All issues
Predecessor
Volume 69, Issue 7
Displaying 1-8 of 8 articles from this issue
- |<
- <
- 1
- >
- >|
Original Article
-
Tomoaki Kaneko, Kimihiko Funahashi, Mayu Goto, Kimihiko Yoshida, Jyuni ...2016 Volume 69 Issue 7 Pages 367-373
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSBackground: The rate of perineal wound complications associated with abdominoperineal resection (APR) and total pelvic exenteration (TPE) is high. Negative pressure wound therapy (NPWT) involves the controlled application of sub-atmospheric pressure to promote wound healing in a closed environment and has been effectively used for intractable wounds. The aim of this study was to investigate the effect of NPWT in preventing perineal wound complications.
Patients and Methods: Between September 2014 and January 2016, 16 patients who were treated with NPWT for perineal wounds were evaluated.
We retrospectively evaluated the patients' background and the rate of perineal wound complications, in comparison with 111 patients who were treated without NPWT.
Results: The population undergoing neoadjuvant chemotherapy and laparoscopic surgery was higher in the NPWT group and blood loss was more in the NPWT negative group. Wound dehiscence and surgical site infection (SSI) were seen in 11 patients (10%) and 36 patients (32.4%) in the NPWT negative group, respectively. On the other hand, in the NPWT group, there was no wound dehiscence and SSI was seen in only 2 patients (12.5%).
Conclusion: NPWT may be useful to decrease perineal wound complications in APR and TPE.View full abstractDownload PDF (714K)
Case Reports
-
Takeshi Tsuchiya, Takahiro Yagi, Mitsuo Tsukamoto, Yoshihisa Fukushima ...2016 Volume 69 Issue 7 Pages 374-378
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSA 50-year-old woman developed acute abdominal pain seven days after receiving upper gastrointestinal radiography. She was admitted to a different hospital, but later was transferred to our hospital because of suspension of defecation and progression of anemia. Abdominal computed tomography showed free air around the sigmoid colon and leakage of barium from the intestinal tract. It also showed a huge barium shadow with strong artifact in the pelvic floor. She was diagnosed with colon perforation and an emergency operation was performed. In the intraoperative findings, perforation occurred on the mesenteric side of the sigmoid colon with necrotic change. A hard foreign body the size of an egg was detected in the rectum. We performed Hartmann's operation and peritoneal drainage. The foreign body was extracted from the rectum, and was found to be fecaloma of barium. The resected specimen showed no diverticulum or neoplasm except for a clear hole 34mm in diameter. Colon perforation after upper gastrointestinal radiography is rare, but sometimes leads to a severe outcome. We report this case of colon perforation by fecaloma of barium with a review of the literature.View full abstractDownload PDF (800K) -
Takamaru Koda, Souichi Tanaka, Katsuhiko Nakai, Kazuhiko Kawakami, Kou ...2016 Volume 69 Issue 7 Pages 379-386
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSGlycerin enemas are widely used in daily practice as well as in home care situations. This medical procedure is generally regarded as safe and is not believed to lead to the development of severe complications. However, there are some reports of rectal injury caused by glycerin enemas and renal dysfunction due to hemolysis caused by the migration of glycerin into the blood vessels. Herein we report four cases of rectal injury caused by glycerin enemas at our institution and discuss the characteristics of this type of complication with reference to the existing literature.
All patients were females aged between 59 and 91 years; three were elderly, aged 85 or older. Three patients had used enemas at home for constipation, and one underwent a pretreatment endoscopy in the hospital. Perirectal free gas in CT images and elevated lipid levels were found in all patients. One patient had widespread pneumoretroperitoneum.
Noninvasive therapy (fasting, fluids, and antibiotics) alleviated the conditions in all patients, and no invasive treatment was required. Glycerol-induced hemolysis developed in one patient, but was corrected by treatment with fluids and diuretics, and did not progress to renal dysfunction.View full abstractDownload PDF (857K) -
Hidetaka Kurebayashi, Yoshihiro Takashima, Yoshinori Munemoto, Kenichi ...2016 Volume 69 Issue 7 Pages 387-391
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSA 41-year-old woman who had suffered constipation for 5 years visited our hospital because of abdominal pain and fullness. Abdominal computed tomography revealed a dilated colon without mechanical obstruction. From these findings, a diagnosis of chronic idiopathic colonic pseudo-obstruction (CICP) was made, and subtotal colectomy was performed. One year after the operation, the abdominal symptoms and constipation had resolved.
