Hiroyuki Uchisako

Clinical Study of Superficial Esophageal Cancer

Esophagectomy was performed in 31 cases of esophageal cancer in our hospital over the past 16 years. We conducted a retrospective study on superficial esophageal cancer concerning treatment and prognosis, and the therapeutic policy based on the depth of invasion was evaluated. As a result, endoscopic mucosectomy or blunt dissection was found to be suitable for cancer which invaded as far as the epithelium. For cancer, which reached the mucosal layer, esophagectomy with level III node dissection should be performed. However, radical esophagectomy with nodal dissection in three areas (cervical, mediastinal, and abdominal), and postoperative adjuvant therapy should be performed for cancer that involves the submucosa.

Experimental and Clinical Study of Blood Flow in the Tracheal Mucosa

We investigated the relationship between prevention of pulmonary complications after surgery for esophageal cancer and preservation of the right bronchial artery and the vagus nerve during surgery experimentally in dogs, and clinically. Changes in the bronchial mucosal blood flow (BMBF) were studied using Laser Doppler velocimetry.

Clinical Approach to Achalasia of the Esophagus from the Viewpoint of Gastrointestinal Hormone

Twenty-seven patients with achalasia of the esophagus were treated at the Department of Surgery II, Yamaguchi University Hospital.

pH Monitoring of Gastric Tube After Esophagectomy

Recently, an increasing number of patients with esophageal cancer who were not considered successfully treated have survived for prolonged periods. Proper selection of the tissue to be reconstructed as well as the reconstruction route is important for proper postoperative functioning. However, there have been few reports concerning acidity in the reconstructed gastric tube after esophagectomy combined with bilateral truncal vagotomy. In this study, we used pH monitoring to examine acid secretion in the reconstructed gastric tube.

Operative Procedure and Clinical Outcome of Carcinoma of the Thoracic Esophagus

One of the greatest concerns among surgeons has been to improve the operative mortality rate after radical operation for carcinoma of the esophagus. In our department, we have performed aggressive lymph node dissection of the upper mediastinum since 1980. In the present study, we evaluated this dissection and also report the results of EFP (etoposide, 5-FU, and cisplatin) therapy in the prevention of hematogenous recurrence.

A Case of Recurrent Esophageal Carcinoma in the Remnant Esophagus which was Resected Six Years after the Operation for Thoracic Esophageal Carcinoma.

われわれは胸部食道癌切除後6年3か月経過して発見された遺残食道再発と思われる1例を経験したので報告する.症例は52歳男性で, 6年3か月前に当科にて胸部食道癌に対して右開胸.開腹胸部食道全摘, 胸壁前食道胃吻合を施行されている.術後経過は良好であり, 近医にて経過観察されていたが, 再び嚥下困難が生じるようになった.上部消化管造影および内視鏡検査にて吻合部付近の狭窄が指摘され, 精査目的で当科再入院となった.前回の摘出標本の病理組織学的検討より遺残食道再発と思われた.頸部食道切除および胃管上部部分切除, 両側頸部郭清を行い, 手術用顕微鏡を用いた血管吻合法を併用して遊離空腸を用いて再建した.術後経過は良好で, 再手術後4年経過したが再発の兆候を認めていない.