Shinya Tanimura

Hand-assisted laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer.

Recently, a minimally invasive operation for gastric malignancies has been advocated, and the laparoscopic operation is noted as a technique that raises the quality of life. We performed distal gastrectomy with regional lymph node dissection by hand-assisted laparoscopic surgery for 60 cases of gastric cancer located in the middle or lower third of the stomach. Billroth I reconstruction was applied intracorporeally to the first 30 cases by using the double stapling method with a conventional circular stapling device, and in the final 30 cases, the quadrilateral (square) stapling technique with a laparoscopic linear stapling device was used to prevent postoperative anastomotic bleeding. This technique not only is less invasive, but also is similarly curative compared with open gastrectomy that was performed for 60 gastric cancer cases of similar staging before the beginning of this procedure.

Laparoscopy-assisted resection for jejunal carcinoma.

Laparoscopic surgery has been applied in small bowel resections for various diseases, such as obstruction including intussusception, diverticula, and tumors. We report a case of successful resection of a jejunal carcinoma that was diagnosed before surgery by using a laparoscopy-assisted technique.

Immunohistological Evaluation of the Presence of Keratins in Esophageal Cancer

The presence of keratin-subunits in carcinoma tissues was evaluated immunohistologically in 41 patients with esophageal cancer. Molecular weights of keratin polypeptides in carcinoma tissues were investigated by enzyme-labeled antibody technique with four kinds of antikeratin monoclonal antibodies with spectrums of different reacting keratin-subunits. Correlation between staining intensity by each antikeratin antibody and histopathological findings was different from one another. Keratin-subunits of molecular weights of 48 and 56 kilodalton(kd) were frequently found in the carcinoma tissue of high malignancy such as severe lymphatic, venous invasion and intramural metastases. Keratin-subunits of molecular weights of 48 and 56kd were tend to be found in the carcinoma tissue of advanced histological stages with deep infiltration and sever lymphnode metastases.