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Resection of a locally advanced hilar tumor and the hepatic artery after stepwise hepatic arterial embolization: A case report

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World Journal of Gastroenterology 2008年第22期14卷 3587-3590页

作者： Takuya Miura Kenichi Hakamada Takashi Ohata Shunji Narumi Yoshikazu Toyoki Masaki Nara Keinosuke Ishido Motonari Ohashi Harue Akasaka Hiroyuki Jin Norihito Kubo Shuichi Ono hiroshi kijima Mutsuo Sasaki Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Radiology and Radiation Oncology Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Pathology and Bioscience Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Pathology and Bioscience Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan

We herein report a case of a hilar tumor with extensive invasion to the proper hepatic artery, which was successfully treated with a radical resection in a 57-year-old female patient after a stepwise hepatic arterial embolization. She underwent right colectomy and partial hepatectomy for advanced colon cancer two years ago and radiofrequency ablation therapy for a liver metastasis one year ago, respectively. A recurrent tumor was noted around the proper hepatic artery with invasion to the left hepatic duct and right hepatic artery 7 mo previously. We planned a radical resection for the patient 5 mo after the absence of tumor progression was confirmed while he was undergoing chemotherapy. To avoid surgery-related liver failure, we tried to promote the formation of collateral hepatic arteries after stepwise arterial embolizationof the posterior and anterior hepatic arteries two weeks apart. Finally, the proper hepatic artery was occluded after formation of collateral flow from the inferior phrenic and superior mesenteric arteries was confirmed. One month later, a left hepatectomy with hepatic arterial resection was successfully performed without any major complications.

关键词： Hepatic arterial embolization Stepwise Hilar tumor Arterial resection Collateral artery

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胆道肿瘤临床实践指南(英文第三版)

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中华消化外科杂志 2021年第4期20卷 359-375页

作者： Masato Nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki hiroshi kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) 爱知癌症中心日本名古屋北海道大学医学院胃肠外二科日本札幌独协医科大学琦玉医学中心普通外科日本越谷独协医科大学普通外二科日本米布静冈癌症中心肝胆胰外科日本长崎东北大学医学院外科系日本仙台名古屋大学医学院外科系日本名古屋国立癌症中心医院东院区肝胆胰外科日本柏市京都大学医学院外科系日本东京国立癌症中心医院日本东京帝京大学千叶医学中心外科系日本市原东京女子医科大学胃肠病研究所普通外科日本东京新泻大学医学与牙科研究生院消化与普通外科日本新泻均天道大学医学研究生院消化内科日本东京国立癌症中心医院肝胆胰肿瘤科日本东京千叶县锯原医院消化内科日本锯原藤田医科大学消化内科及消化肿瘤科日本丰明杏林大学医学院肿瘤内科日本三鹰泰恩金凯医院教育研究中心日本札幌爱知医科大学放射科日本长谷京都府立医科大学医学研究生院放射科日本京都广崎大学医学研究部病理学与生物科学系日本广崎日本红十字会京都第二医院病理科日本京都国际医疗福利大学肝胆胰胃肠外科日本一川横滨市立大学医学研究生院消化外科日本横滨南京大学医学院附属鼓楼医院肝胆胰中心

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确... 详细信息

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。

关键词：胆道肿瘤临床实践指南预防性治疗循证医学证据肝胆胰外科胆道引流推荐意见壶腹癌

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Recent trends in the prevalence and distribution of colonic diverticula in Japan evaluated using computed tomography colonography

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World Journal of Gastroenterology 2021年第27期27卷 4441-4452页

作者： Noriyuki Isohata Koichi Nagata Kenichi Utano Ryoichi Nozaki Satoshi Nozu Takashi Kato Shigeyoshi kijima hiroshi Matsumoto Kenichiro Majima Yasuji Ryu Michiaki Hirayama Shungo Endo Department of Coloproctology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Fukushima Medical UniversityFukushima 960-1295FukushimaJapan Department of Radiology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Takano HospitalColoproctology CenterKumamoto 862-0971KumamotoJapan Department of Radiology Saitama Cancer CenterIna 362-0806SaitamaJapan Department of Gastroenterology National Hospital Organization Hokkaido Medical CenterSapporo 063-0005HokkaidoJapan Department of Radiology Jichi Medical UniversityShimotsuke 329-0498TochigiJapan Division of Gastroenterology Kawasaki Medical School HospitalKurashiki 701-0192OkayamaJapan Department of Health Management Kameda Medical CenterKamogawa 296-8602ChibaJapan Department of Radiology Tonami General HospitalTonami 939-1395ToyamaJapan Department of Gastroenterology Tonan HospitalSapporo 060-0004HokkaidoJapan

