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- 저자 : Yorihisa Sumida (검색결과 2 건)
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Atsushi Nanashima,Yorihisa Sumida,Tetsuro Tominaga,Takeshi Nagayasu 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.4
Backgrounds/Aims: To achieve complete anatomic hepatectomy in a large hepatocellular carcinoma (HCC), hepatic transection through an anterior approach is required. Liver hanging maneuver (LHM) is a useful procedure for transection of an adequately cut plane in anatomical liver resection. It may reduce intraoperative bleeding and transection time. Methods: We examined records of 27 patients with large HCC (over 10 ㎝ in size) who underwent anatomic hepatic resection with LHM (n=11, between 2001 and 2007) or without LHM (n=16, between 2000 and 2003). The two groups were retrospectively compared in terms of patient demographics, preoperative hepatic function, surgical records, and post-hepatectomy outcome. Results: Although transection time was not significantly different between the two groups, the amount of intraoperative blood loss was significantly lower in the LHM group than that in the non-LHM group (1,269±1,407 ml vs. 2,197±1,281 ml, p=0.039). Related blood transfusion or total operation time in the LHM group tended to be lower than those in the non-LHM group, although differences between the two groups were not statistically significant (p<1.0). Prevalence of total complications in the LHM group tended to be lower than that in the LHM group (36% vs. 88%, p=0.011). However, prevalence of hepatectomy-related complications or length of hospital stay was not significantly different between the two groups. Conclusions: LHM can reduce intraoperative blood loss. It is useful for transecting adequately cut plane in a hepatectomy for a large HCC. However, postoperative outcomes are not improved by LHM compared to those by non-LHM.
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Tetsuro Tominaga,Takashi Nonaka,Akiko Fukuda,Toshio Shiraisi,Shintaro Hashimoto,Masato Araki,Yorihisa Sumida,Terumitsu Sawai,Takeshi Nagayasu 대한외과학회 2021 Annals of Surgical Treatment and Research(ASRT) Vol.101 No.2
Purpose: Pelvic exenteration (PE) is a highly invasive procedure with high morbidity and mortality rates. Promising options to reduce this invasiveness have included laparoscopic and transperineal approaches. The aim of this study was to identify the safety of combined transabdominal and transperineal endoscopic PE for colorectal malignancies. Methods: Fourteen patients who underwent combined transabdominal and transperineal PE (T group: 2-team approach, n = 7; O group: 1-team approach, n = 7) for colorectal malignancies between April 2016 and March 2020 in our institutions were included in this study. Clinicopathological features and perioperative outcomes were compared between groups. Results: All patients successfully underwent R0 resection. Operation time tended to be shorter in the T group (463 minutes) than in the O group (636 minutes, P = 0.080). Time to specimen removal was significantly shorter (258 minutes vs. 423 minutes, P = 0.006), blood loss was lower (343 mL vs. 867 mL, P = 0.042), and volume of blood transfusion was less (0 mL vs. 560 mL, P = 0.063) in the T group, respectively. Postoperative complications were similar between groups. Conclusion: Combined transabdominal and transperineal PE under a synchronous 2-team approach was feasible and safe, with the potential to reduce operation time, blood loss, and surgeon stress.
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