Biomedical subjects

Masaru Tsuchiya

Publications and source records attributed to Masaru Tsuchiya.

6 recordsLinked to original sources

PubMed2006

[Case report of a liver metastasis from rectal cancer achieving complete response (CR) by a combination of intra-hepatic arterial infusion of irinotecan (CPT-11) with degradable starch microspheres (DSM) and weekly high-dose intra-hepatic arterial chemotherapy with 5-FU].

A 67-year-old woman, who was diagnosed with rectal cancer and liver metastasis, underwent a low anterior resection of the rectum in May 2004. Two months later, the level of tumor markers increased and a CT scan revealed a 45 x 35 mm liver metastasis in the S(8) segment. She was referred to our hospital for treatment of the liver tumor. Intra-hepatic arterial infusion of irinotecan (CPT-11) and mitomycin C (MMC) with degradable starch microspheres (DSM) was given in July 2004. Following this, a 34-week course of weekly high-dose intra-hepatic arterial 5-FU infusion (5-FU 1,000 mg/m(2)) was performed. In April 2005, the size of the liver metastasis decreased, and the level of serum tumor marker normalized. A CT and echo scan revealed a calcified tumor, and therefore all chemotherapy was stopped. She was followed in the outpatient clinic, with no evidence of recurrence for 12 months. This case suggests that the use of intra-hepatic arterial infusion of CPT-11 and MMC with DSM is useful for the treatment of liver metastases in colorectal cancer.

Adenocarcinoma↗

PubMed2005

Hepatic arterial cannulation using the side holed catheter.

BACKGROUND: Hepatic arterial infusion chemotherapy (HAIC) has been recognized as one of the effective treatments for patients with hepatic metastatic tumor. However it is difficult to perform HAIC in the long term without complications. This report describes the laparotomic approach using the side holed catheter, which is a novel method of implanting a catheter-port system. METHODS AND RESULTS: We designed a new anti-thrombotic catheter for HAIC. This catheter is tapered from 5F (diameter of shaft) to 3.3F (diameter at tip), and a side hole is opened 7 cm from the tip of catheter. This catheter is inserted from the gastroduodenal artery to the common hepatic artery (CHA), and the tip is put in the aorta or in the splenic artery. The side hole is adjusted distal to the CHA. In our surgical department, our new catheter was inserted in four patients at the time of their abdominal surgery. The cannulation was performed successfully in all patients. In two of them, HAIC was finished without problems at 6 months after starting, and two were still treated by HAIC at 9 and 8 months after starting. CONCLUSIONS: Initial results from a study of a new method of implanting a catheter-port system in the hepatic artery using the new tapering side hole catheter suggest that this method may enable operators to avoid complicated selective coiling and may lower the incidence of hepatic artery occlusion in patients receiving long-term HAIC.

Aged↗

PubMed2005

Laparoscopic liver resection of hepatocellular carcinoma.

BACKGROUND: We have continued to develop laparoscopic hepatectomy as a means of surgical therapy for hepatocellular carcinoma (HCC). METHODS: We evaluated the degree of invasiveness and analyzed the outcomes of laparoscopic hepatectomy compared with open hepatectomy for HCC. RESULTS: There were notable differences with respect to blood loss and operating time compared with open hepatectomy cases. Patients started walking and eating significantly earlier in the laparoscopic hepatectomy group, and these more rapid recoveries allowed shorter hospitalizations. On the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, there was no difference in preoperative risk. However, a significant difference was seen in the surgical stress and comprehensive risk scores between the open hepatectomy and laparoscopic hepatectomy groups. Concerning the survival rate and disease-free survival rate, there were no significant differences between procedures. CONCLUSIONS: Laparoscopic hepatectomy avoids some of the disadvantages of open hepatectomy and is beneficial for patient quality of life (QOL) as a minimally invasive procedure if the operative indications are appropriately based on preoperative liver function and the location and size of HCC.

Aged↗

PubMed2005

[Cryotherapy of the resection edge after hepatectomy of colorectal liver metastases].

Obtaining a one-centimeter negative margin is an important factor in preventing disease recurrence after surgery for hepatic tumors. Cryotherapy of the resected edge has been used to achieve optimal margin clearance in cases in which the alternative would be an extended high-risk liver resection. As a concrete method, cryotherapy was delivered with a liquid nitrogen based compact system (CRY-AC, Brymill Co., USA). The resection edge with involved or inadequate resection margins was ablated directly by using the flat probe for 3 minutes per 1 place. Between 2002 and present, a total of 14 patients with colorectal liver metastases underwent edge cryotherapy. Although there was no hemorrhage from the stump, postoperative leak of the bile and stump recurrence were recognized in each patient. Since cryotherapy has features that make the vascular difficult to be damaged, the complication was not recognized in the patient with exposed vascular in the resected edge. By extending the follow-up period, we want to examine whether the edge recurrence could be controlled or not.

Colorectal Neoplasms↗

PubMed2004

Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.

Herein, we report the successful performance of a laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for a patient with pancreatic cystadenoma, as a minimally invasive procedure with the preservation of function. The laparoscopy-assisted distal pancreatectomy procedure involved detaching the spleen and the distal pancreas from the retroperitoneum by a hand-assisted procedure, removing them from the peritoneal cavity through a small incision, and detaching the distal pancreas by ligating and transecting the short gastric artery and vein and the branches of the splenic artery and vein, while the spleen and main splenic artery and vein were preserved under direct view. The pancreatic parenchyma was transected with a stapling device (TL-30), and continuous suturing was added to the resected margin. The patient's postoperative course was uneventful; the patient started to eat and walk on postoperative day 2 and was discharged on day 8. It is considered that the combination of hand-assisted and laparoscopy-assisted distal pancreatectomy, with conservation of the splenic artery and vein, is a minimally invasive and clinically useful technique for treating tumors of cystic disease of the pancreas with low-grade malignant potential, or benign solitary neuroendocrine tumors.

Adult↗

PubMed2004

Hepatic resection using stapling devices.

BACKGROUND: The progress and development of stapling devices has been remarkable. They have become indispensable for gastrointestinal diseases and are increasingly utilized in laparoscopic operations. Liver surgery applications for this technique are continuing to emerge, and in this study, we introduced the use of stapling devices to hepatic surgery. METHODS: We examined the operative procedure and efficacy of hepatic resections using stapling devices as follows: transection of Glisson's pedicle and the hepatic vein using endolineal stapling devices in right and left lobectomies; bisegmentectomy II and III en masse using a stapling device; and application of endolineal stapling devices to vessel transections and dissections of the hepatic parenchyma in laparoscopic hepatectomies. RESULTS: It was considered useful to tactfully apply stapling devices to vessel transections and dissections of the hepatic parenchyma in order to simplify the operative procedures of right or left lobectomies and lateral segmentectomies. Furthermore, the use of endoscopic stapling devices was an acceptable alternative to vessel transactions and dissections of the hepatic parenchyma in laparoscopic hepatectomies. CONCLUSIONS: We believe that stapling devices will become utilized in liver surgery hereafter.

Hepatectomy↗