BACKGROUND Computed tomography colonography(CTC)may be superior to colonoscopy and barium enema for detecting ***,few studies have used CTC to diagnose *** To evaluate the current prevalence and distribution of colonic diverticula in Japan using *** This study was conducted as part of the Japanese National Computed Tomographic Colonography Trial,which included 1181 participants from 14 hospitals in *** analyzed the prevalence and distribution of colonic diverticula and their relationships with age and *** relationship between the diverticula and the length of the large intestine was also *** Diverticulosis was present in 48.1%of the *** prevalence of diverticulosis was higher in the older participants(P<0.001 for trend).The diverticula seen in younger participants were predominantly located in the right-sided *** participants had a higher frequency of bilateral type(located in the rightand left-sided colon)diverticulosis(P<0.001 for trend).The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula(P<0.001).CONCLUSION The prevalence of colonic diverticulosis in Japan is higher than that previously *** prevalence was higher,and the distribution tended to be bilateral in older participants.

关键词： Computed tomography colonography Diverticulosis Diverticular disease Colon

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Present status of endoscopic mastectomy for breast cancer

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World Journal of Clinical Oncology 2015年第3期6卷 25-29页

作者： Tetsuhiro Owaki Yuko kijima Heiji Yoshinaka Munetsugu Hirata hiroshi Okumura Simiya Ishigami Yasuhito Nerome Toshiro Takezaki Shoji Natsugoe Community-based Medicine Graduate School of Medical and Dental HealthKagoshima University

Endoscopy is now being used for breast cancer surgery. Though it is used for mastectomy, lymph node dissection, and breast reconstruction, its prime use is for mastectomy. Because an incision can be placed inconspicuously in the axillary site, a relatively largeincision can be created. A retractor with an endoscope, CO2, and an abrasion device with the endoscope are used for operation space security. It is extremely rare that an endoscope is used for lymph node dissection. For breast reconstruction, it may be used for latissimus muscle flap making, but an endoscope is rarely used for other reconstructions. Endoscopic mastectomy is limited to certain institutions and practiced hands, and it has not been significantly developed in breast cancer surgery. On the other hand, endoscopic surgery may be used widely in breast reconstruction. With respect to the spread of robotic surgery, many factors remain uncertain.

关键词： Endoscopy Video-assisted Breast cancer Surgery Mastectomy

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Elasticity of the Coracoacromial Ligament in Shoulders with Rotator Cuff Tears: Measurement with Ultrasound Elastography

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Surgical Science 2013年第9期4卷 1-5页

作者： Hiroaki kijima hiroshi Minagawa Tatsuru Tomioka Shin Yamada Koji Nozaka Hidetomo Saito Yoichi Shimada Department of Orthopedic Surgery Graduate School of Medicine Akita University Akita Japan Department of Orthopedic Surgery Johto Orthopedic Clinic Akita Japan Department of Orthopedic Surgery Yokote Municipal Hospital Yokote Japan

Background: The symptoms of rotator cuff tear vary and may even be absent. Thus, the symptoms cannot be explained solely by the presence of rotator cuff tear, and other factors are thought to be involved. Because the rotator cuff comes in contact with the coracoacromial ligament, the elasticity of the ligament may be a factor of the symptoms. The purpose of this study was to clarify the elasticity of the coracoacromial ligament in live shoulders with rotator cuff tears. Methods: Forty-one shoulders in 24 persons were enrolled in this study. The average age was 52 years old (range, 15 - 84 years old). We investigated the presence of rotator cuff tear and measured the elasticity of the coracoacromial ligament by ultrasound elastography (EUB-7500, HITACHI, Japan). Ultrasound elastography was a useful method to quantify the strain of soft tissue when pressure was added. The strain ratio (the ratio of strain of the coracoacromial ligament to that of the rotator cuff) was used as the index of the elasticity of coracoacromial ligament. Thus, the higher the strain ratio was, the softer the ligament was. Results: The strain ratio of the coracoacromial ligaments without rotator cuff tear showed a negative correlation to the age (r = ﹣0.825, P 0.01). The strain ratio of the ligaments with rotator cuff tear (23.75 ± 15.05, 69.6 years old) was higher than that of the older ligaments without cuff tear (12.62 ± 7.94, 64.6 years old) (P = 0.0486). In shoulders with rotator cuff tear, the strain ratio of the ligaments with pain (14.37 ± 10.15, 66.7 years old) was lower than that of ligaments without pain (33.12 ± 13.59, 69.1 years old) (P = 0.0221). Conclusions: The coracoacromial ligament became stiffened with aging but softened with the existence of rotator cuff tear. The ligaments with symptomatic cuff tear are more stiffened than the ligaments with asymptomatic cuff tear.

