maeda kotaro

We studied the clinicopathological characteristics of colorectal cancer with perforation in comparison with non-perforation cases, and treatment strategy for colorectal cancer with perforation. T4 cancers and cancers with massive venous invasion fell significantly into the perforation than the non-perforation group. Stage IV caner was seen more in cases with perforation than in non-perforation cases (p=0.08). The perforation occurred at the tumor site in 7 patients, at the oral site of cancer in 7, and at the anal site in 1. One-staged curative resection was performed in 5 patients, and two-staged curative resection was performed in 4. The operative time was longer, and blood loss during curative resection was more in the two-staged than in the one-staged resections. Recurrence occurred in 1 patient with stage II cancer, and in 3 patients with stage IIIa cancer. These four patients with recurrence after curative surgery had peritoneal or subcutaneous dissemination, accompanying cancer spread due to large bowel perforation. However, hematogenous or lymphatic recurrence was also seen in 4 patients including one patient who underwent a curability B resection. More lymph node dissections were seen in non-recurrence cases after curative resection (average: 19.8) than in recurrence cases (average: 6.3). It was believed that primary resection and proper lymph node dissection contributed to prevention of hematogenous or lymphatic recurrence and improvement of prognosis for the patients with large bowel perforation related to colorectal cancer.

When performing anterior resection for rectal cancer, a robotic technique that provides three-dimensional visualization and technical dexterity has been applied to overcome some limitations of conventional laparoscopic surgery. As of the end of March 2013, 56 patients have undergone robotic colorectal surgery at Fujita Health University. We herein introduce our fully-robotic technique with single cart position and report short-term outcomes concerning 43 cases of rectal cancer. The current status and problems regarding robotic surgery for colorectal cancer in the literature are also described. Although robotic surgery for colorectal cancer has been safe and feasible, the long operative time should be shortened by utilizing the learning-curve effect.

Bladder and sexual dysfunction are potential problems after rectal excision. The aim of this study was to prospectively evaluate bladder and sexual dysfunction in male patients with rectal cancer who were treated using fully robotic techniques. Between September 2011 and April 2012, 8 consecutive patients scheduled to undergo a fully robotic resection for the treatment of rectal cancer were prospectively included in this study. The patients were asked to complete validated, self-administered questionnaires regarding their urinary and sexual function before surgery and 3, 6, and 12 months after surgery. Urinary function deteriorated postoperatively in only one of the 8 patients. None of the patients required permanent or intermittent catheterization. Erectile and ejaculation function had returned to the preoperative sexual status at 6 months after surgery. None of the patients were erectile dysfunction or were experiencing retrograde ejaculation at 6 months after surgery.

When performing anterior resection for rectal cancer, a robotic technique that provides three-dimensional visualization and technical dexterity has been applied to overcome some limitations of conventional laparoscopic surgery. As of the end of March 2013, 56 patients have undergone robotic colorectal surgery at Fujita Health University. We herein introduce our fully-robotic technique with single cart position and report short-term outcomes concerning 43 cases of rectal cancer. The current status and problems regarding robotic surgery for colorectal cancer in the literature are also described. Although robotic surgery for colorectal cancer has been safe and feasible, the long operative time should be shortened by utilizing the learning-curve effect.

XELOX+Bevacizumab (BV) is one of the most common regimens for advanced colorectal cancer in Europe and the US, but there is little clinical data in Japan.<BR>We studied the effectiveness and safety of XELOX+BV therapy for advanced colorectal cancer patients in a phase II clinical trial. The primary endpoint was response rate (RR). Secondary endpoints were progression-free survival (PFS), time to treatment failure (TTF) and incidence of adverse events.<BR>In this study we used the team approach for management of adverse events. This report describes the effectiveness of adverse event management and the improvement of ingestion compliance by the team of doctors, nurses, and pharmacists.<BR>The rate of Hand Foot Syndrome grade 2/3 in a domestic phase I/II study JO19380 was 17.2%/1.7% respectively, while that in our study was 13.2%/0%.<BR>The relative dose intensity of six courses was 89.2% (L-OHP) and 91.0% (XELODA), respectively. The response rate was 66.7%, and the decrease control rate was 96.7%.<BR>Outpatient chemotherapy will increase gradually, and so it will become even more important to control adverse events at home.

The patient was a 65-year-old female who had been diagnosed with rectal cancer (RS-Ra 1/3 circumferential type 2 with invasion deeper than SS). During preoperative testing, multiple systemic abscesses including a liver abscess, a right emphysema, a right iliopsoas abscess, and an abscess in the left abdominal muscle layer were observed. Furthermore, CT revealed pyogenic spondylitis in lumbar vertebra L3-4. <I>Klebsiella pneumonia</I> was detected in the patient's blood, urine, and abscess cultures. We assumed this to be because of retroperitoneal penetration and bacteremia caused by the rectal cancer and therefore initiated antibiotic administration. Subsequently, the patient's physical status improved. We performed low anterior resection and anterior lumbar surgical fixation one month later. Postoperative histopathology revealed a well-differentiated adenocarcinoma (SS, N0, H0, M0, P0, Stage II). Since the specimen was non-penetrating, we thought that the systemic abscesses were because of the portal vein routes from the rectal cancer, arteriovenous pathways associated with pressure elevation, and the decreased immunity of the cancer patient.