[A Case of CA19-9-Producing Gastric Cancer with Recurrence of Lymph Node Metastasis That Achieved Clinical CR in Fourth-Line CapeOX Therapy].

A 74-year-old man underwent a distal gastrectomy for advanced gastric cancer. After surgical treatment, lymph node metastasis was observed during postoperative adjuvant S-1 chemotherapy. Weekly PTX plus RAM as second-line therapy and nivolumab as third-line therapy was administered, but lymph node enlarged and CA19-9 remained high. Therefore, 6 courses of CapeOX was administered as the fourth-line therapy, and CA19-9 markedly decreased and normalized, and CT showed marked reduction in all lymph nodes. After 12 courses, CT scan showed lymph node shrinkage and PET-CT scan showed no FDG uptake, and the patient was diagnosed as clinical complete response(cCR). Six months later, maintaining cCR. We experienced a case in which the introduction of CapeOX therapy resulted in a remarkable response to recurrence of lymph nodes after gastric cancer during S-1 therapy.

[A Case Report of Lateral Paracecal Hernia Treated with Single Port Surgery].

An 86-year-old female hospitalized for right femoral fracture complained of a sudden abdominal pain and vomited. Contrast-enhanced computed tomography (CECT) of the abdomen showed an ileal closed loop with dilatation of the oral side intestine. She was diagnosed with a bowel obstruction due to a paracecal hernia with incarceration and underwent an emergency operation. Under laparoscopy, the responsible ileum was incarcerated into the paracolic sulcus and strangulated. After releasing the strangulation by cutting the hernia hilum, the incarcerated ileum did not show any necrotic change. In this case, the CECT suggested paracecal hernia, showing the characteristic position between the cecum and the intestinal loop, which we successfully treated with a single incisional laparoscopic surgery.