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Search Results: 1 - 10 of 1356 matches for " Masashi Takemura "
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Direct Instruction by an Experienced Surgeon Can Shorten the Learning Curve for Laparoscopic-Assisted Distal Gastrectomy  [PDF]
Masashi Takemura, Katsuyuki Mayumi, Takashi Ikebe, Sinya Tanimura
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.46A006

Aim: Laparoscopy-assisted distal gastrectomy (LADG) with regional lymph node dissection is a treatment option for patient with early gastric cancer. However, LADG is a technically complex and advanced procedure, which is challenging for inexperienced surgeons. In this report, we retrospectively evaluated the learning curve for LADG of a single surgeon with no previous experience in LADG and the usefulness of direct instruction by a surgeon experienced in LADG in shortening the learning curve. Patients and Methods: This study was analyzed 80 consecutive patients, who underwent LADG by a single surgeon (first assistant in 10 cases and operator in 70 cases) between January 2008 and December 2012. Patients were divided into 3 sequential groups of 10 (training period), 30 (learning period), and 40 (operating period) cases in each group. Median operation time and estimated blood loss for these 3 groups were determined. Other learning indicators, including transfusion requirement, postoperative complications, number of lymph node harvested, and rate of conversion open gastrectomy, were also evaluated. Results: During the training period, median operation time and estimated blood loss were 219.5 min and 83.0 ml, respectively. During the learning period, the operation time was significantly longer than that of training period. In the operating period, the operation time was significantly lesser than that during the learning period. However, the operation time was not different from that during the training period and reached a plateau. The estimated blood loss during the operating period was significantly lesser than that during the learning period. The difference in the number of lymph nodes retrieved between each group was not significant.

