Biomedical subjects

O Segawa

Publications and source records attributed to O Segawa.

22 records · Page 2Linked to original sources

PubMed1996

[Surgical strategy for the treatment of congenital biliary dilatation based on the location of intrahepatic bile duct dilatation].

Congenital biliary dilatation used to be regarded as having a good prognosis. However, some recent long-term follow-up studies have shown there to be quite a high incidence of postoperative intrahepatic bile duct (IHBD) stone formation. In most of the cases in whom IHBD stones form, the IHBD were found to be dilated as the time of initial surgery. Therefore, preoperative evaluation of IHBD dilatation using various imaging studies is extremely important. Surgically, in cases involving structure of the common hepatic duct (CHD) with dilatation above the structure, resection of the stricture and a wide hepaticointestinal anastomosis are strongly recommended. In cases where there is a stricture of the CHD or of the first branch of the IHBD, a reconstructive technique should be applied to dilate the stricture. Patients who have a structure and cystic dilatation of the IHBD above the second branch should be carefully followed-up postoperatively. Partial liver resection to remove the cyst may be required at the time of initial operation or at a later stage.

Bile Ducts, Intrahepatic↗

PubMed1995

Laparoscopic bipolar strip-tease appendicectomy. A new endosurgical technique.

Since its conception, several techniques have been described for laparoscopic appendicectomy. We describe a technique which utilizes a 5-mm bipolar forceps designed to coagulate and cut tissues at the same time; 50 pediatric patients underwent laparoscopic appendicectomy for acute appendicitis using this "stripping and teasing" technique. No bleeding complications occurred. There were only two postoperative abscesses in the series. We believe that the bipolar laparoscopic striptease appendicectomy technique as developed by the senior author is safe, quick, and effective, even for severe appendicitis.

Abdominal Abscess↗

PubMed1994

Tubed latissimus dorsi musculocutaneous flaps for thoracic esophageal replacement: an experimental study.

Tubed musculocutaneous flap has never been used to replace a circumferential defect of the thoracic esophagus in adults or children. The aim of this study was to examine whether a tubed latissimus dorsi musculocutaneous flap (TLDMF) can be used to repair a long gap defect of the thoracic esophagus. In 14 puppies with an average weight of 4.9 kg, part of the esophagus (two vertebrae in length) was excised through a right thoracotomy. A latissimus dorsi musculocutaneous flap was introduced into the thoracic cavity. The cutaneous layer was rolled into a tube and interposed in the space of the excised esophagus. The muscle layer was wrapped around the anastomosis. Three puppies died of operative complications, such as a minor anastomotic leakage and postoperative bleeding. One died of an unknown cause. Ten puppies were studied postoperatively with a barium meal, endoscopic examination, and autopsy. The management of these puppies over 4 months is described. It proved possible to replace a long gap thoracic esophageal defect with a TLDMF, which was safe, easy to be transferred, and obviated a laparotomy. Thus, this technique might offer an alternative method to bridge a long gap in patients with esophageal atresia or severe stenosis.

Animals↗

PubMed1993

Actin and myosin deposition around bile canaliculi: a predictor of clinical outcome in biliary atresia.

The role of pathological changes of the intrahepatic bile canaliculi in determining postportoenterostomy bile drainage in biliary atresia (BA) patients remains unestablished. It is known that canalicular contraction contributes an active force for bile flow in normal ductal systems. This motility is controlled by the bile canalicular membrane-associated filaments (BCMF), particularly actin and myosin. Wedge resected specimens of liver from 13 patients with BA were studied using histopathological markers of BCMF in order to clarify the morphological and functional changes of bile canaliculi. Histopathological data were also compared with clinical outcomes after portoenterostomy. Patients who showed sufficient bile flow after the operation showed an almost normal shape and level of BCMF accumulation around bile canaliculi, whereas there was markedly increased BCMF volume in patients who did not exhibit bile flow after surgery. The clinical staining patterns of BCMF in BA patients appears closely related to clinical outcome. These findings suggest that BCMF plays an important role in determining the rate of postoperative bile flow in BA patients.

Actins↗