulation in one case. There were no serious complications including dermal flap necrosis. No postoperative recurrences have been found. Conclusions: V-Y plasty is a good operative method because the surgical procedure is easy and provides tension-free skin coverage. Additional cases need to be gathered.View full abstractDownload PDF (1068K) -
Yoshihisa Saida, Toshiyuki Enomoto, Jiro Nagao, Kazuhiro Takabayashi, ...2014 Volume 67 Issue 5 Pages 317-323
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSObjectives: To evaluate the patient acceptability and cleansing ability of a new formulation of sodium phosphate (NaP tablets), a prospective study of colonoscopy patients without any abnormal renal function was conducted.
Methods: Between January 2011 and December 2012, acceptability for 418 patients was measured by questionnaire, while cleansing efficacy was measured by the observation score of a single colonoscopist.
Results: Bowel preparation with the new NaP tablets demonstrated lower incidence of nausea and abdominal pain than the existing NaP tablets. In addition, patients showed relatively high acceptance of the taste and smell. The overall impression of acceptability was 73.8%. Of the patients with experience of polyethylene glycol (PEG) electrolyte lavage solution, 63.9% preferred the new NaP tablets while 13.4% preferred PEG for the next use. Compared with the existing NaP tablets, 69% of patients preferred the new NaP tablets. In terms of cleansing effect, sufficient bowel preparation was observed in about 90%. Drug residue, which is observed mostly in the ileocolic junction and ascending colon, was less with the new NaP tablets.
Conclusion: This study demonstrated higher acceptability and sufficient cleansing ability of the new NaP tablets. Therefore, the new NaP tablets are a feasible alternative for bowel preparation for patients without renal functional disorder or heart diseases.View full abstractDownload PDF (651K) -
Yuri Fukuda, Mitsukuni Azuma2014 Volume 67 Issue 5 Pages 324-329
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSBackground: Pain after hemorrhoidectomy is strong and unpleasant for patients.
Although various pain relievers are used after operation, they are not powerful enough to eliminate postoperative pain. “Shakuyaku-kanzo-to”, a herbal medicine, is widely used for muscle pain in Japan. Recently, administration of Shakuyaku-kanzo-to has been tried for several types of pain and its novel effectiveness has been reported. We performed this prospective randomized study to evaluate the efficacy of Shakuyaku-kanzo-to for prophylaxis against pain after hemorrhoidectomy.
Methods: 103 patients underwent hemorrhoidectomy in this study. This prospective randomized study compared the administration of Shakuyaku-kanzo-to for only seven days after hemorrhoidectomy versus seven days both before and after the operation versus conventional therapy without Shakuyaku-kanzo-to. The degree of pain was quantified using a visual analogue scale (VAS).
Results: Patients in the both before and after operative intervention group experienced significantly less postoperative pain than those without Shakuyaku-kanzo-to on every day except the second postoperative day and less pain than the after operative intervention group on the third postoperative day. Using Shakuyaku-kanzo-to shortened the duration of strong pain significantly.
Conclusions: This study showed that prophylactic administration of Shakuyaku-kanzo-to has novel effects against postoperative hemorrhoidectomy pain.View full abstractDownload PDF (999K)
Case Reports
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Yoshiko Uno, Shintaro Nakajima, Mitsumasa Takeda, Kazuo Kitagawa, Tada ...2014 Volume 67 Issue 5 Pages 330-335
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSStomal prolapse is one of the common late complications that occur after construction of stoma. Such a complication interferes with the patient's quality of life and results in other complications such as bleeding, dermatitis around the stoma and difficulty in fitting a stomal pouch. We herein report two patients who underwent local repair of stomal prolapse using linear stapling devices, and review the literature. First, the prolapsed stoma was grasped by Alice forceps and pulled out as much as possible and the stoma was divided vertically into two forks by using two linear stapling devices. The color and blood supply of the stomal mucosa were evaluated using intestinal clamps. The bottom of the stoma was amputated horizontally using another stapler. The operation time was 18 and 22 min, respectively, and blood loss was minimal in both cases. Their postoperative courses were uneventful and both patients are without recurrent prolapse of the stoma.View full abstractDownload PDF (8146K) -
Hiroyuki Ohta, Keiko Mochizuki, Shoichi Tsukayama, Yukimitsu Kawaura, ...2014 Volume 67 Issue 5 Pages 336-340
