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Article: Successful Systemic Steroid Administration for the Treatment of Edematous Anastomotic Stenosis After the Laparoscopic Augmented Rectangle Technique for Billroth I Reconstruction for Laparoscopic Distal Gastrectomy.

Ito, Tomoaki / Sakurada, Mutsumi / Kushida, Tomoyuki / Tanaka, Kenichiro / Sato, Koichi

2023 Volume 15, Issue 6, Page(s) e40914

Abstract: Edematous anastomotic stenosis is a well-known complication following Billroth I anastomosis for distal gastrectomy. Currently, there is no established treatment for this condition. A 54-year-old female patient underwent the augmented rectangle technique ...

Abstract	Edematous anastomotic stenosis is a well-known complication following Billroth I anastomosis for distal gastrectomy. Currently, there is no established treatment for this condition. A 54-year-old female patient underwent the augmented rectangle technique for Billroth I reconstruction after total laparoscopic distal gastrectomy for early gastric cancer. On postoperative day (POD) 9, the patient started vomiting. During the conservative waiting period, edematous anastomotic stenosis was diagnosed using imaging on PODs 11 and 13. Systemic steroid administration was initiated on POD 13, and the drainage volume of the nasogastric tube decreased four days after initiation. The edematous anastomosis stenosis improved, and gastrografin flowed into the duodenum on POD 19. Food intake was started on POD 20. Oral steroid administration was continued after hospital discharge and gradually terminated. Systemic steroid treatment may help improve edematous anastomotic stenosis.
Language	English
Publishing date	2023-06-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.40914
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Complete wedge resection for duodenal gastrointestinal stromal tumour: A case series of three patients.

Ito, Tomoaki / Kushida, Tomoyuki / Sakurada, Mutsumi / Tanaka, Kenichiro / Sato, Koichi / Maekawa, Hiroshi

International journal of surgery case reports

2021 Volume 90, Page(s) 106674

Abstract: Introduction: Duodenal gastrointestinal stromal tumours (GIST) are rare. Therefore, difficulties are experienced when selecting the appropriate surgical procedure in patients with duodenal GISTs. This report presents the cases of three patients with ... ...

Abstract	Introduction: Duodenal gastrointestinal stromal tumours (GIST) are rare. Therefore, difficulties are experienced when selecting the appropriate surgical procedure in patients with duodenal GISTs. This report presents the cases of three patients with duodenal GISTs who underwent wedge resection. This report would help surgeons identify clinical features and surgical procedures in patients with duodenal GISTs. Presentation of case: Three patients were diagnosed with duodenal submucosal tumours. The first patient presented with melena, the second with postoperative anaemia, and the third with an incidental finding of a large abdominal tumour after presenting with ischaemic colitis. All tumours arose in the 2nd portion of the duodenum and measured 3.5, 3, and 9.2 cm, respectively. Wedge resection of the duodenum was performed in all patients. In patients one and two, simple closure of duodenal wall was performed after wedge resection. In patient three, side-to-side anastomosis with the jejunum was performed because a large area of the wall was removed using the wedge resection technique. Pancreatoduodenectomy was avoided in all patients. Recurrence was not noted in any patient. Discussion: Since GISTs are not generally associated with lymph node metastasis, local resection with negative margins is sufficient to surgically manage patients with GISTs. Conclusion: Our results indicated the effectiveness of performing wedge resection for duodenal GISTs not in close proximity to the ampulla of Vater. Moreover, less invasive procedures should be adopted in patients with duodenal GISTs.
Language	English
Publishing date	2021-12-09
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2021.106674
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Article: Aneurysms of Pancreaticoduodenal Artery due to Median Arcuate Ligament Syndrome, Treated by Open Surgery and Laparoscopic Surgery.

Tokuda, Satoshi / Sakuraba, Shunsuke / Orita, Hajime / Sakurada, Mutsumi / Kushida, Tomoyuki / Maekawa, Hiroshi / Sato, Koichi

Case reports in surgery

2019 Volume 2019, Page(s) 1795653

Abstract: Introduction: There are many possible causes of an abdominal visceral aneurysm, including the obstruction of the celiac artery by the median arcuate ligament (MAL). We report two cases of an aneurysm of the pancreaticoduodenal artery due to MAL syndrome ...

