名古屋大学 · 医学
Shoji Kawakatsu教授の研究室は、消化器がん、特に胃がんや胆道がん、結腸がんに伴う肝転移や胆管転移の治療戦略に注力しています。特に腹腔鏡下手術や同時切除の安全性・有効性の検証が中心であり、術後の合併症や予後に与える影響を精査することで、高リスク患者に対する手術の妥当性を示しています。また、希少な転移例の報告を通じて、がんの生物学的挙動や治療タイミングの意義についても深く探求しています。
Figures are computed from collected data and may differ slightly.
The CR-PF rate was not significantly different between patients treated with Kakita versus Blumgart anastomosis.
Preoperative placement of marking clips and intraoperative endoscopy is helpful in the determination of a safe surgical margin in patients with gastric cancer who undergo laparoscopic gastrectomy.
Cumulative postoperative complications after resection of perihilar cholangiocarcinoma only moderately deteriorate long-term survival, and should not be an argument to deny surgery in this high-risk population.
An extremely rare case of intrapancreatic bile duct metastasis from sigmoid colon adenocarcinoma is herein presented. Sigmoid colon cancer (T3, N0, M0, stage IIA) had been diagnosed and treated by sigmoidectomy in October 1993. In December 2002, a liver metastasis with intrabiliary growth was found, and this was treated by extended right hepatic lobectomy and caudate lobectomy with extrahepatic bile duct resection. In February 2014, intrapancreatic bile duct metastasis was found, and this was tr
Laparoscopic simultaneous resection of SCRLM with the primary tumor by simple hepatectomy is safe and may enhance patients' postoperative recovery, especially in patients with colon cancer.
Although diagnostic sensitivity for SPN before hepatectomy is low, timing of diagnosis does not affect OS. Conclusive lung resection offers OS similar to that of patients without lung metastases.
症例は55歳の女性で，2009年7月初旬に急性腸炎に罹患した際に施行した腹部造影CTで，偶然に肝内門脈枝分岐異常を認めた．門脈右枝から分岐した一つの大きなアーチ状の肝内門脈枝が左方へ転回し，肝左葉を還流していた．門脈本幹から直接に左葉へ向かう枝は認めず，門脈左右分岐部の欠如と診断した．この門脈枝異常はまれな先天奇形ではあるが，肝円索，胆嚢の位置を含め，肝臓に外観上の異常を伴わず，肝切除術，特に肝右葉切除術を施行すると致死的合併症を生じる可能性があるため注意が必要である．肝切除術を施行する際にはこのようにまれな先天奇形も念頭に置いて術前画像検査を詳細に検討することが重要であると考える．
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