JOURNAL OF MEDICAL INVESTIGATION最新文献_第2页

Difference in the accuracy of the third-generation algorithm and the first-generation algorithm of FreeStyle Libre continuous glucose monitoring device. FreeStyle Libre 血糖连续监测仪第三代算法与第一代算法的准确性差异。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.225

Takashi Murata, Naoki Sakane, Yushi Hirota, Masao Toyoda, Munehide Matsuhisa, Akio Kuroda, Arata Itoh, Shu Meguro, Junnosuke Miura, Yuka Matoba, Ken Kato, Shota Suzuki, Akira Shimada

{"title":"Difference in the accuracy of the third-generation algorithm and the first-generation algorithm of FreeStyle Libre continuous glucose monitoring device.","authors":"Takashi Murata, Naoki Sakane, Yushi Hirota, Masao Toyoda, Munehide Matsuhisa, Akio Kuroda, Arata Itoh, Shu Meguro, Junnosuke Miura, Yuka Matoba, Ken Kato, Shota Suzuki, Akira Shimada","doi":"10.2152/jmi.71.225","DOIUrl":"https://doi.org/10.2152/jmi.71.225","url":null,"abstract":"Background: FreeStyle Libre uses the algorithm to calculate the sensor glucose (SG) levels. The manufacturer announced that they had changed the algorithm from the first generation (Gen. 1) to the third generation (Gen. 3). To assess the difference, we conducted an observational study to analyze the characteristics of the measurements by these two algorithms compared to the capillary blood glucose (BG) levels.Methods: Participants with type 1 diabetes wore two FreeStyle Libre sensors, one on the left arm used with Gen. 3 algorithm, and another on the right arm used in combination with the FreeStyle Libre Reader with Gen. 1 algorithm.Results: Data were collected from 11 participants. The Bland-Altman analysis of the measurements by Gen. 3 algorithm showed bias of 7.4 mg/dl and no proportional bias was observed (r=0.130). In contrast, the Bland-Altman analysis of the measurements by Gen. 1 algorithm showed bias of 4.4 mg/dl and proportional bias was observed (r=0.424). The MARD of Gen. 3 algorithm and Gen. 1 algorithm was 11.9±9.0% and 9.7±8.3%, respectively (P=0.053).Conclusion: No proportional bias in the measurements by Gen. 3 algorithm was observed, but in those by Gen. 1 algorithm. J. Med. Invest. 71 : 225-231, August, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Daikenchuto (TU-100) on the early postoperative period in duodenal-jejunal bypass. Daikenchuto (TU-100)对十二指肠空肠旁路术术后早期的影响。

IF 0.7

JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.210

Hideya Kashihara, Shohei Okikawa, Yuji Morine, Kozo Yoshikawa, Takuya Tokunaga, Masaaki Nishi, Chie Takasu, Mitsue Nishiyama, Makoto Zushi, Mitsuo Shimada

