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RISS 인기검색어
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- 저자 : Kazuo Asanoma (검색결과 3 건)
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Gasless single-port laparoscopic cholecystectomy
Masashi Ishikawa,Michihito Asanoma,Yoshihiko Tashiro,Hirokazu Takechi,Kazuo Matsuyama,Takayuki Miyauchi 대한내시경복강경외과학회 2021 Journal of Minimally Invasive Surgery Vol.24 No.3
Purpose: Single-port laparoscopic surgery is anticipated to become the future of minimally invasive surgery. We have devised an alternative approach for laparoscopic cholecystectomy by inserting a single port at the umbilicus and using the abdominal wall-lifting method, without establishing pneumoperitoneum. Methods: Retrospective analysis of 130 patients undergoing laparoscopic cholecystectomy was done to compare the conventional laparoscopic cholecystectomy (CLC) (n = 69) and the novel single-port laparoscopic cholecystectomy (SLC) using the abdominal wall-lifting method (n = 61). The surgical procedures were as follows. A 2- to 3-cm transumbilical incision was made, and a wound retractor was inserted into the abdomen without difficulty. Abdominal distension was obtained using a fan-shaped retractor without the use of carbon dioxide insufflations. A 5-mm flexible scope and modified curved graspers and dissectors were used to give the feeling of triangulation during dissection. Results: The SLC group consisted of 25 males and 36 females with a mean age of 58.1 ± 7.2 years and a mean body mass index of 23.1 ± 3.2 kg/m2. The two groups were comparable for mean age, sex, disease, American Society of Anesthesiologists physical status classification, and comorbidity. Likewise, the duration of operation, postoperative hospital stays, complications, the number of use of analgesics, and conversion rate to open technique were not significantly different in the two groups. Conclusion: The impaired view in single-port laparoscopic surgery can be improved by using articulating instruments that can be rotated out of the field of view. This novel gasless method is cost-effective and produces minimal postoperative discomfort with no additional scars.
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Shohei Eto,Masashi Ishikawa,Michihito Asanoma,Yoshihiko Tashiro,Kazuo Matsuyama,Takehito Oshio 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.2
A 62-year-old man underwent endoscopic mucosal resection for early gastric cancer. The follow-up computed tomography revealed biliary dilatation. The tumor was located in the lower bile duct with biliary dilatation, and no evidence of metastasis in other organs was noted. The patient underwent subtotal stomach-preserving pancreatoduodenectomy with pancreaticogastrostomy and Billroth I anastomosis. At 13 months after the operation, gastrointestinal endoscopy revealed a tumor lesion in the pancreaticogastrostomy site. Computed tomography revealed that the lesion was low enhanced in the pancreaticogastrostomy site and there was no evidence of other distant metastasis. Partial pancreatectomy was performed. Pathological findings of the tumor in the stump of the pancreas revealed findings similar to that of primary biliary carcinoma. Apparently, the patient was diagnosed with recurrence of bile duct cancer via the pancreatic duct. The patient underwent adjuvant chemotherapy for one year subsequent to partial pancreatectomy as the second operation. For 40 months after the second operation, there has been no evidence of recurrence of cancer.
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Kaoru Okugawa,Hideaki Yahata,Tatsuhiro Ohgami,Masafumi Yasunaga,Kazuo Asanoma,Hiroaki Kobayashi,Kiyoko Kato 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.3
Objective: To apply the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system to all patients who underwent trachelectomy in our previous study and to update the oncologic and obstetric results. Methods: We retrospectively reviewed the medical records of patients in whom abdominal trachelectomy was attempted between June 2005 and September 2021. The FIGO 2018 staging system for cervical cancer was applied to all patients. Results: Abdominal trachelectomy was attempted for 265 patients. Trachelectomy was converted to hysterectomy in 35 patients, and trachelectomy was completed successfully in 230 (conversion rate: 13%). Applying the FIGO 2018 staging system, 40% of the patients who underwent radical trachelectomy had stage IA tumors. Among 71 patients who had tumors measuring ≥2 cm, 8 patients were classified as stage IA1 and 14 as stage IA2. Overall recurrence and mortality rates were 2.2% and 1.3%, respectively. One hundred twelve patients attempted to conceive after trachelectomy; 69 pregnancies were achieved in 46 patients (pregnancy rate: 41%). Twenty-three pregnancies ended in first-trimester miscarriage, and 41 infants were delivered between gestational weeks 23 and 37; 16 were deliveries at term (39%) and 25 were premature deliveries (61%). Conclusion: This study suggested that patients judged to be ineligible for trachelectomy and patients receiving overtreatment will continue to appear using the current standard eligibility criteria. With the revisions to the FIGO 2018 staging system, the preoperative eligibility criteria for trachelectomy, which were based on the FIGO 2009 staging system and tumor size, should be changed.
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