Sei‐ichiro Jimi

Kyushu Hospital

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Masayuki Hotokezaka

University of Miyazaki

Kazuo Chijiiwa

University of Miyazaki

Hideki Hidaka

Miyazaki Prefectural Hospital

Naoki Maehara

Kyushu University

Tada-Aki Eto

Kishokai Medical Corporation

Nobuo Tsutsumi

National Hospital Organization Kochi National Hospital

Yoshihiro Oohata

Kyushu Hospital

Michihiko Kuwano

Kyushu University

Mayumi Ono

Chiba University Hospital

Tetsuo Hamada

Kyushu Hospital

Cooperative Institutions

Kyushu University

University of Miyazaki

University of Miyazaki Hospital

National Hospital Organization

University of Occupational and Environmental Health Japan

National Hospital Organization Kochi National Hospital

Kyushu Hospital

Kitakyushu Municipal Medical Center

Harasanshin Hospital

Osaka University

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Signal Transduction of Vascular Endothelial Cells

Japanese Journal of Thrombosis and Hemostasis (1995)

Michihiko Kuwano Hiroto Izumi Tadahisa Shono Sei‐ichiro Jimi Yukihiro Wakabayashi

10.2491/jjsth.6.67

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A Case of Rectal Cancer Accompanied by Tumor Thrombus in the Inferior Mesenteric Vein

The Japanese Journal of Gastroenterological Surgery (2012)

Sei‐ichiro Jimi Hirotaka Kuga Jirô Watanabe H Yamagata Sadafumi Tamiya

症例は54歳の女性で,主訴は下血と貧血であった.入院後,下部内視鏡検査で直腸に2型進行癌を認めた.造影CTで下腸間膜静脈内に陰影欠損を認め,腫瘍塞栓が疑われた.開腹所見では,腫瘍直下から連続して,下腸間膜静脈周囲にかけて硬い索状物を触知した.下腸間膜静脈を最初に結紮し,低位前方切除・子宮合併切除を施行した.病理組織学的診断では深達度a2の粘液癌で,リンパ節転移は認めなかった.下腸間膜静脈内に腫瘍塞栓を認めた.8か月後の腹部CTで肝臓S4に2 cm大の低吸収域を認め,肝内側区域切除を施行した.肝臓腫瘍は粘液癌で直腸癌の肝転移と診断された.術後FOLFOX4+bevacizumab併用療法による化学療法を約1年間行い経過観察した.化学療法終了後に,肝・肺・副腎転移が出現した.全て切除した.初回術後4年2か月経過した現在生存中である.

Inferior mesenteric vein

Superior mesenteric vein

Mesenteric Vein

10.5833/jjgs.45.1066

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A Case of Uterorectal Fistula due to Pyometra Improved by Conservative Therapy

The Japanese Journal of Gastroenterological Surgery (2005)

Nobuhiro Shibata Masayuki Hotokezaka Sei‐ichiro Jimi Masayasu Shima Yoichiro Mori

子宮留膿腫は高齢女性に多くみられる疾患で, まれに腹腔内に穿破し腹膜炎を起こすことがある. 今回, 我々は急性腹症により発症し, 保存的に改善した子宮留膿腫による直腸子宮瘻の1例を経験したので報告する. 症例は61歳の女性で, 2003年5月, 下腹部痛・嘔吐が出現した. 来院時は下腹部に筋性防御がみられ, CTでは直腸と子宮が交通している所見がみられた. 大腸内視鏡では直腸に径2cmの瘻孔を認め, 瘻孔からは子宮内腔が観察され, 子宮留膿腫の直腸穿破と診断した. 発症から約1か月後の大腸内視鏡・注腸検査で瘻孔は縮小傾向にあり, CTでは肥大した子宮の内腔にair densityと液体成分の貯留を認めた. 子宮頸管の癒着による閉鎖がみられたため, 頸管拡張術を施行し経過観察したところ, 症状の再燃はみられなかった. 子宮留膿腫による直腸子宮瘻は適切なドレナージで保存的に閉鎖が期待できるが, 慢性化する可能性もあり, 慎重な経過観察が必要である.

