An Investigation of Early Death Following the Operation for Lung Cancer

In our clinic 212 patients with primary lung cancer had undergone lung resection during 12 years from April 1977 to March 1989. The authors reviewed 41 patients who died within a year after operation. Twenty-eight deaths were from cnacer ; 13 from other causes. We inquired, from the view-point of operative indication and postoperative measurement, what points should be payed attention to in order that the operation performed may indeed benefit the treatment for lung cancer. Conclusions are that the following measures are essential to take precaution against the early death after operation : (1) strict preoperative assessment of the stage of cancer ; (2) avoiding reduction surgery-absolutely non-curative resection ; (3) keeping the blood volume transfused during and after operation as minimum as possible ; (4) preventing atelectasis immediately after operation ; (5) and preventing postoperative aspiration and alimentary tract bleeding

The Prognostic Significance of Subserosal and Serosal Extent of Cancer Invasion in Gastric Cancer

In order to determine the prognostic significance of subserosal and serosal extent of cancer invasion in gastric cancer, 78 patients were reexamined histologically. In these patients curative resection was performed and cancer invaded the subserosal layer with growth pattern of infiltrating type i.e."*"(30 patients), or exposed outside the serosal surface i.e. "*" (48 patients). The significantly favourable prognosis was seen only in patients with ssr cancer being less than 1 cm in extent with a five-year survival rate of 92.3%, and in patients with small amount of cancer cells in the subserosal layer, having a five-year survival rate of 81.8%. In patients with se cancer the five-year survival rate was less favorable

Complications and Management of Hepatic Arterial Infusion Chemotherapy for Liver Metastasis

Complications and management of hepatic arterial infusion chemotherapy for 79 patients with liver metastasis were studied. Complications were observed in 20 cases (25.3%), who included 8 cases (88.9%) of lapalotomy group and 12 cases (17.6%) of left subclavian group. In lapalotomy group, they were 5 cases of system occlusion, 2 cases of catheter tip dislocation and catheter reinsertion through the left subclavian artery was performed in 4 cases. In left subclavian group, they were 4 cases of system occlusion, 3 cases of catheter tip dislocation, 2 cases of hepatic arterial occlusion and hepatic arterial infusion chemotherapy was continued with catheter reinsertion in 8 of the 9 cases. It was considered that positive anti-complication measures including catheter reinsertion would contribute to the improvement of therapeutic results

Application of double stapling technique after anterior resection for rectal cancer

Double stapling technique (DST) were applied in 22 cases who underwent low and high anterior resection of the rectum. Postoperative complications were encounted in six, three were mild strictures and the other three were minor leakages. All were not severe, demonstrating no correlation to the conditions of the anastomosis and subsided by conservative therapy in a short period. Anastomotic leakage occurred in three but these were based on technical problems and it is possible to avoid with careful surgical management. In conclusion, DST is of great benefit for the treatment of carcinoma of the rectum to reduce the consuming operation time and to lessen the risk of bacteriological and oncological contaminations

Surgery for postoperative recurrence of gastric cancer

The six patients who underwent reoperation for recurrence of gastric cancer following surgery were clinically analysed, of whom one had lung metastasis and the other five local recurrences. The conditions of resectability are that carcinoma infiltration should be limited, the disease-free interval-after the first operation should be long and there are no blood-borne metastases into the lung and the liver. The surgical outcome for lung metastasis was pessimistic. It is emphasized that multidisciplinary therapy and early detection are indispensable for improving the surgical outcome in the treatment of recurrence of gastric cancer

Surgery for Stage I Lung Cancer

The surgical outcome for 209 early lung cancers was clinically evaluated. 1) Most (93%) of Stage I cancers were composed of pT1N0 and pT2N0 while 6.3 % was pT1N0. 2) Even in early cancer, nodal involvement and distant metastasis occurred and these related closely to their prognoses. 3) Reoperation should be indicated for recurrence with a 10 month or more time interval from the first operation and should be recommended, if possible. Advances in diagnostic technique for lung cancer have been achieved. As a consequence, early lung cancer has become clinically detected and the surgical curability has been improved with time. This study was undertaken to evaluate surgical treatment for stage I lung cancer patients

Early Gastric Cancer Presenting Pyloric or Prepyloric Stenosis

Out of 390 patients with early gastric cancer (EGC) who underwent gastric resection between Jan. 1968 and Jul. 1987, four patients developed pyloric stenosis and one patient developed prepyloric stenosis. Macroscopic types of EGC were II c in three cases and II c + III in two cases. Histologic types were tubular adenocarcinoma in four patients, and poorly differentiated adenocarcinoma in one patient. Cancer existed just right on or immediately adjacent to the pyloric ring in all patients; and extended transversely to the gastric axis in four patients, and longitudinally in one patient. An associated open ulcer and/or ulcer scar in the cancer lesion was seen in four patients, and submucosal fibrosis in three patients to a variety of degree, both of which were thought to be greatly attributed to pyloric or prepyloric stenosis. A duodenal ulcer was not present in any patients