Papers - AKIYAMA Yuuji

胃癌術後6ヵ月の体重減少と摂取栄養量の変化について

宇夫方 直子, 俵 万里子, 馬場 誠朗, 二階 春香, 遠藤 史隆, 梅邑 晃, 秋山 有史, 高橋 一枝, 佐々木 章

日本臨床栄養学会雑誌 ( (一社)日本臨床栄養学会 )  46 ( 1 ) 16 - 25  2024.04

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【目的】胃癌術後の体重減少を防ぐための栄養指導を目的として,胃癌術後6ヵ月における体重減少と摂取栄養量について検討した.【方法】胃癌手術患者132名の術後6ヵ月における体重減少率と1日の摂取栄養量について胃全摘術と幽門側胃切除術とで比較した.また,胃全摘術後6ヵ月における体重減少率10%未満を維持群,10%以上を減少群として術後6ヵ月における摂取栄養量について検討した.摂取栄養量は一日の摂取エネルギー量およびタンパク質量とした.【結果】胃全摘術42名,幽門側胃切除術90名の体重減少率は,胃全摘で有意に大きかった(14.3% vs 8.76%,p<0.001)が,1日の摂取エネルギー量に有意差を認めなかった(1,663kcal vs 1,591kcal,p=0.129).胃全摘術後維持群9名,減少群33名の1日の摂取エネルギー量,タンパク質摂取量,間食による摂取エネルギー量に有意差は認めなかった(p=0.386,0.208,0.197).【結論】胃全摘術後では幽門側胃切除後に比較して体重が有意に減少していたが,摂取栄養量に差は認めなかったことから,術後の体重減少を防止するためには摂取栄養量以外の因子についての検討が必要である.(著者抄録)

ロボット支援腹腔鏡下胃全摘術と腹腔鏡下胃全摘の短期手術成績の比較

馬場 誠朗, 二階 春香, 藤澤 良介, 高橋 眞人, 熊谷 秀基, 八重樫 瑞典, 藤野 順子, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  96回   475 - 475  2024.02

ロボット支援腹腔鏡下胃全摘術と腹腔鏡下胃全摘の短期手術成績の比較

馬場 誠朗, 二階 春香, 藤澤 良介, 高橋 眞人, 熊谷 秀基, 八重樫 瑞典, 藤野 順子, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  96回   475 - 475  2024.02

非穿孔式内視鏡的胃壁内反切除術により診断しえた胃内反性過誤腫の一例

二階 春香, 馬場 誠朗, 鳥谷 洋右, 藤澤 良介, 熊谷 秀基, 秋山 有史, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 3160 - 3160  2023.12

教室におけるLECSの治療成績

馬場 誠朗, 二階 春香, 鳥谷 洋右, 藤澤 良介, 熊谷 秀基, 八重樫 瑞典, 藤野 順子, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 肥田 圭介, 新田 浩幸, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 1176 - 1176  2023.12

胃癌に対するロボット支援腹腔鏡下胃全摘術の短期手術成績

藤澤 良介, 馬場 誠朗, 二階 春香, 熊谷 秀基, 棚橋 洋太, 八重樫 瑞典, 藤野 順子, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 2129 - 2129  2023.12

教室の胃GISTに対する手術成績

馬場 誠朗, 二階 春香, 熊谷 秀基, 藤澤 良介, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 秋山 有史, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 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 )  56 ( Suppl.2 ) 457 - 457  2023.11

私の手術手技の工夫(上部消化管) 当院の早期胃癌に対するロボット支援腹腔鏡下噴門側胃切除術の再建法

馬場 誠朗, 二階 春香, 秋山 有史, 藤澤 良介, 熊谷 秀基, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 新田 浩幸, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  48 ( 3 ) 376 - 376  2023.05

Examination of fatty infiltration of skeletal muscles by CT value in the evaluation of sarcopenia during preoperative chemotherapy for esophageal cancery

Tagane Megumi, Akiyama Yuji, Tamura Akio, Ieko Yoshiro, Iwaya Takeshi, Sasak Akira

Journal of Iwate Medical Assiociation ( Iwate Medical Association )  75 ( 1 ) 21 - 33  2023.04

