Hemihepatic vascular occlusion using intraoperative ultrasonography: a simple technique.
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Blood Loss, Surgical↗
Biomedical subjects
T Shirakusa
Publications and source records attributed to T Shirakusa.
Lymphangioma in the small intestine: report of a case and review of the Japanese literature.
We report herein a rare case of a 53 year old man with a benign lymphangioma of the small intestine. He presented with a complete obstruction of the small intestine and radiological examination revealed a small intestinal tumor. A long intestinal tube was passed, the intestinograms from which detected a submucosal tumor of the small intestine. Partial resection of the small intestine was thus performed and the tumor was found to be located mainly in the submucosa. The final pathological diagnosis was made as cavernous lymphangioma. This case is presented with a description of the roentgen appearance, followed by a review of the Japanese literature.
Adult↗
Carinal transplantation.
BACKGROUND: Current techniques of management of carinal lesions are not always satisfactory. Carinal transplantation, if feasible, would be valuable in certain circumstances. METHODS AND RESULTS: Carinal transplantation experiments were performed in dogs. In early cross transplant experiments there were problems in controlling ventilation and in obtaining satisfactory anastomoses, and the animals failed to live for even a few days. In seven subsequent experiments the carinal graft was removed from one dog and transplanted into a second dog. Two dogs lived for over four months with immunosuppression. CONCLUSION: The results suggest that carinal transplantation can succeed if (1) the calibre of the graft is matched with that of the recipient; (2) there is an abundant blood supply to the graft; (3) appropriate immunosuppression is provided; (4) ventilation is adequate during surgery.
Anastomosis, Surgical↗
[Investigation of two cases of adenoid cystic carcinoma of the esophagus].
A 59-year-old man and a 55-year-old man with adenoid cystic carcinoma of the esophagus are presented. They were also treated with esophagectomy but whose prognosis were significantly different. The former has been still alive for 3.5 years and the later died at 7 months after the operation. In the patient with good prognosis, the tumor was 1.6 x 1.2 cm in size and pathologically invaded muscularis propria (mp) with no metastases to lymph nodes (pathological stage I). It has been reported that the prognosis of adenoid cystic carcinoma of the esophagus is poorer than that of other histological type of carcinomas. However, it is suggested that if the tumor can been resected when it is small in size with no metastases, it will be able to expect for good prognosis as in this presentation.
Carcinoma, Adenoid Cystic↗
[Panpleuropneumonectomy for primary lung cancer patients with pleural dissemination].
Twelve patients of non-small cell lung cancer with carcinomatous pleuritis were subjected to panpleuropneumonectomy between June 1981 and December 1988. The median survival time was 13 months. One-year and 3-year survival rates were 52% and 26%, respectively. There was no significant difference in prognosis compared with the results of other modality therapies such as pleurodesis with talc and tube drainage for pleural effusion. After panpleuropneumonectomy the patients were divided into the group with only pleural dissemination and the one with pleural effusion. The median survival time in the group of pleural dissemination was 14 months. The three-year survival rate was 50%. The one patient survived for 51 months and the other for 45 months. The median survival time of patients with pleural effusion was 4 months without over 1-year survivor. The statistically significant difference was found between the two groups (p less than 0.05). We concluded that panpleuropneumonectomy is indicated only for the patients of non-small cell lung cancer with diffuse pleural dissemination and no pleural effusion.
Adult↗
[Mutations of ras and p53 genes in human non-small cell lung cancer cell lines and their clinical significance].
We examined 77 non-small cell lung cancer (NSCLC) cell lines for mutations of 3 ras genes and p53 gene, and ras mutations were detected by designed RFLP assay generated by mismatched primers during the PCR step and p53 gene mutations were detected using SSCP analysis. The incidence of ras mutations were 27/77 (35%) while that of p53 gene mutations were 57/77 (74%). The incidence of ras mutations in cell lines with p53 mutations were not different from that without p53 mutations, suggesting that they occurred independently. Neither ras nor p53 mutations correlated with histologic subtype, disease extent, in vitro culture time nor prior therapy status. The patients whose cell lines had any ras mutations survived for shorter period of time not only among the patients who were treated with curative intent but among those treated with palliative treatment. The Cox proportional hazards model predicted the higher risk for patients with ras mutations but not those with p53 mutations. We conclude that ras and p53 mutations are frequent, apparently independent genetic alterations which play different roles in NSCLC and that this information should be utilized in surgical oncology in the near future.
