Biomedical subjects

Takashi Murota

Publications and source records attributed to Takashi Murota.

7 recordsLinked to original sources

PubMed2002

Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors.

OBJECTIVES: The outcome of laparoscopic partial nephrectomy using a microwave tissue coagulator for treatment of small renal tumors was studied. PATIENTS AND METHODS: From June 1999 to May 2001, eight patients with small renal tumors of less than 5.0cm in diameter (1.0-5.0cm, T1N0M0) underwent retroperitoneoscopic partial nephrectomy. To control bleeding during the partial nephrectomy, the renal parenchyma around the tumor was coagulated using a microwave tissue coagulator with a needle of 1.5cm length. The tumor was circumscribed within the coagulated area with 8-13 punctures of the coagulation needle, and partial nephrectomy was performed using scissors and bipolar forceps. RESULTS: All eight patients successfully underwent the procedure retroperitoneoscopically. The average operative time was 295 minutes and the average blood loss was 129ml. Three patients showed urine leakage from the renal calyces, which was controlled by suturing retroperitoneoscopically. In two patients, the surgical margin was revealed to be positive for renal cell carcinoma by frozen section pathology and additional resection was performed in these individuals. The patients were discharged from the hospital with almost full convalescence on day 10 on average. Within the mean follow-up period of 10.4 months, no recurrence was found when examined with computer tomography (CT) using contrast media. As a complication, one patient experienced a decrease in function of the operated kidney caused by unknown reason. CONCLUSION: Retroperitoneal partial nephrectomy using a microwave tissue coagulator is useful for treatment of small renal tumors located at the peripheral area of the kidney. Bleeding from the renal parenchymal incision site is well controlled without occlusion of the renal artery with additional use of a bipolar coagulator, when necessary. Further experience and long-term follow-up are mandatory however, to establish the usefulness of this technique.

Adult↗

PubMed2002

Endoscopic partial cystectomy for bladder leiomyoma using retroperitoneoscopic and transurethral procedures.

Retroperitoneoscopic partial cystectomy was performed to remove a leiomyoma in the right wall of the bladder in a 58-year-old man. The tumor was initially circumscribed with a mucosal incision using a transurethral resectoscope, and once the bladder wall had been penetrated with the resectoscope, the remaining procedures were performed retroperitoneoscopically. The bladder wall was closed using a retroperitoneoscopic suturing technique. Endoscopic partial cystectomy using both a transurethral incision and a retroperitoneoscopic resection is technically feasible in the treatment of small bladder tumors.

Cystectomy↗

PubMed2002

Retroperitoneoscopic nephrectomy for juxtaglomerular cell tumor.

We present a case of juxtaglomerular cell tumor (JGCT) in a 20-year-old woman. She presented with hypertension and elevated plasma renin activity. Computed tomography without enhancement by contrast medium detected a tumor at the center of the left kidney. Retroperitoneoscopic left nephrectomy was performed and postoperatively her blood pressure and plasma renin activity returned to normal. This is the first report of retroperitoneoscopic nephrectomy performed for a JGCT.

Adenocarcinoma↗

PubMed2002

[Cholinergic crisis following administration of distigmine bromide: a case report].

The long-acting anticholinesterase, distigmine bromide (Ubretid), is widely used for the treatment of underactive neurogenic bladder. Therefore, we emphasize its hazardable side-effect of cholinergic crisis. A 78-year-old man with duodenal ulcer complained of nocturia, and was administered distigmine bromide 10 mg daily under the diagnosis of mild benign prostatic hypertrophy with underactive neurogenic bladder. It seemed that administration slightly improved his symptom but he developed bradycardia, dyspnea and drowsiness suddenly on the 4th day. Blood examination revealed extremely low cholinesterase in his serum, suggesting distigmine bromide intoxication. He was treated intensively with several intravenous injections of atropine, high-concentration oxygen and transfusion of fresh frozen plasma. Nevertheless, his condition did not recover, resulting in death of "cholinergic crisis" on the 6th day.

Aged↗

PubMed2002

[A clinical analysis of patients with early-stage prostate cancer managed without initial treatment].

