Hiroe Kitahara, Kai Seharada, M. Yoshimura, Y. Karasawa, T. Orii
{"title":"Risk Factors for Perioperative Deep Vein Thrombosis in Patients Undergoing Gastrointestinal Cancer Surgery","authors":"Hiroe Kitahara, Kai Seharada, M. Yoshimura, Y. Karasawa, T. Orii","doi":"10.3919/jjsa.84.1","DOIUrl":"https://doi.org/10.3919/jjsa.84.1","url":null,"abstract":"","PeriodicalId":19305,"journal":{"name":"Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73306827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
腸管アミロイドーシスは腸管粘膜の虚血・脆弱性をもたらす．腸管再建の際，吻合部の血流障害をきたし，縫合不全の高リスクといわれ，一期的吻合を避け人工肛門造設する例もある．症例は67歳の男性で，関節リウマチで20年間の治療歴がある．貧血を主訴に施行した下部消化管内視鏡検査で，S状結腸に20mm大の隆起性病変を認めた．同時に施行した結腸生検で，粘膜下層内の間質・動脈周囲にアミロイド沈着を認めた．Direct fast scarlet染色陽性であり，腸管アミロイドーシスと診断された．S状結腸腫瘍に対しEMRを施行したところ，垂直断端陽性で外科に紹介となり腹腔鏡下S状結腸切除術を施行した．術中，再建腸管の緊張をとるために脾彎曲部授動を行った．また，腸管再建時にindocyanine green蛍光法で吻合部血流が良好であることを確認し吻合した．術後は明らかな合併症なく経過し，術後10日目に自宅退院となった．
肠淀粉中毒会导致肠粘膜缺血、脆弱。肠管重建时，会造成吻合口的血流障碍，被认为是缝合不全的高风险，也有避免一期吻合而制造人工肛门的例子。病例是一名67岁的男性，患有类风湿关节炎，有20年的治疗史。以贫血为主要症状实施的下消化道内镜检查，发现乙状结肠有20mm大的隆起性病变。同时实施的结肠活检发现粘膜下层内的间质、动脉周围有淀粉样蛋白沉积。Direct fast scarlet染色阳性，被诊断为肠淀粉样中毒。对乙状结肠肿瘤实施EMR时，发现垂直断端呈阳性，转诊至外科实施了腹腔镜乙状结肠切除术。术中，为了消除重建肠管的紧张，进行了脾弯部授动。另外，在肠管重建时，用indocyanine green荧光法确认吻合部位血流良好而吻合。术后无明显并发症，术后十天出院。
{"title":"A Case of Sigmoid Colon Cancer with Intestinal Amyloidosis","authors":"Tetsuro TOMINAGA, Takashi NONAKA, Shosaburo OYAMA, Yuma TAKAMURA, Terumitsu SAWAI, Takeshi NAGAYASU","doi":"10.3919/jjsa.84.615","DOIUrl":"https://doi.org/10.3919/jjsa.84.615","url":null,"abstract":"腸管アミロイドーシスは腸管粘膜の虚血・脆弱性をもたらす．腸管再建の際，吻合部の血流障害をきたし，縫合不全の高リスクといわれ，一期的吻合を避け人工肛門造設する例もある．症例は67歳の男性で，関節リウマチで20年間の治療歴がある．貧血を主訴に施行した下部消化管内視鏡検査で，S状結腸に20mm大の隆起性病変を認めた．同時に施行した結腸生検で，粘膜下層内の間質・動脈周囲にアミロイド沈着を認めた．Direct fast scarlet染色陽性であり，腸管アミロイドーシスと診断された．S状結腸腫瘍に対しEMRを施行したところ，垂直断端陽性で外科に紹介となり腹腔鏡下S状結腸切除術を施行した．術中，再建腸管の緊張をとるために脾彎曲部授動を行った．また，腸管再建時にindocyanine green蛍光法で吻合部血流が良好であることを確認し吻合した．術後は明らかな合併症なく経過し，術後10日目に自宅退院となった．","PeriodicalId":19305,"journal":{"name":"Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iguru Omori, N. Kubo, Kenji Kuroda, T. Hasegawa, Katsunobu Sakurai, K. Maeda
{"title":"A Case of a High-risk Obese Patient with Esophageal Cancer who Underwent the Two-stage Robot-assisted Surgery","authors":"Iguru Omori, N. Kubo, Kenji Kuroda, T. Hasegawa, Katsunobu Sakurai, K. Maeda","doi":"10.3919/jjsa.84.281","DOIUrl":"https://doi.org/10.3919/jjsa.84.281","url":null,"abstract":"","PeriodicalId":19305,"journal":{"name":"Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85795129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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