Abstract	Introduction: There are many possible causes of an abdominal visceral aneurysm, including the obstruction of the celiac artery by the median arcuate ligament (MAL). We report two cases of an aneurysm of the pancreaticoduodenal artery due to MAL syndrome that we treated surgically. Case presentation: Case 1: a 66-year-old Japanese woman was diagnosed with a rupture of an aneurysm of the inferior pancreaticoduodenal artery. Because of the difficulty of endovascular therapy, we performed an emergency operation. We chose an abdominal operation, and the postoperative course was uneventful. Case 2: a 75-year-old Japanese man presented at our hospital with acute abdominal pain, nausea, and cold sweat. Our experience of treating MAL syndrome in case 1 enabled us to diagnose the disease accurately. We chose laparoscopic surgery, and the postoperative course was uneventful. Discussion: There are several treatment choices for an aneurysm of the pancreaticoduodenal artery due to MAL syndrome. We have performed only a release of the MAL for treatment, but it is difficult to conclude whether only releasing the MAL is enough to ensure a positive long-term prognosis. Regular follow-up is needed in such cases. Conclusion: Laparoscopic surgery can be considered one of the options for MAL syndrome.
Language	English
Publishing date	2019-01-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	2657697-1
ISSN	2090-6919 ; 2090-6900
ISSN (online)	2090-6919
ISSN	2090-6900
DOI	10.1155/2019/1795653
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Article: Analysis of the methylation of CpG islands in the

Maekawa, Hiroshi / Ito, Tomoaki / Orita, Hajime / Kushida, Tomoyuki / Sakurada, Mutsumi / Sato, Koichi / Hulbert, Alicia / Brock, Malcolm V

Oncology letters

2020 Volume 19, Issue 3, Page(s) 2197–2204

Abstract: No difference in the gene methylation status of tumor-suppression genes between pancreatic cancer tissues and adjacent non-cancer tissues is observed. The present study investigated whether the promoter CpG islands of the cysteine dioxygenase 1 ( ...

Abstract	No difference in the gene methylation status of tumor-suppression genes between pancreatic cancer tissues and adjacent non-cancer tissues is observed. The present study investigated whether the promoter CpG islands of the cysteine dioxygenase 1 (
Language	English
Publishing date	2020-01-23
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2573196-8
ISSN	1792-1082 ; 1792-1074
ISSN (online)	1792-1082
ISSN	1792-1074
DOI	10.3892/ol.2020.11340
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Article: Detection of gene mutations in gastric cancer tissues using a commercial sequencing panel.

Ito, Tomoaki / Matoba, Ryo / Maekawa, Hiroshi / Sakurada, Mutsumi / Kushida, Tomoyuki / Orita, Hajime / Wada, Ryo / Sato, Koichi

Molecular and clinical oncology

2019 Volume 11, Issue 5, Page(s) 455–460

Abstract: Predicting malignancy is important for adequate adjuvant therapy in patients with cancer. Due to cancer being a genetic disease, the detection of gene mutations could be helpful in predicting the prognosis and efficacy of drugs. Gastric cancer is the ... ...

Abstract	Predicting malignancy is important for adequate adjuvant therapy in patients with cancer. Due to cancer being a genetic disease, the detection of gene mutations could be helpful in predicting the prognosis and efficacy of drugs. Gastric cancer is the fifth most common cancer and is the third leading cause of cancer associated mortality worldwide. Mutations in genes may correlate with clinical information in patients with gastric cancer after surgery and, therefore, may be useful for predicting the prognosis of this disease. In the present study, to assess the usefulness of a commercial sequencing panel, TruSeq
Language	English
Publishing date	2019-09-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2796865-0
ISSN	2049-9469 ; 2049-9450
ISSN (online)	2049-9469
ISSN	2049-9450
DOI	10.3892/mco.2019.1926
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Article: A Case of Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy (LAPEG) for Gastric Volvulus.

Ueda, Shuhei / Orita, Hajime / Ito, Tomoaki / Tokuda, Satoshi / Sakuraba, Shunsuke / Kushida, Tomoyuki / Sakurada, Mutsumi / Maekawa, Hiroshi / Sato, Koichi

Case reports in medicine

2019 Volume 2019, Page(s) 3468084

Abstract: Background: Percutaneous endoscopic gastrostomy (PEG) is the standard modality for long-term enteral nutrition for patients with dysphagia. Compared with open gastrostomy, though PEG is an extremely safe procedure with fewer complications, there are ... ...

