記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSES: This study aimed to evaluate the estimation of the physiological ability and surgical stress (E-PASS) scoring system for predicting the short- and long-term outcomes in gastric cancer (GC) surgery. METHODS: We analyzed a multi-institutional dataset to study patients who underwent gastrectomy with a curative intent between 2010 and 2014. This study evaluated the associations between the optimal E-PASS score cutoff value and the following outcomes: (1) the incidence of postoperative complications in stage I-III GC patients and (2) the prognosis in stage II-III GC patients. RESULTS: A total of 2495 GC patients were included. A cutoff value of 0.419 was determined using the ROC curve analysis. Postoperative complications were observed more frequently in the E-PASS-high group than that in the E-PASS-low group (30% vs. 17%, p < 0.0001). Among pStage II-III GC patients (n = 1009), the overall survival time of the E-PASS-high group was significantly shorter than that of the E-PASS-low group (hazard ratio 2.08; 95% confidence interval 1.64-2.65; p < 0.0001). A forest plot revealed that E-PASS-high was associated with a greater prognostic factor for overall survival in most subgroups. CONCLUSIONS: The E-PASS scoring system may therefore be a useful predictor of the short- and long-term outcomes in patients with GC who have undergone radical gastrectomy.

DOI： 10.1007/s00595-021-02394-3

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: We analyzed the effect of a microscopic positive margin on survival outcomes after gastrectomy for gastric cancer METHODS: We analyzed a multi-institutional dataset to study patients who underwent gastrectomy with curative intent between 2010 and 2014. We used propensity score matching to strictly balance the patients' oncological features, backgrounds, and postoperative treatment to compare the survival outcomes of those with microscopic positive margins and those with negative margins. RESULTS: Among 3029 patients, 32 (1.1%) had positive margins. After matching, we enrolled 128 patients in this retrospective analysis: 32 with a positive margin and 96 with a negative margin. The recurrence-free survival of the positive-margin group was significantly shorter than that of the negative-margin group (hazard ratio [HR], 1.62, 95% confidence interval, 1.00-2.63, p = 0.0485). Consistent results were observed for patients with pStages I-III disease (HR, 1.65, p = 0.0835), whereas the survival curves overlapped in those with pStage IV disease (HR, 1.29, p = 0.5934). The prevalence of overall recurrence in the positive-margin group was higher than that in the negative-margin group (75% vs 58%, p = 0.0917). This trend was consistent with locoregional recurrence (9% vs 3%) and distant recurrence (69% vs 55%). CONCLUSIONS: The survival of patients after curative gastrectomy for gastric cancer was worse in those with microscopic positive margins than in those with negative margins.

DOI： 10.1007/s00595-021-02365-8

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Many studies investigating postoperative pancreatic fistula (POPF) after gastrectomy, including studies measuring drain amylase content (D-AMY) as a predictive factor have been reported. This article reviews previous studies and looks to the future of measuring D-AMY in patients after gastrectomy. The causes of pancreatic fluid leakage are; the parenchymal and/or thermal injury to the pancreas, and blunt injury to the pancreas by compression and retraction. Measurement of D-AMY to predict POPF has become common in clinical practice after pancreatic surgery and was later extended to the gastric surgery. Several studies have reported associations between D-AMY and POPF after gastrectomy, and the high value of D-AMY on postoperative day (POD) 1 was an independent risk factor. To improve both sensitivity and specificity, attempts have been made to enhance the predictive accuracy of factors on POD 1 as well as on POD 3 as combined markers. Although several studies have shown a high predictive ability of POPF, it has not necessarily been exploited in clinical practice. Many problems remain unresolved; ideal timing for measurement, optimal cut-off value, and means of intervention after prediction. Prospective clinical trial could be imperative in order to develop D-AMY measurement in common clinical practice for gastric surgery.

