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Outcomes of endoscopic endonasal dacryocysto-rhinostomy for intractable lacrimal dacryostenosis and associated factors

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International Journal of Ophthalmology(English edition) 2016年第10期9卷 1471-1475页

作者： Tohru Tanigawa Hirokazu Sasaki Hiroshi Nonoyama Yuichiro Horibe Kunihiro Nishimura tetsuro hoshino Tetsuya Ogawa Kenta Murotani Hiromi Ueda Masahiro Kaneda Department of Otolaryngology Aichi Medical University Department of Otolaryngology Tono Kosei Hospital Division of Biostatistics Clinical Research CenterAichi Medical University Department of Ophthalmology Tono Kosei Hospital

AIM：To examine the effects of patient age,canalicular obstruction,mode of anesthesia,and duration of nasolacrimal intubation on the outcomes of endoscopic endonasal dacryocystorhinostomy（DCR）. METHODS： Totally 56 eyes of 46 patients with prolonged epiphora underwent minimally invasive endoscopic endonasal DCR.A successful surgical outcome was defined as a significant improvement in symptoms,adequate water passage from the puncta to the nasal cavity,and patency of the DCR *** outcomes were assessed at least 6mo after ***＇s exact test was used to discuss the factors,and then the logistic regression analysis was made by SAS9.4 ***： The overall success rate was 75.0%,and complete resolution was observed in 27 *** success rate was higher for patients with ≥6mo intubation than for those with 〈6mo ***,there were no significant differences in outcomes between groups stratified by age（〈65 or ≥65y）,presence or absence of canalicular obstruction,mode of anesthesia（local or general）,and use or nonuse of a radiowave *** patient developed subcutaneous emphysema around the eye and nose and one developed subcutaneous hemorrhage after surgery. CONCLUSION： Endoscopic endonasal DCR can be considered safe and minimally invasive with reasonable success rates,particularly when the duration of nasolacrimal intubation is ≥6mo.

关键词： dacryocystorhinostomy endoscopy,, intubation epiphora

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Successful resection of metachronous para-aortic, Virchow lymph node and liver metastatic recurrence of rectal cancer

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World Journal of Gastroenterology 2015年第44期21卷 12722-12728页

作者： Nobuyoshi Takeshita Toru Fukunaga Masayuki Kimura Yuji Sugamoto Kentaro Tasaki Isamu hoshino Takumi Ota tetsuro Maruyama Tomohide Tamachi Takashi Hosokawa Yo Asai Hisahiro Matsubara Department of Surgery Numazu City Hospital Department of Frontier Surgery Chiba University Graduate School of Medicine

A 66-year-old female presented with the main complaint of defecation trouble and abdominal distention. With diagnosis of rectal cancer, c SS, c N0, c H0, c P0, c M0 c Stage Ⅱ, Hartmann's operation with D3 lymph node dissection was performed and a para-aortic lymph node and a disseminated node near the primary tumor were resected. Histological examination showed moderately differentiated adenocarcinoma, p SS, p N3, p H0, p P1, p M1(para-aortic lymph node, dissemination) f Stage Ⅳ. After the operation, the patient received chemotherapy with FOLFIRI regimen. After 12 cycles of FOLFIRI regimen, computed tomography(CT) detected an 11 mm of liver metastasis in the posteroinferior segment of right hepatic lobe. With diagnosis of liver metastatic recurrence, we performed partial hepatectomy. Histological examination revealed moderately differentiated adenocarcinoma as a metastatic rectal cancer with cut end microscopically positive. After the second operation, the patient received chemotherapy with TS1 alone for 2 years. Ten months after the break, CT detected a 20 mm of paraaortic lymph node metastasis and a 10 mm of lymph node metastasis at the hepato-duodenal ligament. With diagnosis of lymph node metastatic recurrences, we performed lymph node dissection. Histological examination revealed moderately differentiated adenocarcinoma as metastatic rectal cancer in paraaortic and hepato-duodenal ligament areas. After the third operation, we started chemotherapy with modified FOLFOX6 regimen. After 2 cycles of modified FOLFOX6 regimen, due to the onset of neutropenia and liver dysfunction, we switched to capecitabine aloneand continued it for 6 mo and then stopped. Eleven months after the break, CT detected two swelling 12 mm of lymph nodes at the left supraclavicular region. With diagnosis of Virchow lymph node metastatic recurrence, we started chemotherapy with capecitabine plus bevacizumab regimen. Due to the onset of neutropenia and hand foot syndrome(Grade 3), we managed

关键词： Rectal cancer Surgical resection Virchow lymph nod

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