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Article type: Cover
2009 Volume 45 Issue 6 Pages
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Article type: Appendix
2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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Article type: Index
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[in Japanese]
Article type: Article
2009 Volume 45 Issue 6 Pages
895-896
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[in Japanese]
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2009 Volume 45 Issue 6 Pages
897-899
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[in Japanese]
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2009 Volume 45 Issue 6 Pages
900-902
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
911-912
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Article type: Article
2009 Volume 45 Issue 6 Pages
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Article type: Article
2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
913-914
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Article type: Article
2009 Volume 45 Issue 6 Pages
914-915
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
915-916
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
917-918
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2009 Volume 45 Issue 6 Pages
918-919
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
920-921
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2009 Volume 45 Issue 6 Pages
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2009 Volume 45 Issue 6 Pages
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Article type: Article
2009 Volume 45 Issue 6 Pages
921-922
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Taichi Hirotani, Kazunori Ohama, Takashi Shimotake, Nobuki Ishikawa, R ...
Article type: Article
2009 Volume 45 Issue 6 Pages
923-927
Published: October 20, 2009
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Purpose: The aim of this study is to determine whether the body surface index replaces the Haller index in order to evaluate the severity of pectus excavatum. Methods: Sixty-nine cases with a diagnosis of pectus excavatum between August 2001 and January 2008 were prospectively enrolled in the study. The anterior-posterior chest dimension, lateral chest dimension and depth of the most profound depressed area were measured. The body surface index was expressed as an equation A/(B-C), where A was the transverse diameter, B was the anterior-posterior diameter and C was the depth of the depressed area. This index was compared to the Haller index in each patient. In this study, each value was measured on a chest CT scan. Results: The body surface index significantly correlated with the Haller index, in which the coefficient of correlation was 0.879 (p<0.01). The body surface index corresponding to Haller index 3.25 seems to be 1.67. We could find the body surface index corresponding to each Haller index. Conclusions: We propose that an evaluation of pectus excavatum by means of body surface measurements is clinically useful, and may replace the Haller index. The body surface index may allow us to assess the severity of pectus excavatum without a CT scan, resulting in a reduction of radiation exposure for children with pectus excavatum. It's possible to evaluate the body surface index by using a relational table between this index and the Haller index. We'll evaluate the body surface index by using values measured on a real body.
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Izumi Muraoka, Yasuharu Ohno, Akira Satomi
Article type: Article
2009 Volume 45 Issue 6 Pages
928-936
Published: October 20, 2009
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Purpose: Our procedure for acute appendicitis is a laparoscopic-assisted appendectomy using a single umbilical puncture which was first described by Pelosi et al. in 1992. We have adopted this technique since 1996. A recent survey was given to all our patients who underwent a transumbilical laparoscopic-assisted appendectomy (TULAA) to evaluate this procedure from the patients' point of view. Methods: We gave a written survey to the patients who underwent TULAA in our department from January 1996 to May 2006. Results: We sent a survey to 386 patients and 168 of them (43.5%) answered. Concerning pain after the operation, 30.4% of them said they had no pain or just a little pain. Concerning the operation scar, 56.5% of them said it was still visible and 43.5% of them said it wasn't noticeable at all. 61.9% of them said they were satisfied with the appearance of the operation scar. The answer to the question about recommending a TULAA for the appendectomy to their family or friends was 73.2% positive. Conclusions: We consider our TULAA procedure to be the best for our patients compared to other techniques of appendectomy because they would recommend our program to their family or friends if they were in need of similar help. We also discussed the current trend in patient-reported outcomes in this report.
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Masashi Kurobe, Shinsuke Ohashi, Syuichi Ashizuka, Jyoji Yoshizawa, Ta ...
Article type: Article
2009 Volume 45 Issue 6 Pages
937-941
Published: October 20, 2009
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Purpose: To elucidate the safety of laparoscopic fundoplication (LF) with gastrostomy tube placement in neurologically impaired patients (NIP) with a ventriculoperitoneal (VP) shunt. Methods: The records of 7 NIP with a VP shunt who underwent LF with gastrostomy tube placement between December 2003 and January 2008 were retro-spectively reviewed. The clinical parameters including operating time and blood loss were compared between NIP with and without a VP shunt who underwent LF with gastrostomy tube placement during the same period. Results: Four NIP with a VP shunt underwent LF with gastrostomy tube placement safely without conversion to laparotomy, while open fundoplication was performed in the remaining three. Among the 7 patients with a VP shunt, none had any evidence of shunt dysfunction related to laparoscopic procedure nor gastrostomy tube placement. When compared with 25 NIP without a VP shunt, there were no differences between the groups with respect to operating time or blood loss. Conclusions: Laparoscopic fundoplication with gastrostomy tube placement can be performed safely in neurologically impaired patients with a ventriculoperitoneal shunt.
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Nana Nakazawa, Akihiro Shimotakahara, Tadaharu Okazaki, Geoffrey J. La ...
Article type: Article
2009 Volume 45 Issue 6 Pages
942-945
Published: October 20, 2009
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The most common causes of meconium peritonitis (MP) are ischemic lesions of the small bowel associated with intestinal obstruction, such as intestinal atresia, volvulus, intussusception, and meconium ileus. There have been only 4 reports of MP due to perforation of Meckel's diverticulum (MD) in the literature. In all cases, MP was diagnosed postnatally. We report a rare case of prenatally diagnosed MP, which was found to be due to a perforated MD at laparotomy. Our case suggests that perforation of MD should be included in the etiology of MP.
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Nami Honda, Motoshi Wada, Takuro Kazama, Hideyuki Sasaki, Shintaro Ama ...
Article type: Article
2009 Volume 45 Issue 6 Pages
946-949
Published: October 20, 2009
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This report describes the psychiatric issues of two cases with small bowel transplantation. Case 1: A man in his 20's with total parenteral nutrition-dependent short-bowel syndrome associated with Hirschsprung disease was waiting for cadaveric organ transplantation. Pre-transplantation, he was depressed and eating impulsively, while post-transplantation he was delirious and agitated, acted impulsively, and had suicidal ideation. Pharmacotherapy and psychotherapy were effective. Case 2: A woman in her 20's with Hirschsprung-related disease underwent living-related small bowel transplantation. Pre-transplantation, she was sleepless and dreaded pain and dependency on painkillers. After transplantation, she had posttraumatic stress due to her ICU experience, had a nightmare, and disliked her increasing body weight. A sleeping pill was prescribed, and psychotherapy was effective. These patients' clinical courses were good. Psychiatric evaluations and attention to psychiatric issues before transplantation appear to be important for small bowel transplant patients.
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