Ken Etoh

Jikei University School of Medicine

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Masaichi Ogawa

Katsushika Medical Center

Katsuhiko Yanaga

Sanno Medical Center

Sadao Anazawa

Jikei University School of Medicine

Michiaki Watanabe

Handa City Hospital

Kenji Ikeuchi

Social Insurance Saitama Chuo Hospital

Yoji Yamazaki

Lion Foundation

Hiroshi Ando

Social Insurance Saitama Chuo Hospital

Fumiaki Yano

Jikei University School of Medicine

Hiroaki Aoki

Chigasaki Rehabilitation College

Tadahiko Masaki

Kyorin University

Cooperative Institutions

Jikei University School of Medicine

The Jikei University Hospital

Katsushika Medical Center

Kyoto Prefectural University of Medicine

The Japanese Society of Gastroenterological Surgery

Kumamoto University

The University of Tokyo

International University of Health and Welfare

Jikei University Kashiwa hospital

Tohoku University

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Chronic abdominal pain, appendiceal mucinous neoplasm, and concurrent intestinal endometriosis: a case report

Journal of Medical Case Reports (2012)

Takanori Kurogochi Tetsuji Fujita Naoko Iida Ken Etoh Masaichi Ogawa

Although both appendiceal tumor and intestinal endometriosis have been reported as rare causes of abdominal pain, the coexistence of appendiceal mucinous neoplasm and ileal endometriosis has not previously been reported.A 41-year-old Japanese woman presented with a positive fecal occult blood test and a 3-year history of menstruation-related lower abdominal pain. A colonoscopy demonstrated extrinsic compression of the cecum, suggesting a mass arising from the appendix or adjacent structures. Abdominal imaging showed a 6-cm cystic mass with intraluminal thick fluids originating from the appendix. At ileocecal resection for an appendiceal tumor, a 2-cm mass in the terminal ileum was incidentally found, which was included in the surgical specimen. Microscopic examination confirmed a diagnosis of a mucinous neoplasm of the appendix with endometriosis of the terminal ileum.To avoid urgent surgery for subsequent serious events associated with disease progression, appendiceal tumor and intestinal endometriosis should be ruled out in patients with chronic abdominal pain.

Cecum

Abdominal mass

Ileocecal valve

Mucinous Tumor

Fecal occult blood

10.1186/1752-1947-6-327

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EXPRESSION OF LAMININ AND CADHERIN ASSOCIATED WITH LIVER METASTASIS IN HUMAN COLORECTAL CANCER -AN APPROACH FROM IMMUNOHISTOCHEMISTRY-

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (2000)

Masaichi Ogawa Kenji Ikeuchi Michiaki Watanabe Yasushi Kaneko Ken Etoh

The significance of laminin and cadherin expression in human colorectal cancer was investigated by immunohistochemical assay, and its correlation with liver metastasis was analyzed. In the synchronous metastasis group, 17 of 34 cases (50%) showed positive staining of laminin, 14 (41%) of cadherin, and 5 (14%) a decreased rate of cadherin. In the metachronous metastasis group, 17 of 30 (57%) showed positive staining of laminin, 12 (40%) of cadherin, and 6 (20%) a decreased rate of cadherin. In a control group (free of disease for 5 years), in spite of no significant differences in clinicopathological factors compared with the other two groups, only 2 of 37 cases (5%) showed positive staining of laminin, 8 (22%) in cadherin, and 2 (5%) a decreased rate of cadherin. Thus, the metastatic groups were significantly higher than the control group in expression of laminin, but no significant difference in expression of cadherin was observed. These findings suggest that laminin is a useful parameter for predicting liver metastasis.

Positive staining

10.3919/jjsa.61.1135

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Expression of matrix metalloproteinase 7, laminin and type IV collagen-associated liver metastasis in human colorectal cancer: immunohistochemical approach.

PubMed (2005)

Masaichi Ogawa Kenji Ikeuchi Michiaki Watanabe Ken Etoh Tetsuya Kobayashi

Matrix metalloproteinase 7 (MMP-7) plays an important role in vessel invasion and metastasis in human colorectal cancer.The significance of MMP-7, laminin and type IV collagen expression in human colorectal cancer was investigated by immunohistochemical assay, and the correlation with liver metastasis was analyzed.In a synchronous metastasis group, 26 of 36 cases (72%) showed positive staining of MMP-7: There were 32 cases (89%) in the lymph channel and 28/32 cases (87%) in the vessels, and 17/34 cases (50%) showed a positive rate of laminin. In the metachronous metastasis group, 14 of 30 cases (47%) showed positive staining of MMP-7: There were 19 cases (63%) in the lymph channel and 13/19 cases (69%) in the vessels, and 17/30 cases (57%) showed a positive rate of laminin. In the control group, which was a 5-year disease-free group, despite there being no significant clinicopathological factors compared with the other two groups, 17 of 37 cases (51%) showed positive staining of MMP-7: There were 12 cases (37%) in the lymph channel and 6 cases (18%) in the vessels, and 2/31 cases (5%) showed a positive rate of laminin. The expression of type IV collagen attenuated in 19 out of 32 cases (59%) in Group S, 10 out of 19 cases (53%) in Group M, and 14 out of 37 cases (38%) in Group C, with no significant differences among the groups. Thus, the metastatic groups were significantly higher than the control group in terms of expression of laminin and MMP-7 in the lymph channel.These findings suggest that laminin and the expression of MMP-7 in the lymph channel is a useful parameter for predicting liver metastasis.

