Nihon Geka Gakkai zasshi
-
Nihon Geka Gakkai zasshi · Mar 2003
[Specialist of general surgery and gastroenterological surgery].
The educational committee of the society of gastroenterological surgery made a rule that the specialist of gastroenterological surgery must have a title of a general surgeon which was approved by the educational committee of the Japan surgical society. This means that a specialist of gastroenterological surgery should be able to treat diseases in the area of the general surgery and should be able to do the primary cares for whole areas of gastroenterological diseases which are the upper and the lower intestinal diseases, hepato-bilial and pancreatic diseases in addition. ⋯ These two courses are proceeding in parallel. The essential contents of these two courses are overlapped, so these common contents may count as experiences for both courses respectively.
-
Among all the other fields in medicine where safety and good quality are always expected, cardiovascular surgery is the one field where you are expected the most. Therefore cardiovascular surgeons should have an ability to deal adequately with a severe relationship between patients and surgeons. A long-term education after several years of basic surgery training is mandatory to be an authorized high quality cardiovascular surgeon. ⋯ In order to authorize general surgeons as well, basic surgery and general surgery should be separated. To avoid the world of cardiovascular surgery becoming the aging society, a long-term training of cardiovascular surgery should begin as early as possible after efficient short-term training of basic surgery. Meanwhile high income should be guaranteed for high risk/volume work.
-
Endotoxin adsorption therapy with a column containing polymyxin B-immobilized fiber (PMX-DHP) has been widely applied in the treatment of endotoxin-induced septic shock in Japan. Recently, the indications for PMX-DHP have been expanded as it has become clear that anandamide can be removed from the bloodstream with PMX-DHP. ⋯ According to our own results, there were no differences in the endotoxin removal rate, anandamide removal rate, and survival rate with or without PMX-DHP during PMMA-CHDF in the treatment of patients with septic shock. These results indicate that there is no need to perform PMX-DHP for septic shock as long as PMMA-CHDF is performed, and that the indications for PMX-DHP should be circumspectly investigated again.
-
Nihon Geka Gakkai zasshi · Oct 2002
Review[Video-assisted thoracic surgical lobectomy in conjunction with lymphadenectomy for lung cancer].
Video-assisted thoracic surgery (VATS) has been in widespread use since the beginning of the 1990s. The initial indications for VATS were benign lesions of the lung, pneumothorax, benign tumors, etc. ⋯ The 8-year survival rate of final stage IA lung cancers following VATS is 97.2%; this survival rate is significantly better than that with open thoracotomy. Here we report on our 10-year experience with VATS lobectomy, focusing on stage I lung cancer.
-
Nihon Geka Gakkai zasshi · Jul 2002
[Pathophysiologic changes in trauma patients and indications of damage control surgery].
Damage control surgery has become an inevitable strategy in the treatment of severely traumatized patients. Rationale for the DCS is the fact that the mortality in surgical patients who developed hypothermia, acidosis, and coagulopathy (lethal triad) is extremely high unless patients' physiologic stability was reestablished. DCS is usually indicated when patient shows signs of lethal triad during surgical operation. As most of patients who subsequently needed DCS could be judged as having most severe injuries during resuscitative phase, it may be more wise to select candidates for DCS during this phase than to indicate DCS during operation.