研究者詳細 - 秋山　有史

論文 - 秋山　有史

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Circulating-tumor DNA from Two Types of Blood Collection Tubes for Monitoring Tumor Burden Validated with Esophageal Squamous Cell Carcinoma Patients

Fumitaka Endo, Takeshi Iwaya, Yasushi Sasaki, Takehiro Chiba, Mizunori Yaegashi, Kohei Kume, Kei Sato, Atsuhiro Arisue, Ryoko Kawagishi, Teppei Matuo, Yuji Akiyama, Akira Sasaki, Yuji Suzuki, Takashi Tokino, Mari Masuda, Tesshi Yamada, Hidewaki Nakagawa, Satoshi S Nishizuka

( Cold Spring Harbor Laboratory ) 2020年08月 [査読有り]

Objective: To evaluate long-term whole blood (WB) storage at room temperature (RT), plasma and peripheral blood mononuclear cell (PBMC) DNA was collected simultaneously using BD Vacutainer® CPT™ Mononuclear Cell Preparation Tubes (CPT) and Streck Cell-Free DNA Blood Collection Tubes (BCT®). Methods: Plasma DNA was isolated from both types of tubes at various time points at RT. DNA from PBMCs was extracted using CPT from WB stored in BCT. The extracted DNA was used to monitor esophageal cancer treatment. Results: BCT maintained steady levels of plasma DNA for up to nine days. After transfer of BCT-stored WB to CPT, PBMC-DNA were yielded with suitable quality for up to seven days. ctDNA from esophageal cancer patients carrying TP53 mutations reflected treatment efficacy. Conclusion: BCT/CPT combinatory procedure allows storage of blood samples for up to seven days at RT for valid clinical assays using ctDNA.

DOI

亜区域切除以上の腹腔鏡下肝切除術の短期・中期成績【International】亜区域以上の腹腔鏡下肝切除術完全腹腔鏡下と腹腔鏡補助下の比較研究(Laparoscopic liver resection more than segmentectomy: A comparative study between pure laparoscopy and laparoscopy-assisted procedure)

長谷川康, 新田浩幸, 高原武志, 片桐弘勝, 菅野将司, 梅邑晃, 安藤太郎, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 PD - 6 2020年08月

高度肥満症患者における腹腔鏡下スリーブ状胃切除術後の非アルコール性脂肪性肝疾患に対する効果

二階春香, 梅邑晃, 馬場誠朗, 木村聡元, 秋山有史, 高原武志, 岩谷岳, 新田浩幸, 大塚幸喜, 肥田圭介, 石田和之, 菅井有, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 SF - 5 2020年08月

抗体関連拒絶を背景とした胆道合併症に対するエベロリムスによる治療成績

片桐弘勝, 新田浩幸, 高原武志, 長谷川康, 菅野将史, 梅邑晃, 安藤太郎, 中村侑哉, 屋成真吾, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 SF - 1 2020年08月

腹腔鏡下・ロボット支援肝胆膵外科手術の可能性と限界【Video】当科における腹腔鏡下肝葉切除の段階的進化

新田浩幸, 高原武志, 長谷川康, 片桐弘勝, 菅野将史, 梅邑晃, 武田大樹, 真壁健二, 秋山有史, 大塚幸喜, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 SY - 1 2020年08月

多発肝腎嚢胞症例に対して、大量小腸切除と生体肝移植で救命できた1例

高原武志, 新田浩幸, 長谷川康, 片桐弘勝, 梅邑晃, 菅野将史, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 SSF - 8 2020年08月

当院での生体肝移植における短期成績に与える因子解析

高原武志, 新田浩幸, 長谷川康, 片桐弘勝, 菅野将史, 梅邑晃, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 佐々木章

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 DP - 6 2020年08月

甲状腺・副甲状腺疾患に対する内視鏡手術の可能性と限界乳房アプローチによる内視鏡下甲状腺切除術の適応とピットフォール

梅邑晃, 佐々木章, 新田浩幸, 高原武志, 長谷川康, 馬場誠朗, 片桐弘勝, 菅野将史, 安藤太郎, 木村聰元, 秋山有史, 岩谷岳, 大塚幸喜

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 120回 PD - 5 2020年08月

Feasibility of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal gastro-gastrostomy for early gastric cancer: a retrospective cohort study.

