Nihon Geka Gakkai zasshi
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Nihon Geka Gakkai zasshi · May 2001
[Liver transplantation for liver metastases of colorectal cancer].
Because of the critical shortage of donor organs, liver transplantation for metastatic tumors should be reserved for patients in whom long-term survival is possible. Transplantation in patients with metastatic tumors from colorectal cancer has resulted only in short disease-free intervals, and palliation was achieved in only a few patients. In patients with symptomatic neuroendocrine tumors unresponsive to conventional therapy, on the other hand, reasonably good disease-free intervals and prolonged survival may justify liver transplantation.
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A quarter of century has passed since specialties and their governing boards were established in the surgical field. It is now time to reestablish more definitive and rational specialties as we begin the 21st century. ⋯ The subsequent specialties (subspecialties) would be gastroenterological surgery, cardiovascular surgery, respiratory organ surgery, and pediatric surgery. In addition, the numerous medical associations in Japan could be overseen by a newly created Japan Board of Medical Specialties (proposed name) to manage the various specialties.
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Nihon Geka Gakkai zasshi · Mar 2001
[Training in specialties and subspecialties of surgery: current system in Japan and a proposal for the future].
The maintenance of quality care of surgical patients is the primary concern of surgeons. The Japan Surgical Society has taken the responsibility for establishing standards for the quality care of patients in surgery and surgical subspecialties. ⋯ Currently, a 3-year training system and subsequent qualifying examination for gastroenterological surgery, pediatric surgery, cardiovascular surgery and pulmonary surgery are being proposed after completing 4-year training and qualifying examination in general surgery. The pros and cons of this system are discussed and a more desirable system for the future is proposed.
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Nihon Geka Gakkai zasshi · Dec 2000
Historical Article[The history and evolution of coronary artery bypass grafting].
It is nearly 40 years since the introduction of coronary artery bypass grafting (CABG) in humans. A. Carrel (1910) attempted the first CABG in animals and G. ⋯ IMA grafting, supplemented by the gastroepiploic artery, inferior epigastric artery, and radial artery, has enabled complete arterial revascularization to be performed in almost all patients. In the graft selection for CABG, the first choice is the left IMA and the second choice is the right IMA. The third choice is the gastroepiploic artery and/or radial artery, depending on the target anastomotic site, degree of stenosis, size of the distal graft, and in situ or free use.
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Pediatric patients with inguinal hernia can be good candidates for day surgery. Since 1986, 1273 such patients have been treated under our day surgery system. Although 8 patients (0.6%) were unable to go home after surgery due to perioperative complications and 21 (1.6%) visited earlier than scheduled after discharge, no major complications were noted and postoperative complications did not differ from those seen in the inpatient setting. ⋯ Based on our own experience and a literature review of day surgery for inguinal hernia repair in children, the problems surrounding the day care system are discussed. Patient selection, preoperative assessment, general anesthesia, postoperative care including oral intake and analgesia, and postoperative follow-up are considered the most important issues in the day care system. A team approach including pediatric surgeons, anesthesiologists, and pediatric nurses is considered indispensable for the safe and satisfactory day surgery treatment.