研究者詳細 - 秋山　有史

論文 - 秋山　有史

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Hyperglycemia 3 days after esophageal cancer surgery is associated with an increased risk of postoperative infection.

Ito N, Iwaya T, Ikeda K, Kimura Y, Akiyama Y, Konosu M, Ishida K, Fujiwara H, Otsuka K, Nitta H, Kashiwaba M, Koeda K, Nishizuka S, Mizuno M, Sasaki A, Wakabayashi G

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 18 ( 9 ) 1547 - 56 2014年09月 [査読有り] [国際誌]

PURPOSE: Postoperative hyperglycemia is associated with infectious complications after various types of surgery. Our objective was to determine whether postoperative blood glucose levels up to 1 week after highly invasive esophageal cancer surgery are associated with the incidence of postoperative infections (POIs). METHODS: We conducted a retrospective chart review of 109 consecutive thoracic esophageal squamous cell cancer patients who underwent invasive esophagectomy with thoracotomy and laparotomy. The incidence of postoperative POIs and risk factors for POIs, including postoperative blood glucose levels, were evaluated. RESULTS: Of the 109 patients, 37 (34.0 %) developed POIs. Clinically, 73.0 % of the POIs became evident on or after postoperative day 4 (median, 5.25 days; interquartile range, 3.00-9.25 days). On and after postoperative day 3, chronological changes in blood glucose levels were significantly different between two groups of patients with or without POIs, as indicated by repeated measures ANOVA (P = 0.006). Multivariate logistic regression analysis results showed that an increased blood glucose concentration on postoperative day 3 was a significant risk factor for POIs. CONCLUSIONS: Our findings suggested that postoperative hyperglycemia on postoperative day 3 was a predictive factor of POIs after highly invasive esophageal cancer surgery.

DOI PubMed

当院における緩和ケアチームの活動状況

木村祐輔, 岩谷岳, 秋山有史, 鴻巣正史, 遠藤史隆, 西塚哲, 大塚幸喜, 佐々木章, 水野大, 若林剛

日本消化器外科学会総会 ( (一社)日本消化器外科学会 ) 69回 RS - 1 2014年07月

当科における食道内分泌細胞癌(小細胞型)切除症例の検討

木村祐輔, 岩谷岳, 秋山有史, 鴻巣正史, 遠藤史隆, 藤原久貴, 西塚哲, 肥田圭介, 佐々木章, 若林剛

日本食道学会学術集会プログラム・抄録集 ( (NPO)日本食道学会 ) 68回 136 - 136 2014年07月

食道扁平上皮癌の発生に関与する17q25.1領域の遺伝子異常

岩谷岳, 秋山有史, 鴻巣正史, 木村祐輔, 遠藤史隆, 石田馨, 佐藤慧, 西塚哲, 佐々木章, 若林剛

日本食道学会学術集会プログラム・抄録集 ( (NPO)日本食道学会 ) 68回 106 - 106 2014年07月

[A case of unresectable multiple liver metastases of colorectal cancer in which ALTA(ZION), used to control internal hemorrhoidal bleeding, enabled administration of bevacizumab].

Kato K, Otsuka K, Kato N, Itabashi T, Akiyama Y, Wakabayashi G

Gan to kagaku ryoho. Cancer & chemotherapy 40 ( 11 ) 1553 - 1555 2013年11月 [査読有り]

PubMed

FOLFIRI plus bevacizumab as a first-line treatment for Japanese patients with metastatic colorectal cancer: a JACCRO CC-03 multicenter phase II study.

Mitsugu Kochi, Yuji Akiyama, Tatsuya Aoki, Ken Hagiwara, Takao Takahashi, Katsuji Hironaka, Futoshi Teranishi, Fumihiko Osuka, Masahiro Takeuchi, Masashi Fujii, Toshifusa Nakajima

Cancer chemotherapy and pharmacology 72 ( 5 ) 1097 - 102 2013年11月 [査読有り] [国際誌]

