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Although several recent meta-analyses have investigated the clinical influence of the addition of lateral lymph node dissection (LLND) on oncologic outcomes in patients with mid-low rectal cancer (RC) undergoing mesorectal excision (ME), most studies included in such meta-analyses were retrospectively designed. Therefore, this study aimed to explore the clinical influence of prophylactic LLND on oncologic outcomes in patients with mid-low RC undergoing ME.

To explore the influence of the no-touch isolation technique (NTIT) on oncologic outcomes for patients with colon cancer (CC) undergoing curative surgery.

High-risk patient selection is required in N0 colon cancer. Although a number of studies have suggested high-risk clinicopathological predictors, most of these are based on analyses in heterogeous patients in terms of surgical procedures. Laparoscopic surgery for colon cancer is becoming a standard procedure worldwide because of its less invasiveness. Accordingly, we aimed to identify bona fide high-risk factors of recurrence in homogeneous N0 patients who underwent laparoscopic surgery. Two hundred and twenty-five patients who underwent laparoscopic curative resection for N0 colon cancer were analyzed. Clinicopathological parameters were tested for their relation to survival. The 5-year recurrence-free survival rate (RFS) was 96.1 per cent. Lymphatic involvement (P < 0.001), vascular involvement (P = 0.007), and size of tumor (P = 0.023) were significantly associated with worse prognosis in the univariate analyses. Lymphatic involvement was the independent prognostic factor associated with RFS in the multivariate analysis (P = 0.013). Importantly, lymphatic involvement predicts detrimental prognosis only when vascular involvement is present. The RFS of the patients with both lymphatic and vascular involvement was 88.9 per cent, whereas it was 100 per cent in the counterpart. Differentiation, vascular involvement preoperative carcinoembryonic antigen, and CA 19-9 levels were significantly associated with lymphatic involvement in a multivariate logistic regression analyses. The present study concludes that lymphatic involvement in the presence of vascular involvement may be a high risk for systemic recurrence in the laparoscopically resected N0 colon cancer.

Adjuvant chemotherapy after resection of colorectal cancer (CRC) lung metastases may reduce recurrences and improve survival. We investigated the effects of adjuvant chemotherapy after curative resection of lung CRC metastases on prognosis.

The main advantage of laparoscopic surgery is that it is minimally invasive because of the use of small incisions. An approach using small incisions offers many benefits including attenuation of surgical wound pain. However, the presence of postoperative pain may undermine the advantages of laparoscopic surgery as a minimally invasive technique. In addition, perioperative pain management is an important factor affecting recovery after surgery. This study investigated the usefulness of a multimodal approach to postoperative pain management with acetaminophen as a baseline analgesic after minimally invasive laparoscopic colorectal surgery.

Gastrointestinal anastomosis remains associated with a considerable burden of morbidity and, in some cases, mortality. Functional end-to-end anastomosis, whilst extremely efficient, is vulnerable to increased intestinal pressure in the immediate postoperative period, which may predispose to development of anastomotic leakage or bleeding. Therefore, there is a requirement for new techniques that facilitate safe and efficacious anastomotic procedures.

The aim of our study was revised as follows: to clarify the postoperative complications of multifunctional central venous ports and the risk factors for such complications to promote the safe use of the PowerPort system in the hospital.

Abdominoperineal resection (APR) of advanced lower rectal cancer carries a high incidence of perineal wound infection. The aim of this study was to retrospectively evaluate risk factors for perineal wound infection after APR.

Laparoscopic surgery has yet to achieve widespread acceptance for the treatment of rectal cancer because of technical difficulty caused by anatomical features and the lack of sufficient evidence supporting effectiveness. Consequently, the safety and long-term outcomes of laparoscopic surgery for rectal cancer remain to be established in Japan. We evaluated the feasibility, safety, and effectiveness of laparoscopic surgery in patients with up to clinical stage 0I rectal cancer.