Yuji Akiyama, Akira Sasaki, Takeshi Iwaya, Ryosuke Fujisawa, Noriyuki Sasaki, Haruka Nikai, Fumitaka Endo, Shigeaki Baba, Yasushi Hasegawa, Toshimoto Kimura, Takeshi Takahara, Hiroyuki Nitta, Koki Otsuka, Keisuke Koeda

World journal of surgical oncology 18 ( 1 ) 170 - 170 2020年07月 [査読有り] [国際誌]

BACKGROUND: Pylorus-preserving gastrectomy (PPG) has been accepted as a function-preserving surgery for the treatment of early gastric cancer in East Asian countries. Therefore, this study aimed to evaluate the feasibility and safety of totally laparoscopic PPG (TLPPG) with intracorporeal anastomosis. METHODS: A total of 43 patients with early gastric cancer underwent laparoscopy-assisted PPG (LAPPG) with extracorporeal anastomosis between May 2006 and November 2012. The operative outcomes of 22 patients who underwent TLPPG between November 2012 and February 2019 were evaluated, and data were compared with that of the LAPPG group. RESULTS: No significant difference in the operative time was observed between the two groups. Blood loss was lower in the TLPPG group (18.5 mL) than in the LAPPG group (30.7 mL, p = 0.008), and the length of abdominal incision was shorter in the TLPPG group (3.8 cm) than in the LAPPG group (4.7 cm, p < 0.001). No significant difference in the complication rate was observed between the two groups (13.6% in the TLPPG vs. 9.3% in the LAPPG group, p = 0.594). No anastomosis-related complications occurred in either group. No significant between-group difference was observed in the delayed gastric emptying (TLPPG, 9.1 vs. LAPPG, 7%, p = 0.762). The initiation of postoperative fluid (TLPPG, 1.0 day vs. LAPPG, 3.0 days, p < 0.001) and meal (TLPPG, 3.0 days vs. LAPPG, 4.0 days, p < 0.001) intake was earlier in the TLPPG group than in the LAPPG group. No significant between-group difference was observed in the postoperative hospital stay. CONCLUSIONS: The findings of this study suggest that TLPPG with intracorporeal reconstruction not only is as feasible and safe as LAPPG for the treatment of patients with early gastric cancer but also provides certain advantages such as reduced blood loss and wound size.

DOI PubMed

Efficacy of enhanced prehabilitation for patients with esophageal cancer undergoing esophagectomy.

Yuji Akiyama, Akira Sasaki, Yusuke Fujii, Ryosuke Fujisawa, Noriyuki Sasaki, Haruka Nikai, Fumitaka Endo, Shigeaki Baba, Yasushi Hasegawa, Toshimoto Kimura, Takeshi Takahara, Hiroyuki Nitta, Koki Otsuka, Keisuke Koeda, Yukihide Nishimura, Takeshi Iwaya

Esophagus : official journal of the Japan Esophageal Society 18 ( 1 ) 56 - 64 2020年07月 [査読有り] [国内誌]

BACKGROUND: Several studies have demonstrated that prehabilitation helps reduce the incidence of postoperative complications. In this study, we investigated the safety and efficacy of enhanced prehabilitation (EP) in the hospital for patients with esophageal cancer. METHODS: We retrospectively reviewed the data of 48 consecutive patients who underwent radical esophagectomy with gastric tube reconstruction between September 2015 and June 2019. EP program had been introduced in August 2017. In the EP group, patients received the EP program during hospitalization 7 days before surgery in addition to conventional perioperative rehabilitation. The EP program consisted of aerobic exercise and muscle strength training in the morning and afternoon. Operative outcomes were compared between patients who received EP (EP group; 23 patients) and patients who did not receive EP (control group; 25 patients). RESULTS: The preoperative (EP group vs. control group, 492.9 ± 79.7 vs. 418.9 ± 71.8 m, p < 0.001) and postoperative (EP group vs. control group, 431.5 ± 80 vs. 378 ± 68.7 m, p < 0.001) 6-min walk distance was significantly higher in the EP group than in the control group. The respiratory complications rate was significantly lower in the EP group (4.3%) than in the control group (36%) (p = 0.007). The incidence of atelectasis was particularly significantly lower in the EP group (0%) than in the control group (24%) (p = 0.012). CONCLUSIONS: EP was performed safely for patients before esophagectomy. EP improved the exercise tolerance of the patients before esophagectomy and might be useful in preventing respiratory complications.