{"title":"Impact of Daikenchuto (TU-100) on the early postoperative period in duodenal-jejunal bypass.","authors":"Hideya Kashihara, Shohei Okikawa, Yuji Morine, Kozo Yoshikawa, Takuya Tokunaga, Masaaki Nishi, Chie Takasu, Mitsue Nishiyama, Makoto Zushi, Mitsuo Shimada","doi":"10.2152/jmi.71.210","DOIUrl":"https://doi.org/10.2152/jmi.71.210","url":null,"abstract":"Introduction: We investigated the effect of Daikenchuto (TU-100) on the early postoperative period in duodenal-jejunal bypass (DJB).Methods: Study 1:The effect of TU-100 on diabetic rats was investigated. Rats were sacrificed after receiving TU-100 for one week. Study 2:The effect of TU-100 on DJB was investigated. Rats in the DJB and TU-100 treated DJB groups were sacrificed 24 hours postoperation to evaluate blood glucose, cytokine expression, and gut microbiome.Results: Study 1:TU-100 did not affect glucose or body weight. TU-100 suppressed intestinal inflammation and modified the gut microbiome. Specifically, Bifidobacterium and Blautia were increased, and Turicibacter were decreased in this group. Study 2:Both DJB and TU-100 treated DJB rats showed lower blood glucose at 24 hours postoperation than at preoperation. Cytokine expression in the liver and small intestine of the TU-100 treated DJB group was significantly lower than that of the DJB group. The gut microbiome composition in TU-100 treated DJB rats was altered. In particular, Bifidobacterium and Blautia were increased in this group.Conclusion: DJB suppressed blood glucose during the early postoperative period. TU-100 may enhance the anti-diabetic effect of metabolic surgery by changing the gut microbiome and suppressing inflammation in the early postoperative period. J. Med. Invest. 71 : 210-218, August, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in intestinal microbiota and biochemical parameters in patients with inflammatory bowel disease and irritable bowel syndrome induced by the prolonged addition of soluble fibers to usual drug therapy. 在常规药物治疗的基础上长期添加可溶性纤维诱导炎症性肠病和肠易激综合征患者肠道微生物群和生化指标的变化。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.121

Hideo Watanabe, Takahisa Inoue, Licht Miyamoto, Yoshito Ono, Kinya Matsumoto, Masanori Takeda, Koichiro Tsuchiya

{"title":"Changes in intestinal microbiota and biochemical parameters in patients with inflammatory bowel disease and irritable bowel syndrome induced by the prolonged addition of soluble fibers to usual drug therapy.","authors":"Hideo Watanabe, Takahisa Inoue, Licht Miyamoto, Yoshito Ono, Kinya Matsumoto, Masanori Takeda, Koichiro Tsuchiya","doi":"10.2152/jmi.71.121","DOIUrl":"https://doi.org/10.2152/jmi.71.121","url":null,"abstract":"Objectives: Partially hydrolyzed guar gum (PHGG) is a soluble dietary fiber;in addition to improving bowel movements, it maintains intestinal health by producing short-chain fatty acids. However, majority of clinical studies on PHGG have been concluded within a month and excluded usual drug therapy. Hence, this study aimed to determine the effects of long-term consumption of PHGG, in combination with drug therapy, on gut bacteria ratios, laboratory values for inflammatory response, and fecal characteristics.Methods and results: The study was performed in patients with irritable bowel syndrome (IBS), Crohn's disease (CD), and ulcerative colitis (UC), by the administration of PHGG for six months while they continued their usual treatment. PHGG treatment caused significant changes in patients with IBS, including an increase in the abundance of short-chain fatty acid-producing bacteria, a significant decrease in Bacteroides abundance, and normalization of the Bristol scale of stool. In patients with UC, non-significant normalization of soft stools and decrease in fecal calprotectin were observed. Adverse events were not observed in any of the groups.Conclusion: Thus, it would be beneficial to include PHGG in the usual drug therapies of patients with IBS. J. Med. Invest. 71 : 121-128, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Study on prediction of early adverse events by CapeOX therapy in patients with colorectal cancer. 通过开普奥克斯疗法预测结直肠癌患者早期不良反应的研究

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.141

Yuki Kumihashi, Yohei Kasai, Takuya Akagawa, Yasuhiro Yuasa, Hisashi Ishikura, Youichi Sato

