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Current status of function-preserving surgery for gastric cancer

World Journal of Gastroenterology 2014年第46期20卷 17297-17304页

作者： takuro saito Yukinori Kurokawa Shuji Takiguchi Masaki Mori Yuichiro Doki Department of Gastroenterological Surgery Osaka University Graduate School of MedicineOsaka 565-0871Japan

Recent advances in diagnostic techniques have allowed the diagnosis of gastric cancer(GC)at an early *** to the low incidence of lymph node metastasis and favorable prognosis in early GC,function-preserving surgery which improves postoperative quality of life may be ***-preserving gastrectomy(PPG)is one such function-preserving procedure,which is expected to offer advantages with regards to dumping syndrome,bile reflux gastritis,and the frequency of flatus,although PPG may induce delayed gastric *** gastrectomy(PG)is another functionpreserving procedure,which is thought to be advantageous in terms of decreased duodenogastric reflux and good food reservoir function in the remnant stomach,although the incidence of heartburn or gastric fullness associated with this procedure is ***,these disadvantages may be overcome by the reconstruction method *** other important problem after PG is remnant GC,which was reported to occur in approximately 5%of ***,the reconstruction technique used with PG should facilitate postoperativeendoscopic examinations for early detection and treatment of remnant gastric *** safety seems to be assured in both procedures,if the preoperative diagnosis is *** selection should be carefully *** many retrospective studies have demonstrated the utility of function-preserving surgery,no consensus on whether to adopt functionpreserving surgery as the standard of care has been *** prospective randomized controlled trials are necessary to evaluate survival and postoperative quality of life associated with function-preserving surgery.

关键词： Gastric cancer Function preserving surgery Quality of life Pylorus preserving surgery Proximal gastrectomy

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Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman

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World Journal of Gastroenterology 2008年第1期14卷 129-131页

作者： Atsushi Takahashi Hironobu saito Yukiko Kanno Kazumichi Abe Junko Yokokawa Atsushi Irisawa Akira Kenjo takuro saito Mitsukazu Gotoh Hiromasa Ohira Department of Internal Medicine Ⅱ Fukushima Medical University School of Medicine 1 Hikarigaoka Fukushima 960-1295 Japan Department of Surgery Ⅰ Fukushima Medical University School of Medicine 1 Hikarigaoka Fukushima 960-1295 Japan

A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.

关键词： Clear-cell hepatocellular carcinoma Liver Middle-aged

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