Short-term and midterm outcomes of surgery remain unclear in very elderly patients (≥85 y) with colorectal cancer. This study was designed to clarify the safety and therapeutic usefulness of surgery for colorectal cancer in this subgroup of patients. We compared postoperative short-term and midterm outcomes between laparoscopic surgery and open surgery to evaluate the feasibility of laparoscopic surgery in very elderly patients.

The aim of this study was to evaluate the benefit of straight laparoscopic restorative proctocolectomy (sLRP) with ileal pouch anal anastomosis for ulcerative colitis (UC).

In order to recreate the landscape of Ishikari Mire, an artificial wetland was made in 2000 at a city park in northern Japan. Its flora, plant communities, and hydrochemical conditions were examined in 2005 and compared with those determined in 2001 and with those of nearby intact fens. Management increased water levels by ca. 10 cm from 2002. Neutral pH, high electrical conductivity (EC), and high concentrations of nitrogen and mineral ions were the same as in 2001, but higher than in fens. The wetland was flooded by river water a few times every year. These hydrochemical conditions suit the growth of fen species. Total species increased from 73 (2001) to 105 (2005), whereas annuals and biennials decreased from 20 to 13 and naturalized exotic species from 18 to 15. Five naturalized exotic species that disappeared by 2005 were all mesophytes, and one of two newly found naturalized exotic species was a hygrophyte. Accordingly, the rapid change can be explained by the change of lifeforms in the early stage of secondary succession, and in some parts, by the disappearance of mesophytic plants as wetness increased. During the 6 years, the wetland communities changed toward that of fens because most of the migrated or imported fen species were increasing. Many other fen plants, therefore, would be able to grow in the wetland, while only four fen species had migrated. Accordingly, importation of other fen plants is essential to recreate the whole plant assemblages of mire.

Background: Dramatic prolongation of the survival of patients with advanced or recurrent colorectal cancer has been achieved by multi-drug chemotherapy using agents such as continuous 5-fluorouracil and leucovorin, irinotecan (CPT-11), L-OHP, bevacizumab and cetuximab. Objective: To explain the background of CPT-11 and to discuss its role in the treatment of advanced or recurrent colorectal cancer in Japan and elsewhere together with the authors' own experience.

We comparatively assessed 41 mucinous colorectal carcinomas (MUCs) and 620 non-MUC (well-, moderately, and poorly differentiated adenocarcinoma) cases for clinicopathologic findings; and 41 MUCs and 115 randomly selected non-MUCs also were studied for the following: (1) apoptotic activity and Ki-67 immunoreactivity; (2) immunohistochemical expression of p21(WAF1/CIP1), p27Kip1, p53, and bcl-2; and (3) c-Ki-ras mutations. The rates for lymph node involvement and peritoneal dissemination were higher in MUCs than in non-MUCs. Multivariate analysis showed MUCs to have a worse prognosis than well-differentiated adenocarcinomas. The Ki-67 labeling for MUCs was significantly lower than that for non-MUCs, whereas the apoptotic index was significantly higher than for the well-differentiated type. The labeling for p21(WAF1/CIP1) and p27Kip1 was lower in MUCs (2.7% and 35.3%, respectively) than in well-differentiated adenocarcinomas (4.2% and 48.6%, respectively). MUCs can be considered a different tumor from the well-differentiated type, with a poor prognosis owing to frequent lymph node metastasis and peritoneal dissemination, and characterized by high apoptotic and low proliferative activities associated with low p21(WAF1/CIP1) and p27Kip1 expression.

It is often said that we live in a world of Big Business, that ever since Japan achieved a high level of economic growth, everything we do from morning until night, or even from cradle to grave, has something to do with large business corporations. It has become exceedingly difficult to escape the sphere of influence of giant corporations in today's "Business Society." Let us take an example.

Colorectal cancer is a rare disease in children. It is often diagnosed at an advanced stage, meaning that these patients often require a multidisciplinary treatment approach. This is a case report of advanced cecal cancer in a teenager who was treated with cytoreductive surgery and long-term chemotherapy with molecular targeted agents.

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