Nihon Daicho Komonbyo Gakkai Zasshi
Online ISSN : 1882-9619
Print ISSN : 0047-1801
ISSN-L : 0047-1801
Current issue
Displaying 1-8 of 8 articles from this issue
Original Article
  • Satoru Akaza, Akira Ouchi, Aina Kunitomo, Yusuke Sato, Takashi Kinoshi ...
    2025 Volume 78 Issue 2 Pages 39-46
    Published: 2025
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

    Aim: To investigate the clinical significance of surgical intervention for colorectal cancer (CRC) with isolated para-aortic lymph node metastasis (PALNM) in the multidisciplinary treatment strategy, using time-varying covariate (TVC) analysis.

    Methods: Forty-five patients with isolated PALNM from CRC from January 2006 to December 2022 were included and retrospectively analyzed. Of the 45 patients, 20 underwent upfront surgical resection, 12 underwent resection after chemotherapy, and 13 underwent chemotherapy alone. The survival of 12 with preoperative chemotherapy was divided before and after surgical resection, and survival analysis was performed.

    Results: The estimated 5-year overall survival (OS) after division and allocation for the surgical resection and chemotherapy groups were 53.9% and 10.8%, respectively (Log-rank p = 0.004). Multivariate analysis after allocation demonstrated that surgical resection significantly improved prognosis (HR 0.571, 95% CI 0.512-0.737, p = 0.001).

    Conclusions: Surgical resection plays an important role in treating isolated PALNM from CRC in the multidisciplinary treatment strategy.

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  • Katsuhisa Shindo, Sadanori Kamikawa, Tadashi Onishi, Mutsumi Fukunaga, ...
    2025 Volume 78 Issue 2 Pages 47-57
    Published: 2025
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

    Purpose: To overcome the shortcomings of the previous versions of the ostomate quality of life (QOL) questionnaire, we attempted to develop and validate a screening version (Sc) based on the usual and short versions.

    Methods: 1) The prototype of the new ostomate QOL questionnaire was drafted based on the usual version of the questionnaire in combination with background characteristics. The answers to the prototype from 953 ostomate users were utilized to evaluate the reliability of the Sc. 2) The final version of the Sc was developed after reviewing 128 examinees' responses at a QOL clinic including the experienced.

    Results: 1) Exploratory analysis showed seven factors suitable for the Sc among the prototype questionnaire. The Sc showed a good fit by a confirmatory analysis and structural equation modeling. 2) For practical use of the Sc, a question regarding sexual problems was deleted, while a question about anxiety in old age was added according to the results of a multidisciplinary quality indicator.

    Conclusion: The final Sc contained nine easy questions including one that could be answered by free comments. The Sc can be widely used to improve the QOL of individual ostomate users.

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  • Katsuhito Suwa, Takuro Ushigome, Hiroya Enomoto, Takahiro Kitagawa, Ke ...
    2025 Volume 78 Issue 2 Pages 58-66
    Published: 2025
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

    Objective: To examine the clinical characteristics and surgical outcomes of parastomal hernias (PSH).

    Methods: We analyzed 51 cases of PSH operations performed from May 2006 to May 2024.

    Results: The most common indication for surgery was pain (49%), followed by difficulty in applying appliances (16%), poor cosmesis (16%), and recurrent bowel obstruction (12%). Emergency operations due to incarceration accounted for 6% of cases. All cases of recurrent bowel obstruction had a history of incarceration. The surgical procedures performed were laparoscopic Sugarbaker method (LSB) in 38 cases, endoscopic Pauli method (ePauli) in 4, relocation in 2, tissue suture method in 2, open keyhole method (KH) in 2, component separation method (CS) in 1, and CS with onlay method in 1. Perioperative complications were observed in 5 cases (10%). Recurrence was observed in 8 cases (16%), with high rates in the KH (100%) and tissue suture method (50%).

    Conclusion: While many PSH cases involved elective surgeries due to pain, 18% of patients experienced incarceration. The recurrence rates were high for the KH and tissue suture methods.

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Case Reports
  • Tsuyoshi Mizuno, Takamichi Komori, Kazuhiro Saso, Masaya Kato, Yuji Uc ...
    2025 Volume 78 Issue 2 Pages 67-71
    Published: 2025
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

    A female in her 50s visited a hospital because of fever, abdominal pain and vomiting. She was diagnosed with acute appendicitis and paralytic ileus and was treated conservatively. An interval appendicectomy was scheduled. However, by the time of the operation, she had abdominal pain and was diagnosed with adhesive bowel obstruction, and so was hospitalized again. She was treated with a long decompression tube, but the intestinal obstruction did not improve, and surgery was conducted. Laparoscopic surgery revealed no obvious intestinal adhesions, and the appendix formed a fistula with the ileum. The cause of the bowel obstruction was thought to be flexion or torsion of the small bowel at the fistula. We cut the root of the appendix by laparoscopy, raised the ileum through a small umbilical incision and performed a partial resection of the small bowel and the fistula. The postoperative course was uneventful. Although there are some reports of appendicitis causing fistula between the appendix and other organs, there are few reports of fistula between the appendix and the small intestine. We report a rare case of appendico-ileal fistula.

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Clinical Study
  • Yosito Ono, Masanori Takeda, Kinya Matsumoto, Manabu Watanabe, Hideo W ...
    2025 Volume 78 Issue 2 Pages 72-77
    Published: 2025
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

    Although the seton procedure for ischiorectal fistula strikes a balance between curability and functional preservation, it is a fact that patients feel discomfort for a while due to the seton. We actively use the seton procedure with coring out the core from the secondary ducts to the primary lesion because it takes a short time to heal. In the present study, we carefully compared the seton procedure with coring out (63 cases) with the seton procedure without coring out (67 cases). When the seton procedure with coring out was used, the range of the seton became smaller, and it took fewer days to drop out. Also, the function of the anus was preserved and there were fewer relapses. Many patients were satisfied with this surgery. In conclusion, the seton procedure with coring out for ischiorectal fistula is expected to shorten the time to heal after surgery.

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