Osmandalby2146

BACKGROUND Laparoscopic transverse colectomy is technically difficult. In mini-laparotomy surgery, colectomy for midtransverse colon cancer can easily be performed, but exact D2 lymph node dissection is very difficult for a variety of vessels in the transverse colon. Using 3D-CT imaging, we present a case of D2 lymph node dissection where mini-laparotomy transverse colectomy was performedby a small incision similar to that usedin laparoscopic surgery. METHOD The patient was a 60-yearoldwoman with early transverse colon cancer, which was locatedin the mid-transverse colon. Surgical treatment was plannedfor pT1b(1.5mm)andpVM1 in pathological findings after EMR. Using CT colonography(CTC), the location of the primary tumor was identified. Using simulation CTC(sCTC), composedof CTC and 3D imaging of the arteries andveins, the dominant artery was identified and D2 lymph node dissection was simulated. In addition, body surface 3D imaging and permeable surface 3D imaging of the abdominal trunk were performed. Using rence for 4 years and2 months after surgery. The cranial incision from the upper rim of the navel has shrank about 3 cm, and the umbilical incision is not noticeable. CONCLUSION D2 lymph node dissection of minilaparotomy transverse colectomy can be a treatment option for early transverse colon cancer through using body surface 3DsCTC.We report 5 cases of implantation cysts at anastomosis after rectal surgery. All patients underwent resection of the rectum usingthe double staplingtechnique (DST). Implantation cysts were recognized within a period of 3 months to 6 years after surgery. Abdominal CT showed cystic masses with calcification in all cases. Colonoscopy revealed submucosal tumor-like lesions in 3 cases, and serum CEA level was increased in 2 cases. In one patient with anal pain, transanal aspiration was performed; the other 4 patients are free from symptoms and are beingobserved without treatment.A 70-year-oldwoman underwent colonoscopy as a follow-up examination for colon polyps, during which early-stage rectosigmoid cancer was detected. Endoscopic submucosal dissection(ESD)was performed to remove this lesion. Additional radical anterior resection was recommended according to the histological findings but the patient chose to undergo observation. Nine months after the ESD, the patient decided to undergo additional surgical resection a CT scan revealed liver metastasis in S6. Laparoscopic anterior resection andpartial resection of S6 of the liver was performed. Histological analysis showed no residual cancer in the rectosigmoid, no lymph node metastasis, and liver metastasis in S6. Carcinoma cells were exposed on the radial margin of the liver. After surgery, oral UFT/LV chemotherapy was administered for 6 months. The patient remains free of recurrence 4 years and6 months after the surgery.BACKGROUND There has been an increase in the number of elderly cancer patients with preoperative comorbidities, which decrease the safety of surgical therapy. Assessment of comorbidities is useful for prediction of the outcome of treatment in these patients. PATIENTS AND METHODS The Charlson comorbidity index(CCI)was determined in 83 elderly patients undergo- ing surgery for gastric and colorectal cancer. Relationships of CCI with prognosis were examined in pathological R0/R1 and R2 cases. RESULTS In the R0/R1 group, CCI was significantly associated with overall survival in univariate(p=0.027)and multivariate( p=0.031)analyses. Mortality from other diseases within a year after surgery for patients with CCIB4 was significantly higher than that for those with CCIC3(11.0% vs 1.4%, p=0.028). CONCLUSION CCI is an independent prognostic factor after surgery for elderly patients with gastric and colorectal cancer.Although surgical resection is the first-line treatment for biliary tract cancer(BTC), elderly patients often have underlying diseases and decreased cardiopulmonary function that place them at a high risk of undergoing surgery. We examined the safety and efficacy of surgical resection in elderly BTC patients. Among the BTC cases that underwent surgical resection at Kobe University Hospital from 2009 to 2015, the safety and prognosis ofthose aged 75 years or older(Group 1)were compared to those younger than 75 years(Group 2)at the time ofsurgery. Fifty-two patients with perihilar cholangiocarcinoma( Bp), 29 patients with intrahepatic cholangiocarcinoma(ICC), and 40 patients with ampulla ofVater cancer(AV) were included. There was no significant difference between the 2 groups with respect to complications of Grade Ⅲor above, while surgery-related death was more common in Bp and ICC ofGroup 1. The median survival ofGroup 1 following hepatectomy for Bp and ICC(22 months)was significantly shorter than that of Group 2(40 months)(p=0.023). There was no significant difference in overall survival of Group 1 and Group 2 patients with AV(p=0.094). Surgical resection for BP and ICC for elderly patients has a higher risk of hepatectomy; therefore, precise assessment of oncologic and patient risk factors should be performed. As we can expect to achieve similar prognoses between non-elderly and elderly patients with AV, aggressive treatments should be considered for elderly patients with AV.METHODS We retrospectively evaluated the post-recurrence survival of 37 cases with brain metastases out of 439 consecutive resected cases of primary lung cancer between 2001 and 2017. FINDINGS There was no difference in survival according to tumor size but survival was significantly shorter in patients with larger numbers of tumors. JG98 HSP (HSP90) inhibitor Patients initially treated with stereotactic radiosurgery(SRS)or surgical resection survived longer than those with whole-brain irradiation(WBI)(median survival 23 months for SRS, 17 months for surgical resection, and 4 months for WBI p less then 0.001 between SRS and WBI). CONCLUSIONS As SRS is recommended for 1-4 tumors with maximum diameters ofC3 cm and surgical resection is recommended for tumors larger than 3 cm, these effective locoregional therapies should be aggressively adopted for local control of brain metastases with the aim of improved QOL and prolonged survival. Due to the deterioration of neurocognitive function, WBI should be avoided as initial treatment for brain metastases when effective locoregional therapy or systemic chemotherapy is available and reserved for leptomeningeal dissemination or miliary metastases.