Surgical Case Reports

Laparoscopic Sugarbaker Repair of Parastomal Hernia with Gastric Incarceration: A Case Report and Review of the Literature

Masatsugu Kojima, et al.

INTRODUCTION: Parastomal hernia is a common complication of stoma creation; however, gastric involvement is extremely rare, with only approximately 2 dozen cases reported. Gastric incarceration in a parastomal hernia can cause severe complications, including gastric outlet obstruction and ischemia, and requires timely surgical management.

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A Case of Late Radiation-Induced Enteritis with Enterolith Caused Enterocutaneous Fistula

Kiyoe Takai, et al.

INTRODUCTION: Radiotherapy for pelvic malignancies contributes to improved patient survival. However, early and late radiation-induced complications are increasing and cause significant impairment of quality of life. We reported a case of late radiation-induced enteritis associated with an enterocutaneous fistula suggestive of enterolith, which required 2 times of surgical treatments.

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Hepatectomy inside the Portal Ring in a Patient with Absence of Portal Vein Bifurcation: A Case Report

Atsuhito Takagi, et al.

INTRODUCTION: Absence of portal vein bifurcation (APB) is a rare congenital anomaly in which the main portal vein does not bifurcate at the hepatic hilum. After giving off posterior and anterior sectoral branches, the trunk curves ventrally around the middle hepatic vein—forming a so-called “portal ring”—and finally enters the umbilical portion of the left portal vein. Hepatectomy performed inside this ring risks compromising perfusion if the portal trunk is injured. We report a case in which anatomical segmentectomy (S4a+S5) was performed for the gallbladder carcinoma with this portal vein anomaly.

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A 21-Year-Old Female with Invasive Breast Cancer within a Benign Phyllodes Tumor

Hisami Yoneda, et al.

INTRODUCTION: Although breast cancer occurring within a phyllodes tumor (PT) has been reported, it is extremely rare in young patients. Herein, we describe a case of breast cancer complicated by a PT in a 21-year-old female.

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A Case of One-Stage Surgical Treatment for a Bladder Hernia with Bladder Calculi

Naoki Kubo, et al.

INTRODUCTION: A bladder hernia associated with bladder calculi is an extremely rare condition, with no consensus established regarding its management. Herein, we report a case in which 1-stage surgical treatment was performed for a bladder hernia complicated by bladder calculi.

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Immune Thrombocytopenia Successfully Controlled by Dissection of an Enlarged Mediastinal Lymph Node Metastasis from Squamous Cell Carcinoma of Unknown Primary: A Case Report

Yoshihito Iijima. et al

INTRODUCTION: Immune thrombocytopenia (ITP) is an autoimmune hematologic disorder characterized by a reduced platelet count resulting from immune-mediated platelet destruction and/or impaired thrombopoiesis. This condition is often associated with malignant tumors, making perioperative management crucial to maintain hemostasis during and after surgery. Herein, we report a case of ITP successfully controlled following surgical dissection of a large mediastinal lymph node metastasis originating from squamous cell carcinoma of unknown primary.

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Two Cases of Inguinal Hernia after Kidney Transplantation Treated with Transabdominal Preperitoneal

Hitomi Zotani, et al.

INTRODUCTION: The Lichtenstein procedure is often selected for kidney transplantation (KT) recipients due to concerns about the risk of injury to the transplanted organ. However, there have been reports of complications such as ureteral obstruction in cases where the Lichtenstein procedure was performed; therefore, safer techniques and approaches must be selected. We herein report 2 cases of inguinal hernia on the transplant side after KT that were treated with laparoscopic hernia repair (transabdominal preperitoneal [TAPP]) following a careful preoperative assessment.

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A Case of Multiple Metastases in the Gastric Wall Due to Needle Tract Seeding after Endoscopic Ultrasound-Guided Tissue Acquisition for Pancreatic Tail Cancer

Kazuhiro Takami, et al.

INTRODUCTION: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is widely used for the diagnosis of pancreatic cancer, other pancreatic tumors, and autoimmune pancreatitis. Among the adverse events, needle tract seeding (NTS) is the most concerning. NTS is a phenomenon in which tumor cells are observed at the site of biopsy needle passage. We herein report a case of multiple gastric wall recurrences resulting from NTS after laparoscopic distal pancreatectomy for pancreatic tail cancer.

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Conversion Surgery for Advanced Gastric Cancer with Para-Aortic Lymph Node Metastases Following Treatment with Capecitabine, Oxaliplatin, and Pembrolizumab: A Case Report

Takuya Ono, et al.

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have recently emerged as an important treatment option for various cancers. In 2024, pembrolizumab was approved as a first-line treatment for unresectable or recurrent gastric cancer. Conversion surgery following ICI-based chemotherapy has been reported; however, cases involving pembrolizumab-based first-line therapy remain rare. Here, we report a case of conversion surgery after treatment with capecitabine plus oxaliplatin (CAPOX), combined with pembrolizumab for unresectable advanced gastric cancer.

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Successful Conversion Surgery after Zolbetuximab-Based Chemotherapy for Claudin 18.2-Positive Gastric Cancer with Peritoneal Dissemination and Cervical Lymph Node Metastasis: A Case Report

Sadaki Shirao, et al.

INTRODUCTION: Zolbetuximab, a monoclonal antibody targeting claudin (CLDN) 18.2, has been approved as a first-line treatment for patients with human epidermal growth factor receptor 2 (HER2)-negative and CLDN-positive advanced gastric cancer. Conversion surgery following chemotherapy has emerged as a promising strategy for improving outcomes in patients with stage IV gastric cancer. Herein, we report a case of CLDN-positive gastric cancer with peritoneal dissemination and cervical lymph node metastasis that was successfully treated with subtotal gastrectomy (sTG) following zolbetuximab-based chemotherapy.

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Successful Surgical Treatment of Hemosuccus Pancreaticus Caused by Rupture of a Transverse Pancreatic Artery Aneurysm: A Case Report

Ayaka Ogura, et al.

INTRODUCTION: A pancreatic pseudoaneurysm is a rare but potentially life-threatening complication of pancreatitis. Although pseudoaneurysms typically arise from the splenic, gastroduodenal, or pancreaticoduodenal arteries, transverse pancreatic artery involvement is uncommon. Here, we report the case of a pseudoaneurysm in the transverse pancreatic artery that presented with repeated episodes of obscure gastrointestinal bleeding over an extended period, with a clinical course suggestive of pancreatic duct rupture.

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Surgical Management of Sigmoid Volvulus: A Retrospective Review of Six Cases with a Focus on the Sharon Operation

Keisuke Inoue, et al

INTRODUCTION: Sigmoid volvulus is a clinically significant cause of large bowel obstruction that occurs particularly in older patients with a reduced physical function. Although endoscopic detorsion is the first-line treatment, volvulus recurrence is common and often requires elective surgery. Despite various reports on the surgical procedures, the optimal approach remains controversial. The Sharon operation, first introduced in 1985, is a minimally invasive technique that avoids mobilization of the sigmoid colon via a small incision in the left lower quadrant. Although it offers several advantages, such as shorter operative time, minimal invasiveness, and favorable clinical outcomes, it remains underutilized, especially in Japan. We evaluated the clinical utility and indications of the Sharon operation in high-risk patients with recurrent sigmoid volvulus

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