Pyometra

Conservative Treatment

10.5833/jjgs.38.1395

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Medical students' attitudes to laparoscopic surgery.

Hepatogastroenterology (2008)

Masayuki Hotokezaka Kazuo Chijiiwa Kazuhiro Kondo Masahiro Kai Tada-Aki Eto

The purpose of the present study was to evaluate the attitude of medical students to laparosocopic surgery.Two hundred and seven medical students completed a questionnaire regarding their visualization of, understanding of, and interest in observation of laparoscopic surgery via laparoscopic monitor (laparoscopic observation) and of open surgery, either directly (open direct observation), or via video monitor observation (open monitor observation). They were also asked about their willingness to become an operator (operator). Responses to each item were given as Likert-type scores ranging from 1 to 5.The visualization score was significantly lower for open direct observation than for open monitor observation (P<0.001) and laparoscopic observation (P<0.001), with the significantly lower score for open monitor observation than for laparoscopic observation (P<0.001). The understanding score was significantly lower for open direct observation than for open monitor observation (P<0.01) and laparoscopic observation (P<0.01). Interest scores did not differ between the three observation methods. The operator score was significantly higher for open surgery than for laparoscopic surgery.Laparoscopic surgery provides good visualization of the operative field. However, students' interest in laparoscopic surgery is similar to those of open surgery.

Open surgery

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Comparative effect of lymph node metastasis classified by the anatomical site or by the number of nodes involved on prognosis of patients with gastric cancer.

PubMed (2009)

Hideki Hidaka Tada-Aki Eto Naoki Maehara Sei‐ichiro Jimi Masayuki Hotokezaka

Lymph node metastasis (pN) is one of the most significant prognostic factors in patients with gastric cancer. The pN classification of the Japanese Gastric Cancer Association (JGCA) is based on the anatomical site of metastatic nodes from the primary tumor, whereas that of the International Union Against Cancer (UICC) is based on the number of nodes involved. The purpose of this study was to determine which system is more useful for predicting patient outcomes.From 1992 to 2002, a total of 318 patients at our hospital underwent surgical resection with lymph node dissection for primary gastric cancer. Their medical records were examined, and the overall survival rates were compared between the two pN classification systems.Under the JGCA system, there was a significant difference in patient survival between pN0 and pN1 and between pN1 and pN2 but not between pN2 and pN3. Under the UICC-TNM system, there was a significant difference in patient survival between all pN classes. When the JGCA-pN1 and JGCA-pN2 classes were regrouped as UICC-pN1 and UICC-pN2-3, respectively, the survival rate was still better for the UICC-pN1 class than for the UICC-pN2-3 class.The better differentiation of outcomes by the UICC-pN system suggests that the number of metastatic lymph nodes is more important than the anatomical site in predicting outcomes.

Primary tumor

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Internal Herniation Through the Mesenteric Opening After Laparoscopy-assisted Right Colectomy: Report of a Case

Surgical Laparoscopy Endoscopy & Percutaneous Techniques (2007)

Sei‐ichiro Jimi Masayuki Hotokezaka Tada-Aki Eto Hideki Hidaka Naoki Maehara

We discuss a rare complication in a patient who underwent laparoscopic colectomy. A 69-year-old woman underwent laparoscopy-assisted right colectomy for cancer of the ascending colon. Two months after the operation, bowel obstruction developed. Decompression with a long intestinal tube failed to resolve the obstruction. Thus, surgery was performed. Abdominal exploration revealed a strangulated ileal loop caused by herniation through the mesenteric opening at the anastomotic site. The mesenterium had not been sutured during the previous operation. The anastomotic segment had twisted semicircularly and adhered to the retroperitoneum, so the mesenteric opening had narrowed.

