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Simultaneous operation for cardiac disease and gastrointestinal malignancy

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World Journal of Gastrointestinal surgery 2014年第8期6卷 146-150页

作者： Teruo Komokata Mikio Fukueda Mamoru Kaieda Takayuki Ueno Yoshihumi Iguro Yutaka Imoto Ryuzo Sakata Department of surgery Kagoshima Medical CenterNational Hospital Organization cardiovascular and gastroenterological surgery Kagoshima University Graduate School of Medical and Dental Sciences cardiovascular surgery Kyoto University Hos-pital

AIM: To investigate the safety of performing simulta-neous cardiac surgery and a resection of a gastrointes-tinal malignancy. METHODS: Among 3664 elective cardiac operations performed in adults at Kagoshima University Hospi-tal from January 1991 to October 2009, this study reviewed the clinical records of the patients who un-derwent concomitant cardiac surgery and a gastroin-testinal resection. Such simultaneous surgeries were performed in 15 patients between January 1991 and October 2009. The cardiac diseases included 8 cases of coronary artery disease and 7 cases with valvular heart disease. Gastrointestinal malignancies included 11 gas-tric and 4 colon cancers. Immediate postoperative andlong-term outcomes were evaluated. RESULTS: Postoperative complications occurred in 5 patients(33.3%), including strokes(n = 1), respiratory failure requiring re-intubation(n = 1), hemorrhage(n = 2), hyperbilirubinemia(n = 1) and aspiration pneu-monia(n = 1). There was 1 hospital death caused by the development of adult respiratory distress syndrome after postoperative surgical bleeding followed aortic valve replacement plus gastrectomy. There was no car-diovascular event in the patients during the follow-up period. The cumulative survival rate for all patients was 69.2% at 5 years. CONCLUSION: Simultaneous procedures are accept-able for the patients who require surgery for both car-diac diseases and gastrointestinal malignancy. In par-ticular, the combination of a standard cardiac operation, such as coronary artery bypass grafting or an isolated valve replacement and simple gastrointestinal resection, such as gastrectomy or colectomy can therefore be safely performed.

关键词： Simultaneous operation Cardiac disease Gastrointestinal malignancy Gastric cancer Colon cancer

Endovascular pseudoaneurysm repair after distal pancreatectomy with celiac axis resection

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World Journal of Gastroenterology 2013年第45期19卷 8435-8439页

作者： Tatsuaki Sumiyoshi Yasuo Shima Yoshihiro Noda Shingo Hosoki Yasuhiro Hata Takehiro Okabayashi Akihito Kozuki Toshio Nakamura Department of gastroenterological surgery Kochi Health Sciences Center Kochi cityKochi 781-8555 Japan Department of Radiology Kochi Health Sciences Center Kochi Kochi 781-8555 Japan Department of cardiovascular Internal Medicine Kochi Health Sciences Center Kochi Kochi 781-8555Japan

Erosive hemorrhage due to pseudoaneurysm is one of the most life-threatening complications after ***,we report an extremely rare case of rupture of a pseudoaneurysm of the common hepatic artery(CHA)stump that developed after distal pancreatectomy with en block celiac axis resection(DP-CAR),and was successfully treated through covered stent *** patient is a 66-year-old woman who underwent DP-CAR after adjuvant chemoradiotherapy for locally advanced pancreatic body *** developed an intra-abdominal abscess around the remnant pancreas head 31 d after the surgery,and computed tomography(CT)showed an occluded portal vein due to the spreading inflammation around the *** general condition improved after CT-guided drainage of the ***,19 d later,she presented with melena,and CT showed a pseudoaneurysm arising from the CHA *** the CHA had been resected during the DP-CAR,this artery could not be used as the access route for endovascular treatment,and instead,we placed a covered stent via the inferior pancreaticoduodenal artery originating from the superior mesenteric *** stent placement,cessation of bleeding and anterograde hepatic artery flow were confirmed,and the patient recovered well without any further *** angiography at the 6-mo follow-up indicated the patency of the covered stent with sustained hepatic artery *** our knowledge,this is the first reported case of endovascular repair of a pseudoaneurysm that developed after DP-CAR.

关键词： Distal pancreatectomy En block celiac axis resection Pseudoaneurysm Endovascular treatment Covered stent

Curative resection of leiomyosarcoma with resection and reconstruction of inferior vena cava

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Case Reports in Clinical Medicine 2013年第6期2卷 335-337页

作者： Yashiro Motooka Daisuke Hashimoto Hisashi Sakaguchi Akira Chikamoto Toru Beppu Michio Kawasuji Hideo Baba Department of cardiovascular surgery Kumamoto University Graduate School of Medical Sciences Kumamoto Japan Department of gastroenterological surgery Kumamoto University Graduate School of Medical Sciences Kumamoto Japan Department of gastroenterological surgery Kumamoto University Graduate School of Medical Sciences Kumamoto Japan

Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor, and it needs complete surgical resection for cure. In addition, the reconstruction of IVC is necessary in many cases. Herein, we indicate the case of a 57-year-old female with leiomyosarcoma in segment I of the IVC, which grew deep into vascular lumen. She underwent complete en bloc resection of the tumor and IVC reconstruction by an artificial pericardium patch.

关键词： Leiomyosarcoma Inferior Vena Cava Reconstruct

Anomalous course of the carotid arteries in the retrooesophageal space: An unusual cause of chest pain

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World Journal of cardiovascular Diseases 2012年第4期2卷 326-329页

作者： Giorgio Bosso Antonio Valvano Valentina Apuzzi Filippo Riccone Ugo Oliviero Department of Internal Medicine and cardiovascular Sciences University of Naples Federico II Naples Italy

The differential diagnosis of chest pain, one of the most frequent symptoms referred in the emergency department, includes cardiac and noncardiac causes and represents a difficult challenge for clinicians. Noncardiac chest pain can be defined as the recurrence of chest pain episodes indistinguishable from coronary events after the exclusion of a cardiac cause. It may be of musculoskeletal, pulmonary, gastroenterological, psychosomatic or neurological aetiology, oesophageal disorders representing the most common detectable cause. In this report we describe a rare case of chest pain which appeared after dinner, due to an oesophageal spasm caused by the anomalous course of the carotid arteries. The case is relevant because it describes a very uncommon variant of the physiological course of the carotid arteries, and because it is unusual that a retro thoracic vascular abnormality can be related to the appearance of chest pain without dysphagia. Chest pain which appears after dinner in our case is probably due to the unusual anatomic connection between oesophagus and carotid arteries that probably begins to make stronger when the patient undertakes the supine position: for that reason nocturnal chest pain promptly relieves after the assumption of orthostatic or semi orthostatic decubitus. In conclusion, in a patient who refers the sudden appearance of nocturnal chest pain certainly unrelated to coronary artery disease, the physicians should consider the involvement of oesophageal system, maybe determined by vascular course abnormalities.

关键词： Chest Pain Carotid Arteries Oesophageal Spasm