Yasuro Kurisu

Internal supravesical hernia repaired via the anterior approach alone: A case report

Highlights • Internal supravesical hernia is very rare.• Most previous reports performed closure of the hernial sac by open laparotomy.• We could successfully repair intraoperatively-diagnosed internal supravesical hernia by the anterior approach alone.

Randomized controlled phase II study of alternate-day S-1 as adjuvant chemotherapy for gastric cancer.

114 Background: Based on the results of ACTS-GC, oral administration of S-1 for 1 year is considered standard postoperative adjuvant chemotherapy for gastric cancer in Japan. However, the 1-year treatment completion rate was only 65.8%, and completion of the treatment is a problem to be solved. On the other hand, we experienced in clinical practice that the alternate-day administration of S-1 reduced adverse effects and was tolerable for advanced gastric cancer patients unwilling to continue the standard daily administration. We therefore conducted a multi-center cooperative prospective study to compare daily with alternate-day administration of S-1 as postoperative adjuvant therapy for gastric cancer. METHODS Patients with Stage II or III gastric cancer who underwent curative surgery were randomly assigned to receive standard daily administration (group A: S-1 80-120 mg/day according to BSA, days 1 to 28, every 6weeks, for 1 year) or alternate-day administration of S-1 (group B: S-1 80-120 mg/day according to BSA, every other day, for 15 months). The primary endpoints were treatment completion rate and relative dose intensity. Secondary endpoints were safety, overall survival, and relapse-free survival. RESULTS A total of 73 patients were enrolled. As of August 30, 2011 analysis of the compliance data of 62 cases had been completed. The results showed a treatment completion rate of 74.2% in group A and 93.5% in group B and relative dose intensity of 72.1% in group A and 85.6% in group B, and compliance tended to be better in group B. Assessment of survival time showed a median follow-up time of 545 days, a 1-year survival rate of 93.8% in group A and 96.9% in group B and 1-year relapse-free survival rate of 79.5% in group A and 90.7% in group B. Digestive system adverse events were less frequent in group B than in group A. CONCLUSIONS We will report the data from the final analysis at this meeting. The current data show improved compliance and mitigation of adverse effects with alternate-day administration of S-1, and it appears to be a more sustainable option for adjuvant chemotherapy for Stage II and III gastric cancer.

Vertical Banded Gastroplasty for Pickwick Syndrome. A Report of Two Cases.

睡眠時無呼吸症候群 (sleep apnea syndrome: SAS) あるいはobesity hypoventilation syndrome (OHS) を伴う重症肥満患者2例にvertical banded gastroplasty (VBG) を施行した.術後合併症はみられなかった.術後の良好な体重減少により睡眠時無呼吸発作の消失とOHSの改善が得られた.覚醒時のperformance activityの向上と精神的なirritabilityの消失によって患者のquality of lifeは著しく向上した.減量によって咽頭部, 胸壁, あるいは腹腔内などに過剰に蓄積した体脂肪が著明に減少したことがSASやOHSの改善に寄与したものと思われた.VBGは術後合併症が少なく, 減量効果の高い術式であり, SASあるいはOHSを伴う重症肥満に対する有用な治療法と考えられた.