Ascending colon

10.1097/sle.0b013e31806bf493

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Citations (21)

[Successful Management of Deep Vein Thromboembolism and Pulmonary Embolism by Edoxaban for Long-Term 5-FU-Based Chemotherapy for Colon Cancer-A Case Report].

PubMed (2019)

Sei‐ichiro Jimi Yoshihiro Oohata Tetsuro Tamura Shunichi Takahata Takafumi Kamei

A woman in her 70s developed deep vein thromboembolism(DVT)and pulmonary embolism(PE)during chemotherapy for advanced transverse colon cancer. After the first treatment with heparin and warfarin, the anticoagulant was changed to edoxaban to reduce the risk of bleeding. She continued receiving chemotherapy for 4 years. We recommend edoxaban as the first choice of anticoagulant for patients with DVT and PE requiring chemotherapy with fluoropyrimidine-based antineoplastic agents.

Edoxaban

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Clinical features and prognostic factors of bone metastases from colorectal cancer

Surgery Today (2012)

Sei‐ichiro Jimi Takaharu Yasui Masayuki Hotokezaka Kazuo Shimada Yuji Shinagawa

Surgical oncology

Univariate analysis

10.1007/s00595-012-0450-z

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Citations (23)

A Case of Sigmoid Colon Cancer with Colo-urethral Fistula, which was Closed by Colostomy and Chemotherapy

Nihon Daicho Komonbyo Gakkai Zasshi (2019)

Sei‐ichiro Jimi Yoshihiro Oohata Tetsuo Hamada

症例は60歳台，男性．201X年に発熱，下腹部痛，残尿感を訴え，初診時に尿に便が混入していた．下部内視鏡検査でS状結腸に全周性の進行癌を認め，生検病理診断にて中分化腺癌と診断した．CTにて膀胱内にガス像を認め，膀胱鏡で便が噴出する孔を認め，結腸膀胱瘻と診断し，腹膜播種が疑われたので，横行結腸に人工肛門を造設し全身化学療法を開始した．Panitumumab+FOLFOX4を4コース，Panitumumab+FOLFIRIを2コース施行したところ腫瘍が縮小し結腸膀胱瘻も閉鎖した．初診から約6ヵ月後にS状結腸切除，瘻孔部の膀胱部分切除を施行した．癌は瘻孔部には検出されず，癌の浸潤は膀胱漿膜にとどまっていた．リンパ節転移はなかった．術後化学療法を行い術後3年経過し無再発生存中である．人工肛門造設，化学療法にて結腸膀胱瘻が閉鎖した症例を経験した．

Panitumumab

FOLFIRI

10.3862/jcoloproctology.72.405

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A Case of Ossified Recurrent Abdominal Wall Tumor from Sigmoid Colon Cancer

Nihon Daicho Komonbyo Gakkai Zasshi (2019)

Sei‐ichiro Jimi Yoshihiro Oohata Hirofumi Koga Tetsuo Hamada

症例は60歳台，女性．200x年にS状結腸癌に対してS状結腸切除術を受けた．病理組織検査では中分化管状腺癌で，pT4aN1M0stageIIIbであった．半年間Tegafur, uracilとHolnato Calciumを服用した．術後1年後に仙骨前面に病変が出現して骨盤内再発と診断し，全身化学療法を開始した．再発化学療法開始後3年6ヵ月後に嘔吐，食欲不振が出現した．CTで仙骨前面の病変は縮小していたが，下腹部正中の腹壁に石灰化した6×4cm大の腫瘤を認めた．FDG-PETで腹壁結節以外に異常集積は認めなかった．腹腔内側に小腸が巻き込まれており小腸壁を楔形に合併切除し腹壁結節を切除した．病理では骨形成を伴った6×4cmの腺癌と診断された．全身化学療法を行ったが，術後1年10ヵ月で永眠された．

Tegafur

10.3862/jcoloproctology.73.33

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