DOI： 10.3748/wjg.v26.i14.1594

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Gastric Cancer  

Background: Few well-controlled studies have compared postoperative complications between Billroth I (B-I) and Roux-en-Y (R-Y). The aim of the present study was to compare the incidence of overall and severe postoperative complications by reconstruction method after distal gastrectomy. Methods: We performed a multi-institutional dataset study of patients who underwent distal gastrectomy with B-I or R-Y reconstruction from 2010 to 2014. Using propensity scores to strictly balance the significant variables, we compared postoperative complications between the techniques. Results: After matching, we enrolled 1014 patients (n = 507 in each group). The incidence of postoperative complications in the R-Y group was significantly higher vs the B-I group (29% vs 17%, P < 0.0001). The incidence of intra-abdominal abscess (4.3% vs 1.8%, P = 0.0177), bowel obstruction (2.6% vs 0.6%, P = 0.0203), and delayed gastric emptying (5.3% vs 1.0%, P < 0.0001) in the R-Y group was significantly higher vs the B-I group, respectively; we saw no significant difference in leakage (3.4% vs 4.1%, P = 0.5084). The incidence of grade ≥ III severe postoperative complications in the R-Y group was significantly higher vs the B-I group (13% vs 7.1%, P = 0.0013). Multivariable analysis showed that R-Y reconstruction was a strong independent risk factor for overall postoperative complications (odds ratio 1.58, P = 0.0044) and grade ≥ III severe postoperative complications (odds ratio 1.75, P = 0.0127). A forest plot revealed that R-Y reconstruction was associated with a greater risk of both overall and grade ≥ III severe postoperative complications in any subgroups. Conclusions: R-Y reconstruction was associated with increasing overall postoperative complications, as well as severe postoperative complications.

DOI： 10.1007/s10120-020-01048-6

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study aimed to evaluate whether the timing of initiating postoperative chemotherapy with S-1 monotherapy affects gastric cancer patients' prognosis. METHODS: A multi-institution dataset identified patients with pStage II or III gastric cancer who received S-1 monotherapy for over 6 months after curative resection between 2010 and 2014. Patients were divided into three groups based on the timing of S-1 monotherapy initiation. Prognostic factors for relapse-free survival (RFS) were investigated. RESULTS: We classified 401 patients into groups as follows: S-1 administered within 6 weeks (n = 247), between 6 and 8 weeks (n = 95), and after 8 weeks (n = 59). The RFS times were not significantly different in the within 6 weeks group and the between 6 and 8 weeks group, but the after 8 weeks group had a shorter RFS time compared with the other two groups (within 6 weeks group vs. after 8 weeks group; P = 0.0044). By disease stage, this trend was the same. The multivariable analysis showed that a larger tumor size (≥ 50 mm), pStage III, and the after 8 weeks group were independent prognostic factors for RFS (after 8 weeks group: hazard ratio, 2.05; P = 0.0069). The prevalence of hematogenous metastasis as the initial recurrence site increased by delayed initiation of S-1. A forest plot revealed that delayed administration after 8 weeks was associated with a greater risk of recurrence in most subgroups. CONCLUSIONS: Postoperative chemotherapy with S-1 monotherapy for gastric cancer is recommended to begin within 8 weeks after surgery.

DOI： 10.1007/s10120-019-00961-9

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3748/wjg.v25.i22.2743

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s10120-019-00967-3

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1245/s10434-019-07302-1

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

The aim of this study was to explore whether a combination of S-1 and paclitaxel offers any benefit over paclitaxel alone to patients pretreated by S-1.
Gastric cancer patients who developed progression during S-1-based first-line chemotherapy or had recurrence during postoperative adjuvant chemotherapy by S-1 were randomly assigned to receive second-line treatment either by weekly administration of paclitaxel at 80 mg/m(2) three times every 4 weeks or daily oral S-1 (80 mg/m(2)) for 2 weeks plus paclitaxel (50 mg/m(2)) given on days 1 and 8, every 3 weeks (S-1 plus paclitaxel). The primary endpoint was progression-free survival (PFS) at 4 months after the initiation of treatment.
A total of 78 patients were eligible for efficacy analyses-40 were assigned to the paclitaxel group and 38 to the S-1 plus paclitaxel group. PFS at 4 months was similar between the groups (50 % for paclitaxel vs 55 % for S-1 plus paclitaxel, P = 0.641). There were no differences between the groups either in progression-free survival (4.6 vs 4.6 months, respectively, P = 0.526), overall survival (10.0 vs 10.0 months, respectively, P = 0.464), or overall response rate (27 vs 22 %, respectively, P = 0.767). The incidences of grade 3 or 4 hematological and non-hematological toxicities were also equivalent between the two groups (25 vs 26 % and 24 vs 26 %, respectively).
No benefit of S-1 administration beyond progression was shown when paclitaxel was selected as the key drug for second-line chemotherapy.

