Abstract:
BACKGROUND:Since carcinoma of the esophagus is usually diagnosed at an advanced stage, many cases of esophageal cancer are beyond possible radical resection and only palliative treatment can be performed in such cases. Therefore, a great deal of discussion has taken place concerning indications for treatment modality, and various procedures have been performed to palliate such patients. The prognosis for such patients is still poor, even though many kinds of palliation have already been developed and applied. To improve the prognosis of such patients we developed a multidisciplinary treatment which includes high dose rate intraluminal brachytherapy (HDR-ILBRT) and evaluated its effectiveness, especially the HDR-ILBRT component. PATIENTS AND TREATMENT METHODS: Sixty-six patients with unresectable esophageal cancer enrolled in this study. Twenty-seven patients underwent bypass operations. Seven of the 27 patients received external irradiation only (group BE), 11 received external irradiation and HDR-ILBRT (group BEH), while the remaining 9 did not receive radiotherapy (group B). Another 39 patients without bypass operations were all treated with radiotherapy, 22 with external irradiation only (group E) and 17 were treated with external irradiation and HDR-ILBRT (group EH). After completion of radiotherapy, all patients received chemotherapy with 5-FU (2,500 mg/body) and CDDP (100 mg/body). RESULTS:Mean survival time and the 5-year survival rate of group BEH (13.3 +/- 1.5 months and 20%) were significantly improved compared with group BE + B (p < 0.05). In the patients without bypass operations, there were significant differences in the mean survival time and the 3-year survival rate in groups EH and E (group EH 16.5 +/- 2.5 months, 21.8%, group E 9.0 +/- 1.3 months, 0%, p < 0.05). The bypass operation itself and chemotherapy did not significantly affect the prognosis of patients with unresectable esophageal cancer. CONCLUSION:These results strongly suggest the use of HDR-ILBRT, as a component of multidisciplinary treatment for unresectable esophageal cancer, was significantly effective and HDR-ILBRT contributed to improve outcomes in patients with advanced esophageal cancer. HDR-ILBRT should be established as a component of treatments for unresectable esophageal cancer.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Iwasa M,Ohmori Y,Iwasa Y,Yamamoto A,Inoue A,Maeda H,Kume M,Ogoshi S,Nishioka A,Ogawa Y,Yoshida Sdoi
10.1159/000018619subject
Has Abstractpub_date
1998-01-01 00:00:00pages
227-35issue
3eissn
0253-4886issn
1421-9883pii
dsu15227journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Laparoscopic distal pancreatectomy (LDP) for large pancreatic tumors may require prolonged dissection, and this could be associated with increased operative time and intraoperative complications. METHODS:From a total cohort of 190 consecutive patients undergoing LDP, 18 patients were found to have pancreati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000445008
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Little information from prospective clinical trials is available on the influences of surgical approaches on postoperative body compositions and nutritional status. We designed a prospective non-randomized trial to compare postoperative chronological changes in body composition and nutritional status between...
journal_title:Digestive surgery
pub_type: 杂志文章,多中心研究
doi:10.1159/000458714
更新日期:2018-01-01 00:00:00
abstract::Dysgerminomas of the ovary rarely metastasize to abdominal viscera and when they do, the involvement is a part of a disseminated disease. A 30-year-old woman developed isolated duodenopancreatic dysgerminoma 14 years after salpingo-oophorectomy. The clinical picture was complicated by the presence of tuberculous lesio...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050198
更新日期:2001-01-01 00:00:00
abstract:AIM:We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. METHODS:A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. RESULTS:The incidence of 14v metastasis correlated w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000165382
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:Crohn's disease is a chronic relapsing inflammatory bowel disease requiring surgery in a large number of patients. This review describes new developments in surgical techniques for treating Crohn's disease. RESULTS:Single-incision laparoscopic surgery decreases abdominal wall trauma by reducing the num...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000341567
更新日期:2012-01-01 00:00:00
abstract::The introduction and widespread application of minimally invasive surgery has been one of the most important innovations that radically changed the practice of surgery during the last few decades. The application to pancreatic surgery of minimally invasive approach has only recently emerged: both laparoscopic distal p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000445012
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:The management of patients with silent or asymptomatic gallstones remains controversial. The objective of this study is to determine the complications of laparoscopic cholecystectomy performed to treat patients under 50 years of age with asymptomatic gallstones. METHOD:207 patients, 13-49 years of age ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018876
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the feasibility and long-term results of early gastric surgery for patients with isolated gastric stricture following acid corrosion injury. MATERIALS AND METHODS:Upper gastrointestinal (UGI) series was routinely performed around the 4th week after acid corrosion injury. Patients with gastric str...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000064582
更新日期:2002-01-01 00:00:00
abstract:AIMS:To describe the extremely rare case of an adenomyoma of the papilla of Vater. CASE REPORT:A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater....
