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World Journal of Pediatric Surgery 2019年第1期2卷 21-23页

作者： Tatsuma Sakaguchi yoshinori hamada Takeshi Shirai Hiroshi hamada Yusuke Shigeta Yusuke Nakamura Takashi Doi Department of Surgery Kansai Medical UniversityOsakaJapan

background We previously reported a pilot study of temporary umbilical loop colostomy for neonates with intermediate-type anorectal malformations(ARM)and recommended this technique because of its cosmetic *** herein report the postoperative complications of umbilical stomas(US)compared with traditional abdominal stomas(AS).Methods From our institutional prospective database,we analyzed the patients with ARMs who underwent stoma creation at Kansai Medical University Hospital from January 1995 to November *** surgical technique used to create the US had been performed since *** US and AS were made for 12 and 27 patients with ARMs,*** postoperative complication rates in patients who underwent US and AS had no significant difference(17%and 11%,p=0.6).The complications comprised a wound infection(one case of US),ileus(one case each of US and AS),mucosal prolapse(one case of AS),and depression(one case of AS).No emergency surgery was required for these *** For patients with ARMs,the umbilicus appears to be a safe alternative site for temporary loop colostomy.

关键词： complications abdominal wound

Efficacy of long-term rifaximin treatment for hepatic encephalopathy in the Japanese

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World Journal of Hepatology 2019年第6期11卷 531-541页

作者： Shinya Nishida Koichi hamada Noriyuki Nishino Daizo Fukushima Ryota Koyanagi yoshinori Horikawa Yoshiki Shiwa Satoshi Saitoh Department of Gastroenterology Shin-Yurigaoka General HospitalKawasaki 215-0026Japan Department of Gastroenterology Southern-Tohoku General HospitalKoriyama 963-8563Japan Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical UniversityFukushima 960-1295Japan Department of Hepatology Toranomon HospitalTokyo 105-8470Japan

BACKGROUND Hepatic encephalopathy(HE)is a complication of liver cirrhosis and can result in neuropsychological and neuromuscular dysfunctions in ***,an antibiotic,has been reported to decrease the occurrence of overt HE and also improve cognitive function in studies from Europe and the United States of *** is not enough evidence of the relationship between the long-term use of rifaximin and its clinical effects in the *** To determine the clinical effects of long-term rifaximin therapy in decompensated liver cirrhosis patients,with overt HE or *** In this single-center retrospective observational cohort study,we reviewed the data of 38 patients who had taken rifaximin at the dose of 1200 mg/d for more than 24 *** primary outcome measured was the efficacy of long-term rifaximin use,and secondary outcome measured was the safety of its long-term use as determined by its influence on portosystemic shunts as well as Escherichia coli-related ***,we compared the prognosis between the rifaximin group and control cases,matched for hepatic elasticity assessed by magnetic resonance ela-stography,age,and Child-Pugh *** Of the 38 patients included in the study,12(31.6%)had overt HE,27(71.1%)had complications of esophageal varices,and 9(23.7%)had hepatocellular carcinoma(HCC).The control group was matched for age,Child-Pugh classification,liver stiffness,and presence of *** median of serum ammonia level before treatment was 104μg/dL(59-297),and 2 wk after treatment,it significantly decreased to 85μg/dL(34-153)(P=0.002).A significantly low value of 80.5μg/dL(44-150)was maintained 24 wk after *** long-term use of rifaximin did not cause a decline in liver *** occurred in 2 patients,who improved with the administration of probiotics,and there were no cases of aborted rifaximin therapy owing to adverse *** patients with Child C,the survival was short,but there

关键词： Hepatic encephalopathy Rifaximin Hepatic cirrhosis Spontaneous portosystemic shunt Magnetic resonance elastography Child-Pugh classification

Effects of Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma Using a Combination of Platinum Agents (Cisplatin plus Miriplatin): A Retrospective Comparison with Cisplatin Monotherapy

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Open Journal of Radiology 2018年第4期8卷 260-273页

作者： Koichi hamada Satoshi Saitoh Shigeki Imai Noriyuki Nishino yoshinori Horikawa Michitaka Honda Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical UniversityFukushimaJapan Department of Gastroenterology Southern-Tohoku General HospitalFukushimaJapan Department of Hepatology Toranomon HospitalTokyoJapan Department of Radiology Southern-Tohoku General HospitalFukushimaJapan