DOI： 10.1007/s10147-015-0919-z

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Intraperitoneal chemotherapy is promising for gastric cancer with peritoneal metastasis. Although a phase III study failed to show a statistically significant superiority of intraperitoneal paclitaxel combined with S-1 and intravenous paclitaxel, the sensitivity analysis suggested clinical efficacy. Thus, attempts to combine intraperitoneal paclitaxel with other systemic therapies with higher efficacy have been warranted. We sought to explore the efficacy of intraperitoneal paclitaxel with S-1 and cisplatin. PATIENTS AND METHODS: Gastric cancer patients with peritoneal metastasis were enrolled in the phase II trial. In addition to the established S-1 and cisplatin regimen every 5 weeks, intraperitoneal paclitaxel was administered on days 1, 8, and 22 at a dose of 20 mg/m2. The primary endpoint was overall survival rate at 1 year after treatment initiation. Secondary endpoints were progression-free survival and toxicity. RESULTS: Fifty-three patients were enrolled and fully evaluated for efficacy and toxicity. The 1-year overall survival rate was 73.6% (95% confidence interval 59.5-83.4%), and the primary endpoint was met. The median survival time was 19.4 months (95% confidence interval, 16.1-24.6 months). The 1-year progression-free survival rate was 49.6% (95% confidence interval, 34.6-62.9%). The incidences of grade 3/4 hematological and non-hematological toxicities were 43% and 47%, respectively. The frequent grade 3/4 toxicities included neutropenia (25%), anemia (30%), diarrhea (13%), and anorexia (17%). Intraperitoneal catheter and implanted port-related complications were observed in four patients. There was one treatment-related death. CONCLUSIONS: Intraperitoneal paclitaxel combined with S-1 and cisplatin is well tolerated and active in gastric cancer patients with peritoneal metastasis.

DOI： 10.1245/s10434-023-14240-6

PubMed

researchmap

DOI： 10.1245/s10434-023-14331-4

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are widely used for various cancers, with the cut-off values of 5.0 ng/mL and 37.0 IU/mL, respectively. However, these cutoff values are not for specific diseases or purposes but are uniformly used for any disease and any purpose . It is also unclear as to whether patients are at equal risk of recurrence if they are below the cutoff values. This study aimed to investigate the optimal cutoff of serum tumor markers in the stratification of recurrence risk after curative resection of gastric cancer. METHODS: We constructed a nine-center integrated database of patients recieved gastrectomy between January 2010 and December 2014 with a 5-year follow-up period. We determined the cutoff value of preoperative serum tumor marker levels correlated with postoperative recurrences and evaluated its performance in risk stratification for recurrences in 948 patients with pStage II/III gastric cancer who underwent radical resection. RESULTS: The hazard ratio for postoperative recurrences increased at two points of preoperative CEA levels; 3.6 ng/mL and 5.0 ng/mL, which were set as cutoffs. These two cutoffs stratified relapse-free survival into three levels. CONCLUSIONS: By adding a second cutoff value for preoperative serum CEA, which was proposed specifically for the prediction of recurrences, patients can be stratified into low-, intermediate-, and high-risk recurrences after curative resection of gastric cancer.

DOI： 10.1159/000533143

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND/AIM: Pancreatic cancer cells release certain tissue factors into the bloodstream. It is well known that pancreatic cancer progresses with thrombus formation. Because we routinely measure serum D-dimer levels in preoperative patients as a screening marker of deep venous thrombosis, we examined its association with high serum D-dimer in our cohort of pancreatic cancer resected cases. PATIENTS AND METHODS: We examined 315 patients with pancreatic ductal adenocarcinoma who underwent surgical resection in our department from January 2012 to July 2021. All cases were divided into high D-dimer cases (n=118) and low D-dimer cases (n=197) using the cut-off value of 1.0 μg/ml, an institutional upper limit. Clinicohistological characteristics and postoperative survival outcomes were evaluated. RESULTS: Preoperative high D-dimer cases showed significantly worse progression-free survival (PFS) (p=0.021) and overall survival (OS) (p=0.027) than low D-dimer cases; median PFS was 13.9 months versus 21.4 months, and that of OS was 33.4 months versus 68.0 months. Clinicohistological characteristics of high D-dimer cases were age over 70 years (p<0.001), pathological portal vein invasion (p=0.003), and initially borderline resectable or unresectable cases (p=0.027). Multivariate analysis indicated that preoperative high D-dimer was a significant prognostic factor of PFS (hazard ratio=1.42, p=0.025) and OS (hazard ratio=1.51, p=0.036). CONCLUSION: Preoperative high serum D-dimer over 1.0 μg/ml was associated with pathological portal vein invasion and could be an unfavorable prognostic marker of PFS and OS after surgery, typically due to distant metastasis.