Operative Benefits of Artificial Pneumothorax in Thoracoscopic Esophagectomy in the Left Lateral Decubitus Position for Esophageal Cancer  [PDF]
Masashi Takemura, Nobuaki Kaibe, Mamiko Takii, Mitsuru Sasako
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.612127
Abstract: Objectives: This study aimed to evaluate operative benefits of artificial pnuemothorax in thoracoscopic esophagectomy in the left lateral decubitus position. Methods: We retrospectively analyzed short-term surgical outcomes including learning curve of 60 consecutive patients who underwent thoracoscopic esophagectomy with artificial pnuemothorax in the left lateral decubitus position between April 2010 and November 2012 in our department. Results: The median operation time and intraoperative blood loss were 443 min and 220 ml, respectively, and these values were 174 min and 95 ml, respectively, in the thoracic phase of surgery. The median number of harvested lymph node was 37. Only 1 patient required conversion to open esophagectomy. The postoperative 30-day mortality rate was 1.7%. The thoracic operation time significantly decreased after an experience of 10 cases and intraoperative blood loss during thoracic phasesignificantly decreased after an experience of 20 cases (p < 0.05), and operation time remained constant for the following cases. The number of harvested lymph nodes did not exhibit significant changes with an increase in the number of case experienced. Conclusions: Artificial pneumothorax provided the shorting of learning curve at the thoracoscopic esophagectomy in the left lateral decubitus position.
Thoracoscopic resection of thoracic esophageal duplication cyst containing ectopic pancreatic tissue in adult
Masashi Takemura, Kayo Yoshida, Keiichirou Morimura
Journal of Cardiothoracic Surgery , 2011, DOI: 10.1186/1749-8090-6-118
Abstract: In adults, the patients with esophageal duplication cysts are asymptomatic and accidentally diagnosed on chest X-ray photograph or computed tomography. Cysts may become symptomatic owing to various complications such as esophageal stenosis, respiratory system compression, rupture, infarction, or malignancy [1-5]. Definitive treatment involves complete surgical resection of the cysts via thoracotomy, even in asymptomatic [6,7]. But, in recent years, the thoracoscopic approach makes more indicate for mediastinal diseases [8,9].In this report, we describe a case of esophageal duplication cyst, which contained the ectopic pancreatic tissue in the solid portion of cyst, was resected under the thoracoscopic approach in a young adult.A 21-year-old woman with history of repeated chest pain was admitted to our hospital. She had been initially diagnosed mediastinal abscess due to rupture of esophageal diverticulum at another facility. Blood examination showed leucocytosis (12430/mm3), but normal level of C-reactive protein. Chest x-ray photograph revealed no sign of mediastinal mass and pleural effusion. The bilateral lung fields were apparently normal. The chest vertebral bodies and intervertebral disc spaces have unremarkable changes. An upper gastrointestinal endoscopy showed the esophageal diverticulum lined columnar epithelium at left side of middle thoracic esophagus (Figure 1). Chest computed tomography showed a meditational mass at caudal side of tracheal carina at the left side of middle thoracic esophagus, and maximum diameter of approximately 3 cm. The mass lesion have thin wall and contained partially air density part and solid portion (Figure 2). The patient was diagnosed as having a mediastinal abscess due to perforation of esophageal diverticulum from these findings.Surgery was carried out via right thoracoscopic approach. The double lumen endotracheal tube was used for deflates the right lung. The arch of azygos vein was ligated and cutted. The middle thoracic
Gastric malignant schwannoma presenting with upper gastrointestinal bleeding: a case report
Masashi Takemura, Kayo Yoshida, Mamiko Takii, Katsunobu Sakurai, Akishige Kanazawa
Journal of Medical Case Reports , 2012, DOI: 10.1186/1752-1947-6-37
Abstract: A 70-year-old Japanese man presented with gastrointestinal bleeding to our hospital. Gastrointestinal endoscopy revealed a protruding lesion in the gastric body. Hematoxylin and eosin staining of biopsy specimens from this lesion revealed sheets of spindle cells. Immunohistochemistry revealed that these cells were positive for S-100 protein and negative for c-Kit and smooth muscle actin. Because mitosis was diffusely visible, this tumor was diagnosed as a gastric malignant schwannoma. Distal gastrectomy with lymph node dissection was performed and the patient's postoperative course was uneventful. However, five months after the surgery, he died from multiple liver metastases.Cases of gastric malignant schwannoma have rarely been reported. The efficacy of surgical resection and postoperative prognosis continues to remain unclear and should be investigated further.Schwannomas are neurogenic tumors that originate from different organs as well as other areas throughout the body. Gastric schwannomas are rare; however, if they do occur in the gastrointestinal tract, the most common site is the stomach. Gastric schwannomas represent 0.2% of all gastric neoplasms [1]. Gastrointestinal endoscopy, such as endosonography, is the principal diagnostic tool for gastric schwannoma [2]. However, differentiating a schwannoma from other gastric submucosal tumors is often difficult. The definitive diagnosis of gastric schwannoma is established by pathological and immunohistochemical examination of resected surgical specimens [3].Schwannomas are generally benign. Complete surgical removal is sufficient treatment for a benign gastric schwannoma because of excellent postoperative prognosis. Gastric malignant schwannomas are extremely rare and only a few cases have been reported [4,5]. We present the case of a 70-year-old man who presented with gastrointestinal bleeding because of gastric malignant schwannoma.A 70-year-old Japanese man with melena that began five days before admission was
Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome
Takemura Masashi,Sakurai Katsunobu,Takii Mamiko,Yoshida Kayo
Journal of Cardiothoracic Surgery , 2012, DOI: 10.1186/1749-8090-7-103
