Aims : In this study, we examined whether the integrin β1 subunit, thought to play an important role in colorectal cancer invasion and metastasis, can be used as a prognostic marker for colorectal cancer. Patients and Methods : The subjects of this study were 86 patients who underwent surgery for colorectal cancer at this department. We measured preoperative serum integrin β1 levels and conducted a 5 year retrospective postoperative study, examining the relationship between integrin β1 levels and survival curves. Results: For patients with postoperative recurrence or metastasis, outcomes were significantly better in those with a preoperative serum integrin β1 level ≥600 ng/mL than those with <600 ng/mL (p=0.0062). Conclusions: Even in patients with metastases identified preoperatively, outcomes were favourable if preoperative serum integrin β1 levels were high. These results indicate that integrin β1 shows promise as a prognostic marker in metastatic colorectal cancer.
We performed intraoperative endoscopic sphincterotomy (EST) using rendezvous technique (RT) during laparoscopic cholecystectomy (LC). The case was a 62–year–old woman visited our clinic for the complaints of abdominal pain and vomiting. She was admitted based on a diagnosis of acute cholangitis and secondary acalculous cholecystitis caused by cholestasis. Since hepatic function impairment and exacerbation of inflammatory findings was getting worse the day after admission, she was judged to have moderate acute cholangitis unresponsive to initial treatment and endoscopic retrograde cholangiopancreatography (ERCP) was performed. The presence of peripapillary duodenal diverticula made it difficult to employ a selective approach to the CBD even after a total of two implementations of ERCP. Then we performed LC and intraoperative EST using RT in order to perform endoscopic biliary drainage and cholecystectomy simultaneously. RT is a well–established procedure as a single–stage therapy using an antegrade approach for the treatment of choledocholithiasis, and is able to reduce the incidences of complications. Since RT has some disadvantages such as requiring special operating room equipments and numerous specialists, it is therefore necessary to examine the usefulness of RT in combination with LC as a single–stage surgical treatment for choledocholithiasis.
Surgical approaches for an appendiceal mucocele remain controversial, since caution needs to be exercised during surgery to avoid inadvertent rupture of the lesion, which may cause pseudomyxoma peritonei if the lesion is neoplastic. We report a case of mucinous cystadenoma of the vermiform appendix treated successfully by single–incision laparoscopic surgery (SILS). A 71–year–old woman was admitted for the treatment of a cystic mass in the right iliac fossa. Abdominal computed tomography revealed a well–encapsulated cystic mass measuring 30 mm in diameter, adjacent to the cecum. SILS ileocecal resection with lateral–to–medial mobilization and extracorporeal anastomosis was performed via a 3.5–cm–long transumbilical incision. The operative time was 145 minutes and the blood loss was about 10 mL. There were no intra– or postoperative complications. The histological diagnosis was mucinous cystadenoma. SILS seems to be a useful option for minimally invasive treatment of appendiceal mucocele, however, as mentioned above, care is needed to prevent complications.