CICP is characterized by chronic disturbance in colonic motility without mechanical obstruction, any underlying disease, or medication use. To ensure acute passage, treatment at an early stage is essential, and subtotal colectomy helps resolves symptoms.View full abstractDownload PDF (801K) -
Takashi Miyake, Masahiko Suzuki, Yutaro Asaba2016 Volume 69 Issue 7 Pages 392-396
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSThe patient was an 87-year-old woman. She underwent high anterior resection combined with partial resection of the uterus for rectosigmoid cancer in March 2012. The tumor was diagnosed as moderately differentiated adenocarcinoma (pT4b (uterus), pN0, cM0, ly1, v1, INFc, PM0, DM0, RM1 (uterus), pStage II). Anastomotic bleeding and anastomotic leakage occurred postoperatively, but they were successfully treated conservatively. In August 2014, she visited our hospital because of nausea and an operation was performed for the reason of ileus. Intraoperatively, a mass was palpable in the small intestine about 200 cm distal to the ligament of Treitz, and was causing intestinal obstruction with a caliber change. Macroscopically, the tumor did not extend to the serosal surface and it was suspected to be a primary small intestinal tumor so we performed a partial small bowel resection. The histopathology showed moderately differentiated adenocarcinoma similar to the preexisting rectosigmoid cancer, and the main lesion was in the muscular layer but it did not quite extend to the serosal surface or the mucosal surface. Therefore we diagnosed the tumor as an isolated small intestinal metastasis from the colon cancer. The postoperative course was good and the patient has been free from recurrence up to the present time.View full abstractDownload PDF (831K) -
A Case of Residual Rectal Cancer for Ulcerative Colitis Five Years after Ileo-Anal Canal AnastomosisShingo Kawano, Yurika Makino, Shunsuke Motegi, Kumpei Honjo, Hisashi R ...2016 Volume 69 Issue 7 Pages 397-403
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSWe report a case of residual rectal cancer for ulcerative colitis five years after ileo-anal canal anastomosis. A woman in her 50s had undergone a proctocolectomy and reconstruction by ileo-anal canal anastomosis for a rectosigmoid cancer in 2009. She had received postoperative chemotherapy for half a year because of pT3 tumor with metastatic lymph nodes. Five years later, she developed a cancer in the residual rectum just caudal to the ileo-anal canal anastomosis, and underwent rectal amputation. Her pathological diagnosis was pT3N3M1, pStage IV. There was no recurrence of the tumor for one year after the second operation. Even after an operation of near-total proctocolectomy or ileo-anal canal anastomosis, there is still the possibility of cancer occurring from the residual rectal mucosa.View full abstractDownload PDF (926K) -
Tomonari Katayama, Yoshiaki Maeda, Toshiki Shinohara, Tomonori Hamada, ...2016 Volume 69 Issue 7 Pages 404-408
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSA 76-year-old man underwent screening colonoscopy after endoscopic mucosal resection for gastric polyps. A black tumor 6 mm in diameter was found in the anorectal area. Because of mobility ofthe tumor, we assessed the depth of submucosa clinically. The biopsy specimen showed malignant melanoma, preoperatively cT1 (SM), cN0, cM0, cStage I.
Subsequently we conducted laparoscopic-abdominoperineal resection with D2 lymph node dissection. The tissue type and diagnosis were malignant melanoma, pT2 (MP), ly0, v0, pN0, pStage I. We followed the patient without adjuvant chemotherapy, who remains alive postoperatively at 12 months with no sign of recurrence.View full abstractDownload PDF (777K)
-
[in Japanese]2016 Volume 69 Issue 7 Pages Mics07_1
Published: 2016
Released on J-STAGE: June 24, 2016
JOURNAL FREE ACCESSDownload PDF (517K)
- |<
- <
- 1
- >
- >|