Carcinoma, Non-Small-Cell Lung↗
[Resection of tracheal carcinoma using partial cardiopulmonary bypass--report of a case].
A 43-year-old male was admitted to our hospital with chief complaints of stridor and dyspnea. Bronchoscopy revealed a tumor obstructing almost the whole lumen of the trachea. As it was impossible to insert an endotracheal tube into the distal site of the stenosis in the mediastinum, we used partial cardiopulmonary bypass to maintain gas exchange. The axillary artery and the femoral artery and vein were cannulated for the bypass using local anesthesia. During 105 minutes of bypass, the PaO2 value was good but the PaCO2 value increased up to 70 mmHg. After the trachea was opened, the anesthetic gas was administered across the operative field through the endotracheal tube and the cardiopulmonary bypass was discontinued. Tracheolaryngectomy and permanent tracheostomy with relocation to the right and caudal side of the brachiocephalic artery was performed successfully. The post operative course was very smooth. The patient has been well for 6 months since the surgery. Partial cardiopulmonary bypass proved to be useful for maintaining gas exchange during reconstructive surgery of the trachea. We treated a case of tracheal carcinoma by resection while using partial cardiopulmonary bypass. We believe this is the ninth such case reported Japanese literature.
Adult↗
[An assessment of the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination as a dissecting measure in the surgical treatment of lung cancer].
The availability of the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination as a dissecting measure was analyzed according to prognosis retrospectively because mediastinal lymph nodes dissection is made with ease and certainty after the examination. The separation by mediastinoscopic examination did not have an impact on the mediastinal lymph nodes dissection for carcinoma of the left lung and superior mediastinal lymph nodes metastases (# 1-4), but an influence on the dissection for carcinoma of the right lung and middle and lower mediastinal lymph nodes metastases (# 5-9). This result showed the existence of occult metastases and the good effects caused by the separation of mediastinal lymph nodes. In the histological type, the effects were present in squamous cell carcinoma and p-N0 adenocarcinoma, but it was concluded that the prognosis in adenocarcinoma was associated with other factors rather than lymph node metastasis. Therefore, it can be seen that the separation of mediastinal lymph nodes by preoperative mediastinoscopic examination is available as a dissecting measure.
Adult↗
A new surgical technique for voice restoration after laryngopharyngoesophagectomy with a free ileocolic graft: preliminary report.
We describe a new one-stage surgical technique for voice restoration combined with reconstruction of the cervical esophagus after laryngopharyngoesophagectomy with a free ileocolic autograft. Reconstruction of the alimentary tract is accomplished with the colonic segment, and the phonatory shunt is fashioned from the terminal ileum. The ileocolic valve, reinforced by "cecal application," functions as an inherent valve that prevents aspiration through the shunt. Six patients underwent reconstruction with this method. There was no graft necrosis, although one venous anastomosis required correction because of kinking. There were two hospital deaths: one patient died of multiple organ failure in the perioperative period and the other died of a recurrence of the disease. The remaining four patients were tolerating a regular diet at discharge from the hospital. Five of the six patients were able to achieve a fair to good voice.
Aged↗
[Tracheal reconstruction of extensive circumferential defects using cadaveric tracheal allograft: preliminary report].
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Animals↗
[A fatal rheumatoid pneumonitis following surgery for lung cancer].
A 64-year-old man was admitted to our division because of an abnormal mass with a diffuse reticular shadow seen on chest roentgenogram. A right upper lobectomy was performed after the diagnosis of lung cancer. From the 18th postoperative day he complained of dyspnea, which was caused by the exacerbation of rheumatoid pneumonitis based on rheumatoid arthritis, and died on the 44th postoperative day. The course of illness and clinicopathological analysis of this case is described in this paper.
Arthritis, Rheumatoid↗
[Result of surgical treatment in 226 cases of primary lung cancer].
From August, 1979 to June, 1990, 226 cases of primary lung cancer were treated surgically at our Department. Of these, 176 cases, excluding hospital deaths from lung cancer and other diseases, were analyzed according to prognosis. The 5-year survival rate of the 176 cases was 40.2% and the 5-year survival rates according to sex were, male, 36.1%; female, 53.2%. The 5-year survival rates according to postoperative stage were, stage I, 64.1%; stage II, 44.1%; stage III A, 22.1%; stage III B & IV, 0% and the 5-year survival rates according to histologic type were, adenocarcinoma, 40.5%; squamous cell carcinoma, 49.7%; large cell carcinoma, 18.9%; small cell carcinoma, 0%. The 5-year survival rates according to primary site were, right side, 43.8%; left side, 34.6%; right upper lobe, 39.7%; right middle lobe, 60.0%; right lower lobe, 44.4%; left upper lobe, 41.7%; left lower lobe, 18.1%. The prognosis of squamous cell carcinoma, and the early stage, female group, right side group, right middle & lower lobe group, were all fairly good.