{"title":"Study on prediction of early adverse events by CapeOX therapy in patients with colorectal cancer.","authors":"Yuki Kumihashi, Yohei Kasai, Takuya Akagawa, Yasuhiro Yuasa, Hisashi Ishikura, Youichi Sato","doi":"10.2152/jmi.71.141","DOIUrl":"https://doi.org/10.2152/jmi.71.141","url":null,"abstract":"CapeOX is a regimen used as postoperative adjuvant chemotherapy for the treatment of advanced recurrent colorectal cancer. If early adverse events occur, treatment may not progress as planned and further dose reduction may be necessary. In this study, we investigated whether pre-treatment medical records could be used to predict adverse events in order to prevent adverse events caused by CapeOX treatment. The 178 patients were classified into two groups (97 in the adverse event positive group and 81 in the adverse event-negative group) based on withdrawal or postponement of four or fewer courses. In univariate analysis, age, height, weight, body surface area (BSA), creatinine clearance, muscle mass, and lean body mass were associated with early adverse events (P<0.05). The area under the receiver operating characteristic curve obtained by Stepwise logistic regression analysis using the Akaike information criterion method was 0.832. For nested k-fold cross validation, the accuracy rates of the support vector machine, random forest, and logistic regression algorithms were 0.71, 0.70, and 0.75, respectively. The results of the present study suggest that a logistic regression prediction model may be useful in predicting early adverse events caused by CapeOX therapy in patients with colorectal cancer. J. Med. Invest. 71 : 141-147, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mismatch between Augmented Reality Navigation Images and Actual Location of a Cauda Equina Tumor:A Case Report. 增强现实导航图像与马尾肿瘤实际位置不匹配：病例报告。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.174

Shutaro Fujimoto, Fumitake Tezuka, Takahiro Ogawa, Shunsuke Tamaki, Kosuke Sugiura, Makoto Takeuchi, Masatoshi Morimoto, Kazuta Yamashita, Koichi Sairyo

{"title":"Mismatch between Augmented Reality Navigation Images and Actual Location of a Cauda Equina Tumor:A Case Report.","authors":"Shutaro Fujimoto, Fumitake Tezuka, Takahiro Ogawa, Shunsuke Tamaki, Kosuke Sugiura, Makoto Takeuchi, Masatoshi Morimoto, Kazuta Yamashita, Koichi Sairyo","doi":"10.2152/jmi.71.174","DOIUrl":"10.2152/jmi.71.174","url":null,"abstract":"Background: Augmented reality navigation is the one of the navigation technologies that allows computer-generated virtual images to be projected onto a real-world environment. Augmented reality navigation can be used in spinal tumor surgery. However, it is unknown if there are any pitfalls when using this technique.Case presentation: The patient in this report underwent complete resection of a cauda equina tumor at the L2-L3 level using microscope-based augmented reality navigation. Although the registration error of navigation was <1 mm, we found a discrepancy between the augmented reality navigation images and the actual location of the tumor, which we have called \"navigation mismatch\". This mismatch, which was caused by the mobility of the spinal tumor in the dura mater, seems to be one of the pitfalls of augmented reality navigation for spinal tumors.Conclusions: Combined use of intraoperative ultrasound and augmented reality navigation seems advisable in such cases. J. Med. Invest. 71 : 174-176, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developmental Changes in Stroop Task Performance among Individuals with High-Functioning Pervasive Developmental Disorders. 高功能性广泛性发育障碍患者完成 Stroop 任务的发育变化。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.254

Ruriko Yamashita, Yukie Iwasa, Toshiaki Hashimoto

{"title":"Developmental Changes in Stroop Task Performance among Individuals with High-Functioning Pervasive Developmental Disorders.","authors":"Ruriko Yamashita, Yukie Iwasa, Toshiaki Hashimoto","doi":"10.2152/jmi.71.254","DOIUrl":"https://doi.org/10.2152/jmi.71.254","url":null,"abstract":"Objective: This study aimed to assess age-related changes in Stroop Color and Word test indices in individuals with high-functioning pervasive developmental disorder (HF-PDD) and compare their performance with typically developing (TD) individuals.Methods: There were a total of 125 participants (57 TD, 68 HF-PDD), aged 6-24. Stimuli were displayed on computer screens, and participants verbally responded with response times recorded via voice key function.Results: Single regression analysis revealed age-associated trends in Stroop test indices for both groups, indicating shorter response times and reduced Stroop interference with age. The age at which the best Stroop test results were obtained ranged from 220 to 260 months for TD and from 195 to 201 months for HF-PDD. While color naming and word reading tasks showed no significant group differences, color word naming task response times were significantly longer for the HF-PDD group. Around 30% of HF-PDD participants scored over two standard deviations above the TD mean.Conclusions: Both TD and HF-PDD groups exhibited age-related changes in Stroop task performance, which were fitted by a quadratic regression curve. Prolongation of the color word naming task in the HF-PDD group suggests that approximately 30% of individuals with HF-PDD have difficulty with stereotype suppression. J. Med. Invest. 71 : 254-259, August, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Symptomatic adverse events of chemotherapy in breast cancer patients:Using CTCAE, PRO-CTCAE, and EORTC QLQ-C30. 乳腺癌患者化疗的症状性不良事件：使用 CTCAE、PRO-CTCAE 和 EORTC QLQ-C30。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.82

