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Oki, Eiji,Sakaguchi, Yoshihisa,Ohgaki, Kippei,Saeki, Hiroshi,Chinen, Yoshiki,Minami, Kazuhito,Sakamoto, Yasuo,Toh, Yasushi,Kusumoto, Testuya,Okamura, Takeshi,Maehara, Yoshihiko The Korean Gastric Cancer Association 2012 Journal of gastric cancer Vol.12 No.2
Purpose: Since a patient's obesity can affect the mortality and morbidity of the surgery, less drastic surgeries may have a major benefit for obese individuals. This study evaluated the feasibility of performing a totally laparoscopic distal gastrectomy, with intracorporeal anastomosis, in obese patients suffering from gastric cancer. Materials and Methods: This was a retrospective analysis of the 138 patients, who underwent a totally laparoscopic distal gastrectomy from April 2005 to March 2009, at the National Kyushu Cancer Center. The body mass index of 20 patients was ${\geq}25$, and in 118 patients, it was <25 kg/$m^2$. Results: The mean values of body mass index in the 2 groups were $27.3{\pm}2.2$ and $21.4{\pm}2.3$. Hypertension was significantly more frequent in the obese patients than in the non-obese patients. The intraoperative blood loss, duration of surgery, post-operative complication rate, post-operative hospital stay, and a number of retrieved lymph nodes were not significantly different between the two groups. Conclusions: Intracorporeal anastomosis seemed to have a benefit for obese individuals. Totally laparoscopic gastrectomy is, therefore, considered to be a safe and an effective modality for obese patients.
Complications Related to Gastric Endoscopic Submucosal Dissection and Their Managements
Itaru Saito,Yosuke Tsuji,Yoshiki Sakaguchi,Keiko Niimi,Satoshi Ono,Shinya Kodashima,Nobutake Yamamichi,Mitsuhiro Fujishiro,Kazuhiko Koike 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.5
Endoscopic submucosal dissection (ESD) for early gastric cancer is a well-established procedure with the advantage of resection in an en bloc fashion, regardless of the size, shape, coexisting ulcer, and location of the lesion. However, gastric ESD is a more difficult and meticulous technique, and also requires a longer procedure time, than conventional endoscopic mucosal resection. These factors naturally increase the risk of various complications. The two most common complications accompanying gastric ESD are bleeding and perforation. These complications are known to occur both intraoperatively and postoperatively. However, there are other rare but serious complications related to gastric ESD, including aspiration pneumonia, stenosis, venous thromboembolism, and air embolism. Endoscopists should have sufficient knowledge about such complications and be prepared to deal with them appropriately, as successful management of complications is necessary for the successful completion of the entire ESD procedure.
Eiji Oki,Yoshihisa Sakaguchi,Kippei Ohgaki,Hiroshi Saeki,Yoshiki Chinen,Kazuhito Minami,Yasuo Sakamoto,Yasushi Toh,Testuya Kusumoto,Takeshi Okamura,Yoshihiko Maehara 대한위암학회 2012 Journal of gastric cancer Vol.12 No.2
Purpose: Since a patient's obesity can affect the mortality and morbidity of the surgery, less drastic surgeries may have a major benefit for obese individuals. This study evaluated the feasibility of performing a totally laparoscopic distal gastrectomy, with intracorporeal anastomosis, in obese patients suffering from gastric cancer. Materials and Methods: This was a retrospective analysis of the 138 patients, who underwent a totally laparoscopic distal gastrectomy from April 2005 to March 2009, at the National Kyushu Cancer Center. The body mass index of 20 patients was ≥25, and in 118 patients, it was <25 kg/m2. Results: The mean values of body mass index in the 2 groups were 27.3±2.2 and 21.4±2.3. Hypertension was significantly more frequent in the obese patients than in the non-obese patients. The intraoperative blood loss, duration of surgery, post-operative complication rate, post-operative hospital stay, and a number of retrieved lymph nodes were not significantly different between the two groups. Conclusions: Intracorporeal anastomosis seemed to have a benefit for obese individuals. Totally laparoscopic gastrectomy is, therefore, considered to be a safe and an effective modality for obese patients.
Recent Development of Techniques and Devices in Colorectal Endoscopic Submucosal Dissection
Hiroya Mizutani,Satoshi Ono,Daisuke Ohki,Chihiro Takeuchi,Seiichi Yakabi,Yosuke Kataoka,Itaru Saito,Yoshiki Sakaguchi,Chihiro Minatsuki,Yosuke Tsuji,Keiko Niimi,Shinya Kodashima,Nobutake Yamamichi,Mit 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.6
Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.