著者

神谷 純広 清水 智治 園田 寛道 目片 英治 遠藤 善裕 三宅 亨 山口 剛 森 毅 仲 成幸 谷 徹

出版者

日本外科系連合学会

雑誌

日本外科系連合学会誌 (ISSN:03857883)

巻号頁・発行日

vol.37, no.4, pp.826-831, 2012 (Released:2013-08-25)

参考文献数

14

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(症例)42歳女性,既往歴:23年前からうつ病,20年前にも針を誤飲.自殺企図にて3日前に5cmほどの縫針5本をプリンと一緒に飲んだという.排便時に肛門痛を自覚し当院を救急受診した.初診時,肛門部皮膚には異常は認めなかった.胸腹部X線写真にて上腹部に1本,下腹部に2本の陰影を認めた.腹部CTにて胃・上部および下部直腸内に陰影を確認でき,下部直腸では管腔外に脱出している可能性が示唆された.初診12時間後に肛門部右前方皮下に異物を触知し局所麻酔下に針を摘出した.胃内の針は内視鏡下に摘出した.上部直腸内に残存する針は2日後には自然排出を確認した.誤飲した針が肛門括約筋外から排泄された症例は極めて稀である.針のような臓器損傷の可能性が高い異物は,アプローチしやすい部位に存在する場合は積極的に摘出処置を行い,それ以外の部位では誤飲から日が浅ければ経過観察することも可能であると考えられた.

著者

森川 茂廣 来見 良誠 仲 成幸 塩見 尚礼 村山 浩之 村上 耕一郎 Hasnine A. Haque 犬伏 俊郎 谷 徹

出版者

特定非営利活動法人 Microwave Surgery研究会

雑誌

Journal of Microwave Surgery (ISSN:09177728)

巻号頁・発行日

no.29, pp.33-38, 2011

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We started microwave ablation therapy of liver tumors under MR image guidance with an open configuration MR scanner. The combination of these two was quite feasible. At the beginning, preparations of MR compatible electrodes and a noise-eliminating filter were required. After the measurements against the noise, microwave irradiation did not disturb MR images and temperature changes could be monitored using MR temperature maps, which were useful for the real-time evaluation of therapeutic effects. In addition, MR temperature maps could be used to investigate the condition of microwave ablation with newly developed instruments and applications. The encounter of microwave ablation with MR imaging made a breakthrough in the image-guided minimally invasive therapy. Further developments of new technologies for therapeutic procedures are expected from this combination.

著者

来見 良誠 谷 徹 仲 成幸 佐藤 浩一郎 遠藤 善裕 花澤 一芳 森川 茂廣 犬伏 俊郎 野坂 修一 村田 喜代史

出版者

特定非営利活動法人 Microwave Surgery研究会

雑誌

Journal of Microwave Surgery (ISSN:09177728)

巻号頁・発行日

vol.19, pp.99-103, 2001 (Released:2008-09-24)

参考文献数

6

被引用文献数

4 3

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Microwave Ablation is one of the useful treatments of hepatic tumor. It has been used as an interventional device for thermoablation therapy under ultrasonographic or laparoscopic guidance. We have done clinical studies of MR-guided microwave ablation therapy of hepatic tumors since January 2000. From January through September 2000, 18 patients with liver tumors were hospitalized in the 1st Department of Surgery at Shiga University of Medical Science. There were 13 cases of metastatic hepatic tumor. All of which had previously had primary surgery. The other 5 cases were primary hepatic cancer. All patients were selected because percutaneous ethanol injection therapy (PEIT) or transcathetal arterial embolization (TAE) was ineffective, and surgical resection could not be done because of hepatic dysfunction.We had already performed MR-guided microwave ablation therapy to hepatic tumors located in every segment of the liver. However, percutaneous puncture of the tumors in the subphrenic area was not easy with the abdominal approach. In these cases, a combination of thoracoscopic and MR-guidance has been beneficial. MR compatible endoscope made us easily to puncture hepatic tumors located in every segment of the liver. MR-guided microwave ablation therapy is a feasible treatment for hepatic tumors.