DOI： 10.21873/anticanres.16491

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nutrition and Cancer  

Background: The pretreatment albumin–globulin ratio (AGR) is a frequently used inflammation-associated factor that has been reported to have associations with the survival outcomes of various malignancies. Methods: We retrospectively analyzed 162 patients with pancreatic cancer who underwent preoperative treatment followed by curative surgery at Nagoya University Hospital between April 2010 and December 2020. Representative nutritional status indicators of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and albumin–globulin ratio (AGR) were calculated for each case. Results: Among pretreatment blood examination parameters, only AGR (cutoff: 1.33) showed a significant difference in overall survival time (OS) and progression-free survival time (PFS) from the beginning of the preoperative treatment. Median PFS was 22.3 mo, in high AGR cases and 17.1 mo, in low AGR cases (P = 0.019). Median OS was 48.7 mo, in high AGR cases and 32.9 mo, in low AGR cases (P = 0.043). Conclusion: High pretreatment AGR may be a favorable prognostic factor for pancreatic cancer patients who received preoperative multimodal therapy followed by curative cancer resection. It may imply that nutritional status and inflammation control before the multimodal treatment affect the survival outcomes of pancreatic cancer cases and needs to be optimized.

DOI： 10.1080/01635581.2023.2191384

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical and Experimental Gastroenterology  

Pancreatic fistula after gastrectomy with lymph node dissection is associated with prolonged hospital stay and critical complications such as intra-abdominal bleeding and sepsis. Polyglycolic acid (PGA) sheets are absorbable suture reinforcement materials. A randomized Phase II trial has been planned to evaluate the effect of PGA sheets on preventing postoperative pancreatic fistula. A total of 320 patients will be recruited from thirteen institutions. Patients who are scheduled to undergo distal or total gastrectomy will be randomly allocated into the PGA group or control group, and the dissected area around the pancreas will be covered by the PGA sheet in the PGA group. The primary endpoint will be the maximum value of drain amylase concentration up to 5 days after surgery. The secondary endpoints will be as follows: transition of value of amylases of drain discharge, incidence of pancreatic fistula, incidence of intra-abdominal abscess, white blood cell count, value of C-reactive protein, incidence of postoperative complication, duration of antibiotic agents administration, duration of abdominal drainage, usage of octreotide, duration of hospital stay, incidence of bleeding in abdominal cavity, mortality, and incidence of reoperation.

DOI： 10.2147/CEG.S421531

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Clinical Oncology  

Cisplatin should be administered with diuretics and Magnesium supplementation under adequate hydration to avoid renal impairment. Patients should be evaluated for eGFR (estimated glomerular filtration rate) during the treatment with pemetrexed, as kidney injury has been reported. Pemetrexed should be administered with caution in patients with a CCr (creatinine clearance) < 45 mL/min. Mesna is used to prevent hemorrhagic cystitis in patients receiving ifosfamide. Febuxostat is effective in avoiding hyperuricemia induced by TLS (tumor lysis syndrome). Preventative rasburicase is recommended in high-risk cases of TLS. Thrombotic microangiopathy could be triggered by anticancer drugs and there is no evidence of efficacy of plasma exchange therapy. When proteinuria occurs during treatment with anti-angiogenic agents or multi-kinase inhibitors, dose reductions or interruptions based on grading should be considered. Grade 3 proteinuria and renal dysfunction require urgent intervention, including drug interruption or withdrawal, and referral to a nephrologist should be considered. The first-line drugs used for blood pressure elevation due to anti-angiogenic agents are ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers). The protein binding of drugs and their pharmacokinetics are considerably altered in patients with hypoalbuminemia. The clearance of rituximab is increased in patients with proteinuria, and the correlation with urinary IgG suggests similar pharmacokinetic changes when using other antibody drugs. AIN (acute interstitial nephritis) is the most common cause of ICI (immune checkpoint inhibitor)-related kidney injury that is often treated with steroids. The need for renal biopsy in patients with kidney injury that occurs during treatment with ICI remains controversial.

