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| 1 | Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery显示文摘AIM:To investigate the effects of gastric lavage with2000 mL of saline in laparoscopic and endoscopic cooperative surgery.METHODS:Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled.In former term,irrigations of the stomach were conducted whenever it was necessary,not systematically(Non systemic lavage group).In latter term,the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet,and Duodenal balloon occlusion was conducted to prevent refluxedbile and pancreatic juice(Systemic lavage+balloon occlusion group).The gastric wall was sprayed with 20mL of distilled water,and 20 mL of gastric juice was collected in a sterile tube and submitted for culture.20mL of ascites was also collected from the laparoscopic ports and submitted for culture.We compared WBC,CRP,BT between two groups,and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group.RESULTS:WBC count before,1 d after,and 3 d after laparoscopic and endoscopic cooperative surgery(LECS)were 5060(95%CI:4250-9640),12140(6050-14110),and 6910(5320-12520)in Non systemic lavage group,4400(3660-7620),8910(6480-10980),and 5950(4840-7860)in Systemic lavage+balloon occlusion group.Significant differences between two groups at the day after LECS(P=0.029)and the 3 d after LECS(P=0.042).CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS(P=0.005)and the 3 d after LECS(P=0.028).BTs(℃)in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS(P=0.004)and the 3 d after LECS(P=0.006).In a logarithmic comparison,bacterial load before gastric lavage,after lavage,and ascites culture were 6.08(95%CI:4.04-6.97),0.48(0-0.85),and 0.21(0-0.56).The bacterial counts before and after gastric lavage were significantly suppressed(P=0.007),but no significant difference between gastric juice culture after lavage and ascites(P=0.154).CONCLUSION:Pre-LECS lavage with 2000 mL of saline exhibited a bacteria-reducing effect equivalent to disinfectants and obtained favorable results in terms of clinical symptoms and data. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Joji Tani Hisaaki Miyoshi Asahiro Morishita Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，42： | 9 |
| 2 | Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth显示文摘Gastric hamartomatous inverted polyps(GHIP)are difficult to diagnose accurately because of inversion into the submucosal layer.GHIP are diagnosed using the pathological characteristics of the tumor,including the fibroblast cells,smooth muscle,nerve components,glandular hyperplasia,and cystic gland dilatation.Although Peutz-Jeghers syndrome,juvenile polyposis,and Cowden disease are hereditary,it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas.The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases.There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps.Based on our experience with 2 successive,rare GHIP cases,we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer,some of these components are exposed to the gastric mucosa and,consequently,form a hypertrophic lesion.In Case 1,our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy.There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1,and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection(ESD).Regarding the pathogenesis of GHIP,a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions.An en bloc resection using ESD is recommended for treatment. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，19： | 7 |
| 3 | Laparoscopic and endoscopic cooperative surgery for duodenal neuroendocrine tumor (NET) G1: Report of a case显示文摘 | Takaaki Tsushimi Hirohito Mori Takasuke Harada Takashi Nagase Yoshitaka Iked Hiromo Ohnishi | 2014 | International Journal of Surgery Case Reports2014，，12： | 3 |
