The University of Tokyo · Medicine
Professor Alan Kawarai Lefor's research lab focuses on minimally invasive surgical techniques, particularly laparoscopic splenectomy for hematologic disorders such as immune thrombocytopenia purpura, and on improving diagnostic accuracy in colorectal and head and neck cancers through advanced histopathological methods. The lab investigates the role of immunohistochemical and special staining techniques—such as D2-40, EVG, and CAM5.2—in identifying critical prognostic factors like lymphatic and venous invasion and tumor budding. Additionally, the lab explores the biological effects of hyperthermia on tumor and normal tissue permeability, contributing to oncological therapeutics. The research integrates surgical innovation with translational pathology to enhance patient outcomes.
Figures are computed from collected data and may differ slightly.
Laparoscopic splenectomy may be performed with efficacy, morbidity, and mortality rates comparable to those of open splenectomy for hematologic diseases, and it appears to retain other patient benefits of laparoscopic surgery.
Evaluation of pathologic predictors of metastases in T1 stage colorectal cancer may be difficult with hematoxylin and eosin (HE) staining alone. The aim of this study was to clarify the role of pathologic predictors by using immunohistochemical staining and Elastica van Gieson (EVG) staining. One hundred and twenty-four patients who underwent bowel resection for single T1 stage colorectal cancer from 1990 to 2004 in 1 institution were studied. D2-40, EVG staining, and CAM5.2 were used to detect
The role of splenectomy in the management of immune thrombocytopenia purpura is well known. Recent improvements in laparoscopic technology have significantly expanded the variety of general surgical procedures amenable to a minimally invasive approach. An initial experience of four cases of immune thrombocytopenic purpura managed by laparoscopic splenectomy is presented. The entire procedure was completed under laparoscopic guidance in three of four cases, and a counterincision was required to c
The effects of hyperthermia on vascular permeability in Walker carcinosarcomas and host liver tissue were studied in Sprague-Dawley rats. A quantitative Evans blue technique was used to measure permeability. With tumors heated to 40 degrees C, a nontherapeutic level, no changes in tumor vascular permeability as compared to control levels were noted. However, with tumors heated to 43 degrees C, within the therapeutic range of hyperthermia, significant rises in tumor vascular permeability occurred
Procedure skill after training with low fidelity simulators was not inferior to skill after training with high fidelity simulators in 15/17 studies. Some data suggest that the effectiveness of different fidelity simulators depends on the level of training of participants and requires further study.
Independent primary cancers of the head and neck and of the lung may be confused with lung metastases from a head and neck tumor. We retrospectively reviewed the cases of 55 patients who had head and neck malignancies and pulmonary lesions. To distinguish between independent primary tumors and lung metastases we applied an algorithm using the following criteria: sequence of appearance of the lesions; tumor histology; radiologic appearance of the lesions; and presence of malignant anterior cervic
We have created a technique of laparoscopic wedge biopsy of the liver that uses the Endo-GIA instrument. Two staple lines are placed at right angles on the edge of the liver to release a wedge of hepatic parenchyma. We have used this technique as part of a laparoscopic staging procedure for Hodgkin's lymphoma and found it to be simple and rapidly performed.
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