Kazunori Ogino

Nonfunctional Paraganglioma of the Pancreas: Report of a Case

We report herein the case of a 61-year-old man found to have a rare nonfunctional paraganglioma of the pancreas. Interestingly, the preoperative data and images showed similar characteristics to neuroendocrine tumors of the pancreas. Both paragangliomas and neuroendocrine tumors of the pancreas belong to the category of Amine Precursor Uptake and Decarboxylation (APUD) tumors (APUDomas). Thus, it is important to examine the serum level of pancreatic endocrine hormones and a variety of peptides to differentiate paragangliomas of the pancreas from other pancreatic tumors. Paragangliomas of the pancreas grow slowly, so radical resection is recommended to achieve curability with a good prognosis.

Evaluation of endoscopic ultrasonography as an indicator for surgical treatment of gastric cancer

Background and Methods : Clinicopathological analysis of 346 patients with gastric cancer was made retrospectively and new criteria for the indication of a limited operation using endoscopic ultrasonography (EUS) was developed. Suggested new criteria for selecting gastric cancer patients for the limited operation were: (i) the cancer is located in the mucosa and the lymph nodes are not involved as indicated by EUS examination; (ii) the maximum size of the tumour is less than 2.0 cm; (iii) there are no multiple gastric cancers or simultaneous abdominal cancers; and (iv) the mucosal cancer of elevated type less than 2.0 cm is excluded because there are good indications for endoscopic mucosal resection.

Chylous ascites as a complication of laparoscopic colorectal surgery.

Until now, no data have been available on the incidence of chylous ascites after laparoscopic colorectal surgery.

Clinical outcomes of laparoscopic surgery for transverse and descending colon cancers in a community setting.

The feasibility, safety and oncological outcomes of laparoscopic surgery for transverse and descending colon cancers in a community hospital setting were evaluated.

Impact of adjuvant radiation therapy for microscopic residual tumor after resection of extrahepatic bile duct cancer.

Objectives:The effect of adjuvant radiation therapy (RT) in extrahepatic bile duct (EHBD) cancer patients with microscopic-positive resection margins (R1 resection) is still controversial. Methods:Between January 2000 and March 2010, 52 patients with EHBD cancer underwent surgery at our institution, of whom 36 were subjected to a retrospective analysis. Eleven patients received adjuvant RT after resection [surgery (S)+RT group], which included 9 patients with R1 resection and 2 with para-aortic lymph node metastasis. Their oncological outcomes were analyzed and compared with those of the 25 patients with R0 resection who did not receive adjuvant RT (S group). Results:Patients in the S+RT group had significantly more advanced disease than those in the S group. However, there was no significant difference in disease-free survival or overall survival between the 2 groups. Median survival times for the S+RT and the S groups were 44 and 47 months, respectively, whereas the 5-year survival rates were 38.9% and 46%, respectively (P=0.707). Locoregional recurrence was less frequent in the S+RT group as compared with the S group, but the incidence of distant metastasis was unaffected by the adjuvant RT. Conclusions:Our results support the beneficial effect of adjuvant RT in EHBD cancer patients with R1 resection. This effect seems to result from an improved control of the locoregional tumor by adjuvant RT.

Oncological Outcome of Laparoscopic Surgery for Advanced Colon Cancer: A Community Hospital’s Experience

BACKGROUND/AIMS Similar oncological outcomes of laparoscopic and open surgery for advanced colon cancer have been reported by several large-scale studies. Whether those results are applicable to community hospitals is questionable. METHODOLOGY From January 2007 to December 2010, 95 patients with colon cancer underwent laparoscopic surgery at Seirei Mikatahara General Hospital. Of these, 40 patients with pathological stage II/III colon cancer were subjected to this retrospective analysis (laparoscopic resection (LAP) group). Their outcomes were compared with those of 58 patients with pathological stage II/III colon cancer who underwent open surgery between January 2005 and December 2006 (open resection (OP) group). RESULTS Surgical complications were significantly less frequent in the LAP group than in the OP group. Three-year disease-free survival (DFS) and overall survival (OS) for stage II colon cancer were 88.9% and 100% in the LAP group, and 90% and 86.7% in the OP group (p=0.976 and p=0.285), respectively. Three-year DFS and OS for stage III colon cancer were 85.4% and 86.9% in the LAP group, and 75.3% and 83.8% in the OP group (p=0.613 and p=0.837), respectively. CONCLUSIONS Laparoscopic surgery for advanced colon cancer seems feasible and the oncological outcome is adequate in a community hospital setting.