Abstract	Background: Percutaneous endoscopic gastrostomy (PEG) is the standard modality for long-term enteral nutrition for patients with dysphagia. Compared with open gastrostomy, though PEG is an extremely safe procedure with fewer complications, there are severe cases due to anatomical features. For these cases, laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) is the optimal method. Case presentation: A 52-year-old man had a disturbance in swallowing because of cerebral infarction. We attempted PEG under gastrointestinal fiberscope (GIF) and colon ﬁberscope inspection; however, the procedure was unsuccessful because it was impossible to move the transverse colon downward. We therefore attempted LAPEG to observe the stomach and other organs. Under laparoscopic observation, we diagnosed gastric volvulus, classified as the organo-axial type. For this reason, inserting the tube through the skin was very difficult. We easily corrected the gastric volvulus by using laparoscopic forceps and were finally able to place the PEG tube safely. Discussion: Gastric volvulus is rare in clinical practice. The treatment of gastric volvulus depends on whether mucosal ischemia is present. Endoscopic reduction of gastric volvulus is effective for many patients. Surgical treatment should be considered for patients with gastric volvulus that frequently recurs. In our patient, completely inserting the GIF was impossible; therefore, we could not correctly diagnose gastric volvulus. Laparoscopy-assisted PEG is a useful and safe technique for placing a gastrostomy tube in patients presenting with anatomical difficulties. Moreover, in our patient, gastropexy was performed with PEG. Therefore, LAPEG may be used to prevent the recurrence of gastric volvulus. Gastropexy is a useful option in LAPEG. Conclusions: Laparoscopy has the advantage of allowing a direct inspection of the stomach while gastrostomy is performed and may reveal complications to PEG insertion. Furthermore, in our patient, gastropexy was performed with PEG.
Language	English
Publishing date	2019-12-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2502642-2
ISSN	1687-9635 ; 1687-9627
ISSN (online)	1687-9635
ISSN	1687-9627
DOI	10.1155/2019/3468084
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Article: Group A Streptococcal Toxic Shock-Like Syndrome in a Male Presenting as Primary Peritonitis: A Case Report and a Review in Japan.

Sakuraba, Shunsuke / Ueda, Shuhei / Tokuda, Satoshi / Ito, Tomoaki / Kushida, Tomoyuki / Sakurada, Mutsumi / Maekawa, Hiroshi / Sato, Koichi

Case reports in gastrointestinal medicine

2019 Volume 2019, Page(s) 4984679

Abstract: Background: Streptococcal toxic shock-like syndrome (TSLS) is a severe infection caused by group A hemolytic streptococcus. It is clinically characterized by rapidly progressive septic shock and multiple organ failure within just a few hours. TSLS ... ...

Abstract	Background: Streptococcal toxic shock-like syndrome (TSLS) is a severe infection caused by group A hemolytic streptococcus. It is clinically characterized by rapidly progressive septic shock and multiple organ failure within just a few hours. TSLS presenting as primary peritonitis is rare, especially in a male. Herein, we report a case of TSLS in a male presenting with primary peritonitis, with a review of 25 cases in Japan. Case presentation: A 51-year-old male was referred to our hospital with abdominal pain and hypotension. We made a preoperative diagnosis of peritonitis with septic shock and performed an emergency operation. Intraoperative findings indicated no marked origin of the peritonitis. Preoperative blood culture showed the presence of group A hemolytic streptococcus. The patient required intensive care involving artificial respiration, abdominal drainage and cytokine absorption therapy, and was discharged on postoperative day 25. Conclusion: TSLS in a male presenting as primary peritonitis is rare. Although this condition is a severe infection, it can be treated by multimodal therapy.
Language	English
Publishing date	2019-12-17
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627636-7
ISSN	2090-6536 ; 2090-6528
ISSN (online)	2090-6536
ISSN	2090-6528
DOI	10.1155/2019/4984679
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Article: Two cases of laparoscopic simultaneous resection of colorectal cancer and synchronous liver metastases in elderly patients.

Ito, Tomoaki / Kushida, Tomoyuki / Sakurada, Mutsumi / Maekawa, Hiroshi / Orita, Hajime / Mizuguchi, Konomi / Sato, Koichi

International journal of surgery case reports

2016 Volume 26, Page(s) 134–137

Abstract: Introduction: The laparoscopic resection of colorectal cancer and laparoscopic liver surgery are widely considered to be safe. Recently, it has been reported that the simultaneous laparoscopic resection of primary colorectal cancer and liver metastasis ... ...

Abstract	Introduction: The laparoscopic resection of colorectal cancer and laparoscopic liver surgery are widely considered to be safe. Recently, it has been reported that the simultaneous laparoscopic resection of primary colorectal cancer and liver metastasis is technically feasible and safe when it is performed at experienced centers. However, the feasibility of simultaneous laparoscopic procedures for colorectal cancer and synchronous colorectal liver metastases in elderly patients has not been studied sufficiently. In this study, two cases in which elderly patients with colorectal cancer and synchronous liver metastases were treated with simultaneous laparoscopic resection are reported. Presentation of cases: An 83-year-old female was diagnosed with ascending colon cancer and synchronous hepatic metastases. Simultaneous laparoscopic resection of the primary colon cancer and the liver metastasis was performed. Another tiny hepatic metastasis was subsequently detected in the right hepatic lobe. It was treated with hand-assisted radiofrequency ablation (RFA). The total operative time was 470min, and 340g of intraoperative blood loss occurred. The other case involved a 78-year-old male who was diagnosed with ascending colon cancer and synchronous hepatic metastasis in the right hepatic lobe. Simultaneous laparoscopic resection of the primary colon tumor and liver metastasis was performed. The total operative time was 471min, and 240g of intraoperative blood loss occurred. The postoperative courses of both patients were uneventful. Discussion and conclusion: Our results indicate that simultaneous laparoscopic resection of colorectal cancer and synchronous liver metastases is feasible and safe in elderly patients.
Language	English
Publishing date	2016-07-27
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2016.07.030
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Article ; Online: Risk factors for postoperative complications in patients on maintenance hemodialysis who undergo abdominal surgery.