PURPOSE: The purpose of this multicenter phase II study was to evaluate the efficacy and safety of a combination of irinotecan, 5-fluorouracil (5-FU), and leucovorin (FOLFIRI) plus bevacizumab as first-line chemotherapy in Japanese patients with metastatic colorectal cancer. METHODS: Patients with metastatic colorectal cancer were eligible for enrollment. On day 1 of a 14-day cycle, patients received bevacizumab 5 mg/kg, irinotecan 150 mg/m², and L-leucovorin 200 mg/m² as an intravenous infusion, followed by 5-FU 400 mg/m² as an intravenous bolus and then 5-FU 2,400 mg/m² as an 46-h intravenous infusion. This treatment cycle was repeated. The primary endpoint was progression-free survival (PFS). RESULTS: We enrolled 40 patients, but one withdrew consent before starting treatment. The remaining 39 patients received a total of 509 cycles of FOLFIRI plus bevacizumab (median 11 per patient; range 1-30). The median PFS was 11.5 months, the median overall survival (OS) was 22.0 months, and the 1-year OS rate was 81.8 %. All 39 patients had adverse events. Grade 3 or 4 neutropenia and stomatitis occurred in 21 (53.9 %) and 4 (10.3 %) patients, respectively. CONCLUSION: Our results suggest that FOLFIRI plus bevacizumab is a clinically effective regimen with a manageable toxicity profile as first-line chemotherapy in patients with metastatic colorectal cancer.

DOI PubMed

光力学を利用した細胞診(Photodynamic Cytodiagnosis)

杉立彰夫, 久米浩平, 石田馨, 遠藤史隆, 片桐弘勝, 伊藤直子, 板橋哲也, 秋山有史, 岩谷岳, 西塚哲, 若林剛

日本癌学会総会記事 ( (一社)日本癌学会 ) 72回 184 - 184 2013年10月

食道切除後再建術における工夫と短期治療成績

木村祐輔, 岩谷岳, 秋山有史, 鴻巣正史, 遠藤史隆, 藤原久貴, 西塚哲, 大塚幸喜, 新田浩幸, 肥田圭介, 佐々木章, 水野大, 若林剛

日本消化器外科学会雑誌 ( (一社)日本消化器外科学会 ) 46 ( Suppl.2 ) 137 - 137 2013年10月

食道癌肉腫と扁平上皮癌の3重多発癌の1例

梅邑晃, 木村祐輔, 岩谷岳, 秋山有史, 鴻巣正史, 肥田圭介, 藤原久貴, 佐々木章, 若林剛

日本食道学会学術集会プログラム・抄録集 ( (NPO)日本食道学会 ) 67回 318 - 318 2013年06月

進行食道癌に対する食道ステント治療成績

木村祐輔, 岩谷岳, 秋山有史, 鴻巣正史, 遠藤史隆, 藤原久貴, 肥田圭介, 佐々木章, 水野大, 若林剛

日本食道学会学術集会プログラム・抄録集 ( (NPO)日本食道学会 ) 67回 221 - 221 2013年06月

A case of unresectable multiple liver metastases of colorectal cancer in which ALTA (ZION®) used to control internal hemorrhoidal bleeding, enabled administration of bevacizumab

Kuniyuki Kato, Koki Otsuka, Norihiro Kato, Tetsuya Itabashi, Yuji Akiyama, Go Wakabayashi

Japanese Journal of Cancer and Chemotherapy ( Japanese Journal of Cancer and Chemotherapy Publishers Inc. ) 40 ( 11 ) 1553 - 1555 2013年 [査読有り]

Our patient was a 58-year-old woman with internal bleeding hemorrhoids who was undergoing FOLFOX6 treatment for unresectable multiple hepatic metastases of colorectal cancer. Response evaluation after 6 courses showed stable disease (SD), but side effects necessitated a change in regimen. Hemorrhoidal bleeding had also increased, and hemorrhoid-sclerosing therapy with ALTA (ZION®) injections was administered. Because no bleeding was evident after treatment and the clinical course was uneventful, chemotherapy with bevacizumab was restarted. No hemorrhoidal bleeding occurred after bevacizumab administration, and the patient is currently continuing chemotherapy. In patients with advanced cancer who have bleeding internal hemorrhoids that cannot be controlled with conservative treatment, hemorrhoid-sclerosing therapy using ALTA appears to offer an effective treatment variation that enables the use of bevacizumab in cases with limited available therapeutic regimen options.

PubMed

[Usefulness of esophageal stenting for esophagorespiratory fistula with esophageal cancer].