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050115
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:In the treatment of gastroesophageal reflux disease (GERD), anterior fundoplications are emphasized for their lower risk of complications compared to the posterior approach. AIM:The aim of this study was to evaluate the long-term results of laparoscopic anterior 180 degrees fundoplication in consideration o...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000235959
更新日期:2009-01-01 00:00:00
abstract::The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and m...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018651
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Long-term functional results of ileal pouch-anal anastomosis (IPAA) with mucosal proctectomy (MP) for ulcerative colitis (UC) are satisfactory but may be compromised by perianal fistulae. METHODS:We analyzed the effect of the level of MP (above or below the dentate line) on the risk of perianal fistulae in ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000351443
更新日期:2013-01-01 00:00:00
abstract::The monocyte/macrophage plays a key role in the network of immune reactions. Dependent on activation, it is able to produce various cytokines which act on other cells of the immune system in the sense of upregulation or downregulation. In addition, it presents antigens by the HLA-DR molecule as an initial trigger of a...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018601
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000091444
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Pancreatic serous cystic tumors are considered to have a benign biological and clinical course with only few malignant cases. METHODS:We retrospectively analyzed data from 26 patients affected by serous cystic tumors consecutively observed in our Pancreas Unit. We explored the different clinical pictures in...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000142947
更新日期:2008-01-01 00:00:00
abstract::Infectious complications in surgical patients often originate from the intestinal microflora. In the critically ill patient, small bowel motility is disturbed, leading to bacterial overgrowth and subsequent bacterial translocation due to dysfunction of the gut mucosal barrier. The optimal prophylactic strategy should ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000088053
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/AIMS:Graft failure is a critical complication associated with vascular occlusion in esophageal reconstruction with a free jejunal graft following pharyngolaryngoesophagectomy. In this study, we evaluated the usefulness of intramucosal pH (pHi) measurement using a tonometer to assess the graft viability. MET...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000102902
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Early postoperative small bowel obstruction (EPSBO) is a common complication following colon cancer surgery. EPSBO is associated with increased hospital stays, mortality rates, and healthcare costs. The purpose of this study was to identify risk factors for EPSBO following elective colon cancer surgery. STU...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000468155
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND AND AIMS:It is generally advised to perform colonoscopy after conservatively treated diverticulitis because colon cancer may present itself with similar symptoms, laboratory and radiological results. With this study we investigated in what percentage of patients a malignancy was found by performing routine c...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000345332
更新日期:2012-01-01 00:00:00
abstract::The abdominal cocoon is a rare disease that is characterized by a total or partial encasement of the small bowel by a thick and fibrotic membrane. Thirty-five cases were reported since it was first described. It occurs primarily in females. Preoperative diagnosis is a matter of challenge and usually made at laparotomy...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000065827
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Hilar resection in combination with extended liver resections has resulted in a higher rate of R0 resections and increased survival in patients with hilar cholangiocarcinoma (HCCA). This aggressive surgical approach is, however, associated with high rates of operative morbidity and mortality, largely due to ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000323825
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:Predicting models of operative morbidity and mortality in the geriatric population are important in the prevention of adverse surgical outcomes. METHODS:A retrospective review of medical records was performed for patients over 80 years of age who underwent gastrointestinal surgery from 1998 to 2008. R...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000274485
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND/AIMS:The surgical treatment of duodenogastric reflux (DGR), resistant to medical therapy, in patients with intact stomach is difficult to standardize. The aim of this study is to present our experience on 5 patients, all cholecystectomized, with severe DGR disease treated surgically. METHODS:Out of a group ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018583
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:It has recently been reported that rebamipide (OPC-12759) inhibits inflammatory cytokines and activation of neutrophils. The aim of the present study was to investigate the effects of preoperative administration of rebamipide on parameters of systemic inflammatory response syndrome (SIRS) and serum leve...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章
doi:10.1159/000073645
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The prevalence and significance of joint symptoms appearing in patients with ulcerative colitis (UC) following a colectomy are unclear. AIM:We investigated the relationship between joint symptoms during steroid tapering following an ileal pouch-anal anastomosis (IPAA) and the cumulative risk for developing ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000093495
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND/AIM:Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer has rarely been studied. To investigate the efficacy and advantages of laparoscopy-assisted distal gastrectomy (LADG) with D2 dissection of lymph nodes versus conventional open D2 dista...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000281818
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND AIM:Most patients with hepatic metastases from colorectal carcinoma are unsuitable for resection. Radiofrequency ablation (RFA) has been applied to such lesions at laparotomy. This study aimed to evaluate the less invasive approach of percutaneous RFA. METHOD:Patients with unresectable liver metastases ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000080886
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the diagnostic value of fluorine-18 2-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (F-18-FDG-PET/CT) in patients with colorectal cancer (CRC) has been reported, the association between the F-18-FDG uptake in metastatic lymph nodes (FDGLN) and clinicopatho...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000448222
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Proinflammatory cytokines like TNF-alpha and IL-8 have been thought to play a pivotal role in the propagation of severe acute pancreatitis (AP) and the development of its systemic complications, particularly acute lung injury. OBJECTIVE:To investigate the effects of pretreatment with hydrocortisone on the p...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018730
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Despite decennia of experience, ileal pouch anal anastomosis for ulcerative colitis is still associated with high complication rates. The development of automatic vessel sealers has resulted in the revival of a promising surgical alternative to the conventional procedure: close rectal dissection. By preservi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000331255
更新日期:2011-01-01 00:00:00