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Successful endoscopic closure of a colonic perforation one day after endoscopic mucosal resection of a lesion in the transverse colon

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World Journal of Clinical Cases 2016年第8期4卷 238-242页

作者： Kazuya Inoki taku sakamoto Masau Sekiguchi Masayoshi Yamada Takeshi Nakajima Takahisa Matsuda Yutaka Saito Endoscopy Division National Cancer Center HospitalTokyo Cancer Screening Division Research Center for Cancer Prevention and Screening National Cancer Center HospitalTokyo

A 73-year-old man underwent endoscopic mucosal resection(EMR) of a 20-mm flat elevated lesion on the transverse colon. The morning after the procedure, he started to have severe right upper quadrant pain after his first meal. A computed tomography scan revealed free air and a stomach filled with food. He was diagnosed to have delayed post-EMR intestinal perforation. He underwent emergent colonoscopy and clipping of the perforated site. He was discharged 8 d after the endoscopic closure without the need for surgical intervention. The meal was not the cause of the colon transversum perforation.

关键词： Colonoscopy Colorectal tumors Endoscopic surgical procedure Emergencies Intestinal perforation

Endoscopic reduction of colocolonic intussusception due to metastatic malignant melanoma:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5816-5820页

作者： Kengo Kasuga taku sakamoto Hiroyuki Takamaru Masau Sekiguchi Masayoshi Yamada Naoya Yamazaki Taiki Hashimoto Toshio Uraoka Yutaka Saito Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Cancer Screening Center National Cancer Center HospitalTokyo 104-0045Japan Department of Dermatologic Oncology National Cancer Center HospitalTokyo 104-0045Japan Division of Diagnostic Pathology National Cancer Center HospitalTokyo 104-0045Japan Department of Gastroenterology and Hepatology Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan

BACKGROUND Intussusception rarely causes intestinal obstruction in *** malignant melanoma is the main cause of intussusception of the small intestine among ***,malignant melanoma rarely causes intussusception of the ***,emergent surgery is usually performed for such ***,we report a case of a patient with colocolonic intussusception caused by a malignant melanoma,for which endoscopic reduction and elective surgery were *** SUMMARY The patient was a 64-year-old woman who underwent multiple surgeries and received chemotherapy and immunotherapy for a malignant *** immunotherapy,she had abdominal pain,diarrhea,and bloody *** examination and laboratory studies did not reveal any findings that warranted emergent *** tomography revealed intussusception in the descending colon without intestinal necrosis and *** was reduced endoscopically,and elective surgery was *** This report suggests that endoscopic reduction and elective surgery constitute a treatment option for colocolonic intussusception of metastatic malignant melanomas.

关键词： Metastatic malignant melanoma Intussusception Colon Nonsurgical management Endoscopic reduction Case report

Endoscopic submucosal dissection for colorectal neoplasms:A review

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World Journal of Gastroenterology 2014年第43期20卷 16153-16158页

作者： taku sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima Takahisa Matsuda Yutaka Saito Endoscopy Division National Cancer Center Hospital

The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their *** has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal ***,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically ***,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal *** the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of *** diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated *** review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure.

关键词： Colorectum Endoscopic submucosal dissection Short-term outcomes Training indication for endoscopic treatment

Condyloma acuminatum of the anal canal,treated with endoscopic submucosal dissection

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World Journal of Gastroenterology 2016年第8期22卷 2636-2641页

作者： Akiko Sasaki Takeshi Nakajima Hideto Egashira Kotaro Takeda Shinnosuke Tokoro Chikamasa Ichita Sakue Masuda Haruki Uojima Kazuya Koizumi Takeshi Kinbara taku sakamoto Yutaka Saito Makoto Kako Gastroenterology Medicine Center Shonan Kamakura General Hospital 1370-1 Okamoto Kamakura Endoscopy Division National Cancer Center Hospital5-1-1 Tsukiji Chuoku Diagnostic Pathology Shonan Kamakura General Hospital 1370-1 Okamoto Kamakura

Condyloma acuminatum(CA) is a common sexually transmitted disease caused by human papilloma virus infection. Not all individuals develop persistent, progressive disease, but careful follow up is required with moderate-to-severe dysplasia to prevent progression to malignancy. Standard therapies include surgical treatments(trans-anal resection and transanal endoscopic microsurgery) and immunotherapeutic and topical methods(topical imiquimod); however, local recurrence remains a considerable problem. Here, we report a case with superficial CA of the anal canal, treated with endoscopic submucosal dissection(ESD). A 28-year-old man presented with a chief complaint of hematochezia. Digital exam did not detect a tumor. Screening colonoscopy revealed 10-mm long, whitish condyles extending from the anal canal to the lower rectum. The lesion covered almost the whole circumference, and only a small amount of normal mucosa remained. Magnifying endoscopy with narrow band imaging showed brownish hairpin-shaped, coiled capillaries. Although histopathological diagnosis by biopsy revealed CA, accurate histological differentiation between CA, papilloma, and squamous cell carcinoma can be difficult with a small specimen. Therefore, weperformed diagnostic ESD, which provides a complete specimen for precise histopathological evaluation. The pathological diagnosis was CA, with moderate dysplasia(anal intraepithelial neoplasia 2). There was no recurrence at 16 mo after the initial ESD. Compared to surgical treatment, endoscopic diagnosis and resection could be performed simultaneously and the tumor margin observed clearly with a magnifying chromocolonoscopy, resulting in less recurrence. These findings suggest that endoscopic resection may be an alternative method for CA that prevents recurrence.

