Case Report: Retropancreatic fascia hernia protruding into the thoracic cavity through a Bochdalek hernia

Retropancreatic fascia hernia is a novel internal hernia originating from the retropancreatic fascial defect, which subsequently expands toward the dorsal aspect of the pancreatic body and migrates into the retroperitoneal space. We encountered a rare case of concomitant retropancreatic fascia and Bochdalek hernias. Here, we describe the imaging characteristics of this hernia type and its surgical strategies

Case report: Laparoscopic gastrojejunostomy for duodenal atresia with situs inversus and preduodenal portal vein: a report of two cases

Congenital duodenal atresia with situs inversus is occasionally accompanied by a preduodenal portal vein (PDPV), which is incidentally diagnosed during surgery. Duodenoduodenostomy is the most common and effective treatment. However, some patients require other anastomoses. Here, we present two cases of laparoscopic gastrojejunostomy for congenital duodenal atresia with situs inversus and PDPV and describe the reason for selecting gastrojejunostomy. The optimal surgical strategy is patient specific and should be determined based on the patient's general and physical condition

Laparoscopic restorative proctocolectomy with ileal-J-pouch anal canal anastomosis without diverting ileostomy for total colonic and extensive aganglionosis is safe and feasible with combined Lugol's iodine staining technique and indocyanine green fluorescence angiography

BackgroundWe present the surgical technique and outcomes of reduced-port laparoscopic restorative proctocolectomy with ileal-J-pouch anal canal anastomosis (IPACA) without diverting ileostomy for total colonic and extensive aganglionosis (TCA+).MethodsWe retrospectively reviewed TCA+ cases between 2014 and 2022. Preoperative ileostomy was performed when transanal bowel irrigation was ineffective. Radical surgery for TCA+ was performed at approximately 6 kg. The surgery was performed using laparoscopy through a multi-channel trocar with or without an additional 3-mm trocar and IPACA reconstruction with indocyanine green fluorescence angiography (ICG) to assess anastomotic perfusion and Lugol's iodine staining to visualize the surgical anal canal.ResultsTen patients with TCA+ were included. Ileostomy was performed in seven cases. The median operation time and blood loss were 274.5 min and 20 ml, respectively. No significant postoperative complications were found. All patients experienced frequent liquid stools and perianal excoriation in the early postoperative period, requiring anti-flatulence or codeine. The median follow-up period was 3.5 years. Three patients required irrigation management 1 year postoperatively, and the others defecated a median of 3.5 times per day. The median Kelly's clinical score was 5 in 5 patients aged >4 years.ConclusionReduced-port surgery, combined with Lugol's iodine staining and ICG, was safe, feasible, and had cosmetically and clinically acceptable mid-term outcomes

Plasma irradiation experiment on the metal pebble flow in the TPDsheet-U

A new divertor concept REVOLVER-D2 that uses metal pebbles as a divertor target has been proposed for the LHD-type helical fusion reactor FFHR-c1. Demonstration of sufficient plasma shielding rate is one of the important issues to show the feasibility of the REVOLVER-D2. For this purpose, an experiment on the plasma irradiation to the metal pebble flow has been conducted in the sheet plasma device TPDsheet-U in Tokai University. Reduction of the ion flux and electron density in the metal pebble flow was observed and it was confirmed that the metal pebble flow can play the role of the divertor target. The measured shielding rate is consistent with the prediction by the model based on the Lambert-Beer-Bouger’s law. Achievement of the shielding rate of > 72 % is expected in the FFHR-c1 using the nozzle with the size of > 310 mm × 310 mm and the pebble flow with the diameter of 5 mm

A long-surviving patient with advanced esophageal basaloid squamous cell carcinoma treated only with radiotherapy: case report and literature review

Abstract Background Esophageal basaloid squamous cell carcinoma (EBSCC) is a rare malignant disease. Advanced EBSCC (AEBSCC) has a poorer prognosis than the more common esophageal squamous cell carcinoma, but no treatment policy has yet been established. This is the first reported case with AEBSCC treated only with radiotherapy. Thus, our long-surviving patient merits consideration. We therefore reviewed cases with the same stage of AEBSCC for further investigation. Case presentation An 85-year-old man with a chief complaint of difficulty swallowing foods was diagnosed with AEBSCC, cT3N1M0, stage III, by thorough examination. The basaloid carcinoma extended from the upper thoracic esophagus to the middle thoracic esophagus based on imaging studies, endoscopy and biopsy. Morphologically, the tumor was an elevated ulcerative area. We conducted radiotherapy to relieve symptoms, as the patient and his family refused aggressive treatment. He has remained alive without recurrence for 2 years, to date, after completing radiotherapy. Conclusions Basaloid carcinoma might be highly sensitive to radiotherapy. Thus, radiotherapy for local control might be beneficial for elderly patients with complications and those refusing aggressive treatment