Type IV collagen

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Low Anterior Resection Syndrome: A Questionnaire Survey for Colorectal Surgeons in Tokyo and the Surrounding Districts

Nihon Daicho Komonbyo Gakkai Zasshi (2021)

Hiroyoshi Matsuoka Masamichi Yasuno Keiichi Takahashi Kimihiko Funahashi Yoshihisa Saida

【目的】直腸低位前方切除症候群（以下LARS）に関する外科医からみた実態を明らかにする．

10.3862/jcoloproctology.74.430

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A Clinical Study of the Laparoscopic Wedge Resection of Stomach and Percutaneus Transgastricwall Mucosal Resecton for Early Gastric Cancer

Progress of Digestive Endoscopy(1972) (1995)

Norio Mitsumori Ryuzo Murai Hiroshi Ando Ken Etoh Kazuhito Sasaya

We evaluated the laparoscopic wedge resection (LWR) and percutaneus transgastricwall mucosal resection (PTEMR) for early gastric cancer. LWR indicated anterior, greater curveture and partial posterior gastricwall lesions. Under general anesthesia, 3-5 tracars are inserted abdominal wall. After crumping jejunum at Treiz ligament, two needles (18G) are injected percutaneus transgastricwall around the lesion. A suture is inserted through the needle and catched that by looped stainless wire from another site. Then two points lifting of the gastric wall is made. Same way, another two needles are inserted around the lesion for 4 points cross lifting of the gastricwall and wedge resection was perfomed with autosuture device. PTEMR is a procedure for gastric mucosal resection under gastroendoscopy using laparoscopic forceps and scissors through gastrostomy. The lesion is grasped by the forceps and resected by a snare with electrocautery under gastroscopic view. We have perfomed 7 lesions of 6 cases by PTEMR, and 2 cases by LWR for early gastric cancers.

Wedge resection

10.11641/pdensks.47.0_148

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Internal hernia through a mesenteric defect after laparoscopic sigmoidectomy for early sigmoid colon cancer^|^mdash;a case report^|^mdash;

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (2012)

Tadashi Anan Ken Etoh Yoshinobu Mitsuyama Masaichi Ogawa Nobuo Omura

症例は66歳,男性.当院で早期S状結腸癌に対し腹腔鏡下S状結腸切除術を施行し,外来経過観察中であった.深夜より腹痛を訴え近医受診,腹部写真で腸閉塞と診断され当院救急搬送となった.腹部は緊満し圧痛を伴い,腹部造影CTでS状結腸の吻合部に接して拡張腸管を認め,内ヘルニアによる絞扼性イレウスを疑い同日緊急手術を施行した.開腹所見では血性腹水を認め,回腸が約60cmにわたりS状結腸間膜欠損孔より脱出し内ヘルニアとなっていた.脱出腸管に壊死を認め,腸管切除を行った.術後は第4病日まで発熱,炎症所見の遷延を認めたが,以後は問題なく経過し第16病日に退院となった.腸管の手術において,腸間膜は閉鎖するのが一般的と考えられていたが,腹腔鏡手術では手技が困難なこと等を理由に閉鎖されないことが多い.文献上も必要性は述べられているが,手技の難易度,内ヘルニア発症率を考慮する必要があると考えられる.

Internal hernia

Sigmoid function

10.3919/jjsa.73.2716

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Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors

Shuzo Kohno Masahiro Ikegami Toru Ikegami Hiroaki Aoki Masaichi Ogawa

Neuroendocrine tumors develop from systemic endocrine and nerve cells, and their occurrence has increased recently. Since these tumors are heterogeneous, pathological classification has been based on the affected organ. In 2019, the World Health Organization introduced a change that is expected to influence neuroendocrine tumor research, as gastroenteropancreatic neuroendocrine tumors are now included within a unified classification. In this retrospective study, we aimed to investigate the characteristics (e.g., lymph node metastases, all other metastases) of gastroenteropancreatic neuroendocrine tumors using this new classification in 50 cases. Tumor size, depth, MIB-1 index, lymphatic invasion, venous invasion, and neuroendocrine tumor grade were significantly correlated with lymph node metastasis and all other metastases. Venous invasion was more strongly correlated with lymph node metastasis and all other types of metastasis than with lymphatic invasion. Identification rates for lymphatic invasion were considered lower because of structural problems such as lymphatic vessels being much thinner than veins. However, venous invasion was considered effective in compensating for the low rate of identification in cases of lymphatic invasion. In future research, a unified classification and standardized framework for assessment will be important when analyzing the characteristics of neuroendocrine tumors, and large-scale studies are required.

Lymphovascular invasion

10.20944/preprints202111.0161.v1

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