关键词： Condylomata acuminate Recurrence Endoscopy Dissection Carcinoma in situ

Endoscopic submucosal dissection for large laterally spreading tumors involving the ileocecal valve and terminal ileum

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World Journal of Gastroenterology 2012年第3期18卷 291-294页

作者： Gustavo Kishimoto Yutaka Saito Hajime Takisawa Haruhisa Suzuki taku sakamoto Takeshi Nakajima Takahisa Matsuda National Cancer Center Hospital Endoscopy Division 5-1-1 Tsukiji Chuo-ku Tokyo 104-0045 Japan

Endoscopic submucosal dissection is a challenging technique that enables en-bloc resection for large colorectal tumors, as laterally spreading tumors, particularly difficult, if the ileocecal valve and terminal ileum is involved. Herein, we report on one of 4 cases. The procedures, using a bipolar needle knife (B-Knife) to reduce the perforation risk and carbon dioxide instead of conventional air insufflation for patient comfort, achieved curative resections without any complications.

关键词： Ileocecal valve Colorectal neoplasms Lat- erally spreading tumor Endoscopic mucosal resection Endoscopic submucosal dissection Bipolar current needle knife B-Knife IT-Knife

Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection

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World Journal of Gastroenterology 2012年第28期18卷 3721-3726页

作者： Takaya Aoki Takeshi Nakajima Yutaka Saito Takahisa Matsuda taku sakamoto Takao Itoi Yassir Khiyar Fuminori Moriyasu Endoscopy Division National Cancer Center Hospital Tokyo 104-0045 Japan Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo 160-0023 Japan

AIM: To determine the effective hospitalization period as the clinical pathway to prepare patients for endoscopic submucosal dissection (ESD). METHODS: This is a retrospective observational study which included 189 patients consecutively treated by ESD at the National Cancer Center Hospital from May 2007 to March 2009. Patients were divided into 2 groups; patients in group A were discharged in 5 d and patients in group B included those who stayed longer than 5 d. The following data were collected for both groups: mean hospitalization period, tumor site, median tumor size, post-ESD rectal bleeding requiring urgent endoscopy, perforation during or after ESD, abdominal pain, fever above 38 ℃, and blood test results positive for inflammatory markers before and after ESD. Each parameter was compared after data collection. RESULTS: A total of 83% (156/189) of all patients could be discharged from the hospital on day 3 postESD. Complications were observed in 12.1% (23/189) of patients. Perforation occurred in 3.7% (7/189) of patients. All the perforations occurred during the ESD procedure and they were managed with endoscopic clipping. The incidence of post-operative bleeding was 2.6% (5/189); all the cases involved rectal bleeding. We divided the subjects into 2 groups: tumor diameter ≥ 4 cm and < 4 cm; there was no significant difference between the 2 groups (P = 0.93, χ 2 test with Yates correction). The incidence of abdominal pain was 3.7% (7/189). All the cases occurred on the day of the procedure or the next day. The median white blood cell count was 6800 ± 2280 (cells/μL; ± SD) for group A, and 7700 ± 2775 (cells/μL; ± SD) for group B, showing a statistically significant difference (P = 0.023, t-test). The mean C-reactive protein values the day after ESD were 0.4 ± 1.3 mg/dL and 0.5 ± 1.3 mg/dL for groups A and B, respectively, with no significant difference between the 2 groups (P = 0.54, t -test). CONCLUSION: One-day admission is sufficient in the absence of compl

关键词： Clinical pathway Colon Complication Endoscopic submucosal dissection Hospitalization period Rectum

Prospect of lenvatinib for unresectable hepatocellular carcinoma in the new era of systemic chemotherapy

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 2076-2087页

作者： takuya Sho Kenichi Morikawa Akinori Kubo Yoshimasa Tokuchi Takashi Kitagataya Ren Yamada taku Shigesawa Mugumi Kimura Masato Nakai Goki Suda Mitsuteru Natsuizaka Koji Ogawa Naoya sakamoto Department of Gastroenterology and Hepatology Hokkaido University Faculty of Medicine and Graduate School of MedicineSapporo 060-8638HokkaidoJapan

