Biomedical subjects

M Kusunoki

Publications and source records attributed to M Kusunoki.

259 records · Page 15Linked to original sources

PubMedDate not supplied

Colonic J pouch-anal reconstruction with gluteus maximus transposition for a post-irradiation rectovaginal fistula.

A 44-year-old female with rectal cancer underwent anoabdominal rectal resection and colonic J pouch-anal anastomosis after preoperative intraluminal brachytherapy. Pelvic sepsis developed a rectovaginal fistula. We attempted to close the fistula and restore the anal function with coloanal re-anastomosis and bilateral gluteus maximus transposition. She regained good anal function without recurrence of the fistula.

Adult↗

PubMedDate not supplied

Hepatic artery-biliary fistula during infusion chemotherapy.

A 52-year-old man with rectal cancer and liver metastasis underwent tumor resection with hepatic arterial catheterization. During adjuvant chemotherapy, he developed epigastric pain, nausea, and melena. Digital subtraction angiography revealed a hepatic artery-biliary fistula and a pseudoaneurysm at the catheter tip. This rare complication of intra-arterial chemotherapy is reported in detail.

Angiography, Digital Subtraction↗

PubMedDate not supplied

The regrowth of rectal adenocarcinoma after pre-operative radiotherapy with a report of two cases.

To evaluate the factors that contribute towards the regrowth of rectal carcinoma after pre-operative radiotherapy. Of 120 patients, we pre-operatively treated with intraluminal brachytherapy or external beam radiotherapy since 1986, two showed regrowth of rectal carcinoma. For them, the case reports and findings for the resected specimen obtained using immunohistochemical staining for the P53 tumor suppressor gene (P53) and proliferating cell nuclear antigen (PCNA) were retrospectively evaluated. The regrowth of rectal carcinoma was observed 40 days after intraluminal brachytherapy in one patient, and 33 days after external radiotherapy in the other. Both P53 and PCNA staining was seen in the recurrent tumors or during the examination of the resected specimen. These results suggest that polypoid tumors with regrowth have a malignant potential. The interval between radiotherapy and operation reported in the literature varies widely. The potential for regrowth should be considered in the preoperative radiotherapy for rectal cancer.

Adenocarcinoma↗

PubMedDate not supplied

Jejunal pouch length influences metabolism after total gastrectomy.

BACKGROUND/AIMS: To determine whether the length of the jejunal pouch used for reconstruction after total gastrectomy influences the postoperative metabolic and clinical outcome. METHODOLOGY: Twenty-one patients who underwent total gastrectomy with long jejunal pouch reconstruction (length 20 cm: n = 9) or short jejunal pouch reconstruction (length 15 cm: n = 12) were studied. The volume of a single meal, clinical symptoms, glucose metabolism, and other metabolic parameters were studied. RESULTS: Food intake, body weight, and dumping symptoms were similar in both groups, but the short pouch group had less reflux symptoms. Serum albumin and total cholesterol levels were higher in the short pouch group than in the long pouch group at 12 months postoperatively (p < 0.05). However, the short pouch group showed reduced glucose tolerance. CONCLUSION: These findings suggest that jejunal pouch length might have a role in postoperative physiological status.

Adenocarcinoma↗

PubMedDate not supplied

The relationship between stapling doughnuts: characteristics and functional results after total gastrectomy.

BACKGROUND/AIMS: The objective of this study was to determine whether the thickness of the esophageal doughnut is related to postoperative results in total gastrectomy. METHODOLOGY: Thirty-eight total gastrectomy patients were studied, including 18 who underwent jejunal pouch reconstruction and 20 who did not have pouch reconstruction. We used the Proximate-ILS circular stapler, with purse-string suturing at the cut end of the esophagus performing only the mucosal layer manually in all cases. We divided the esophageal doughnuts after stapling into two groups: Group A: doughnut involving muscle tissue of 0-25% of the esophageal circumference; Group B: doughnut involved muscle tissue of 25-100% of the esophageal circumference. Reflux scores and the scintigraphic reflux index were determined. RESULTS: No significant difference was found between the two groups in reflux score or scintigraphic reflux index. CONCLUSIONS: These findings indicate that the degree of postoperative reflux esophagitis was not affected by the amount of the muscular layer included in the esophageal doughnut. Continuity, and not variability of the degree of involved muscle in the esophageal doughnut, is an important factor at the time of stapling.

Aged↗

PubMedDate not supplied

Magnetic resonance imaging in the diagnosis of jejunal leiomyoblastoma.

We report a case of large leiomyoblastoma of the jejunum. The sagittal views in pre-operative magnetic resonance imaging (MRI) indicated that a cystic tumor with solid component was present, sequential from the small bowel. We suspected a smooth muscle tumor of the small bowel, but did not rule out the malignancy. The operative diagnosis was smooth muscle tumor of the proximal jejunum, and partial resection of the small bowel was performed. The pathological examination revealed benign leiomyoblastoma of the jejunum without metastasis. MRI contributed to the pre-operative diagnosis of the origin of this rare tumor, in a non-invasive fashion.

Aged↗

PubMedDate not supplied

The prediction of the prognosis for rectal carcinoma down-staged by pre-operative radiotherapy by transrectal ultrasonography.

BACKGROUND: We attempted to determine whether the results of transrectal ultrasonography (TRUS) could provide any prognostic information about patients with rectal carcinoma treated with pre-operative radiotherapy (RT). METHODS: Ninety-eight patients with rectal carcinoma were treated with pre-operative RT and radical surgery. We categorized the TRUS results with respect to TNM classification before the RT (Pre-RT staging), those after the RT (Post-RT staging), and the results of the pathological examination (Post-OP staging). We analysed the associations among these three stagings, and the survival time of the patients. RESULTS: The prevalence of under T2-stage (TNM classification) in the pre-RT staging was significantly lower than that in both the Post-RT and Post-OP staging. The number of tumours diagnosed as T4 stage in both the Post-RT and Post-OP staging was significantly lower than that before irradiation. The survival periods of the patients with tumours remaining as T4 after radiation were significantly shorter than those of the patients diagnosed as having T4 tumours at the Pre-RT staging (Pre-RT versus Post-RT, p = 0.019; Pre-RT versus Post-OP, p = 0.030). These results suggested that radio-insensitive residual cells might associate with the poor prognosis. CONCLUSION: We could predict the possible prognosis in rectal carcinoma patients treated with pre-operative radiotherapy before operation by TRUS.

Aged↗