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World Journal of Gastroenterology 2017年第1期23卷 167-172页

作者： Atsushi Kohga Akihiro Kawabe Yuto Hasegawa Kiyoshige Yajima Takuya Okumura kimihiro yamashita Jun Isogaki Kenji Suzuki Akira Komiyama Division of Surgery Fujinomiya City General Hospital Division of Pathology Fujinomiya City General Hospital

Intraabdominal lymphangiomas are uncommon;additionally,those affecting the gastrointestinal tract are rare and account for less than 1%of *** caused by a cystic lymphangioma of the small bowel is extremely *** patient was a20-year-old woman who visited our emergency room with a complaint of abdominal pain.A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a ***-incision laparoscopic-assisted ileal resection was *** surgical specimen consisted of a soft polycystic ***,a pedunculated polyp with a convolutional pattern was ***,the inner surfaces of the cysts were covered with a single layer of endothelial *** immunohistochemical examination,the endothelial cells were partially positive for D2-40 and *** muscle cells were also found around the *** lesion was diagnosed as a cystic *** of cases of small bowel lymphangiomas have previously been *** these,cases with intussusception were very *** is the first case of small bowel intussusception due to lymphangioma treated by singleincision laparoscopic-assisted surgery.

关键词：摄取单个切口的帮助 laparoscopic 的外科淋巴管瘤

Local advanced rectal cancer perforation in the midst of preoperative chemoradiotherapy:A case report and literature review

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World Journal of Clinical Cases 2017年第1期5卷 18-23页

作者： Nobuhisa Takase kimihiro yamashita Yasuo Sumi Hiroshi Hasegawa Masashi Yamamoto Shingo Kanaji Yoshiko Matsuda Takeru Matsuda Taro Oshikiri Tetsu Nakamura Satoshi Suzuki Yu-Ichiro Koma Masato Komatsu Ryohei Sasaki Yoshihiro Kakeji Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine Division of Pathology Department of Pathology Kobe University Graduate School of Medicine Division of Diagnostic Pathology Department of Pathology Kobe University Graduate School of Medicine Department of Surgery Hyogo Cancer Center Department of Radiation Oncology Kobe University Graduate School of Medicine

Standard chemoradiotherapy(CRT) for local advanced rectal cancer(LARC) rarely induce rectal perforation. Here we report a rare case of rectal perforation in a patient with LARC in the midst of preoperative CRT. A 56-year-old male was conveyed to our hospital exhibiting general malaise. Colonoscopy and imaging tests resulted in a clinical diagnosis of LARC with direct invasion to adjacent organs and regional lymphadenopathy. Preoperative 5-fluorouracil-based CRT was started. At 25 d after the start of CRT, the patient developed a typical fever. Computed tomography revealed rectal perforation, and he underwent emergency sigmoid colostomy. At 12 d after the surgery, the remaining CRT was completed according to the original plan. The histopathological findings after radical operation revealed a wide field of tumor necrosis and fibrosis without lymph node metastasis. We share this case as important evidence for the treatment of LARC perforation in the midst of preoperative CRT.

关键词： Local advanced rectal cancer Preoperative chemoradiotherapy Rectal perforation 5-fluorouracil Tumor necrosis

Effects of Subcutaneous Closed Suction Drain for the Prevention of Incisional SSI in Patients with Colorectal Perforation

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Surgical Science 2014年第3期5卷 122-127页

作者： Yasuo Sumi kimihiro yamashita Kiyonori Kanemitsu Shingo Kanaji Masashi Yamamoto Tatsuya Imanishi Tetsu Nakamura Satoshi Suzuki Kenichi Tanaka Yoshihiro Kakeji Division of Gastrointestinal Surgery department of SURGERY Kobe University Graduate School of Medicine Kobe Japan

Objective: To determine if a subcutaneous closed suction drain decreases the incidence of wound complications in patients undergoing emergency surgery for colorectal perforation. Materials and Methods: Data on 47 patients who underwent emergency operations for colorectal perforation were examined retrospectively. The clinical features of these cases with or without the use of the J-VACTM Drainage System were examined, and statistical analysis was performed. Results: In these high-risk cases, the overall incidence of incisional surgical site infection (SSI) was 36.2%. The incidence of incisional SSI in these cases with and without the J-VACTM Drainage System was 16.7% and 56.5%, respectively. Conclusion: Our results suggest that a subcutaneous closed suction drain is effective for preventing incisional SSI in patients who have undergone emergency operations for colorectal perforation.

关键词： Surgical Wound Infection Intestinal Perforation Closed Suction Drainage Emergency Operation

Appendicitis with psoas abscess successfully treated by laparoscopic surgery

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World Journal of Gastroenterology 2014年第25期20卷 8317-8319页

作者： Yasunori Otowa Yasuo Sumi Shingo Kanaji Kiyonori Kanemitsu kimihiro yamashita Tatsuya Imanishi Tetsu Nakamura Satoshi Suzuki Kenichi Tanaka Yoshihiro Kakeji Division of Gastrointestinal Surgery Department of SurgeryKobe University Graduate School of Medicine 7-5-2 Kusunokichou Chuo-ku Kobe Hyogo Prefecture 650-0017 Japan Division of Gastrointestinal Surgery Department of SurgeryKobe University Graduate School of Medicine7-5-2 KusunokichouChuo-ku KobeHyogo Prefecture 650-0017Japan

Although acute appendicitis is a common disease, retroperitoneal abscesses are rarely observed. Here, we report a case consisting of a psoas abscess and cutaneous fistula caused by appendicitis. The patient was a 56-year-old male who was introduced to our institution due to an intractable right psoas abscess. Imaging tests had been performed over the previous 3 years; however, clinicians could not find the origin of the abscess and failed to resolve the problem. A successful operation was performed via a laparoscopic approach, and 17 mo have passed without recurrence. The advantage of laparoscopic surgery is well understood in cases of appendicitis with abscesses. However, the indication for laparoscopic approach is not clear for retroperitoneal abscesses. From our experience, we can conclude that appendicitis with retroperitonealabscesses can be managed and treated using a laparoscopic approach.

关键词： Appendicitis Laparoscopic surgery Psoas abscess Re