Kenji Shimamoto

Cavernous hemangioma of the urinary bladder in an 8-year-old child.

An 8‐year‐old boy was admitted to Ehime University Hospital, Ehime, Japan, for the further investigation of a 5‐month episode of gross hematuria accompanied by lower abdominal pain. Magnetic resonance imaging revealed a solid tumor measuring 3 cm in diameter of the bladder wall. Cystoscopy demonstrated a red, wide‐based, nodular tumor situated on the dome of the bladder. Histological examination of tissue taken at hot biopsy showed fibrolipoma. In consideration of potential malignancy, a partial cystectomy was carried out after informed consent was given. Histological examination of the resected specimen showed it to be cavernous hemangioma.

Gemcitabine and cisplatin for advanced urothelial carcinomas: the Ehime University Hospital experience

BackgroundThe aim of this study was to evaluate the efficacy and safety of a combined chemotherapy regimen, gemcitabine and cisplatin (GC), in the treatment of advanced urothelial carcinomas.MethodsFifty-five patients with advanced urothelial cancer were treated with GC (gemcitabine 1000 mg/m2 on days 1, 8, and 15; cisplatin 70 mg/m2 on day 2) every 28 days. The median follow-up was 30 months (range, 3 to 57 months).ResultsWith the GC therapy, 35 of the 55 patients (63.6%) showed an objective response, with 7 (12.7%) achieving a clinical complete response (CR) and 28 (50.9%), a partial response (PR). GC therapy had a better impact on metastases in the lung and lymph nodes than on metastases in the liver and bone. Lung and lymph nodes showed objective responses of 64.7% and 65.8%, respectively. Eight of the 20 patients (40.0%) who had previously been treated with other regimens showed an objective response, with 1 achieving a CR and 7 achieving a PR. In the 47 patients with metastasis, the median time to progression was 7.0 months (range, 2 to 49 months), and the median overall survival was 12.0 months (range, 3 to 49 months). The 2-year survival rate was 80.0% in the CR group, while it was 55.1% in the PR group and 10.0% in the progressive disease (PD) group. The toxicities associated with GC, particularly mucositis, anorexia, and alopecia, were quite mild. Grade 3–4 toxicity was primarily hematological, including anemia (27.3%), neutropenia (32.7%), and thrombocytopenia (43.6%).ConclusionGC is considered to be a highly effective and well-tolerated regimen for the treatment of advanced urothelial carcinomas, with moderate toxicity.

Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium.

Aim:  The application of cardiopulmonary bypass to atrial involvement represents an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking. Our experiences of the management of extended thrombi into the right atrium in patients with retroperitoneal malignancy using a cardiopulmonary bypass were discussed.

Primary retroperitoneal lymphocele in a pregnant woman: the first report.

Abstract  In a 32‐year‐old pregnant woman, routine ultrasonography revealed right hydronephrosis and a huge retroperitoneal mass (20 × 7 cm) containing a fluid collection. Percutaneous drainage of the mass was performed and 2 L of clear, yellowish fluid was collected. Four months following the delivery, a recurrent retroperitoneal lymphocele was identified. Six months after the delivery, laparoscopic marsupialization was performed through a 10‐mm umbilical camera port and two 5‐mm ports on the right side of the abdomen. A posterior peritoneal window was established by creating a wide opening in the anterior wall of the lymphocele. Subsequent ultrasonography did not indicate a recurrence of the lymphocele or right hydronephrosis over a follow‐up period of 8 months.

A case report of living kidney transplantation using ectopic pelvic kidney harvested by reduced port laparoscopic donor nephrectomy

A 28-year-old woman was diagnosed as having an ectopic kidney in adolescence. She desired to donate her ectopic kidney to her mother, who was diagnosed as having renal failure. The ectopic kidney was located behind the sigmoid colon with 3 renal arteries and 3 renal veins. Laparoscopic donor nephrectomy was performed by reduced port surgery using the GelPOINT access platforms at a midline incision below the umbilicus with 1 accessory port. A thin artery of the donated kidney was ligated. An artery of the upper pole was anastomosed to the internal iliac artery, and a second artery was anastomosed directly to the inferior epigastric artery. Three veins were anastomosed to the external iliac vein: 1 anastomosed directly, 1 interposed by saphenous vein graft, and 1 interposed by harvested ovarian vein. To our knowledge, this is the first successful case of transplantation using an ectopic pelvic kidney by reduced port laparoscopic donor nephrectomy.