1.Indications for Dental Floss Clip Traction During Gastric Endoscopic Submucosal Dissection by LessExperienced Endoscopists
Hirosato TAMARI ; Shiro OKA ; Takahiro KOTACHI ; Hajime TESHIMA ; Junichi MIZUNO ; Motomitsu FUKUHARA ; Hidenori TANAKA ; Akiyoshi TSUBOI ; Ken YAMASHITA ; Ryo YUGE ; Yuji URABE ; Yasuhiko KITADAI ; Koji ARIHIRO ; Shinji TANAKA
Journal of Gastric Cancer 2023;23(4):512-522
Purpose:
Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists.
Methods:
and Methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (−) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared.
Results:
The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (−) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (−) group.
Conclusions
The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.
2.Bicuspidization of the Unicuspid Aortic Valve by Preserving the Free Margin Tissue
Ryo KAWABATA ; Koutaro TSUNEMI ; Takanori OKA ; Yutaka OKITA
Japanese Journal of Cardiovascular Surgery 2020;49(3):99-101
A 35-year-old man was referred to our hospital for surgical repair of grade IV/IV aortic regurgitation secondary to a congenital unicuspid aortic valve accompanied by aneurysm of the ascending aorta. The aortic valve was the unicuspid unicommissural type and a fully developed commissure was located in the left lateral position (left coronary/right coronary). The anterior (non-coronary/right coronary) and posterior (non-coronary/left coronary) borders were rudimentary with calcified raphe. We performed aortic valve repair in combination with valve sparing root replacement (reimplantation) and partial arch replacement. We converted the unicuspid into a bicuspid aortic valve by preserving his own free margin tissue and creating a neocommissure to the 180 degrees opposite side of the left lateral commissure at the same height by enlarging the cusp with a glutaraldehyde-treated autologous pericardium patch to the cusp belly. The patient was discharged on the 17th postoperative day with trace aortic regurgitation. We successfully repaired the unicuspid aortic valve by augmenting the cusp size using a pericardium patch in order to preserve the free margin of the cusp.
3.Worsening of the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in patients with prostate cancer after androgen deprivation therapy.
Ryo OKA ; Takanobu UTSUMI ; Takumi ENDO ; Masashi YANO ; Shuichi KAMIJIMA ; Naoto KAMIYA ; Hiroyoshi SUZUKI
Asian Journal of Andrology 2018;20(6):634-636
Aged
;
Androgen Antagonists/adverse effects*
;
Anticholesteremic Agents/therapeutic use*
;
Cholesterol, HDL/blood*
;
Cholesterol, LDL/blood*
;
Humans
;
Hypercholesterolemia/chemically induced*
;
Lipids/blood*
;
Male
;
Middle Aged
;
Prostatic Neoplasms/therapy*
;
Retrospective Studies
;
Testosterone/blood*