DOI： 10.1007/s10147-023-02382-2

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Journal of Surgery  

Background: The presence of chronic inflammation and nutritional status in cancer patients affects its prognosis. There is a clinical need for a prognostic predictor that is objective and accurate, and that can be easily evaluated by preoperative screening. We evaluated the importance and usefulness of the preoperative modified systemic inflammation score (mSIS) to predict the long-term outcome of patients undergoing curative resection for gastric cancer (GC). Methods: Of the 3571 patients who underwent curative resection for GC in nine institutions between January 2010 and December 2014, 1764 patients who met the inclusion criteria were included. The mSIS was formulated according to the serum albumin level (ALB) and lymphocyte-to-monocyte ratio (LMR) as follows: mSIS 0 (ALB ≥ 4.0 g/dL and LMR ≥ 3.4), mSIS 1 (ALB < 4.0 g/dL or LMR < 3.4), and mSIS 2 (ALB < 4.0 g/dL and LMR < 3.4). Results: Patients were categorized into preoperative mSIS 0 (n = 955), mSIS 1 (n = 584), and mSIS 2 (n = 225) groups. The overall survival times and the disease-free survival times of patients in preoperative mSIS 0,1 and 2 sequentially shortened (P < 0.0001), and mSIS 1 and 2 were identified as an independent prognostic factor (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.06–1.272, P = 0.0125 and HR 1.63, 95% CI 1.21–2.19, P = 0.0012). A stepwise increase in the prevalence of hematogenous recurrences was directly proportional to the mSIS. A forest plot revealed that mSIS 0,1 was associated with a greater risk of overall survival in most subgroups. Conclusion: Preoperative mSIS can be easily calculated, and it is suggested that it is useful as a prognostic predictor of patients with different disease stages, for stratifying and evaluating clinical outcomes.

DOI： 10.1007/s00268-021-06138-9

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy. METHODS: We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014. Patients with clinical stage-III gastric adenocarcinoma were divided into a neoadjuvant chemotherapy (NAC) group and a non-NAC group. We performed propensity-matched comparative analysis to stratify the groups according to age, sex, tumor region, tumor type, preoperative stage, procedure, lymph node dissection, and tumor differentiation. Preoperative blood data, surgical findings, and postoperative complications were analyzed. RESULTS: Analysis of the matched NAC (n = 64) and non-NAC (n = 128) groups revealed that the preoperative values of neutrophils, platelets, and Hb were significantly lower in the NAC group. Blood loss during surgery was significantly higher, surgical times were longer, and the rate of repeat surgery was significantly lower in the NAC group; however, the rates of rehospitalization did not differ between the groups and mortality was 0% in both groups. Postoperative complications were not significantly different between the groups. CONCLUSIONS: NAC did not increase the complication rate of gastrectomy for gastric cancer.

DOI： 10.1007/s00595-020-02179-0

PubMed

researchmap

記述言語：日本語  

Web of Science

記述言語：英語  

DOI： 10.1245/s10434-019-07718-9

PubMed

researchmap

記述言語：英語  

DOI： 10.1245/s10434-019-07572-9

PubMed

researchmap

記述言語：日本語  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: Intra-abdominal desmoid tumors are usually slow growing and solitary, but multifocal desmoid tumors develop on rare occasions. Diagnosing desmoid tumors before histological examination of a surgical biopsy is often difficult. In particular, if a patient has a prior history of malignancy, it may be difficult to differentiate between these lesions and disease recurrence or metastasis.
Case presentation: We present a rare case of multiple rapidly growing intra-abdominal desmoid tumors after surgical trauma, without familial adenomatous polyposis. A 51-year-old male underwent abdominal perineal resection with lateral lymph node dissection after neoadjuvant chemotherapy for lower rectal cancer. Follow- up computed tomography (CT), performed 6 months after primary surgery, showed a 20-mm solitary mass in the pelvic mesentery. Another CT scan, performed 3 months later, revealed that the mass had grown to 35 mm in size and that two new masses had formed. Based on imaging studies and his medical history, it was difficult to distinguish the desmoid tumors from recurrence of rectal cancer. Curative resection was chosen for therapeutic diagnosis. The pathological diagnosis was multiple mesenteric desmoid tumors.
Conclusions: Desmoid tumors should not be excluded as a differential diagnosis for intra-abdominal masses after intra-abdominal surgery, even in cases of rapidly growing multiple masses.

