type: misc

label: url

en: 【ドクターTの心の声を聞け!留置&抜去の理由がわかる! 術式別術後ドレーンの観察とケア】 肝切除術

en: Gastroenterological Surgery Nursing

ja: 消化器外科Nursing


en: 【がん治療医のための漢方ハンドブック】 漢方と癌診療

ja: 【がん治療医のための漢方ハンドブック】 漢方と癌診療

en: 臨床外科

ja: 臨床外科


en: Esophagus Hiatus Hernia after Laparoscopic Total Gastrectomy

ja: 腹腔鏡下胃全摘術1年後に傍食道裂孔ヘルニアを発症した1例

en: We report on a rare case of esophageal hitus hernia after laparoscopic total gastrectomy (LTG). A 73-year-old man underwent LTG with D2 lymph node dissection and Roux-en-Y (overlap) reconstruction for early gastric cancer. After one year, he was admitted to our hospital with acute abdominal pain. Abdominal CT scan revealed a dilated small intestine prolapsing into the thoracic cavity through the left side of the esophageal hiatus and ischemia of the prolapsed small intestine. He underwent emergency operation based on a diagnosis of strangulation ileus caused by esophageal hiatal hernia. We successfully reduced the prolapsed small intestine back to the abdominal cavity. There was no necrosis in the area. The hernia orifice was occluded by suturing posterior walls of the diaphragm crus and the esophagus was securely fixed by 4 sutures to the diaphragm crus.

ja: 腹腔鏡下胃全摘術1年後に傍食道裂孔ヘルニアを発症した1例を経験したので報告する．症例は73歳男性で，1年前に当院で早期胃癌に対して腹腔鏡下胃全摘術，Roux-en-Y再建を施行した．2012年5月，突然の腹痛を主訴に来院した．腹部は板状硬でBlumberg signを認めた．胸腹部造影CTにて食道裂孔より左胸腔内へ拡張した腸管の脱出像と胸水貯留を認めた．食道裂孔ヘルニアによる絞扼性イレウスと診断し，緊急手術を施行した．食道裂孔を介して挙上空腸が左胸腔内へ進入しており，傍食道裂孔ヘルニアと診断した．食道裂孔を切開しヘルニア門を開大し，腹腔側から空腸を引き戻し，裂孔部を縫合閉鎖し空腸を固定し手術を終了した．術後14日目に軽快，退院した．術後1年の現在まで再発の徴候はない．

en: The Japanese Journal of Gastroenterological Surgery

ja: 日本消化器外科学会雑誌


en: 【食道癌・胃癌におけるロボット支援手術の有用性】 地方での胃癌に対するロボット支援手術導入の現状と問題点

en: Japanese Journal of Cancer Clinics

ja: 癌の臨床


en: 【漢方を上手に使う―エビデンスに基づいた外科診療】 周術期管理・合併症と漢方 高アンモニア血症 大建中湯 効果のメカニズム


en: Evaluation of ICG fluorescence method for confirmation of blood folw in intraoperative pre-anastomosis for laparoscopic anterior resection.

ja: 腹腔鏡下直腸切除術におけるICG蛍光法を用いた腸管血流評価

en: Journal of Japan Society of Computer Aided Surgery

ja: 日本コンピュータ外科学会誌


en: A case of rectal metastasis from gastric cancer

ja: 症例報告 胃癌術後に直腸転移を来した1例

en: We report a case of rectal metastasis from gastric cancer. The patient was a 69-year-old man with diarrhea as his major symptoms, who underwent a distal gastrostomy for gastric cancer 2 years previously. We suspected primary or metastatic rectal cancer from colonoscopic examination and barium enema. A lower anterior resection was performed. Postoperative historical examination identified poorly differentiated adenocarcinoma and signet cell carcinoma identical to the gastric cancer. Finally the lesion was diagnosed as metastatic rectal cancer from gastric cancer that showed same pattern in PAS stain. There were only 40 cases in reports in the literature from 2002 to 2012, to our knowledge. We report a rare case.

en: Shikoku Acta Medica

ja: 四国医学雑誌


en: The beneficial effects of Kampo medicine Dai-Ken-Chu-To after hepatic resection: a prospective randomized control study.

en: After hepatic resection, delayed flatus and impaired bowel movement often cause problematic postoperative ileus. Kampo medicine, Dai-kenchu-to (DKT), is reported to have a various beneficial effects on bowel systems. The aim of this study was to prospectively evaluate effects of DKT after hepatic resection. Thirty-two patients who underwent hepatic resection between July 2007 and August 2008 in Tokushima University Hospital were prospectively divided into DKT group (n=16) and control group (n=16). In DKT group, 2.5 g of DKT was administered orally three times a day from postoperative day (POD) 1. Blood was examined on POD 1, 3, 5 and 7. Postoperative first flatus, bowel movement and full recovery of oral intake, hospital stays and complications were checked. In DKT group, levels of c-reactive protein and beta-(1-3)-D-glucan on POD 3 were significantly decreased (p<0.05). Moreover, postoperative periods for the first flatus, bowel movement and the full recovery of oral intake were significantly shortened in DKT group (p<0.05). DKT suppressed inflammatory reaction, stimulated bowel movement and improved oral intake after hepatic resection, which may decrease serious morbidity after hepatic resection.

en: Hepato-Gastroenterology

ja: Hepato-Gastroenterology