Konosu M, Kimura Y, Iwaya T, Akiyama Y, Fujiwara H, Endo F, Sugitachi A, Nishizuka S, Nitta H, Otsuka K, Kashiwaba M, Koeda K, Sasaki A, Mizuno M, Wakabayashi G

Gan to kagaku ryoho. Cancer & chemotherapy 39 ( 12 ) 1849 - 51 2012年11月 [査読有り] [国内誌]

We evaluated the outcome of esophageal stenting for esophagorespiratory fistula in patients with advanced esophageal cancer. Six patients with such fistula underwent esophageal stenting at our department from January 2000 to May 2012. Intraoral ingestion improved in all patients. Cough decreased immediately after stenting in 3 patients, and pneumonia detected by chest radiography improved within 1 week in 2 patients. Ventilation was weaned 2 days after stenting in 1 patient. The median survival duration after stenting was 31 days, and the cause of death was cancer in all patients. The following background factors were identified at the time of death: bleeding(n=3), mediastinitis(n=1), and pneumonia(n=1). Esophageal stenting, which should always be performed with the informed consent of the patient, improves respiratory symptoms, intraoral ingestion, and quality of life. Therefore, it is one of the best palliative therapies for patients with esophagorespiratory fistula associated with advanced esophageal cancer.

PubMed

腹壁瘢痕ヘルニア

加藤久仁之, 大塚幸喜, 板橋哲也, 秋山有史, 石田馨, 眞壁健二, 八重樫瑞典, 藤井仁志, 木村祐輔, 新田浩幸, 肥田圭介, 水野大, 佐々木章, 井谷史嗣, 若林剛

外科 74 ( 6 ) 643 - 647 2012年06月

メシル酸イマチニブ投与後に肛門温存手術を施行した直腸GISTの1例

加藤久仁之, 大塚幸喜, 板橋哲也, 秋山有史, 吉田雅一, 若林剛

日本大腸肛門病学会雑誌 ( The Japan Society of Coloproctology ) 65 ( 4 ) 239 - 244 2012年

症例は55歳女性，肛門部痛と排便困難を主訴に来院した．直腸指診で直腸全壁に表面平滑な腫瘤を触知した．CTでは長径112mmの腫瘤を認め，子宮との境界は不明瞭であった．針生検による病理組織学的検査でc-kit陽性で直腸gastrointestinal stromal tumor（GIST）と診断した．手術を考慮した場合，直腸切断術および子宮合併切除が必要と考えられたが，患者本人が肛門温存を希望したため，術前補助療法としてメシル酸イマチニブ（400mg/日）の投与を行った．投与開始60日後のCTでは腫瘍は43mmへ縮小し，子宮との境界は明瞭であり肛門温存手術が可能と判断し内肛門括約筋切除術を施行した．腫瘍は液状変性を来たしており，c-kitおよびCD34陰性であり，組織学的効果判定はgrade3（pCR）であった．GISTの治療の第一選択は外科的切除であり，直腸の場合，直腸切断術が選択されることが多いが，自検例のように術前補助療法により肛門温存できる可能性が示唆された．

DOI CiNii

Effect of a selective neutrophil elastase inhibitor on early recovery from body water imbalance after transthoracic esophagectomy

M. Kobayashi, T. Irinoda, Y. Akiyama, E. Meguro, Y. Hayakawa, O. Funato, A. Takagane

DISEASES OF THE ESOPHAGUS ( WILEY-BLACKWELL PUBLISHING, INC ) 23 ( 7 ) 565 - 571 2010年09月 [査読有り]

P>The objective of the study was to evaluate the efficacy of sivelestat, a selective neutrophil elastase inhibitor, on body fluid balance after transthoracic esophagectomy. Esophagectomy with elective lymphadenectomy may induce excessive release of neutrophil elastase, which then promotes vascular permeability and an excessive water shift from the intravascular space to the peripheral compartment. Body fluid imbalance after esophagectomy often leads to circular instability, a decrease of urine output, and a delay in the shift to a diuretic state. The study was designed as a case-control study with a historical control group. A retrospective analysis was performed to examine our hypothesis that sivelestat improves abnormal body fluid retention and prevents subsequent pulmonary complications. To reveal the direct influence of sivelestat on the postoperative course, we avoided using steroids or other diuretic agents. Eighty-eight patients who underwent thoracic esophagectomy with extended lymphadenectomy from 2000 to 2008 were divided into two groups: those treated from 2003 to 2008, who all received postoperative administration of sivelestat (n = 60); and those treated from 2000 to 2002, who did not receive sivelestat and were used as the control group (n = 28). Both groups received fluid management using the same protocol. The time to reach a diuretic state, time until extubation of the tracheal tube, and development of delayed respiratory dysfunction were compared between the groups using univariate and multivariate analysis. The time until a shift to a diuretic state was significantly shorter after treatment with sivelestat (p < 0.0001) and with a shorter operation time (p < 0.0001). The tracheal tube was extubated significantly earlier in the sivelestat group (p < 0.0001) and the incidence of delayed respiratory dysfunction was also significantly lower (p = 0.0028) in this group. Multivariate logistic regression analysis showed that a delay in a shift to a diuretic state was a strong independent risk factor for the time to tracheal extubation (odds ratio 2.539, p = 0.0056) and occurrence of delayed respiratory dysfunction (odds ratio 1.989, p = 0.0104). Sivelestat treatment was not independently associated with reduced pulmonary complications, but the diuretic state was strongly regulated by sivelestat treatment (odds ratio 0.044, p = 0.0003). Thus, administration of sivelestat has a beneficial influence on recovery from body water imbalance through a more rapid return to a diuretic state after esophagectomy, which contributes to prevention of subsequent pulmonary complications.

