Naoki Wajima

Hirosaki University

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Kenichi Hakamada

Hirosaki University

Takahiro Muroya

Hirosaki University

Hitoshi Kawasaki

Saitama Medical University

Norihito Kubo

Ome Municipal General Hospital

Makoto Nakai

Unitika (Japan)

Harue Akasaka

Hirosaki University

Keiichi Miyamoto

Kajima Corporation (Japan)

Akitoshi Kimura

Nippon Veterinary and Life Science University

Shinnosuke Yonaiyama

Hachinohe Gakuin University

Yoshihito Nakayama

Hachinohe Gakuin University

Cooperative Institutions

Hirosaki University

Hirosaki University Hospital

Hirosaki National Hospital

Aomori Rosai Hospital

Aomori Prefectural Central Hospital

Tohoku University

Nihon University

The University of Tokyo

City Hospital

Nippon Medical School

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[Two cases of complete response of primary esophageal carcinoma treated with 5-FU/CDDP as neoadjuvant chemotherapy].

PubMed (2011)

Kentaro Takahashi Hitoshi Kawasaki Naoki Wajima Keiichi Miyamoto Masateru Maruyama

CASE 1: A 67-year-old man with lower thoracic esophageal carcinoma, T2N0M0, cStage II, underwent neoadjuvant chemotherapy (NAC) with 5-FU/CDDP. After 2 courses of NAC, radical resection of the esophageal carcinoma was performed. Primary tumor was not palpable, and lymph node swelling was not found in the resected specimens. Pathologic examination of the resected specimens revealed no malignant cells in the esophagus. Histologic effect of the NAC was grade 3. We obtained down-staging of carcinoma in T0N0M0, fStage 0. CASE 2: A 58-year-old man with thoracic esophageal cancer, T3N2M0, cStage III, underwent NAC with 5-FU/CDDP. After 2 courses of NAC, radical resection of the esophageal carcinoma was performed. Primary tumor was not found in the resected specimens. Pathologic examination of the resected specimens revealed only an irregular fibrosis of esophageal wall, and no malignant cells in the esophagus. Two lymph node metastasis and surrounding fibrosis was found. We obtained down-staging of carcinoma in T0N2M0, fStage II. We report two cases of complete response of primary esophageal carcinoma treated with 5-FU/CDDP as neoadjuvant chemotherapy.

Primary tumor

Esophageal disease

Esophagectomy

Neoadjuvant Therapy

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Citations (2)

[A case of pneumatosis cystoides intestinalis after neoadjuvant chemotherapy for esophageal cancer].

PubMed (2014)

Harue Akasaka Naoki Wajima Akitoshi Kimura Shingo Sakuraba Norihito Kubo

A man in his 60s was diagnosed with esophageal cancer (T3, N0, StageII) and treated with 5-fluorouracil and cisplatin as neoadjuvant chemotherapy (NAC). On day 18 of the second NAC course, the patient developed febrile neutropenia, and a computed tomography (CT) scan showed pneumatosis cystoides intestinalis (PCI) of the ascending and transverse colon, free air around the ascending colon, thickening of the gallbladder wall, pleural effusion, and ascites. Because there were no signs of peritoneal irritation and intestinal perforation was ruled out, conservative treatment was selected. Seven days after PCI was diagnosed, CT showed improvement in PCI and the free air had disappeared, and 26 days after the diagnosis, a subtotal esophagectomy was performed. Observation of the abdomen did not show a thickened wall or stenosis of the ascending or transverse colon. PCI could be treated conservatively, even with free air in the abdominal cavity, by comprehensively assessing not only the imaging but also the physical findings. We were able to perform radical resection of the esophageal cancer without excessive treatment for PCI.

Ascending colon

Transverse colon

Pneumatosis Cystoides Intestinalis

Perforation

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Citations (2)

Incidence of Bile Duct Stone after Prophylactic Cholecystectomy Incorporated in Curative Gastrectomy for Cancer

Hirosaki igaku (1996)

Yuzuru SUGIYAMA Ryukichi Hada Hiroyasu Kobori Yutaka HARA Naoki Wajima

Bile duct cancer

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Citations (0)

[Analysis of postoperative pulmonary complications after esophagectomy for esophageal cancer].