Adenocarcinoma↗
[Tracheal reconstruction in 29 canines using allograft--a surgical technique].
We have been performing the tracheal reconstruction using allograft in 29 canines, and have obtained favorable results. In this paper, the details of the surgical technique of tracheal reconstruction are described. Important points for achieving technical success are the following: 1) good anesthetic control during operation, 2) proper anastomoses between recipient's trachea and the graft, 3) use of the omental pedicle flap for wrapping around the anastomotic portion.
Anastomosis, Surgical↗
Involucrin in well-differentiated adenocarcinoma of the lung. Comparison with adenocarcinomas of different organs.
Using immunoperoxidase stain for involucrin, 50 well-differentiated adenocarcinomas of the lung were compared with similarly well-differentiated adenocarcinomas of other organs, 30 from the stomach, 30 from the colon, 12 from the pancreas and 12 from the prostate. Thirty (60%) adenocarcinomas of the lung were positive for involucrin; in 24 of 30 cases from 10% to more than 60% of tumor cells were positive and in the remaining 6 cases a few cells were positive. The positive cells included columnar or cuboidal tumor cells as well as some squamoid tumor cells. In contrast, only 4 (4.8%) of 84 tumors in the other organs were involucrin positive. Most of the involucrin positive foci of these four cases seemed to show squamous differentiation. These findings suggest that pulmonary adenocarcinoma is more prone to show squamous differentiation, compared with gastric, colonic, pancreatic and prostatic adenocarcinomas. The result may be applied for the differential diagnosis between primary and metastatic well-differentiated adenocarcinomas in the lung.
Adenocarcinoma↗
Partial atrial resection in advanced lung carcinoma with and without cardiopulmonary bypass.
Combined pneumonectomy and partial resection of the left atrium was performed in 12 patients with advanced lung carcinoma (T3 and T4 in the new UICC classification). In the eight patients with a T3 lung carcinoma intrapericardial atrial resection with vascular clamping was carried out; four of the patients died within a year. The remaining four patients had a T4 tumour and underwent removal of the right lung and part of the left atrium under total cardiopulmonary bypass. One patient died shortly after the operation from cerebral and cerebellar infarction, and one died 11 months later from brain metastases. Two are alive and well. Complete resection appears to offer a chance for longer survival in patients with advanced lung carcinoma that extends directly into the intrapericardial pulmonary vessels or atrium.
Adenocarcinoma↗
Atypical lipoma of the lung.
An unusual endobronchial lipoma characterised by pleomorphic, multinucleated giant cells admixed with mature adipose cells developed in a 52 year old woman, arising from the right middle lobe bronchus. Lobectomy was performed and the postoperative course was uneventful.
Bronchi↗
Surgical results of brain metastasis from lung cancer--prognostic factors.
Twenty-five patients receiving surgical treatment for brain metastasis from lung cancer were retrospectively studied to evaluate the prognostic factors for survival time. Twenty-two patients had died of respiratory distress by April, 1989. Favorable prognostic factors derived from the median survival time (MST) in these patients included; 1) resection of primary tumor (MST 10 months); 2) total or subtotal removal of metastatic tumor (MST 6.5 months); 3) adenocarcinoma (MST 13 months); 4) metachronous onset of brain metastasis (MST 12 months); 5) single metastasis (MST 8 months). These results suggest that therapy for the primary lung cancer is important before surgery for metastatic brain tumor.
Adenocarcinoma↗
[Primary multiple neurilemmoma of the diaphragm].
Primary tumor of the diaphragm is very rare. Furthermore, to our knowledge, no cases of multiple neurilemmoma of the diaphragm have appeared in the literature. A 61-year-old female was admitted to our hospital because of epigastric discomfort. Roentgenologic examination of the chest showed a tumor in the left leaf of the diaphragm. Laparotomy revealed two tumors, one measuring about 5 cm in diameter, and the other about 1 cm in diameter arising from the diaphragm. There was no adhesion to adjacent organs. The two tumors were resected with a part of the left diaphragm. Histological examination revealed benign neurilemmoma of the diaphragm. There has been follow-up on the patient for two and a half years without evidence of recurrence.
Diaphragm↗