| 4 | Endoscopic management of a rare granulation polyp in a colonic diverticulum显示文摘There are many case reports on colon diverticula that cause irritable bowel syndrome,constipation,bleeding,diverticulitis,stricture due to multiple recurrences of diverticulitis,and perforation.However,few articles have examined neoplasms that arise from a diverticulum,such as adenoma and adenocarcinoma,and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis.We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis.Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp.We successfully resected the polyp using endoscopic mucosal resection.We inverted the diverticulum,and the resected stalk of the polyp was used to close the diverticulum with an over-thescope clip.If a granulomatous polyp could arise from a diverticulum,differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment. | Hirohito Mori Takaaki Tsushimi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Tae Matsunaga Maki Ayagi Tatsuo Yachida Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，48： | 3 |
| 5 | Early laparoscopic cholecystectomy for acute gangrenous cholecystitis显示文摘 | Tsushimi T Matsui N Takemoto Y | 2007 | Surg Lapa-rosc Endosc Percutan Tech2007，17，1： | 1 |
| 6 | Expression of P21^^WAF1/CIP1 and p53 proteins in gastric carcinoma: its relationships with cell proliferation activity and prognosis 显示文摘 | Liu XP Tsushimi K Tsushimi M | 2001 | Cancer Lett2001，170，2： | 1 |
| 7 | Adenoma of the nipple, focusing on the contrast-enhanced magnetic resonance imaging findings:report of a case显示文摘 | Tsushimi T Enoki T Takemoto Y | 2011 | Surg Today2011，41，8： | 1 |
| 8 | Early laparoscopic cholecystectomy for acute gangrenous cholecystitis显示文摘 | Tsushimi T Matsui N Takemoto Y | 2007 | Surg Laparosc Endosc Percutan Tech2007，17，1： | 1 |
| 9 | Early laparoscopiccholecystectomy for acute gangrenous cholecystitis显示文摘 | Tsushimi T Matsui N Takemoto Y | 2007 | SurgLaparosc Endosc Percutan Tech2007，，17： | 1 |
| 10 | Early laparoscopic cholecystectomy for acute gangrenous choleeystitis 显示文摘 | Tsushimi T Matsui N Takemoto Y | 2007 | Surg Laparosc Endosc Percutan Tech2007，17，1： | 1 |
| 11 | Expression of p21(WAF1/CIP1) and p53 proteins in gastric carcinoma: its relationships with proliferation activity and prognosis显示文摘 | Liu X-P Tsushimi K Tsushimi M | 2001 | CancerLett2001，170，2： | 1 |
| 12 | A case of hyperosmolar nonketotic coma occurring during chemotherapy in lung cancer显示文摘 | Takamori S Tsushimi M Onaka A | | 0，，： | 1 |
| 13 | Expression of p53protein as a prognostec indicator of reduced surival time in diffuse-type gatrie carcinoma显示文摘 | Liu X P Tsushimi K Tsushimi M | 2001 | Pathol Int2001，51，6： | 1 |
| 14 | Small cell carci-noma of the prostate successfully treated with combinedchemotherapy and radiotherapy: a case report 显示文摘 | Ishizu K Tsushimi M Shimajiri S | 2002 | Hin-yokika Kiyo2002，48，2： | 1 |
| 15 | Expression of p53protein as a prognostec indicator of reduced surival time in diffuse-type gatric carcinoma显示文摘 | Liu X P Tsushimi K Tsushimi M et al | 2001 | Pathol Int2001，51，6： | 1 |
| 16 | Ectopic hepatocellular carcinoma arising in the bile duct显示文摘 | Takaaki Tsushimi Tadahiko Enoki Eijirou Harada Masahiko Orita Shinji Noshima Michiyoshi Masuda Kimikazu Hamano | 2005 | Journal of Hepato - Biliary - Pancreatic Surgery2005，，3： | 1 |
| 17 | Ectopic hepatocellularcarcinoma arising in the bile duct 显示文摘 | Tsushimi T Enoki T Harada E | 2005 | J Hepatobiliary PancreatSurg2005，12，3： | 1 |
| 18 | Laparoscopic Resection of an Ileal Lipoma: Report of a Case显示文摘 | Takaaki Tsushimi Norichika Matsui Hiroshi Kurazumi Yoshihiro Takemoto Kazuhito Oka Atsushi Seyama Tomoaki Morita | 2006 | Surgery Today2006，，11： | 1 |
| 19 | DNA amplification and Chromosomal translocations are accompanied by chromosomal instability : analysis of seven human colon cancer cell lines by comparative genomic hybridization and spectral karyotyping显示文摘 | Tsushimi T Noshima S O gaA | 2001 | Cancer Genet Cytogenet2001，26，1： | 1 |
| 20 | Ectopic hepatocel- lular carcinoma arising in the bile duct显示文摘 | Tsushimi T Enoki T Harada E | 2005 | J Hepatobiliary Pancreat Surg2005，12，3： | 1 |
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