Susumu Kawano

How Can We Control Intraoperative Bacterial Contamination and Surgical-Site Infection During an Anterior Resection or Hartmann’s/Miles’ Operation?

PurposeIntraoperative bacterial contamination (IBC) is a major cause of surgical-site infection (SSI). Therefore, we investigated whether the ingenuity of surgical procedures could reduce the incidence of IBC/SSI.MethodsSixty patients who were surgically treated for recto-sigmoid cancer were investigated. Among these patients, the colon was transected during the early perioperative period (ET) in 29 patients and during the late period (LT) in 31 patients. Three samples for IBC were obtained from the irrigation fluid before abdominal closure (LAVAGE), the remaining cut sutures after peritoneal closure (SUTURE), and a subcutaneous swab of the wound (SUBCUT).ResultsThe overall SSI and IBC rates were 25% and 55.2%, respectively. Patients who developed SSI had an extremely high IBC rate (85%), and IBC patients also had a high SSI rate (68%). IBC was highest in the LAVAGE (26%) followed by the SUBCUT (26%), and the SUTURE (12%). The incidence of IBC in the LT was significantly lower than that in the ET (19% vs. 55%, p < 0.01), although the incidence of SSI was similar in both IBC groups.ConclusionShortening the exposure of the colonic mucosa decreased the incidence of IBC/SSI; thus, careful operations to minimize IBC are recommended.

Erratum to: Laparoscopic gastrectomy for gastric cancer in the elderly patients

Tables 1, 4, and 5 had the following corrections implemented: ‘‘3 7 (10.0) 6 (4.9)’’ should be ‘‘C3 7 (10.0) 6 (4.9)’’ (on p. 1383, line 11 in Table 1). ‘‘3 8 (4.6) 5 (27.8)’’ should be ‘‘C3 8 (4.6) 5 (27.8)’’ (on p. 1385, line 14 in Table 4). ‘‘D2 3 (36.0) 7 (38.9)’’ should be ‘‘D2 63 (36.0) 7 (38.9)’’ (on p. 1385, line 29 in Table 4). ‘‘3 0.034 14.44 1.22–170.56’’ should be ‘‘C3 0.034 14.44 1.22–170.56’’ (on p. 1386, line 6 in Table 5). The corrected tables are displayed below:

A Case of Glomus Tumor of the Stomach Resected by Laparoscopic Surgery - A Case Report.

症例は62歳の男性. 検診の上部消化管造影検査の際胃の異常陰影を指摘され当院外来を受診した. 身体所見, 血液検査では異常所見は認められなかった. 上部消化管造影検査では幽門前庭部小彎に2.5cm大の立ち上がりなだらかで表面平滑な隆起性病変を認め, 超音波内視鏡検査 (EUS) では筋層内の均一な低エコーの腫瘍と描出され, 胃平滑筋腫の疑いと診断された. 生検ではGroup 1であった. 確定診断と治療を兼ね腹腔鏡下胃部分切除術を行った. 病理組織学的には腫瘍細胞は固有筋層内に存在し, 卵円形, 均一で広い胞体を有し胃glomus腫瘍と診断した.胃glomus腫瘍は1962年に本邦で初めて報告されて以来69例しか報告例のないまれな疾患である. 腹腔鏡下に切除した報告例は過去1例だけであるが, 良性腫瘍である胃glomus腫瘍に対する治療法としては腹腔鏡下胃部分切除が妥当であると考える.

The usefulness of thoracoscopic surgery for pleuritis carcinomatosa

We performed thoracoscopic surgery for pleuritis carcinomatosa, in which re-expansion of the collapsed lung was impossible, by employing tube thoracostomy. One of the treatments used for pleuritis carcinomatosa was drainage of the pleural effusion followed by re-expansion of the collapsed lung. The decortication and biopsy of the pleura and the pleural effusion drainage with the thoracoscopic procedure were performed, allowing control of the pleural effusion and re-expansion of the collapsed lung to be accomplished. We conclude that thoracoscopic surgery is useful for the thoracic treatment of pleuritis carcinomatosa.