DOI PubMed

[A novel anticancer drug delivery system -DAC-70/CDDP].

Sugitachi A, Otsuka K, Fujisawa K, Itabashi T, Akiyama Y, Sasaki A, Ikeda K, Yoshida Y, Takamori Y, Kurozumi S, Mori T, Wakabayashi G

Gan to kagaku ryoho. Cancer & chemotherapy 34 ( 12 ) 2159 - 61 2007年11月 [査読有り] [国内誌]

We devised a muco-adhesive anticancer drug delivery system using 70% deacetylated chitin (DAC-70) and cisplatin (CDDP) and 5-fluorouracil (5-FU). The adhesive force between the system and human colonic mucosa was measured ex vivo, and a release profile of each drug was examined in vitro. Each system demonstrated a stronger muco-adhesive force at 37 degrees C than that of 25 degrees C. The CDDP-loaded system showed a sustained release of the drug while the 5-FU-loaded system exhibited an initial bursting of the agent. We presume that the release profile of CDDP and 5-FU is closely related to both degradability of the chitin and interactions between the chitin and each drug. The DAC-70/CDDP system would be clinically promising in loco-regional cancer chemotherapy.

PubMed

[Current status and problems in laparoscopic surgery for colorectal cancer].

Otsuka Y, Itabashi T, Fujisawa K, Akiyama Y, Sasaki A, Ikeda K, Wakabayashi T

Gan to kagaku ryoho. Cancer & chemotherapy 34 ( 11 ) 1764 - 1767 2007年11月 [査読有り]

PubMed

[A novel approach to loco-regional cancer chemotherapy with a chitosan-CDDP solution].

Otsuka K, Akiyama Y, Itabashi T, Sasaki A, Ikeda K, Takamori Y, Kurozumi S, Wakabayashi G

Gan to kagaku ryoho. Cancer & chemotherapy 33 ( 12 ) 1866 - 8 2006年11月 [査読有り] [国内誌]

The authors applied 70% deacetylated chitin (DAC 70, chitosan) as a vehicle of cis-platinum (CDDP) to achieve loco-regional cancer chemotherapy, in an attempt to hold the drug in the target region with a locally sustained release. The DAC-70 powder was dissolved in a 0.1 M HCI solution into where CDDP solution and glycerol phosphate solution were added. The resulting product, DAC-70/CDDP became a muco-adhesive solution. The adhesiveness between the solution and human colonic mucosa was measured ex vivo by our own method, and a release profile of the CDDP was examined in vitro using an atomic absorption method. The adhesive force was stronger at 37 degrees C than that of at 25 degrees C. Ten percent of the CDDP was gradually delivered for 6 hours, while the release was maintained at the same levels for the following 72 hours. The release rate increased by 10-20% when lysozyme was added in the incubation systems. However, the release profile of the drug showed no remarkable changes. The DAC-70/CDDP solution provided a favorable adhesiveness with human colonic mucosa, while in situ degradability of the solution should be improved further more.

PubMed

腹腔鏡補助下イレウス解除術の成績

板橋哲也, 大塚幸喜, 秋山有史, 佐々木章, 旭博史, 若林剛

日本外科学会雑誌 ( 一般社団法人日本外科学会 ) 107 ( 2 ) 407 - 407 2006年03月

CiNii

腹腔鏡下大腸癌手術の再発症例からみた術後フォローアップの検討

大塚幸喜, 秋山有史, 板橋哲也, 藤澤健太郎, 川崎雄一郎, 細井信之, 佐々木章, 若林剛

日本外科学会雑誌 ( 一般社団法人日本外科学会 ) 107 ( 2 ) 397 - 397 2006年03月

CiNii

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