1.Review of Surgical Cases of Colorectal Cancer
Nobuyiki KOBAYASHI ; Fusakuni KURODA ; Takashi DOI ; Makoto KINOUCHI ; Yasuhiro WATANABE ; Naoyuki KANEKO ; Manabu SATOU
Journal of the Japanese Association of Rural Medicine 2004;53(1):75-79
During the period of 25 years from January 1978 through December 2002, a total of 808 colorectal cancer cases were operated on in Shirakawa Kosei General Hospital. The number of sugical resection cases came to 713 (ratio : 88.25%). Curative resection was performed on 593 cases (ratio : 73.4%). The total number of cases was broken down into 446 cases of cancer of the colon and 369 cases of cancer of the rectum (7 multiple cancer cases included). By sex, male cases numbered 329 and female cases 379. Clinically or histologically, many cases were diagnosed as stage IIIa or stage II cancer. The 5-year-survival rate for the resection cases was calculated at 67.2% and that for the cure resection cases, at 79.5%.
Excision
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Malignant Neoplasms
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Colorectal Cancer
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Cases
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Review of
2.Risk factors for non-reaching of ileal pouch to the anus in laparoscopic restorative proctocolectomy with handsewn anastomosis for ulcerative colitis
Shigenobu EMOTO ; Keisuke HATA ; Hiroaki NOZAWA ; Kazushige KAWAI ; Toshiaki TANAKA ; Takeshi NISHIKAWA ; Yasutaka SHUNO ; Kazuhito SASAKI ; Manabu KANEKO ; Koji MURONO ; Yuuki IIDA ; Hiroaki ISHII ; Yuichiro YOKOYAMA ; Hiroyuki ANZAI ; Hirofumi SONODA ; Soichiro ISHIHARA
Intestinal Research 2022;20(3):313-320
Background/Aims:
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis and handsewn anastomosis for ulcerative colitis requires pulling down of the ileal pouch into the pelvis, which can be technically challenging. We examined risk factors for the pouch not reaching the anus.
Methods:
Clinical records of 62 consecutive patients who were scheduled to undergo RPC with handsewn anastomosis at the University of Tokyo Hospital during 1989–2019 were reviewed. Risk factors for non-reaching were analyzed in patients in whom hand sewing was abandoned for stapled anastomosis because of nonreaching. Risk factors for non-reaching in laparoscopic RPC were separately analyzed. Anatomical indicators obtained from presurgical computed tomography (CT) were also evaluated.
Results:
Thirty-seven of 62 cases underwent laparoscopic procedures. In 6 cases (9.7%), handsewn anastomosis was changed to stapled anastomosis because of non-reaching. Male sex and a laparoscopic approach were independent risk factors of non-reaching. Distance between the terminal of the superior mesenteric artery (SMA) ileal branch and the anus > 11 cm was a risk factor for non-reaching.
Conclusions
Laparoscopic RPC with handsewn anastomosis may limit extension and induction of the ileal pouch into the anus. Preoperative CT measurement from the terminal SMA to the anus may be useful for predicting non-reaching.