Hirotaka Miyai

Establishment of a simple predictive scoring system for pancreatic fistula after laparoscopy-assisted gastrectomy.

The potential severity of postoperative pancreatic fistula (POPF) after laparoscopy‐assisted gastrectomy (LAG) necessitates efforts to identify predictive factors for POPF. The aim of the present study was to identify predictive factors for POPF and to establish a predictive scoring system for POPF after LAG.

Successful combination chemotherapy with irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma: report of a case

Primary gastric small cell carcinoma is a rare and aggressive malignant disease with a poor prognosis that was first reported in 1976 by Matsusaka et al. The incidence is very low and the clinicopathological features are similar to those of small cell lung carcinoma.We herein report a case of successful treatment by combination chemotherapy consisting of irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma. The patient was a 71-year-old male who was admitted to a local hospital with anemia. Gastrointestinal endoscopy revealed the presence of advanced gastric carcinoma at the upper region of the stomach. The patient underwent surgery, and the pathological diagnosis was small cell carcinoma due to the presence of the typical features of small round cells with scant cytoplasm that were positive for synaptophysin and chromogranin A in the resected specimen. The patient underwent subsequent combination chemotherapy, which provided him with over 1 year of survival and a good quality of life. We also present a review of the literature regarding chemotherapy for primary gastric small cell carcinoma.

Successful Gastrointestinal Stromal Tumor Resection using Modified Laparoscopic and Endoscopic Cooperative Surgery: Report of a Case

Introduction: Gastrointestinal stromal tumors (GISTs) are commonly treated with surgical resection only, because they do not generally metastasize. We herein report our experience with curative resection of a GIST located at high lesser curvature using laparoscopic and endoscopic cooperative surgery. Case presentation: An 81 year old male with hematochezia was diagnosed with a GIST in stomach and hemorrhoids. Endoscopy revealed that the tumor was located at high lesser curvature, jutted into the lumen of the stomach; no metastases were apparent. Laparoscopic surgery was performed to remove the tumor. The tumor, covered by mucosa and without ulceration, was resected with adequate surgical margins. Postoperatively, the patient was discharged without complications. Surgical technique: We performed laparoscopic partial gastric resection assisted by endoscopy. The tumor was not visible through the laparoscope, but intraoperative endoscopy aided in its identification. The space left by enucleation of the tumor was closed using a flexible linear stapling forceps while an intracorporeal functional anastomosis was subsequently performed. Conclusion: It is well-known that laparoscopic resection near high lesser curvature is difficult, but we were able to resect the tumor using this laparoscopic and endoscopic cooperative surgery (LECS) safely and easily.