DOI： 10.1186/s12957-017-1248-7

Web of Science

researchmap

掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society of Interventional Radiology  

DOI： 10.22575/interventionalradiology.2.1_19

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

ポリスチレンスルホン酸カルシウム(アーガメイトゼリー)は急性および慢性腎不全に伴う高カリウム血症の治療に用いられる陽イオン交換樹脂の一つである。副作用としては便秘をはじめとする消化器症状がよく知られている。また重大な副作用として腸管穿孔の報告があり,添付文書でも注意勧告がなされている。今回,同剤内服中に大腸穿孔を起こした3症例を経験した。本症例と文献的な検討を行った結果,穿孔部はS状結腸,直腸に集中していること,ほとんどの症例で便秘を認めることが特徴であった。本剤内服中に便秘になり,便塊が停滞し機械的な損傷から大腸穿孔をきたすものと考えられた。本剤を投薬する際には,浸透圧性下剤,刺激性下剤をうまく使いながら適切に排便コントロールを行うことが重要であり,関係者に広く啓発していく必要があると思われる。(著者抄録)

DOI： 10.11231/jaem.35.355

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞ポイント ◆オペ記事の作成は遅くとも当日中に,オペに関する記憶が残っている間に行う.◆手術内容(切離した動静脈や臓器の切除範囲,リンパ節郭清範囲,再建方法など)をもれなく記載する.

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞ポイント ◆ICI(免疫チェックポイント阻害薬)併用化学療法は高い奏効率が期待できるが,現時点ではconversion surgeryの可能性に関するエビデンスは乏しい.◆ICI併用化学療法では,irAE(免疫関連有害事象)と化学療法の有害事象との鑑別とマネジメントが重要である.◆ICI併用化学療法は重篤な有害事象のリスクが高まり,conversion surgeryの適応や安全性に影響する可能性がある.

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-東海支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-東海支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1407213675

CiNii Books

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

J-GLOBAL

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本病院薬剤師会  

外来化学療法への薬剤師業務が推進されているが、地方中規模一般病院での費用対効果は明らかではない。そこで、中津川市民病院(以下、当院)の外来化学療法室において2018年8月1日〜2019年7月31日の1年間に薬剤師が主治医に薬物療法に関する提案あるいは情報提供(薬学的介入)を行った内容を後向きに調査した。期間中に行った薬剤管理指導は1,067件であり、薬学的介入が294件、受諾率は88.1%であった。そのうち抗がん剤に関する提案は192件、その他の併用薬に関する提案が69件であった。田坂らによる推算を用いると、薬学的介入による医療経済効果は年間11,032,000円と考えられる。一方で、がん患者指導管理料3による収益は684,000円であった。外来化学療法の薬剤管理指導は、現在はその収益で補うことはできていないが、安全性・有効性の確保と医療訴訟の回避により病院を損失から守り、かつ医療経済効果は高いと考える。(著者抄録)

researchmap

記述言語：英語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：金原出版(株)  

CiNii Books

J-GLOBAL

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2019316311

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞ポイント ◆Linear staplerを使用する場合は,staplerの食道粘膜下への迷入,挙上空腸の穿孔に注意する.◆Circular staplerを使用する場合は,挙上空腸の噛み込みに注意する.◆両方法ともに,胃管の噛み込みに注意が必要である.器械の不具合が起こりうるので対応法は把握しておく必要がある.◆ファイヤーする前の準備を確実に行い,焦らずゆっくり操作し吻合することで,トラブルが起こるリスクを最小限にすることができる.

researchmap

J-GLOBAL

researchmap

記述言語：日本語  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語  

J-GLOBAL

researchmap

記述言語：日本語  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本インターベンショナルラジオロジー学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本インターベンショナルラジオロジー学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

症例は35歳女性。妊娠29週に腹痛,嘔吐を主訴に近医を受診し,イレウスの疑いで当院へ搬送となった。1回の経妊経産歴があり開腹歴はなかった。腹部単純CTで臍左側背側の小腸に閉塞機転を疑う所見を認め,小腸イレウスの診断で入院となった。第3病日になってもイレウス所見の改善がないため,緊急手術となった。まず帝王切開を施行した後に,腹腔内を観察するとS状結腸間膜左葉に2cm大の小孔を認め,Treitz靱帯から290cmの小腸が嵌頓しており,S状結腸間膜内ヘルニアによるイレウスと診断した。用手的に整復することができ,Richter型の嵌頓で腸管壊死は認めなかったため,イレウス解除術で終了し,術後6日目に軽快退院となった。児は生後5ヵ月明らかな障害はなく生存中である。妊娠時イレウスは母児ともに死亡率の高い疾患であり,積極的な検査と手術のタイミングを逸しないことが母児の救命に直結すると考えられる。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J02824&link_issn=&doc_id=20151026400016&doc_link_id=10.11231%2Fjaem.35.781&url=https%3A%2F%2Fdoi.org%2F10.11231%2Fjaem.35.781&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語  

J-GLOBAL

researchmap