关键词： Rotator Cuff Tear Coracoacromial Ligament Pain Ultrasound Elastography

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Oncoplastic Breast Surgery Using Spindle Shaped-Partial Mastectomy for Early Breast Cancer in the Upper Quadrant Area

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Modern Plastic Surgery 2013年第2期3卷 57-64页

作者： Yuko kijima Heiji Yoshinaka Munetsugu Hirata Yoshiaki Shinden Sumiya Ishigami Akihiro Nakajo Hideo Arima Takaaki Arigami hiroshi Okumura Shoji Natsugoe Department of Digestive Surgery Breast and Thyroid Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan.

Background: Oncoplastic surgery is becoming more common, however, only several reports have been published in Japan. We report the results of simple oncoplastic surgery for Japanese patients with early breast cancer in the upper quadrant area. Methods: In seven patients with a past history of breast-feeding and ptotic breasts, we performed oncoplastic surgery involving partial mastectomy and the resection of excess skin and parenchymal tissue. Results: None of the patients received a contralateral operation to produce symmetrical breasts. The width of the resected excess skin tissue ranged from 20 to 50 mm, with the mean width being 30 mm, and its length ranged from 50 to 90, with the mean length being 77 mm. The width of the resected gland tissue ranged from 40 to 65 mm, with the mean width being 53 mm, and its length ranged from 70 to 100 mm, with the mean length being 97 mm. The cosmetic results were excellent. Conclusions: Oncoplastic surgery using spindle shaped-resection was successfully performed in patients with upper quadrant lesions, and the cosmetic results were excellent.

关键词： Breast Cancer Spindle-Shaped Resection Breast-Conserving Surgery Oncoplastic Surgery Reduction Mammoplasty

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Clinical Outcomes of Patients Who Perform High-Load Activities after Total Hip Arthroplasty in Snowy Agricultural Areas

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Surgical Science 2018年第8期9卷 248-255页

作者： Tetsuya Kawano Hiroaki kijima Toshiaki Aizawa Shin Yamada Natsuo Konishi Hitoshi Kubota hiroshi Tazawa Takayuki Tani Norio Suzuki Keiji Kamo Yoshihiko Okudera Ken Sasaki Masashi Fujii Yosuke Iwamoto Itsuki Nagahata Takanori Miura Naohisa Miyakoshi Yoichi Shimada Department of Orthopedic Surgery Kita-Akita Municipal Hospital Akita Japan Akita Hip Research Group Akita Japan Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan

Background: In snowy agricultural areas, weeding and snow shoveling are essential activities, and sports activities are common recreational activities. Clarifying the relationships between the degrees of these activities after total hip arthroplasty (THA) and the clinical outcomes may enable us to predict the results of THA for high-load activity patients. Methods: The subjects were 227 post-THA patients who were followed up between 2012 and 2014. Patient-reported outcomes were investigated by the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) and a questionnaire on postoperative activity. In addition, the Japanese Orthopaedic Association Hip Score (JOA score) was used to quantify hip function. Results: Patients who resumed activities had significantly higher JOA and JHEQ scores than patients who had given up their activities. However, 25.8% of patients had not resumed weeding with a squatting posture. Furthermore, 20% had not resumed sports activities. The most common reason for giving up these activities was fear of implant failure. Conclusions: If the patients were informed that there is no problem restarting their activities after THA, the patients could resume activities and their clinical outcomes may be improved.

关键词： Total Hip Arthroplasty Postoperative Activities Weeding Snow Shoveling

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