Highlights
We experienced a case of a broad ligament hernia of the uterus, which is relatively rare among the cases of internal hernia that were treated by less invasive laparoscopic surgery.
If intestinal ischemia can be ruled out, a less invasive laparoscopic surgery may be performed after intestinal decompression.
Making a diagnosis of broad ligament hernia of the uterus by CT can lead to easier and safer laparoscopic surgery and shorter operation time.
The minimum sample volume for capillary electrophoresis-Fourier transform mass spectrometry (CE-FTMS) useful for analyzing hydrophilic metabolites was investigated using samples obtained from colorectal cancer patients. One, two, five, and ten biopsies were collected from tumor and nontumor parts of the surgically removed specimens from each of the five patients who had undergone colorectal cancer surgery. Metabolomics was performed on the collected samples using CE-FTMS. To determine the minimum number of specimens based on data volume and biological interpretability, we compared the number of annotated metabolites in each sample with different numbers of biopsies and conducted principal component analysis (PCA), hierarchical cluster analysis (HCA), quantitative enrichment analysis (QEA), and random forest analysis (RFA). The number of metabolites detected in one biopsy was significantly lower than those in 2, 5, and 10 biopsies, whereas those detected among 2, 5, and 10 pieces were not significantly different. Moreover, a binary classification model developed by RFA based on 2-biopsy data perfectly distinguished tumor and nontumor samples with 5- and 10-biopsy data. Taken together, two biopsies would be sufficient for CE-FTMS-based metabolomics from a data content and biological interpretability viewpoint, which opens the gate of biopsy metabolomics for practical clinical applications.
We report a case of intrapelvic locally recurrent rectal cancer after surgery in which clinical complete response was achieved after chemoradiotherapy with capecitabine and oxaliplatin (CAPOX), and discuss the relevant literature. The patient was a 67-year-old woman who had undergone lower anterior resection for Ra rectal cancer. Nine months after the surgery, contrast-enhanced CT scans of the abdomen and pelvis, which were taken because of perineal pain, revealed a 48mm mass in the pelvic floor, and the patient was thus diagnosed as having local recurrence. Since the lesion was suspected to have invaded surrounding organs, radical resection was considered impractical, and chemoradiotherapy was chosen.Radiation (50 Gy) + eight courses of CAPOX were administered. A contrast-enhanced CT examination of the abdomen 5 months after starting chemoradiotherapy revealed a marked size reduction of the recurrent lesion, which was identified as a 23-mm soft tissue shadow, with no signs of distant metastasis. As of 9 years and 6 months after the diagnosis of intrapelvic local recurrence and 8 years after the completion of chemoradiotherapy, metastatic recurrence has not been reported.
Objective] The aim of this study was to confirm the safety and economic benefits of laparoscopic-assisted colorectomy (LAC) in elderly patients with colorectal cancer. [Methods] This propensity score-matched case-control study assessed patients aged ≥80 years with clinical stage Icolorectal cancer over a 6-year period. The short-term outcomes of LAC and open colorectomy (OC) were compared.[Results] Hospitalization was shorter (8 vs. 9 days), whereas freedom from complications (74.5% vs. 48.9%) and cost of hospitalization (441,194 vs. 476,410 yen) were better in the LAC than in the OC group.[Conclusion] The short-term outcomes of colorectal cancer with low invasiveness were better with LAC than with OC.
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