Ito, Tomoaki / Maekawa, Hiroshi / Sakurada, Mutsumi / Orita, Hajime / Kushida, Tomoyuki / Senuma, Koji / Sato, Koichi

Asian journal of surgery

2016 Volume 39, Issue 4, Page(s) 211–217

Abstract: Background/objective: Patients on hemodialysis (HD) who undergo abdominal surgery for gastrointestinal disease are at increased risk of postoperative complications. In this study, we retrospectively investigated the predictors of postoperative ... ...

Abstract	Background/objective: Patients on hemodialysis (HD) who undergo abdominal surgery for gastrointestinal disease are at increased risk of postoperative complications. In this study, we retrospectively investigated the predictors of postoperative complications among such patients. Methods: The study group comprised 36 HD patients who underwent abdominal surgery for gastrointestinal disease between 2003 and 2012. The clinicopathological factors of the patients who did and did not suffer postoperative complications were compared. Results: The overall morbidity and mortality rates were 39% (14/36) and 14% (5/36), respectively. Physical status according to the American Society of Anesthesiologists (ASA) classification (p = 0.0203) and intraoperative blood loss (p = 0.0013) were found to differ significantly between the groups. Conclusion: The morbidity and mortality rates of HD patients who underwent abdominal surgery for gastrointestinal disease were high. Physical status according to the ASA classification and intraoperative blood loss were found to be associated with postoperative complications. Therefore, patients with comorbidities, such as heart disease and diabetes mellitus, have to be treated appropriately before surgery. In addition, it is important that surgeons perform operations carefully and avoid excessive blood loss.
MeSH term(s)	Abdomen/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrointestinal Diseases/surgery ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Renal Dialysis ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2016-10
Publishing country	China
Document type	Journal Article
ZDB-ID	1068461-x
ISSN	0219-3108 ; 1015-9584
ISSN (online)	0219-3108
ISSN	1015-9584
DOI	10.1016/j.asjsur.2015.03.013
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Article: A Case of Segmental Arterial Mediolysis Presenting as Mucosal Gastric Hematoma.

Sakuraba, Shunsuke / Orita, Hajime / Ueda, Shuhei / Tokuda, Satoshi / Ito, Tomoaki / Kushida, Tomoyuki / Sakurada, Mutsumi / Maekawa, Hiroshi / Wada, Ryo / Sato, Koichi

Case reports in gastrointestinal medicine

2017 Volume 2017, Page(s) 3634967

Abstract: Background: Although segmental arterial mediolysis (SAM) has been increasingly recognized as arteriopathy and there are some case reports about SAM, it is still very rare. It is characterized clinically by aneurysm, dissection, stenosis, and occlusion ... ...

Abstract	Background: Although segmental arterial mediolysis (SAM) has been increasingly recognized as arteriopathy and there are some case reports about SAM, it is still very rare. It is characterized clinically by aneurysm, dissection, stenosis, and occlusion within splanchnic arterial branches, causing intra-abdominal hemorrhage or bowel ischemia. Mortality is as high as 50% in acute events. Case presentation: A 51-year-old man was referred to our hospital with hematemesis. Gastroscopy revealed a submucosal-like tumor on the posterior wall of gastric angle with ulceration. Computed tomography indicated a tumor measuring 65 × 50 mm in the stomach, which was suspected to have invaded into the pancreas. Significant hematemesis recurred; the patient developed shock and underwent emergency distal gastrectomy, distal pancreatectomy, and splenectomy. The pathology and the clinical course were compatible with SAM splenic artery rupture causing retroperitoneal hemorrhage that penetrated into the stomach. After that surgery, aneurysm of common hepatic artery ruptured and coil embolization was performed. Conclusion: SAM is an important cause of intra-abdominal or retroperitoneal hemorrhage in patients without underlying disease. SAM typically presents as intra-abdominal hemorrhage, but, in this case, the retroperitoneal hemorrhage penetrated into the stomach and it looked like a submucosal tumor.
Language	English
Publishing date	2017-11-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627636-7
ISSN	2090-6536 ; 2090-6528
ISSN (online)	2090-6536
ISSN	2090-6528
DOI	10.1155/2017/3634967
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