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSThe present report describes two cases of Schloffer tumor demonstrating PET false positive. The first case was a 62-year-old female who underwent sigmoidectomy for sigmoid colon cancer. After 8 months, she underwent partial resection of the small intestine for strangulated ileus. Two years after the initial surgery, an abdominal growing nodule demonstrating PET positive was detected. Therefore, she was diagnosed as recurrence of colon cancer, and underwent resection of the previous anastomosis with suspicious recurrent nodule. Pathological examination revealed that the nodule was the suture sinus, the so-called Schloffer tumor. The second case was a 77-year-old female who underwent right hemi-colectomy and cholecystectomy for ascending colon cancer and cholecystlithiasis. After one year, hepatic tumor demonstrating PET positive was detected, so she was diagnosed as liver metastasis, and underwent partial resection of the liver. Pathological examination revealed that the nodule was a foreign body granuloma.View full abstractDownload PDF (2369K) -
Yosuke Miura, Katsuhiro Ogawa2014 Volume 67 Issue 5 Pages 341-346
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSIdiopathic mesenteric phlebosclerosis is a rare disease of intestinal ischemia caused by calcified peripheral mesenteric veins and a thickened colonic wall. We here report a case of asymptomatic idiopathic mesenteric phlebosclerosis discovered by fecal occult blood positive, diagnosed by endoscopic biopsy. A 41-year-old man was referred for anemia and fecal occult blood positive. Colonoscopy showed dark purplish-blue edematous mucosa from the cecum to the transverse colon. Computed tomography (CT) showed a thickened colonic wall and nodular/linear calcification. The deposition of amorphous substances (HE staining) and collagen fibers (Azan staining) in the mucosa, which was found by endoscopic biopsy, confirmed the diagnosis of idiopathic mesenteric phlebosclerosis. The salient pathological and clinical features of idiopathic mesenteric phlebosclerosis are discussed along with a review of the literature.View full abstractDownload PDF (1569K) -
Chiyo Maeda, Shungo Endo, Yusuke Takehara, Tomokatsu Omoto, Shumpei Mu ...2014 Volume 67 Issue 5 Pages 347-352
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSWe report two cases of patients with metastatic anal fistula cancer who underwent local resection of the anal fistula and tumor, and achieved long-term survival.
Case 1: A 58-year-old man who had developed an anal fistula 8 years previously underwent high anterior resection and lymph node dissection for ileus caused by rectosigmoid cancer. The final diagnosis was pSE, pN1, cM0, fStage IIIa. Eight months after surgery, a perianal tumor developed.
Case 2: A 65-year-old man underwent low anterior resection and lymph node dissection for lower rectal cancer, and the final diagnosis was pMP, pN0, cM0, fStage II. Nine months after surgery, a perianal tumor enlarged gradually.
In both cases, the perianal tumor was diagnosed as metastatic anal fistula cancer from rectal cancer by biopsy. Local resection of the anal fistula and tumor was performed. The histological findings of the primary rectal cancer and the resected anal fistula tumor were nearly identical, and immunohistochemical staining patterns were similar as well. These findings suggest that the metastatic lesion resulted from implantation of rectal cancer cells via the anal fistula. Case 1 achieved recurrence-free survival for 8 years and 3 months and Case 2 for 5 years and 10 months.View full abstractDownload PDF (1713K) -
Satoru Kagami, Kimihiko Funahashi, Akihatu Kurihara, Junichi Koike, Hi ...2014 Volume 67 Issue 5 Pages 353-358
Published: 2014
Released on J-STAGE: April 30, 2014
JOURNAL FREE ACCESSLeiomyoma of the rectum is relatively rare and is difficult to diagnose histologically preoperatively.
A 65-year-old woman was admitted to our hospital upon referral from another hospital to undergo an operation for internal and external hemorrhoid. Barium enema showed a smooth defect in the anterior wall of the rectum. Colonofiberscopic examination showed a submucosal tumor in the anterior wall of the rectum. It was diagnosed as leiomyoma by needle biopsy and so transvaginal tumorectomy was performed. In the operation, it passed and the transanal ultrasound image was effective.
Since continuity with internal sphincter muscle was accepted, the tumor was considered to have originated in the internal sphincter muscle. The histological diagnosis was leiomyoma.
The postoperative course was uneventful. It is thought that transvaginal tumorectomy might contribute to safe and minimally invasive resection for leiomyoma in the anterior wall of the rectum.View full abstractDownload PDF (2769K)
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