Takuo Hara

Clinicopathological and biological assessment of lung cancers with pleural dissemination

BACKGROUND This study provides the surgical outcome of lung cancer patients with pleural dissemination, with the assessment of the clinicopathological and biological prognostic factors. METHODS Forty-three patients who underwent operations were studied. Vascular endothelial growth factor (VEGF) and autocrine motility factor receptor (AMFR/gp78) expression was immunohistochemically evaluated. RESULTS In total, the overall 3 and 5-year survival rates were 31.4% and 13.1%, respectively. The patients who underwent the pleuropneumonectomy had a worse outcome than those who underwent limited operations (pleurectomy plus parenchymal resections were less than pneumonectomy). VEGF and AMFR/gp78 were highly expressed in primary tumors. Among the patients who underwent limited operations, pathological types other than adenocarcinoma and high expression of VEGF were significantly associated with a worse outcome. The pathological type was the only characteristic to retain a significant independent prognostic impact on overall survival. CONCLUSIONS The results imply the validation of limited operation for lung cancer with pleural dissemination for the local control. High frequency of VEGF and AMFR/gp78 expression conform to the interpretation that patients with pleural dissemination have a high-risk of systemic disease.

Completion pneumonectomy for patients with recurrent lung cancer: the impact of microvessel density on outcome.

P < 0.0001). The vessel densities in the primary and recurrent tumors of 2 of 3 long-term survivors were found to be relatively low. These results indicate the high-grade malignant potential of recurrent tumors, which led us to conclude that the use of CP should be carefully evaluated in patients with recurrence. Assessing the vasculature in primary tumors may be a useful indicator for determining which patients could benefit from CP.

Anticipation of umbistoma in laparoscopic anterior rectal resection: Ileostomy and ostomy closure

Objective: The use of laparoscopic surgery for rectal disease is expected to provide good cosmetic benefits for patients postoperatively. However, this expectation is significantly reduced when a diverting ileostomy is created. We present a new technique that reduces the size of the skin wound by constructing a diverting ileostomy in the umbilicus. This procedure, diverting umbilical ileostomy (umbistoma) does not require special tools for its construction and closure. Methods: Twenty-nine patients underwent treatment with umbilical diverting stoma, including five women and 24 men, with a mean age of 70 years (range: 40-88 years). At the time of ostomy closure, a new umbilicus was formed by subcutaneously suturing the wound to the fascia. In addition, we did not close the new umbilical upper and lower spaces, so as to allow open drainage of the healing wound. Results: All procedures were completed successfully without any perioperative complications. Conclusions: Our findings suggest that the umbilical diverting stoma could provide improved safety and cosmetic advantages in laparoscopic rectal resection.

Corrigendum to “Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan” [J Infect Chemother 24 (2018) 330–340]

Yoshio Takesue a, w, , Shinya Kusachi a, , Hiroshige Mikamo a, , Junko Sato , Akira Watanabe , Hiroshi Kiyota , Satoshi Iwata , Mitsuo Kaku , Hideaki Hanaki , Yoshinobu Sumiyama c, , Yuko Kitagawa c, , Kazuhiko Nakajima , Takashi Ueda , Motoi Uchino , Toru Mizuguchi , Yoshiyasu Ambo , Masafumi Konosu , Keiichiro Ishibashi , Akihisa Matsuda , Kazuo Hase , Yasushi Harihara , Koji Okabayashi , Shiko Seki , Takuo Hara , Koshi Matsui , Yoichi Matsuo , Minako Kobayashi , Shoji Kubo , Kazuhisa Uchiyama , Junzo Shimizu , Ryohei Kawabata , Hiroki Ohge , Shinji Akagi , Masaaki Oka , Toshiro Wakatsuki , Katsunori Suzuki , Kohji Okamoto , Katsunori Yanagihara ae

Laparoscopic versus Open stoma creation: A retrospective analysis

Objectives: This study aimed to compare open stoma (OS) creation with laparoscopic stoma (LS) creation considering the operation time, blood loss, time of oral intake, and complications. We also compared multiport LS and single-incision laparoscopic stoma (SILS) creation. Methods: We reviewed the demographic data, diagnosis, indications, operation time, blood loss, time of oral intake, operative procedure, and complications of 50 patients who underwent stoma creation between April 2014 and April 2016. Results: The mean blood loss was significantly lower in the LS group (7.85±18.4 ml) than in the OS group (38.1±73.2 ml; P=0.02). There were no statistical differences between the groups in terms of the operation time (LS, 72.1±32.7 min; OS, 61.2±31.2 min; P=0.23) or time of oral intake (LS, 1.0±0 days; OS, 1.91±2.71 days; P=0.17). Peristomal skin problems occurred in 11 patients (47.8%) in the OS group and 5 patients (18.5%) in the LS group. There were no statistically significant differences between the SILS and multiport LS groups, considering the operation time, amount of bleeding, and time of oral intake. Conclusions: LS is comparable with OS in terms of operation time and time of oral intake and may cause lesser blood loss. Considering its advantages, LS is a useful approach for patients requiring biopsies or intra-abdominal inspection. SILS is a minimally invasive technique, suitable for patients in whom the stoma site is preoperatively decided.

Laparoscopic pelvic lymph node dissection for malignant foot melanoma

A 39 year‐old woman with malignant foot melanoma underwent wide excision of the primary tumor with a safety margin and sentinel lymph node biopsy (SLNB) for the right inguinal lymph node. SLNB was positive and a computed tomography (CT) scan revealed right iliac lymph node swelling. Positron emission tomography computed tomography (PET–CT) scan of the lymph nodes revealed abnormal uptake of fluorodeoxyglucose (FDG). We performed a laparoscopic pelvic lymph node obturator, iliac lymph node) dissection. During the operation, several black lymph nodes were observed in the iliac lymph node. Pathologically, the iliac lymph node consisted of metastasized atypical melanocytes. This surgical method for pelvic lymph node dissection is not a standard procedure among institutions. There have been no reported cases of malignant melanoma with pelvic lymph node metastasis treated by laparoscopic surgery. However, due to the minimally invasive technique, this method is worth considering to be used for pelvic lymph node dissection in malignant melanoma as well as other cancers in the field of urology or gynecology.