Biomedical subjects

Masaru Tsuchiya

Publications and source records attributed to Masaru Tsuchiya.

3 recordsLinked to original sources

PubMed2005

Laparoscopic liver resection of hepatocellular carcinoma.

BACKGROUND: We have continued to develop laparoscopic hepatectomy as a means of surgical therapy for hepatocellular carcinoma (HCC). METHODS: We evaluated the degree of invasiveness and analyzed the outcomes of laparoscopic hepatectomy compared with open hepatectomy for HCC. RESULTS: There were notable differences with respect to blood loss and operating time compared with open hepatectomy cases. Patients started walking and eating significantly earlier in the laparoscopic hepatectomy group, and these more rapid recoveries allowed shorter hospitalizations. On the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, there was no difference in preoperative risk. However, a significant difference was seen in the surgical stress and comprehensive risk scores between the open hepatectomy and laparoscopic hepatectomy groups. Concerning the survival rate and disease-free survival rate, there were no significant differences between procedures. CONCLUSIONS: Laparoscopic hepatectomy avoids some of the disadvantages of open hepatectomy and is beneficial for patient quality of life (QOL) as a minimally invasive procedure if the operative indications are appropriately based on preoperative liver function and the location and size of HCC.

Aged↗

PubMed2004

Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.

Herein, we report the successful performance of a laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for a patient with pancreatic cystadenoma, as a minimally invasive procedure with the preservation of function. The laparoscopy-assisted distal pancreatectomy procedure involved detaching the spleen and the distal pancreas from the retroperitoneum by a hand-assisted procedure, removing them from the peritoneal cavity through a small incision, and detaching the distal pancreas by ligating and transecting the short gastric artery and vein and the branches of the splenic artery and vein, while the spleen and main splenic artery and vein were preserved under direct view. The pancreatic parenchyma was transected with a stapling device (TL-30), and continuous suturing was added to the resected margin. The patient's postoperative course was uneventful; the patient started to eat and walk on postoperative day 2 and was discharged on day 8. It is considered that the combination of hand-assisted and laparoscopy-assisted distal pancreatectomy, with conservation of the splenic artery and vein, is a minimally invasive and clinically useful technique for treating tumors of cystic disease of the pancreas with low-grade malignant potential, or benign solitary neuroendocrine tumors.

Adult↗

PubMed2004

Hepatic resection using stapling devices.

BACKGROUND: The progress and development of stapling devices has been remarkable. They have become indispensable for gastrointestinal diseases and are increasingly utilized in laparoscopic operations. Liver surgery applications for this technique are continuing to emerge, and in this study, we introduced the use of stapling devices to hepatic surgery. METHODS: We examined the operative procedure and efficacy of hepatic resections using stapling devices as follows: transection of Glisson's pedicle and the hepatic vein using endolineal stapling devices in right and left lobectomies; bisegmentectomy II and III en masse using a stapling device; and application of endolineal stapling devices to vessel transections and dissections of the hepatic parenchyma in laparoscopic hepatectomies. RESULTS: It was considered useful to tactfully apply stapling devices to vessel transections and dissections of the hepatic parenchyma in order to simplify the operative procedures of right or left lobectomies and lateral segmentectomies. Furthermore, the use of endoscopic stapling devices was an acceptable alternative to vessel transactions and dissections of the hepatic parenchyma in laparoscopic hepatectomies. CONCLUSIONS: We believe that stapling devices will become utilized in liver surgery hereafter.

Hepatectomy↗