1.Endoscopic Ultrasonography-Guided Gallbladder Drainage Replacement in Percutaneous Transhepatic Drainage: A Report of 2 Cases
Yasukazu KANIE ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Naoya TORII ; Masayoshi SAKUMA ; Kousuke INADA ; Kenji TAKEUCHI ; Akihito OGATA ; Akiko OSADA
Journal of the Japanese Association of Rural Medicine 2020;69(2):155-160
The patient was a 52-year-old woman who had undergone laparoscopic colectomy with lymph node dissection and inferior mesenteric artery preservation for cancer of the descending colon. Functional end-to-end anastomosis was performed using a linear stapler. Colonoscopy at the 1-year follow-up revealed a type 2 tumor at the anastomotic site. She was diagnosed with anastomotic recurrence. We performed laparoscopic high anterior resection with inferior mesenteric artery dissection. Rectal resection preceded mobilization of the mesocolon because of severe adhesion around the anastomotic site. Laparoscopic surgery for anastomotic site recurrence is an option under the condition that the initial surgery was laparoscopic.
2.Open Versus Laparoscopic Surgery for Acute Appendicitis in Adults
Masayoshi SAKUMA ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Naoya TORII ; Yasukazu KANIE ; Kosuke INADA ; Kenji TAKEUCHI ; Akihito OGATA ; Akiko OSADA
Journal of the Japanese Association of Rural Medicine 2020;69(1):43-47
The purpose of this study was to compare the results of open surgery and laparoscopic surgery for acute appendicitis in adults. In 2013, we primarily selected open surgery for acute appendicitis, but in 2017 we opted to select mainly laparoscopic surgery. We compared between 92 patients who had undergone open surgery in 2013 and 88 patients who underwent laparoscopic surgery group in 2017. There was no difference in age, sex, body mass index, white blood cell count, C-reactive protein, or perforation rate on computed tomography between the two groups. The laparoscopic surgery group had significantly longer operation time but significantly lower blood loss and postoperative complication rate. In particular, laparoscopic surgery was advantageous in terms of hemostasis for moderate bleeding. The results suggest that laparoscopic surgery may be more useful in adult appendicitis than open surgery.