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9 results on '"Yamaoka, Hajime"'

3. Secondary aortoenteric fistula possibly associated with continuous physical stimulation: a case report and review of the literature

Author

60878362, Saito, Hiroaki, Nishikawa, Yoshitaka, Akahira, Jun-ichi, Yamaoka, Hajime, Okuzono, Toru, Sawano, Toyoaki, Tsubokura, Masaharu, Yamaya, Kazuhiro, 60878362, Saito, Hiroaki, Nishikawa, Yoshitaka, Akahira, Jun-ichi, Yamaoka, Hajime, Okuzono, Toru, Sawano, Toyoaki, Tsubokura, Masaharu, and Yamaya, Kazuhiro

Abstract

Background: Secondary aortoenteric fistula is a rare but fatal complication after reconstructive surgery for an aortic aneurysm characterized by abdominal pain, fever, hematochezia, and hematemesis, and the mortality rate is high. It has been suggested that it arises due to either continuous physical stimulation or prosthesis infection during primary surgery. We describe an aortoenteric fistula following reconstructive surgery for an abdominal aortic aneurysm together with postmortem pathological findings. Case presentation: A 59-year-old Japanese man who had undergone reconstructive surgery for an abdominal aortic aneurysm 20 months earlier presented with the chief complaint of hematochezia and malaise. Esophagogastroduodenoscopy and total colonoscopy revealed only colon diverticula with no bleeding. Contrast-enhanced computed tomography revealed gas within the aneurysm sac and adhesion between the replaced aortic graft and intestinal tract, suggesting a graft infection. After 18 days of antibiotic treatment, he suddenly went into a state of shock, with massive fresh bloody stool and hematemesis, followed by cardiac arrest. An autopsy revealed communication between the artery and the ileum through an ulcerative fistula at the suture line between the left aortic graft branch and the left common iliac artery. Pathological analysis revealed tight adherence between the arterial and intestinal walls, but no marked sign of infection around the fistula, suggesting that the fistula had arisen due to physical stimuli. Conclusions: Pathological analysis suggested that the present secondary aortoenteric fistula arose due to physical stimuli. This reaffirms the importance of keeping reconstructed aortas isolated from the intestine after abdominal aortic aneurysm surgery.

Published
2019

7. Usefulness of the S-O clip for gastric endoscopic submucosal dissection (with video).

Author

Hashimoto, Rintaro, Hirasawa, Dai, Iwaki, Tomoyuki, Yamaoka, Hajime, Nihei, Kousuke, Tanaka, Ippei, Chonan, Akimichi, and Takase, Kei

Subjects
ENDOSCOPIC surgery, EXTRAORAL traction appliances, GASTROINTESTINAL cancer, PROPENSITY score matching, MULTIVARIATE analysis, ADENOMA, GASTRECTOMY, PROBABILITY theory, STOMACH tumors, LOGISTIC regression analysis, TREATMENT effectiveness, RETROSPECTIVE studies
Abstract

Background: Endoscopic submucosal dissection (ESD) is technically one of the most complicated endoscopic procedures. Traction methods have been reported to be effective for ESD. A recent study revealed that the S-O clip allowed faster and safer colonic ESD. We assessed the efficacy and safety of gastric ESD with the S-O clip for gastric epithelial neoplasm.Methods: We performed a retrospective cohort study of patients treated for gastric ESD using the S-O clip between September and November 2016 (SO group, n = 48). The subjects were matched with patients treated with conventional gastric ESD from September 2015 to August 2016 (control group, n = 258) at Sendai Kousei Hospital, a tertiary endoscopic center. The primary outcome was procedure time. Multivariate logistic regression and propensity score matching analyses were performed to reduce the effects of selection bias for potential confounding factors differences like age, sex, lesion location, lesion position, presence of ulcer scarring, resected specimen size, and operator experiences.Results: Forty-eight pairs were created after propensity score matching. The mean procedure time (including the S-O clip attachment time) was significantly shorter in the SO group (47.2 ± 24.6 vs. 69.2 ± 67.1 min, p = 0.035). The mean clip attachment time was 4.4 (range 2-15) min. There were no significant differences in other treatment outcomes (en-bloc resection rate: 100 vs. 100%, p = 1.000; perforation rate: 0 vs. 2.1%, p = 0.315; delayed bleeding rate: 2.1 vs. 4.3%, p = 0.558).Conclusions: The S-O clip improved the speed of gastric ESD by approximately 25%, without increasing adverse events. [ABSTRACT FROM AUTHOR]

Published
2018
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9. A case of a glomus tumor of the stomach resected by laparoscopy endoscopy cooperative surgery.

Author

Nakajo K, Chonan A, Tsuboi R, Nihei K, Iwaki T, Yamaoka H, Sato S, Matsuda T, Nakahori M, and Endo M

Subjects
Female, Gastroscopy, Humans, Laparoscopy, Middle Aged, Tomography, X-Ray Computed, Glomus Tumor diagnostic imaging, Glomus Tumor surgery, Stomach Neoplasms diagnostic imaging, Stomach Neoplasms surgery
Abstract

A 56-year-old woman who was found to have a submucosal tumor (SMT) of the stomach in a medical check-up was admitted to our hospital for a detailed investigation of the SMT. Upper gastrointestinal endoscopy revealed an SMT of 20mm at the anterior wall of the antrum of the stomach. Endoscopic ultrasonography showed a hyperechoic tumor in the fourth layer of the stomach wall. CT examination showed a strongly enhancing tumor on arterial phase images and persistent enhancement on portal venous phase images. Laparoscopy endoscopy cooperative surgery was performed with a diagnosis of SMT of the stomach highly suspicious of a glomus tumor. Immunohistochemistry revealed expression of α-SMA but no expression of desmin, c-kit, CD34, or S-100. The tumor was finally diagnosed as a glomus tumor of the stomach.

Published
2016
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