Hiromi Arahori, Kazuya Kondo, Yoshie Imai, Takae Bando, Hiroaki Inoue, Soichiro Sasa, Hiromitsu Takizawa

{"title":"Symptomatic adverse events of chemotherapy in breast cancer patients:Using CTCAE, PRO-CTCAE, and EORTC QLQ-C30.","authors":"Hiromi Arahori, Kazuya Kondo, Yoshie Imai, Takae Bando, Hiroaki Inoue, Soichiro Sasa, Hiromitsu Takizawa","doi":"10.2152/jmi.71.82","DOIUrl":"https://doi.org/10.2152/jmi.71.82","url":null,"abstract":"Background: The Common Terminology Criteria for Adverse Events (CTCAE) is used as a tool to evaluate the adverse events (AE) of chemotherapy in cancer patients. Since CTCAE by medical providers underestimates AE more than patient-reported outcomes (PRO), the National Cancer Institute developed PRO-CTCAE. The present study investigated differences between symptoms detected using CTCAE by medical providers and PRO-CTCAE by breast cancer patients.Methods: Patients received chemotherapy comprising epirubicin and cyclophosphamide pre- or postoperatively. AE were evaluated using 4 questionnaires:PRO-CTCAE, CTCAE, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-30), and Hospital Anxiety and Depression Scale (HADS) after 1, 2, and 3 courses of chemotherapy.Results: Forty-two patients were registered. Regarding the recognition of psychological symptoms, such as fatigue, anxiety, and discouragement, and subjective symptoms, including heart palpitations and shortness of breath, PRO using PRO-CTCAE was significantly higher than medical provider-recognized outcomes using CTCAE. Concerning the recognition of regimen-specific symptoms, such as vomiting, nausea, and decreased appetite, medical provider- recognized outcomes were the same or higher than PRO. In QLQ-C30, the physical and role functions, fatigue and dyspnea significantly worsened after 2 and 3 courses of chemotherapy. J. Med. Invest. 71 : 82-91, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spinal magnetic resonance imaging artifacts in lumboperitoneal shunt surgery using adjustable valve implantation on the paravertebral spinal muscles. 腰腹腔分流手术中使用可调节瓣膜植入脊柱旁肌肉时的脊柱磁共振成像伪影。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.154

Tatsuya Tanaka, Ryohei Sashida, Yu Hirokawa, Tomihiro Wakamiya, Yuhei Michiwaki, Kazuaki Shimoji, Eiichi Suehiro, Keisuke Onoda, Fumitaka Yamane, Akira Matsuno, Tadatsugu Morimoto