PubMed (2011)

Keiichi Miyamoto Hiroyuki Koizumi Hiroyuki Shiobara Hitoshi Kawasaki Naoki Wajima

We examined factors contributing to an onset of postoperative pulmonary complications following esophagectomy for esophagus cancer. One hundred thirty-two cases of the resected esophageal cancer were studied. We considered the relationship between preoperative patient factors, operative factors, clinical stage factors and postoperative pulmonary complications. Postoperative pulmonary complication was observed in 27 cases (20%). The incidence of postoperative pulmonary complications was significantly higher in patients aged 70 and above and those with a preoperative serum albumin value of less than 4 .0 g/dL. Additionally, these two factors were correlated with an onset of postoperative pulmonary complications in multivariate analyses. A decrease of preoperative serum albumin value was reflecting the chronic poor nutritional condition. Moreover, it was possible that poor nutritional condition served as a prognostic factor of postoperative complications in relation to reduction of cellular immunity. The results indicated that there was a possibility of decreasing an onset of postoperative pulmonary complications using various nutrition managements before operations.

Esophagectomy

Pulmonary infection

Serum Albumin

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[A case of syndrome of inappropriate antidiuretic hormone secretion in a patient with esophageal carcinoma possibly induced by cisplatin in neoadjuvant chemotherapy].

PubMed (2014)

Takeyuki Sawano Hitoshi Kawasaki Naoki Wajima Keiichi Miyamoto Yoshiya Ishizawa

A 60 -year-old man complained of dysphagia and was admitted to our hospital for adjuvant chemotherapy under a diagnosis of esophageal carcinoma(squamous cell carcinoma[SCC], Stage II ). He was treated with cisplatin(CDDP)and 5- fluorouracil(5-FU). On the fifth day after administration, he experienced mild disorientation, and early morning on the sixth day, he showed impaired consciousness. Laboratory studies revealed a serum sodium level of 111mEq/L and a serum chloride level of 73mEq/L. The findings of computed tomography and magnetic resonance imaging of the head were unremarkable. Other laboratory studies revealed a plasma vasopressin level of 19.2 pg/mL, a plasma osmolality of 219mOsm/kg, a serum creatinine level of 0.61mg/dL, a serum cortisol level of 27.1 mg/dL, a urine osmolality of 665mOsm/kg, and a urine sodium level of 157.1mEq/L. There were no signs of dehydration, and so the patient was diagnosed with syndrome of inappropriate antidiuretic hormone secretion(SIADH). We discontinued chemotherapy and initiated fluid restriction and sodium supplementation. After this treatment, the patient's consciousness progressively improved. On the fifth day of treatment, laboratory studies revealed a serum sodium level of 138mEq/L and a serum chloride level of 98mEq/L, indicating recovery from hyponatremia.

Urine osmolality

Plasma osmolality

Oliguria

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Citations (6)

[A Successfully Treated Patient Who Underwent Esophageal Bypass Surgery after Undergoing Stent Placement for Unresectable Advanced Esophageal Cancer Stenosed after CRT].

PubMed (2019)

Takanobu Akaishi Naoki Wajima Takahiro Muroya Norihito Kubo Eri Yoshida

Esophageal bypass surgery is a treatment for oral ingestion in cases of unresectable esophageal cancer with esophageal stricture. Esophageal bypass surgery may be necessary especially in cases of advanced esophageal stricture after CRT because of the high risk of bleeding and perforation due to esophageal stent placement. In recent years, as a safe technique with fewer complications, esophageal bypass surgery using a Y-shaped gastric tube has been increasingly performed. Therefore, we will introduce cases that have undergone esophageal bypass surgery after undergoing stent placement for unresectable advanced esophageal cancer stenosed after CRT.

Esophageal stricture

Perforation

Esophageal stent

Bypass surgery

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A Case of Surgically Treated Varices of the Rectum and Sigmoid Colon with Klippel-Trenaunay-Weber Syndrome.

Nihon Daicho Komonbyo Gakkai Zasshi (1995)

T. Sugoh Takayuki Morita Y. Yamanaka Kimiaki Hirama Naoki Wajima

症例は53歳,男性.小学生の頃より,左下肢の腫脹と下血があり,17歳時にKlippe1-Trenaunay-Weber症候群と診断された.1990年11月18日,十二指腸潰瘍穿孔のために,公立七戸病院で手術が行われ,手術中の腹腔内検索で,S状結腸から直腸にかけて静脈瘤が認められた,下血を繰り返し,静脈瘤による腸管狭窄症状を併発しているため根治的手術が必要と判断され,当科に紹介された.1991年2月26日,S状結腸・直腸切除を行い,経肛門的に結腸肛門吻合で再建した.予防的回腸ストーマ閉鎖後の排便は頻回であったが,現在は日常生活に支障なく社会復帰している.S状結腸・直腸に静脈瘤を合併しているKlippel-Trenaunay-Weber症候群は本邦では6例が報告されている.いずれの症例も保存的に治療されており,われわれの症例は根治的な肛門温存手術で治療された第1例目である.この手術は,下血を繰り返す例や腸管狭窄の症状を伴う例には有効な術式と考えられた.

