At some point in the natural course of colorectal cancer up to 50% of patients will develop metastasis to the liver and it is one of the most critical effects for patient prognosis. The incidence of synchronous liver ...At some point in the natural course of colorectal cancer up to 50% of patients will develop metastasis to the liver and it is one of the most critical effects for patient prognosis. The incidence of synchronous liver metastasis has been detected at around 20% - 25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases. Then, traditional surgical strategies of hepatic resection in accordance with past chemotherapeutic regimens have been used decreasingly over the past several years. This review will primarily discuss treatments in association with the recent developed chemotherapeutic regimens and surgical procedure from the clinical data and the concept for epithetlial-mesenchymal transition, which has recently been studied to elucidate mechanisms of the liver metastatic process.展开更多
Among the ablation procedures used against advanced liver cancer, thermal ablation therapy is widely applied, and the safety and efficacy of this technique have been well characterized. In contrast, the principle of c...Among the ablation procedures used against advanced liver cancer, thermal ablation therapy is widely applied, and the safety and efficacy of this technique have been well characterized. In contrast, the principle of cryosurgery is not only to control local recurrence, but also to stimulate the immune system into initiating an anti-tumor response. In recent years, we have developed a treatment method for patients with advanced liver tumors. From these experiences, repeated treatment was demonstrated to induce anti-cancer immune reaction-related factors. In the present review, mechanisms for anti-tumor immune reaction will be argued with introducing a novel strategy of a cryoablation.展开更多
Pancreatoduodenectomy (PD) has been performed commonly, but the occurrence of pancreatic fistula (PF) is a critical trigger of complications, which are potentially life threatening, and is also associated with markedl...Pancreatoduodenectomy (PD) has been performed commonly, but the occurrence of pancreatic fistula (PF) is a critical trigger of complications, which are potentially life threatening, and is also associated with markedly prolonged hospitalization. Many techniques have been proposed for connecting the pancreatic stump with the gastrointestinal tract, stomach vs. jejunum, etc. Among the risk factors for PF, such as general patient factors or disease-related factors, the most important is the texture of the remnant pancreas. Surgical technique might be one improvable aspect that can reduce the pancreatic leakage rate, therefore;various methods of managing the pancreatic remnant have been studied. Methods of reconstruction between the remnant pancreas and the intestine include end-to-side with/without duct-to-mucosa anastomosis or end-to-end invagination styles, has been argued. Here, we review several trials for safety and methods of treating the pancreatic stump after PD, and demonstrate our experiences.展开更多
文摘At some point in the natural course of colorectal cancer up to 50% of patients will develop metastasis to the liver and it is one of the most critical effects for patient prognosis. The incidence of synchronous liver metastasis has been detected at around 20% - 25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases. Then, traditional surgical strategies of hepatic resection in accordance with past chemotherapeutic regimens have been used decreasingly over the past several years. This review will primarily discuss treatments in association with the recent developed chemotherapeutic regimens and surgical procedure from the clinical data and the concept for epithetlial-mesenchymal transition, which has recently been studied to elucidate mechanisms of the liver metastatic process.
文摘Among the ablation procedures used against advanced liver cancer, thermal ablation therapy is widely applied, and the safety and efficacy of this technique have been well characterized. In contrast, the principle of cryosurgery is not only to control local recurrence, but also to stimulate the immune system into initiating an anti-tumor response. In recent years, we have developed a treatment method for patients with advanced liver tumors. From these experiences, repeated treatment was demonstrated to induce anti-cancer immune reaction-related factors. In the present review, mechanisms for anti-tumor immune reaction will be argued with introducing a novel strategy of a cryoablation.
文摘Pancreatoduodenectomy (PD) has been performed commonly, but the occurrence of pancreatic fistula (PF) is a critical trigger of complications, which are potentially life threatening, and is also associated with markedly prolonged hospitalization. Many techniques have been proposed for connecting the pancreatic stump with the gastrointestinal tract, stomach vs. jejunum, etc. Among the risk factors for PF, such as general patient factors or disease-related factors, the most important is the texture of the remnant pancreas. Surgical technique might be one improvable aspect that can reduce the pancreatic leakage rate, therefore;various methods of managing the pancreatic remnant have been studied. Methods of reconstruction between the remnant pancreas and the intestine include end-to-side with/without duct-to-mucosa anastomosis or end-to-end invagination styles, has been argued. Here, we review several trials for safety and methods of treating the pancreatic stump after PD, and demonstrate our experiences.
