Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Nov 2014
Case Reports[A case of ARDS after esophagectomy treated with low-dose steroid therapy].
A 48-year-old woman was found to have an esophageal cancer, and after preoperative chemotherapy with cisplatin (CDDP)/5-fluorouracil (5-FU), radical subtotal esophagectomy was performed. On the fifth day after surgery, her respiratory condition suddenly worsened and a chest radiograph showed low permeability in both lung fields, leading to a diagnosis of acute respiratory distress syndrome (ARDS) and intubation for mechanical ventilation. Since clinical examination did not detect signs of infection on the seventh day, we began administering hydrocortisone at a dose of 300 mg. ⋯ ARDS remains a refractory disease and no drug has proven to be effective in randomized controlled trials. The use of steroids for ARDS management remains controversial. Our present case suggests that low-dose steroids from an early stage in uninfected ARDS patients may improve prognosis.
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Gan To Kagaku Ryoho · Nov 2014
[Laparoscopic hemi-double stapling and reduced-port laparoscopic distal gastrectomy for gastric cancer].
The hemi-double stapling method (HDS) is typically used for extracorporeal Billroth-I anastomosis. We used HDS for reduced-port surgery. Laparoscopic HDS is used for intracorporeal Billroth-I anastomosis after laparoscopic distal gastrectomy. We performed reduced-port laparoscopic distal gastrectomy for gastric cancer. ⋯ Laparoscopic HDS and reduced-port laparoscopic distal gastrectomy are safe and feasible procedures.
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Gan To Kagaku Ryoho · Nov 2014
[Effect of recombinant human soluble thrombomodulin in patients with solid carcinoma with DIC].
There are only a few reports in the literature about the effect of recombinant human soluble thrombomodulin (rTM) in patients with solid carcinoma with disseminated intravascular coagulation (DIC). A retrospective study of 40 patients with solid carcinoma with DIC was performed between February 2009 and April 2013. ⋯ Patients with successful withdrawal of DIC had significantly better outcomes (p<.001). Therapy with rTM is one of the treatment options for patients with solid carcinoma with DIC.
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Gan To Kagaku Ryoho · Nov 2014
[Efficacy and safety of transdermal fentanyl patches for opioid initiation in patients with gastrointestinal obstruction].
The transdermal fentanyl patch (TDF) can be used when switching from other opioids; therefore, little is known about the efficacy and safety of TDF patches applied for opioid initiation. However, TDF patches have been applied for opioid initiation in gastrointestinal cancer patients with gastrointestinal obstruction. In this study, we retrospectively investigated 12 gastrointestinal cancer patients to evaluate the efficacy and frequency of adverse effects of TDF patches compared to oral oxycodone (OXY) for opioid initiation. ⋯ No severe adverse effects were observed, and there was no significant difference between the TDF patch and OXY groups. Moreover, according to the numerical pain rating scale(ranging from 0 [no pain] to 10 [worst possible pain]), the pain intensity in the TDF patch group decreased from 5.42 on the first day to 3.33 after 3 days (p=0.0377), and 2.67 after 7 days (p=0.0089), with no significant difference between groups. Our study results suggest that TDF patches applied for opioid initiation may be useful for gastrointestinal cancer patients with gastrointestinal obstruction.
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Gan To Kagaku Ryoho · Nov 2014
Case Reports[Efficiency of pre-operative chemoradiotherapy in treating a case of advanced rectal cancer].
There is insufficient evidence for the pre-operative use of chemoradiotherapy (CRT) in treatment of advanced rectal cancers, and its efficiency and safety are unclear. However, it has recently been suggested that a new class of carcinostatic agents are more effective during preoperative CRT. ⋯ The Japanese Society for Cancer of Colon and Rectum (JSCCR) guidelines for 2014 also recommend the use of both drugs during preoperative CRT. We report a case of rectal cancer, which was successfully treated with radical resection and neoadjuvant chemoradiotherapy.