Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Nov 2014
[Laparoscopic hemi-double stapling and reduced-port laparoscopic distal gastrectomy for gastric cancer].
The hemi-double stapling method (HDS) is typically used for extracorporeal Billroth-I anastomosis. We used HDS for reduced-port surgery. Laparoscopic HDS is used for intracorporeal Billroth-I anastomosis after laparoscopic distal gastrectomy. We performed reduced-port laparoscopic distal gastrectomy for gastric cancer. ⋯ Laparoscopic HDS and reduced-port laparoscopic distal gastrectomy are safe and feasible procedures.
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Gan To Kagaku Ryoho · Nov 2014
Case Reports[A case of curative resection after downsizing chemotherapy in initially unresectable locally advanced intrahepatic cholangiocarcinoma].
This case report describes an 83-year-old man with intrahepatic cholangiocarcinoma who was referred by a local hospital. Abdominal computed tomography (CT) showed a large tumor in hepatic segments 4, 5, and 8 involving the right hepatic vein and inferior vena cava, which is normally indicative of an unresectable locally advanced tumor. After systemic chemotherapy with gemcitabine and cisplatin, the observed decrease in the level of tumor marker suggested that the cancer was responding to treatment, while radiological findings showed the main tumor shrunk without the presence of distant metastases. ⋯ Eighteen months after surgery, the patient is free of disease and shows no signs of recurrence. An initially unresectable, locally advanced biliary tract cancer may be down sized by chemotherapy, which makes radical resection possible, at least in a proportion of patients. This approach provides longer survival and may have a potential for disease eradication as a new multidisciplinary approach for patients with unresectable locally advanced biliary tract cancer.
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Gan To Kagaku Ryoho · Nov 2014
Case Reports[Efficiency of pre-operative chemoradiotherapy in treating a case of advanced rectal cancer].
There is insufficient evidence for the pre-operative use of chemoradiotherapy (CRT) in treatment of advanced rectal cancers, and its efficiency and safety are unclear. However, it has recently been suggested that a new class of carcinostatic agents are more effective during preoperative CRT. ⋯ The Japanese Society for Cancer of Colon and Rectum (JSCCR) guidelines for 2014 also recommend the use of both drugs during preoperative CRT. We report a case of rectal cancer, which was successfully treated with radical resection and neoadjuvant chemoradiotherapy.
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Gan To Kagaku Ryoho · Nov 2014
Case Reports[A case of ARDS after esophagectomy treated with low-dose steroid therapy].
A 48-year-old woman was found to have an esophageal cancer, and after preoperative chemotherapy with cisplatin (CDDP)/5-fluorouracil (5-FU), radical subtotal esophagectomy was performed. On the fifth day after surgery, her respiratory condition suddenly worsened and a chest radiograph showed low permeability in both lung fields, leading to a diagnosis of acute respiratory distress syndrome (ARDS) and intubation for mechanical ventilation. Since clinical examination did not detect signs of infection on the seventh day, we began administering hydrocortisone at a dose of 300 mg. ⋯ ARDS remains a refractory disease and no drug has proven to be effective in randomized controlled trials. The use of steroids for ARDS management remains controversial. Our present case suggests that low-dose steroids from an early stage in uninfected ARDS patients may improve prognosis.
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Gan To Kagaku Ryoho · Nov 2014
[Effect of recombinant human soluble thrombomodulin in patients with solid carcinoma with DIC].
There are only a few reports in the literature about the effect of recombinant human soluble thrombomodulin (rTM) in patients with solid carcinoma with disseminated intravascular coagulation (DIC). A retrospective study of 40 patients with solid carcinoma with DIC was performed between February 2009 and April 2013. ⋯ Patients with successful withdrawal of DIC had significantly better outcomes (p<.001). Therapy with rTM is one of the treatment options for patients with solid carcinoma with DIC.