DOI PubMed

[A Thoracic Aortic Dissection Case during Treatment with Ramucirumab plus Nab-Paclitaxel].

Haruka Nikai, Yuji Akiyama, Ryosuke Fujisawa, Fumitaka Endo, Shigeaki Baba, Keisuke Koeda, Akira Sasaki

Gan to kagaku ryoho. Cancer & chemotherapy 47 ( 6 ) 981 - 983 2020年06月 [査読有り] [国内誌]

Ramucirumab(RAM)plus nab-paclitaxel(nab-PTX)therapy is a regimen that is recommended for the second round of chemotherapy in recurrent, progressive gastric cancer. We report the first case of a thoracic aortic dissection developed during RAM plus nab-PTX therapy. A 59-year-old male who had undergone a proximal gastrectomy for esophagogastric junction cancer had a recurrence of cancer 6 years later(metastasis to the para-aortic lymph node and left adrenal gland, local recurrence, and multiple bone metastases). He was treated with RAM plus nab-PTX therapy for second-line chemotherapy. On day 9 of the third cycle, he experienced sudden, severe neck pain and visited the outpatient emergency department. Computed tomography detected a Stanford type-A thoracic aortic dissection. However, the patient suffered from a myocardial infarction before the operation, and died. This is the first report of an aortic dissection associated with RAM. Clinicians must be aware of this complication.

PubMed

Safety of thoracoscopic esophagectomy after induction chemotherapy for locally advanced unresectable esophageal squamous cell carcinoma.

Yuji Akiyama, Takeshi Iwaya, Fumitaka Endo, Haruka Nikai, Shigeaki Baba, Takehiro Chiba, Toshimoto Kimura, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Masaru Mizuno, Yusuke Kimura, Keisuke Koeda, Akira Sasaki

Asian journal of endoscopic surgery 13 ( 2 ) 152 - 159 2020年04月 [査読有り] [国内誌]

INTRODUCTION: Recent studies have reported that induction chemotherapy with docetaxel plus cisplatin and 5-fluorouracil (DCF) is an effective treatment for unresectable, locally advanced esophageal cancer. The aim of this study was to investigate the safety and feasibility of thoracoscopic esophagectomy (TE) after DCF for initially unresectable esophageal squamous cell carcinoma (ESCC). METHODS: Twenty-three patients with initially unresectable T4 thoracic ESCC underwent TE after induction DCF. RESULTS: The neighboring organs with tumors were the tracheobronchus in nine patients, thoracic aorta in 13, and pericardium and diaphragm in three each (concurrent overlapping invasion occurred in five patients). The mean total operation time was 556.3 ± 107.2 minutes, and the mean time of the thoracic procedure was 258.9 ± 83.9 minutes. The mean total blood loss was 166.2 ± 117.8 mL, and the loss during the thoracic procedure was 33.5 ± 24.6 mL. All patients achieved complete R0 resection under TE. No conversions to open thoracotomy were performed. The postoperative morbidity rate was 34.8%. The postoperative hospital stay was 24.3 (range, 13-38) days. Five patients had recurrence: four had distant metastasis (lung, two; liver, three; and one with overlap), and one had mediastinal lymph node recurrence. No local recurrence was noted at the site of the primary T4 tumor. CONCLUSIONS: TE was safely performed in 23 patients after DCF therapy for locally advanced unresectable ESCC. Induction DCF, followed by TE, could be an alternative treatment for unresectable T4 ESCC.