Abstract: Background Few reports discuss the outcome of pulmonary metastasis after radical esophagectomy for esophageal cancer. To clarify the data from such cases, we conducted a retrospective study on the clinical outcome of patients who developed pulmonary metastasis after undergoing radical esophagectomy. Methods We retrospectively reviewed the prognosis and clinical outcome of 25 patients who developed metachronous pulmonary metastasis after esophagectomy for esophageal cancer. Results The site of recurrence was pulmonary without extrapulmonary metastasis in 14 patients and extrapulmonary metastasis was observed in 11. Nineteen patients had multiple pulmonary metastasis and 6 had solitary pulmonary metastasis. Twenty-four of patients underwent systemic chemotherapy during initial treatment for metastatic lesions. Pulmonary metastasectomy was indicated in 5 patients with solitary metastasis. The actual 1-, 2- and 4-year survival rates were 60%, 36% and 27%, respectively. Gender, operative procedure, and postoperative morbidity were not significant prognostic factors. However, pathological staging of primary esophageal cancer was a significant prognostic factor. Survival was significantly worse in patients who did not undergo resection than in those who did. The number of pulmonary metastasis, complicated extrapulmonary metastasis and the time of recurrence were also significant prognostic factors. Conclusions Multiple pulmonary metastases or complicated extrapulmonary metastasis were unfavorable prognostic factors for patients with pulmonary metastasis arising from esophageal cancer. Although, surgical intervention is not recommended in such cases, metastasectomy is an acceptable choice of treatment for solitary pulmonary metastasis.
Short Term Operative Outcomes of Laparoscopic Gastric Mobilization in Esophagectomy for Esophageal Cancer: Comparison with Hand Assisted Technique  [PDF]
Masashi Takemura, Mamiko Takii, Nobuaki Kaibe, Tsutomu Oshima, Mitsuru Sasako
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.77039
Abstract: Objective: This study evaluated the safety and operative utilities of the laparoscopic gastric mobilization compared with hand-assisted laparoscopic gastric mobilization. Patients and Methods: From April 2010 to November 2015, 125 patients with esophageal cancer have been performed laparoscopic mobilization; 33 under hand-assisted laparoscopic gastric mobilization (HLG group) and 92 under laparoscopic gastric mobilization without hand-assisted technique (LG group). Preoperative data and surgical outcomes of 2 groups were compared. Results: Preoperative data were not significantly different except for BMI. Operation time in abdominal procedure of LG group is significantly longer than HLG group (P < 0.0001). Otherwise, the blood loss and number of dissected nodes of abdominal procedure was not significantly different in two groups. The perioperative blood transfusions were needed in 7 cases (21.2%) in HLG group and 25 (27.1%) in LG group. The postoperative complications and mortality within 30 days after surgery were not significantly different in two groups. The length of hospital stay was 29 days in HLG group and 31 days in HG group, respectively. Conclusions: Our results suggested that laparoscopic gastric mobilization was safe technique and the short-term operative outcomes were comparable with that of hand-assisted laparoscopic mobilization.
One-stage laparoscopic-assisted resection of gastrojejunocolic fistula after gastrojejunostomy for duodenal ulcer: a case report
Masashi Takemura, Genya Hamano, Takayoshi Nishioka, Mamiko Takii, Katsuyuki Mayumi, Takashi Ikebe
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-543
Abstract: A 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.Modern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.Gastrojejunocolic (GJC) fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy [1-3]. In the late 1930s, since patients with GJC fistula were usually malnourished, operative mortality and morbidity were high. Therefore, a two-stage or three-stage procedure was recommended [1]. However, due to recent advances in parenteral nutritional support and intensive care, a one-stage resection can be performed [4].Currently, surgical treatment for many gastrointestinal diseases can be performed laparoscopically. The aim of this study was to describe the first laparoscopic one-stage resection of a GJC fistula.A 41-year-old Japanese man was admitted to our hospital complaining of diarrhea immediately after oral intake (10 bowel movements per day for the last 10 months), weight loss (15 kg) and weakness. He reported a partial gastrect
Isolated ileal perforation due to cytomegalovirus reactivation during management of terbinafine hypersensitivity
Soichi Sano, Hiroki Ueno, Keiko Yamagami, Yosuke Yakushiji, Yoshihiro Isaka, Isao Kawasaki, Masashi Takemura, Takeshi Inoue, Masayuki Hosoi
World Journal of Gastroenterology , 2010,
Abstract: We report a case of 71-year-old man who developed a hypersensitivity syndrome associated with terbinafine. He was placed on terbinafine (250 mg/d) for the treatment of tinea pedis due to diabetes mellitus. Following the treatment with terbinafine, he developed drug-induced hypersensitivity syndrome (DIHS). Systemic corticosteroid led to transient improvement of his clinical manifestations. Three months after disease onset, he presented with panperitonitis due to ileal perforation, and underwent an emergency operation. The affected ileum was resected and ileostomy was performed in the terminal ileum. Cytomegalovirus (CMV)-specific IgG antibodies were significantly increased, high-titer CMV antigenemia was detected, and pathological examination of the resected ileum confirmed CMV infection. Based on these observations, we strongly recommend that physicians monitor reactivation of the family of herpesvirus other than herpesvirus 6, to manage DIHS properly.
Distribution of Deviation Distance to Alternative Fuel Stations  [PDF]
Masashi Miyagawa
American Journal of Operations Research (AJOR) , 2013, DOI: 10.4236/ajor.2013.33033
Abstract: This paper derives the distribution of the deviation distance to visit an alternative fuel station. Distance is measured as the Euclidean distance on a continuous plane. The distribution explicitly considers the vehicle range and whether the round trip between origin and destination can be made. Three cases are examined: fuel is available at both origin and destination, fuel is available at either origin or destination, and fuel is available at neither origin nor destination. The analytical expressions for the distribution demonstrate how the vehicle range, the shortest distance, and the refueling availability at origin and destination affect the deviation distance. The distribution will thus be useful to estimate the number of vehicles refueled at a station.

Weak Values Influenced by Environment  [PDF]
Masashi Ban
Journal of Modern Physics (JMP) , 2013, DOI: 10.4236/jmp.2013.411A1001

A weak value of an observable is studied for a quantum system which is placed under the influence of an environment, where a quantum system irreversibly evolves from a pre-selected state to a post-selected state. A general expression for a weak value influenced by an environment is provided. For a Markovian environment, the weak value is calculated in terms of the predictive and retrodictive density matrices, or by means of the quantum regression theorem. For a non-Markovian environment, a weak value is examined by making use of exactly solvable models. It is found that although the anomalous property is significantly suppressed by a Markovian environment, it can survive a non-Markovian environment.

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