{"title":"Spinal magnetic resonance imaging artifacts in lumboperitoneal shunt surgery using adjustable valve implantation on the paravertebral spinal muscles.","authors":"Tatsuya Tanaka, Ryohei Sashida, Yu Hirokawa, Tomihiro Wakamiya, Yuhei Michiwaki, Kazuaki Shimoji, Eiichi Suehiro, Keisuke Onoda, Fumitaka Yamane, Akira Matsuno, Tadatsugu Morimoto","doi":"10.2152/jmi.71.154","DOIUrl":"https://doi.org/10.2152/jmi.71.154","url":null,"abstract":"Background: Adjustable shunt valves that have been developed for managing hydrocephalus rely on intrinsically magnetic components ; thus, artifacts with these valves on magnetic resonance imaging (MRI) are inevitable. No studies on valve-induced artifacts in lumboperitoneal shunt (LPS) surgery have been published. Therefore, this study aimed to evaluate valve-induced artifacts in LPS.Methods: We retrospectively reviewed all MRIs obtained between January 2023 and June 2023 in patients with an implanted Codman CERTAS Plus adjustable shunt valve (Integra Life Sciences, Princeton, New Jersey, USA). The valve was placed <1 cm subcutaneously on the paravertebral spinal muscle of the back, with its long axis perpendicular to the body axis. The scans were performed using a Toshiba Medical Systems 1.5 Tesla scanner. The in-plane artifact sizes were assessed as the maximum distance of the artifact from the expected region of the back.Results: All spinal structures or spinal cords can be recognized, even with valve-induced artifacts. The median maximum valve-induced artifact distance on T1-weighted axial imaging was 25.63 mm (mean, 25.98 mm ; range, 22.24-30.94 mm). The median maximum valve-induced artifact distance on T2-weighted axial imaging was 25.56 mm (mean, 26.27 mm ; range, 21.83-29.53 mm).Conclusion: LPS surgery with adjustable valve implantation on paravertebral muscles did not cause valve-induced artifacts in the spine and spinal cord. We considered that LPS could simplify the postoperative care of these patients. J. Med. Invest. 71 : 154-157, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Y chromosome haplogroups are associated with birth size in Japanese men. 日本男性的 Y 染色体单倍群与出生体型有关。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.129

Youichi Sato

引用次数: 0

Usefulness of hand-assisted retroperitoneal laparoscopic radical nephrectomy for extreme obese patients -a case report. 手辅助腹膜后腹腔镜根治性肾切除术对极度肥胖患者的实用性--病例报告。

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JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI: 10.2152/jmi.71.187

Masato Yanagi, Tsutomu Hamasaki, Akifumi Katsu, Hiroyoshi Kono, Ryoji Kimata, Taiji Nishimura, Yukihiro Kondo

{"title":"Usefulness of hand-assisted retroperitoneal laparoscopic radical nephrectomy for extreme obese patients -a case report.","authors":"Masato Yanagi, Tsutomu Hamasaki, Akifumi Katsu, Hiroyoshi Kono, Ryoji Kimata, Taiji Nishimura, Yukihiro Kondo","doi":"10.2152/jmi.71.187","DOIUrl":"10.2152/jmi.71.187","url":null,"abstract":"We report a case of retroperitoneal laparoscopic radical nephrectomy (LRN) in which the addition of a hand port was necessary and effective. A 52-year-old man with obesity (BMI 40.6 kg/m2) was diagnosed with a 52-mm left renal cell carcinoma (cT1bN0M0). To avoid thick subcutaneous and visceral fat in the abdomen, we selected LRN using a retroperitoneal approach with four ports in the kidney position. During surgery, a large amount of flank pad and perirenal fat prevented us from securing a sufficient surgical field through traction of the kidney with a retractor. A pure laparoscopic procedure was not feasible;therefore, we added a hand port. Subsequently, we removed the flank pad from the hand port and secured the surgical field by tracing the kidney manually. Finally, hand-assisted LRN was completed without an open conversion. In retroperitoneal LRN, we rarely encounter patients for whom a pure laparoscopic procedure is not feasible because of the large amount of flank pad or perirenal fat. It is important to preoperatively confirm not only the BMI but also the amount of flank pad and perirenal fat on imaging. Hand-assisted LRN via the retroperitoneal approach can be safely performed even in extremely obese patients. J. Med. Invest. 71 : 187-190, February, 2024.","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0