DOI PubMed

Glucocorticoid use and ischemia-reperfusion injury in laparoscopic liver resection: Randomized controlled trial.

Yasushi Hasegawa, Hiroyuki Nitta, Takeshi Takahara, Hirokatsu Katagiri, Shoji Kanno, Akira Umemura, Yuji Akiyama, Takeshi Iwaya, Koki Otsuka, Akira Sasaki

Annals of gastroenterological surgery 4 ( 1 ) 76 - 83 2020年01月 [査読有り] [国内誌]

Aim: Laparoscopic liver resection (LLR) is increasingly carried out worldwide. However, there are concerns regarding ischemia-reperfusion injury caused by pneumoperitoneum and the Pringle maneuver. It is not clear whether perioperative use of glucocorticoids lowers the risk of ischemia-reperfusion hepatic injury in LLR as has been reported for open liver resection. The aim of the present study was to investigate the role of perioperative glucocorticoid use in improving hepatic function and surgical outcomes after LLR. Methods: In this double-blind, randomized controlled trial (UMIN000013823), we enrolled 130 patients who presented to our institution for LLR between April 2014 and October 2018. Six patients were excluded, resulting in 124 patients being randomized to either the glucocorticoid or the control group. Preoperatively, patients in the glucocorticoid group received 500 mg methylprednisolone in saline solution, patients in the control group saline solution only. Surgical outcomes and blood parameters were compared between the two groups. Results: The Pringle maneuver could not be carried out in 24 patients, resulting in 50 patients in each group being included in the analysis. Postoperatively, total, direct and indirect bilirubin, and C-reactive protein and interleukin-6 levels were significantly lower, albumin levels were significantly higher, and prothrombin time was significantly shorter in the glucocorticoid than in the control group. Surgical outcomes were not significantly different between the groups. Conclusion: This first report on preoperative glucocorticoid use in LLR showed that it significantly improved postoperative liver function and thus might enhance the safety of LLR.

DOI PubMed

Esophageal carcinosarcoma in which the sarcomatous element has sloughed off: A case report.

Noriyuki Sasaki, Takeshi Iwaya, Yuji Akiyama, Shigeaki Baba, Fumitaka Endo, Haruka Nikai, Ryosuke Fujisawa, Toshimoto Kimura, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Yusuke Kimura, Keisuke Koeda, Ryo Sugimoto, Noriyuki Uesugi, Tamotsu Sugai, Akira Sasaki

International journal of surgery case reports 74 27 - 31 2020年 [査読有り] [国際誌]

INTRODUCTION: Most esophageal carcinosarcoma (ECS) tumors present as a polypoid tumor that is continuous with the superficial lesion and suspended by a pedicle. Here, we report a case of ECS in which a polypoid lesion sloughed off before surgery. PRESENTATION OF CASE: A 76-year-old man with dysphagia was admitted to our hospital. Esophagogastroscopy revealed a 20-mm polypoid tumor continuous with a superficial lesion and attached to the lesion by a thin pedicle in the mid-thoracic esophagus. Histopathological examination of the endoscopic biopsy showed that the superficial lesion was a moderately differentiated squamous cell carcinoma and that the polypoid tumor contained a sarcomatous element. He was diagnosed with ECS and underwent radical esophagectomy with three-field lymph node dissection. In the resected specimen, no polypoid tumor was found, and only a superficial lesion was observed. The histopathological findings revealed only squamous cell carcinoma, and the pathological diagnosis was esophageal squamous cell carcinoma, pT1bN0M0, pathological stage I. The patient was discharged from the hospital 22 days after surgery and did not experience any complications. He is currently alive and remained cancer-free for three years since surgery was performed. DISCUSSION: Due to the distinctive configuration in which the polypoid lesion was connected to the superficial cancerous lesion by a very thin pedicle, researchers suggested that the polypoid tumor, which consisted of a sarcomatous element, was sloughed off before surgery. CONCLUSION: We encountered a rare case of ECS in which the sarcomatous element sloughed off prior to surgical resection.

