One-to-One Correspondence Locations of Resected Polyps after Endoscopic Resection Using Catcher Tagged Method: A Randomized Prospective Study.

BACKGROUND/AIMS: Multiple colorectal polyps with a diameter in the range of 10-19 mm are unable to be retrieved through a 3-mm endoscopic channel by the aspiration method. This study aims to assess the usefulness of Catcher Tag retrieval, which not only allows the accurate identification of the resected location but also enables the easiest retrieval in a short time without any special device. METHODS: One hundred thirty five patients (483 polyps) were diagnosed with colorectal neoplasm, and 64 patients (225 polyps) were enrolled and randomly allocated into the Net forceps group (NET) and the Catcher Tagged group (TAG). In TAG, 3 types of colored ring-threads were used to retrieve resected polyps. After local injection of natural saline, ring-threads were placed close to polyps. The primary outcome was the number of one-to-one correspondence locations (UMIN000020826). RESULTS: There was significant difference in one-to-one correspondence (p = 0.004). The average retrieval procedure time was 13.56 ± 3.47 (min) in NET and 3.55 ± 1.68 in TAG (p = 0.006). In NET, 1 polyp in each of 4 cases was lost during endoscopic mucosal resection and 2 polyps were lost in 1 case. In TAG, no polyp was lost (p = 0.016). CONCLUSION: The Catcher Tagged method is very useful for accurate one-to-one correspondence locations and pathological evaluation, and easy-to-retrieve multiple resected specimens.

Retroperitoneal solitary fibrous tumor of the pelvis with pollakiuria: a case report.

BACKGROUND: Solitary fibrous tumor (SFT) is rare soft tissue tumor, and it occurs most commonly in the pleura. Retroperitoneal SFT is generally found by palpable mass or abdominal distention. Here we report a case of SFT presenting pollakiuria. CASE PRESENTATION: A 64-year-old man was referred to our hospital for pollakiuria. Contrasted-enhanced computed tomography revealed a heterogeneously enhanced pelvic tumor of approximately 10 × 8 × 7 cm. Invasion of the surrounding organs, distal metastasis, and lymph node swelling were absent. Therefore, surgical resection was performed. The resected specimen was a 13 × 8 × 5.5-cm encapsulated elastic hard tumor weighing 420 g. Histologically, the tumor consisted of oval or spindle cells growing in a random manner in a collagenous matrix. Immunohistochemically, the specimen was positive for CD34, bcl-2, as well as vimentin and negative for c-kit. On the basis of these findings, a retroperitoneal solitary fibrous tumor (SFT) of the pelvis was diagnosed. CONCLUSION: Surgery is the primary treatment for SFT, and pathologically negative margins are important for good prognosis.

Sutureless pneumostasis using polyglycolic acid mesh as artificial pleura during video-assisted major pulmonary resection.

BACKGROUND: Postoperative air leaks impede rehabilitation and prolong hospitalization after pulmonary resection. To promote rehabilitation after video-assisted major pulmonary resection, we attempted to control alveolar air leaks without suturing, using polyglycolic acid mesh as artificial pleura. METHODS: Forty-five patients undergoing video-assisted major pulmonary resection in our institute were enrolled in this study. Pneumostasis was done for intraoperative air leaks, by combining polyglycolic acid mesh with fibrin glue. We removed the chest tube the day after the air leaks stopped. RESULTS: Pneumostasis was done for intraoperative air leaks in 28 patients. The air leaks stopped immediately, allowing chest tube removal on postoperative day 1 in all but one patient whose air leak took 1 day longer to disappear. The time of chest tube drainage and the postoperative stay were similar in the patients with and those without intraoperative air leaks (mean 1.0 days vs 1.2 days and 6.8 days vs 7.1 days, respectively). The percentage of predicted forced expiratory volume in one second was significantly lower in patients with, than in those without, intraoperative air leaks (p < 0.05). CONCLUSIONS: We achieved sutureless pneumostasis using bioabsorbable artificial pleura during video-assisted major pulmonary resection. This method may contribute to reducing hospitalization, especially in patients with poor pulmonary function.

Computed tomography-diagnosed emphysema, not airway obstruction, is associated with the prognostic outcome of early-stage lung cancer.

PURPOSE: Because both emphysema and lung cancer can arise from biological damage caused by cigarette smoking, we investigated if the development of emphysema is associated with the clinical features of smoker's lung cancer. EXPERIMENTAL DESIGN: The subjects were a consecutive series of 100 smokers who underwent lobectomy with hilar and mediastinal dissection for clinical stage I non-small cell lung cancer. We studied the relationship between the presence or absence of emphysema at the onset of the lung cancer and clinicopathologic features. Emphysema was diagnosed by measuring the low-attenuation area using computed tomography densitometry. RESULTS: There were no differences in clinicopathologic variables, including the degree of smoking exposure between the patients with (n=58) and those without (n=42) emphysema, although male gender and airflow limitation were predominant in the patients with emphysema. The presence of emphysema, but neither male gender nor airflow limitation, adversely affected both overall and disease-specific survival. According to Cox regression analysis, emphysema was an independent prognosticator among age, gender, degree of smoking exposure, tumor size, nodal status, histologic subtype, histologic grade, and microvessel invasion. These results were stabilized by a bootstrap sampling model. CONCLUSIONS: Computed tomography-diagnosed emphysema, but not airway obstruction, is associated with poor prognosis in smokers with early-stage lung cancer. Thus, routine computed tomography densitometry in smokers with lung cancer should be mandatory.