Shigeru Yakabe

Jejunal lipomatosis with diverticulosis: report of a case.

We herein report the very rare case of a 68-year-old Japanese man with multiple jejunal lipomatosis and diverticulosis. He was admitted to our hospital with the chief complaint of melena and anemia. A barium study of the small bowel showed multiple lipomatosis and diverticulosis. An approximately 200-cm length of the jejunum was therefore resected. Thereafter, two diverticula and 215 lipomas were recognized in the resected specimen. A pathological examination showed mature adipose tissue with fibrous septa in the submucosal and muscularis propria. These findings were thus suggested to be due to the attenuation of the muscularis propria. The complications of lipomatosis are also discussed.

Pseudomyxoma peritonei concomitant with early gastric cancer: Report of a case

The preoperative diagnosis of both appendiceal carcinoma and pseudomyxoma peritonei is difficult because of the nonspecific nature of the associated symptoms. More than 50% of all patients with carcinoma of the appendix are diagnosed with and treated for acute appendicitis. In addition, there have been few reports on patients with an appendiceal carcinoma or pseudomyxoma peritonei in association with other synchronous or metachronous malignancies of the alimentary tract. We herein report the first known patient with synchronous early gastric cancer and pseudomyxoma peritonei, in which the origin was correctly identified preoperatively.

Intraoperative localization of right-sided small colonic lesions: a novel use of the cholangioscope.

Background/Aim: We describe a novel use of the cholangioscope to help in the intraoperative localization of small colonic malignancies on the right side of the colon. Methods: A small incision was made at the base of the appendix and a cholangioscope was inserted into the ascending colon through the incised hole of the appendix. Results: The site of the lesion was precisely determined by palpating the distal end of the cholangioscope while observing the area right under it. Conclusion: Our procedure therefore appears to be worthy of consideration in patients with small colonic lesions on the right side of the colon in whom preoperative endoscopic marking techniques might otherwise be required.

Successful one-stage operation for completely obstructive colorectal carcinoma.

We describe herein a new and successful method of performing a safe and steady one-stage operation for completely obstructive colorectal carcinoma. First, a long ileus tube is utilized to decompress the dilated proximal bowel preoperatively and irrigate the feces-loaded colon intraoperatively. Following this procedure, a standard resection with radical lymph node dissection is carried out without a diverting colostomy. We performed this procedure successfully in seven patients, none of whom developed any anastomotic leakage.