DOI PubMed

Super-late pulmonary recurrence after radical esophagectomy for esophageal squamous cell carcinoma.

Akira Umemura, Yuji Akiyama, Takeshi Iwaya, Keisuke Koeda, Ryo Sugimoto, Tamotsu Sugai, Fumitaka Endo, Shigeaki Baba, Haruka Nikai, Hiroyuki Nitta, Takeshi Takahara, Koki Otuska, Toshimoto Kimura, Hajime Saito, Hiroyuki Deguchi, Makoto Tomoyasu, Akira Sasaki

International journal of surgery case reports 72 166 - 171 2020年 [査読有り] [国際誌]

INTRODUCTION: Pulmonary metastases from esophageal squamous cell carcinoma (ESCC) are often detected bilateral and multiple lesions and are often accompanied by metastases to other sites. The concept of oligometastasis has been developed, and limited distant metastases have been considered as indications for surgical resection for the purpose of extending overall survival. We herein present a long-surviving case of super-late pulmonary recurrence of ESCC, seven years after radical esophagectomy. PRESENTATION OF CASE: A 71-year-old woman who underwent radical subtotal esophagectomy with three-field lymph node dissection with a diagnosis of an advanced poorly differentiated ESCC with cT3N1M0 seven years ago visited our hospital. Chest X-ray and computed tomography at the 7-year follow-up revealed a solitary pulmonary tumor, 1.5 cm in diameter, at the right middle lobe without any extrapulmonary metastases; however, we could not diagnose whether primary lung cancer or pulmonary metastasis of ESCC was present. Therefore, we performed thoracoscopic partial resection of the right middle lobe. A histopathological examination including immunohistochemical staining revealed that the tumor was not derived from both alveolar epithelium and neuroendocrine cells and was diagnosed as pulmonary oligometastasis of ESCC. She has been followed for four years without re-recurrence. CONCLUSION: Pulmonary oligometastases of ESCC should be considered as surgical indications if the tumor is detected after a long disease-free interval without any extrapulmonary recurrences.

DOI PubMed

胆道癌における膵頭十二指腸切除の合併症が予後に及ぼす影響

高原武志, 新田浩幸, 長谷川康, 片桐弘勝, 菅野将史, 梅邑晃, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 石田和之, 菅井有, 佐々木章

日本消化器外科学会雑誌 ( (一社)日本消化器外科学会 ) 52 ( Suppl.2 ) 205 - 205 2019年11月

生体肝移植において術後門脈血栓に対して大腿静脈を用いて膵下縁から門脈再建を施行した1例

高原武志, 新田浩幸, 長谷川康, 片桐弘勝, 菅野将史, 梅邑晃, 安藤太郎, 木村聡元, 秋山有史, 岩谷岳, 大塚幸喜, 佐々木章

移植 ( (一社)日本移植学会 ) 54 ( 総会臨時 ) 199 - 199 2019年09月

術前DCFによる化学療法と胸腔鏡下食道切除術による進行食道癌の治療成績

秋山有史, 岩谷岳, 遠藤史隆, 二階春香, 馬場誠郎, 千葉丈広, 木村祐輔, 肥田圭介, 佐々木章

日本消化器外科学会総会 ( (一社)日本消化器外科学会 ) 74回 P17 - 4 2019年07月

消化管癌の新規バイオマーカーとしてのCirculating tumor DNAの有用性

岩谷岳, 遠藤史隆, 八重樫瑞典, 千葉丈広, 佐々木教之, 佐藤慧, 秋山有史, 佐々木章, 西塚哲

日本消化器外科学会総会 ( (一社)日本消化器外科学会 ) 74回 P285 - 1 2019年07月

腹腔鏡下幽門側胃切除後の残胃に発生したデスモイド腫瘍の1例

馬場誠朗, 秋山有史, 肥田圭介, 二階春香, 遠藤史隆, 千葉丈広, 岩谷岳, 上杉憲幸, 菅井有, 佐々木章

日本消化器外科学会総会 ( (一社)日本消化器外科学会 ) 74回 P61 - 1 2019年07月

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