Background: Miriplatin is a slow-release, lipophilic platinum complex, developed to produce a superior antitumor effect for hepatocellular carcinoma (HCC). However, the miriplatin suspension is highly viscous and can form an embolism in the hepatic artery, which can result in insufficient antitumor effect. Thus, reducing the viscosity of the suspension compound by combining it with the less-viscous cisplatin suspension might reduce or even prevent vessel embolism, while providing the quick-release effects of cisplatin. Purpose: To compare the outcomes of therapy using miriplatin plus cisplatin and cisplatin monotherapy in transcatheter arterial chemoembolization (TACE) for HCC. Methods: We retrospectively evaluated a total of 87 patients with Barcelona Clinic Liver Cancer (BCLC) stage A or B HCC who received conventional TACE using a combination of platinum agents (cisplatin and miriplatin) (n = 50) or cisplatin alone (n = 37) for the first time from September 2006 to December 2012. Short term therapeutic effect was measured by dynamic computed tomography 1 - 3 months after TACE, in reference to the modified Response Evaluation Criteria in Solid Tumors. Treatment-related adverse effects were graded by the National Cancer Institute Common Terminology Criteria (ver. 4.0). 1-, 3-, and 5-year survival rates were calculated. Subgroup analyses were performed by Child-Pugh classification and BCLC criteria. Results: Median duration of follow-up was 35 months (range 7 - 90). Median overall survival was 38 months. Patients who had combination therapy had better 1-, 3-, and 5-year survival rates: 100%, 56.7%, and 26.2%, respectively, compared to monotherapy: 100%, 42.1%, and 9.0%, respectively (p = 0.034). No serious complication or treatment-related mortality was observed in both groups. Conclusion: TACE using miriplatin plus cisplatin was related to a prolonged survival, with comparable adverse effects of TACE using cisplatin alone.

关键词： Hepatocellular Carcinoma Transcatheter Arterial Chemoembolization Miriplatin Cisplatin

A standardized technique for safe pancreaticojejunostomy:Pair-Watch suturing technique

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World Journal of Gastrointestinal Surgery 2010年第8期2卷 260-264页

作者： yoshinori Azumi Shuji Isaji Hiroyuki Kato Yuu Nobuoka Naohisa Kuriyama Masashi Kishiwada Takashi hamada Shugo Mizuno Masanobu Usui Hiroyuki Sakurai Masami Tabata Department of Hepatobiliary Pancreatic and Transplant Surgery Mie University Graduate School of Medicine

AIM:To prevent pancreatic leakage after pancreaticoje-junostomy,we designed a new standardized technique that we term the "Pair-Watch suturing technique".METHODS:Before anastomosis,we imagine the faces of a pair of watches on the jejunal hole and pancreatic *** first stitch was put between 9 o'clock of the pancreatic side and 3 o'clock of the jejunal side,and a total of 7 stitches were put on the posterior wall,followed by the 5 stitches on the anterior *** this technique,twelve stitches can be sutured on the first layer anastomosis regardless of the caliber of the pancreatic *** all cases the amylase activity of the drain were measured.A postoperative pancreatic fistula was diagnosed using postoperative pancreatic fistula ***:From March 2007 to July 2008,29 consecutive cases underwent pancreaticojejunostomy using this *** examination results showed pancreatic carcinoma(n=14),intraductal papillary-mucinous neoplasm(n=10),intraductal papillary-mucinous carcinoma(n=1),carcinoma of ampulla of Vater(n=1),carcinoma of extrahepatic bile duct(n=1),metastasis of renal cell carcinoma(n=1),and duodenal carcinoma(n=1).Pancreaticojejunal anastomoses using this technique were all watertight during the surgical *** mean diameter of main pancreatic duct was 3.4 mm(range 2-7 mm).Three patients were recognized as having an amylase level greater than 3 times the serum amylase level,but all of them were diagnosed as grade A postoperative pancreatic fistula grading and required no *** of the cases developed complications such as hemorrhage,abdominal abscess,and pulmonary *** was no postoperative ***:Our technique is less complicated than other methods and very secure,providing reliable anastomosis for any size of pancreatic duct.

关键词： Pancreaticoduodenectomy Pancreaticoje-junostomy Suturing technique