Sigmoid function

Klippel-Trenaunay-Weber Syndrome

10.3862/jcoloproctology.48.6_489

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Citations (1)

[A Case of Neuroendocrine Carcinoma of the Esophagus Treated with Neoadjuvant Chemotherapy Comprising 5-Fluorouracil plus Cisplatin].

PubMed (2016)

Takahiro Muroya Naoki Wajima Harue Akasaka Tatsuya HASEBE Yuta Yakoshi

Esophageal neuroendocrine carcinoma is relatively rare and the prognosis is poor owing to its aggressive malignancy. We experienced a case of neuroendocrine carcinoma of the esophagus treated with neoadjuvant chemotherapy of 5-fluorouracil plus cisplatin. A 71-year-old man was diagnosed with esophageal carcinoma(clinical T3N1M0, Stage III ). He received neoadjuvant chemotherapy comprising 5-fluorouracil plus cisplatin, followed by subtotal esophagectomy with dissection of 3 regional lymph nodes. Immunohistochemical findings were synaptophysin-positive, CD56-positive, Ki-67(labeling index) B90%. The final diagnosis was neuroendocrine carcinoma, categorized as CT-pT1a-MM, pN0, Stage 0. The pathological response to neoadjuvant chemotherapy was Grade 2. The patient is alive 8 months after esophagectomy without metastasis.

Esophagectomy

Neoadjuvant Therapy

Synaptophysin

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[A Case of Perforated Gastric Cancer Treated with Curative Resection Following Conservative Medical Management and Chemotherapy].

PubMed (2018)

Yuto Mitsuhashi Takahiro Muroya Naoki Wajima Norihito Kubo Eri Yoshida

Perforated gastric cancer typically requires life-saving emergency surgery. However, preoperative diagnosis is difficult, the rate of radical resection is low, and the prognosis remains poor. Perforated gastric cancer is generally treated with 1- or 2- stage gastrectomy, but radical resection is rarely performed after a conservative medical management and chemotherapy for perforated gastric cancer. A 65-year-old man visited another hospital with left upper abdominal pain. He was diagnosed with upper GI perforation, and conservative medical management was selected because peritonitis was limited. After close examination, a Type 3 tumor was found in the cardiac region of the stomach. As the advanced gastric cancer was unresectable, chemotherapy, comprising4 courses of SP plus T-mab, was subsequently administered. As the therapeutic effect was PR, we performed total gastrectomy. The pathological findings were tub2>tub1>por2: pT2N1CY0H0P0M0, pStageⅡ, and we achieved curative resection. Postoperatively, S-1 treatment was performed as an adjuvant chemotherapy. The patient remains alive, without recurrence, for 3 years and 6 months postoperatively.

Perforation

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[A case of cancer in the dilated jejunal pouch after total gastrectomy].

PubMed (2013)

Takeyuki Sawano Hitoshi Kawasaki Naoki Wajima Akitoshi Kimura Makoto Nakai

We report a case of cancer in the dilated jejunal pouch after total gastrectomy, in which we resected the jejunal pouch. The patient was a man in his 60s and had a history of total gastrectomy with jejunal pouch ρ-interposition for mucosa-associated lymphoid tissue (MALT) lymphoma in 1994. In late July 2012, he presented to the emergency department with a protracted ileus-like symptom and was admitted to the gastroenterological department after the diagnosis of a dilated jejunal pouch. He was managed conservatively; however, the same symptom recurred. Examinations showed a duodenal carcinoma and cancer in the jejunal pouch; therefore, he was referred for digestive surgery in early August. Endoscopic mucosal resection( EMR) was performed on the duodenal carcinoma, and we resected the jejunal pouch with Roux-en-Y reconstruction for the jejunal cancer. He recovered from postoperative wound infection and was discharged 15 days after the second operation.

Pouch

Ileus

Jejunum

Duodenal cancer

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Citations (1)