To search for a more suitable qualification indicating watchful waiting, we performed a retrospective study against early-stage prostate cancer patients managed without initial treatment. Thirty-three patients who had not been treated for more than 6 months after diagnosed as T1c or T2 prostate cancer were studied. The median values of total observation period, age at diagnosis, and initial PSA were 27.0 months, 69.0 years old, and 7.0 ng/ml, respectively. Among 28 patients who had had measurement of serum PSA at least three times, seven patients showed a significant PSA elevation when transition of PSA level was analyzed using linear regression analysis. The other patients had been stable or PSA level declined. Between these two groups, there was no significant difference regarding age, initial PSA, PSA density, Gleason score, number of cancer-positive core, and cancer-occupying rate in biopsy specimen. The median PSA doubling time in patients showing PSA elevation was 36.3 months. There were no patients showing PSA elevation among those with a cancer-occupying rate of less than 5%. Clinical disease progression was obviously observed in two cases although one did not show PSA elevation. During the observation period, treatment was eventually started in seven patients. The 5-year rate of no treatment was 53.8%. Although a significant independent factor predicting the future treatment was not identified, univariate analysis revealed that the initial PSA value in patients undergoing treatment was significantly higher than that of those without treatment (p = 0.032). We concluded that early-stage prostate cancer has clinical variability, and regular clinical evaluations as digital rectal examination should be performed when the patient was managed with watchful waiting.

Aged↗

PubMed2002

[The experience of laparoscopic radical nephrectomy for renal tumors].

We evaluate the safety and feasibility of laparoscopic radical nephrectomy for renal tumors. Between September 1993 and October 2001, 18 patients with renal tumors underwent laparoscopic radical nephrectomy. The mean patient age was 57.1 years ranging from 36 to 78. Clinical stage was T1N0 in all patients. The mean tumor diameter was 4.0 cm ranging from 1.8 to 7.0. Laparoscopic radical nephrectomy was performed by using the transperitoneal anterior approach on 11 patients and retroperitoneal approach on 7 patients. The specimen was removed through an extended stab wound after blunt segmentation of renal parenchyma in a specimen bag (LapSac). The mean operative time was 405 (270-550) and 453 (325-635) min for the transperitoneal approach and retroperitoneal approach respectively, and the mean blood loss was 281 (52-700) and 223 (10-850) ml, respectively. There was an intraoperative complication of minor splenic injury in 2 patients receiving the transperitoneal approach, which was conservatively managed. Histopathology revealed renal cell carcinoma in 17 patients and renal oncocytoma in one patient. There was no recurrence with a mean follow-up of 28.9 months. Compared with 13 patients who underwent open radical nephrectomy during the same period, laparoscopic nephrectomy has a longer operative time (424 versus 214 min, p < 0.001), equal blood loss (259 versus 210 ml, p = 0.59), quicker resumption of ambulation (1.8 versus 2.5 days, p = 0.016) and food intake (1.4 versus 2.2 days, p = 0.003), shorter postoperative hospital stay (10.9 versus 18 days, p = 0.0016), and a tendency of less frequent analgesic requirements (1.9 versus 4.7 times, p = 0.09). Laparoscopic radical nephrectomy is a safe and useful surgery for renal tumors providing minimal invasiveness.

Adult↗

PubMedDate not supplied

The effect of eicosapentaenoic acid on prostate-specific antigen.

The "Study of EPA Effects on Prostate Cancer" (SEEPC) Group has been conducting a clinical trial with patients who underwent radical prostatectomy. The main purpose of the SEEPC is to evaluate whether eicosapentaenoic acid (EPA) prevents prostate cancer (PC) recurrence. As the surrogate marker of recurrence, the prostate-specific antigen (PSA) level was measured. However, if EPA affects the PSA values independently of PC, PSA may not be a good marker of recurrence in the event of EPA treatment. Thus, in the present study, whether EPA affected the PSA values was investigated using non-PC volunteers. Twenty men, of at least 50 years of age, were recruited, mostly from hospital staff The volunteers were randomly allocated either to the EPA group or the control. The subjects in the EPA group were administered EPA-ethyl ester a dose of 2400 mg/day for 12 weeks, whereas the controls were administered none. Fasting blood samples were obtained before the start of EPA administration and 4 and 12 weeks later. The EPA concentrations in erythrocytes increased in all the subjects in the EPA group (174+/-96%) with no significant changes in the control group (8.5+/-14.0%). There were no significant differences between the two groups in the serum PSA levels, allowing the conclusion that the PSA is an appropriate surrogate marker of recurrence in prostate cancer.

Aged↗