The phase III clinical trial of the novel molecular targeted agent(MTA)lenvatinib for patients with advanced hepatocellular carcinoma(HCC)(REFLECT trial)found that lenvatinib was non-inferior to sorafenib in overall ***,the efficacy of multiple MTAs,including lenvatinib,in practice has been reported,and therapeutic strategies for Barcelona Clinic Liver Cancer(BCLC)intermediate stage HCC are undergoing major *** on these results,lenvatinib could be recommended for patients with transcatheter arterial chemoembolization(TACE)-refractory,ALBI grade 1,within the up-to-seven criteria in the BCLC intermediate *** provides a more favorable outcome than TACE,even in cases with large or multinodular HCC beyond the up-to-seven criteria with Child-Pugh grade *** patients meet the definitions of TACE-refractory or TACE-unsuitable,switching to systemic chemotherapy,including lenvatinib,is for favorable for preserving liver *** initial treatment,including MTA,has a significant therapeutic effect and downstaging of HCC is obtained,additional TACE or surgical resection should be *** also has a therapeutic effect for poorly differentiated type and non-simple nodular type HCC thanks to the survival-prolonging effect of this ***,a significant therapeutic effect is expected in tumors with more than 50%liver involvement or main portal vein invasion,which have traditionally been considered to have a poor prognosis in *** suggests that at the start of lenvatinib treatment,HCC patients with ALBI grade 1 may be able to maintain liver functional reserve.

关键词： Hepatocellular carcinoma Lenvatinib Molecular targeted agent TACE refractory TACE-unsuitable Barcelona Clinic Liver Cancer intermediate stage

Examination of Screening of the Pachinko/Pachislot Playing Disorder Based on Gambling Disorder Scales

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Open Journal of Psychiatry 2018年第3期8卷 315-327页

作者： Akiyo Shoun Akira sakamoto Kumiko Akiyama Yasunobu Komoto taku Sato Naoyuki Nishimura Kikunori Shinohara Hitoshi Ishida Nobuo Makino Graduate School of Humanities and Sciences Ochanomizu University Tokyo Japan Faculty of Core Research Human Science Division Ochanomizu University Tokyo Japan The Nikkoso Research Foundation for Safe Society Tokyo Japan Yoshino Hospital Tokyo Japan Naruse Mental Clinic Tokyo Japan Recovery Support Network Okinawa Japan Tokyo University of Science SUWA Nagano Japan Japan Women’s University Tokyo Japan

Pachinko and pachislot are unique forms of entertainment that dominate gambling activities in Japan. In this study, a web survey and interview were conducted in order to adjust three scales (DSM-5, SOGS, and PGSI) to pachinko/pachislot and explore an appropriate cutoff point for each of them. Using the assessment result in the interview as the outcome, the ROC curve of each scale was examined. The cutoff points were 4, 7, and 8 and the area under the curves (AUC) were 0.730, 0.783, and 0.724 for the DSM-5, SOGS, and PGSI, respectively. The study found that the type and situation of gambling influenced cutoff points in different ways depending on the questions asked in the scale.

关键词： Gambling Disorder Pachinko/Pachislot Playing Disorder ROC Curve Cutoff Point

Perceptions of post-transplant recidivism in liver transplantation for alcoholic liver disease

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World Journal of Hepatology 2014年第11期6卷 812-817页

作者： Yoshikuni Kawaguchi Yasuhiko Sugawara Nobuhisa Akamatsu Junichi Kaneko Tomohiro Tanaka Sumihito Tamura taku Aoki Yoshihiro sakamoto Kiyoshi Hasegawa Norihiro Kokudo Artificial Organ and Transplantation Surgery Division Department of Surgery Graduate School of Medicine University of Tokyo Organ Transplantation Service University of Tokyo

Although alcoholic liver disease(ALD) is regarded as a common indication for liver transplantation(LT), debatable issues exist on the requirement for preceding alcoholic abstinence, appropriate indication criteria, predictive factors for alcoholic recidivism, and outcomes following living-donor LT. In most institutions, an abstinence period of six months before LT has been adopted as a mandatory selection criterion. Data indicating that pre-transplant abstinence is an associated predictive factor for alcoholic recidivism supports the reasoning behind this. However, conclusive evidence about the benefit of adopting an abstinence period is yet to be established. On the other hand, a limited number of reports available on living-donor LT experiences for ALD patients suggest that organ donations from relatives have no suppressive effect on alcoholic recidivism. Prevention of alcoholic recidivism has proved to be the most important treatment after LT based on the resultant inferior long-term outcome of patients. Further evaluations are still needed to establish strategies before and after LT for ALD.

关键词： Abstinence Alcoholic liver disease Liver transplantation Six-month rule