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Indirect inguinal hernia containing portosystemic shunt vessel: A case report

World Journal of Clinical Cases 2021年第2期9卷 509-515页

作者： Masahiro Yura Kikuo Yo Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko hiroto fujisaki AkiraHirata Kiminori Takano Kumiko Hongo Kimiyasu Yoneyama Motohito Nakagawa Department of Surgery Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan

BACKGROUND Inguinal hernia repair is one of the most common general surgical operations *** present a case of indirect inguinal hernia containing an expanded portosystemic shunt *** SUMMARY We report a 72-year-old man who had a 4 cm×4 cm swelling in the right inguinal region,which disappeared with light manual ***-pelvic computed tomography(CT)revealed a right inguinal hernia containing an expanded portosystemic shunt vessel,which had been noted for 7 years due to liver *** performed Lichtenstein’s herniorrhaphy and identified the hernia sac as being indirect and the shunt vessel existing in the extraperitoneal cavity through the internal inguinal ***,we found two short branches between the expanded shunt vessel and testicular vein in the middle part of the inguinal canal and cut these branches to allow the shunt vessel to return to the extraperitoneal cavity of the *** hernia sac was returned as *** encountered no intraoperative *** discharge,groin seroma requiring puncture at the outpatient clinic was *** If an inguinal hernia patient has portal hypertension,ultrasound should be used to determine the contents of the *** atypical vessels are visualized,they may be shunt vessels and additional CT is recommended to ensure the selection of an adequate approach for safe hernia repair.

关键词： Inguinal hernia Lichtenstein’s herniorrhaphy Portosystemic shunt Portal hypertension Shunt vessel Case report

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Unresectable esophageal cancer treated with multiple chemotherapies in combination with chemoradiotherapy:A case report

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World Journal of Clinical Cases 2021年第12期9卷 2801-2810页

作者： Masahiro Yura Kazuo Koyanagi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko hiroto fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Yoshifumi Tamai Reiko Dehari Motohito Nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Radiology Hiratsuka City HospitalKanagawa 2540065Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Definitive chemoradiotherapy(dCRT)using cisplatin plus 5fluorouracil(CF)with radiation is considered the standard treatment for unresectable locally advanced T4 esophageal squamous cell carcinoma(ESCC).Recently,induction chemotherapy has received attention as an effective treatment *** SUMMARY We report a successful case of a 59-year-old female with unresectable locally advanced T4 ESCC treated by two additional courses of chemotherapy with CF after induction chemotherapy with docetaxel,cisplatin and fluorouracil(DCF)followed by *** esophagogastroduodenoscopy(EGD)detected a type 2 advanced lesion located on the middle part of the esophagus,with *** tomography detected the primary tumor with suspected invasion of the left bronchus and 90°of direct contact with the aorta,and upper mediastinal lymph node *** findings from biopsy revealed squamous cell *** initially performed induction chemotherapy using three courses of DCF,but the lesion was still evaluated unresectable after DCF ***,we subsequently performed dCRT treatment(CF and radiation).After dCRT,prominent reduction of the primary tumor was recognized but a residual tumor with ulceration was detected by *** the patient had some surgical risk,we performed two additional courses of CF and achieved a clinically complete *** 14 mo from last administration of CF chemotherapy,recurrence has not been detected by computed tomography and EGD,and biopsy from the scar formation has revealed no cancer *** We report successful case with tumor remnants even after DCF and subsequent dCRT,for whom a complete response was finally achieved with two additional courses of CF *** CF chemotherapy could be one radical treatment option for residual ESCC after treatment with induction DCF followed by dCRT to avoid salvage surgery,especially for high-risk patients.

关键词： Unresectable esophageal cancer Induction docetaxel,cisplatin and fluorouracil Chemoradiotherapy Complete response Additional chemotherapy Case report

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Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head:A case report

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World Journal of Gastroenterology 2021年第6期27卷 534-544页

作者： Masahiro Yura Kiminori Takano Kiyohiko Adachi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Yoichiro Ikoma hiroto fujisaki Akira Hirata Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Reiko Dehari Kazuo Koyanagi Motohito Nakagawa Department of Surgery Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Surgical Pathology Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 259193KanagawaJapan

BACKGROUND Pancreaticoduodenectomy(PD)for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival ***,neoadjuvant chemotherapy for advanced gastric cancer has improved,and chemotherapy combined with trastuzumab may have a preoperative tumorreducing effect,especially for human epidermal growth factor receptor 2(HER2)-positive *** SUMMARY We report a case of successful radical resection with PD after neoadjuvant S-1 plus oxaliplatin(SOX)and trastuzumab in a patient(66-year-old male)with advanced gastric cancer invading the pancreatic *** esophagogastroduodenoscopy detected a type 3 advanced lesion located on the lower part of the stomach obstructing the pyloric *** tomography detected lymph node metastasis and tumor invasion to the pancreatic head without distant *** findings revealed adenocarcinoma and HER2 positivity(immunohistochemical score of 3+).We performed staging laparoscopy and confirmed no liver metastasis,no dissemination,negative lavage cytological findings,and immobility of the distal side of the stomach due to invasion to the *** gastrojejunostomy was performed at that *** course of SOX and three courses of SOX plus trastuzumab were *** computed tomography showed partial response;therefore,PD was performed after neoadjuvant chemotherapy,and pathological radical resection was *** We suggest that radical resection with PD after neoadjuvant chemotherapy plus trastuzumab is an option for locally advanced HER2-positive gastric cancer invading the pancreatic head in the absence of non-curative factors.

关键词： Pancreaticoduodenectomy Gastric cancer Neoadjuvant chemotherapy Trastuzumab Human epidermal growth factor receptor 2 Case report

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Distal gastric tube resection with vascular preservation for gastric tube cancer:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2020年第9期12卷 397-406页

作者： Masahiro Yura Kazuo Koyanagi Kiyohiko Adachi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko hiroto fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Reiko Dehari Motohito Nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also *** resection of the gastric tube with lymph node dissection is considered a radical treatment,but GTC surgery is more invasive and involves a higher risk of severe complications or death,particularly in elderly *** SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y(R-Y)*** tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric *** submucosal resection was not indicated because the primary lesion was submucosally invasive,was undifferentiated type,surrounded the pyloric ring,and had invaded the *** of distal gastric tube with R-Y reconstruction was safely performed,with preservation of the right gastroepiploic artery(RGEA)and right gastric artery(RGA).CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.

关键词： Gastric tube cancer Distal resection Preservation of right gastroepiploic artery and right gastric artery Elderly patients Duodenal invasion Case report Posterior mediastinal reconstruction

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