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Sarcopenia was associated with postoperative complications and poor prognosis in various cancers. We aimed to evaluate quantitative and qualitative changes by using computed tomography ‹CT› during preoperative chemotherapy. We retrospectively reviewed 60 patients who received preoperative chemotherapy, followed by esophagectomy. We assessed the change in muscle mass and CT value of the bilateral iliopsoas and erector spinae muscles before and after chemotherapy and examined how these changes affect the postoperative period. The area of iliopsoas muscles significantly decreased between before and after chemotherapy ‹1217.3 ± 417.5 vs. 1123.4 ± 354.6, p < 0.001›. Meanwhile, there was no significant difference in the area of the erector spinae muscles. Although there was no significant difference in the CT value of iliopsoas muscles between before and after chemotherapy, the CT value of the erector spinae muscle significantly decreased ‹44.2 ± 11.6 vs. 42.5 ± 11.4, p = 0.015›. Our results indicated that chemotherapy might have a different effect on different muscles. It was suggested that the assessment of sarcopenia requires not only the assessment of muscle mass but also the assessment of fatty infiltration. We developed a simple and quantitative method to evaluate sarcopenia during preoperative chemotherapy by assessing CT value.

DOI

薬剤師と医師の診療連携におけるアンケート調査

石田 和茂, 天野 総, 八重樫 瑞典, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 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 )  123回   DP - 7  2023.04

減量・代謝改善手術ネクストステージ 減量・代謝改善手術におけるヘパトカインの変動と代謝動態の変化

梅邑 晃, 佐々木 章, 新田 浩幸, 高橋 眞人, 熊谷 秀基, 片桐 弘勝, 馬場 誠朗, 八重樫 瑞典, 秋山 有史, 鈴木 信

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  123回   SY - 2  2023.04

当科におけるUR-LA膵癌に対する集学的治療の現状

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 安藤 太郎, 天野 怜, 八重樫 瑞典, 馬場 誠朗, 鈴木 信, 秋山 有史, 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 )  123回   DP - 4  2023.04

Gastroblastoma mimics the embryonic mesenchyme of the foregut: a case report.

Ryo Sugimoto, Noriyuki Uesugi, Noriyuki Yamada, Mitsumasa Osakabe, Shigeaki Baba, Naoki Yanagawa, Yuji Akiyama, Wataru Habano, Akira Sasaki, Yoshinao Oda, Tamotsu Sugai

Diagnostic pathology   18 ( 1 ) 24 - 24  2023.02  [International journal]

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BACKGROUND: Gastroblastoma is a rare gastric tumor composed of epithelial and spindle cell components. The characteristic MALAT-GLI1 fusion gene has only been identified in 5 reported cases. We report the morphological characterization of gastroblastoma with the MALAT1-GLI1 fusion gene in a young Japanese woman. CASE PRESENTATION: A 29-year-old Japanese woman visited Iwate Medical University Hospital with upper abdominal pain. Computed tomography revealed a tumor in expansive lesions involving the gastric antrum. Histologically, we observed a biphasic morphology composed of epithelial and spindle cell components. The epithelial components appeared as slit-like glandular structures with tubular or rosette-like differentiation. The spindle cell components consisted of short spindle-shaped oval cells. Immunohistochemical (IHC) analysis revealed that the spindle cell component was positive for vimentin, CD10, CD56, GLI1, and HDAC2, and focally positive for PD-L1. The epithelial component was positive for CK AE1/AE3, CAM5.2, and CK7, and negative for CK20 and EMA. Both components were negative for KIT, CD34, DOG1, SMA, desmin, S100 protein, chromogranin A, synaptophysin, CDX2, and SS18-SSX. The MALAT-GLI1 fusion gene was detected molecularly. CONCLUSIONS: We report the following new findings with this case: (i) gastric tumors mimic the gastrointestinal mesenchyme in the embryonic period; (ii) nuclear expression of PD-L1 and HDAC2 were observed in the spindle cell component of a gastroblastoma. We speculate that histone deacetylase (HDAC) inhibitors may offer a promising treatment option for gastroblastoma.

DOI PubMed

教室における胃粘膜下腫瘍に対する腹腔鏡下胃楔状切除術とLECSの手術成績

馬場 誠朗, 秋山 有史, 鳥谷 洋右, 二階 春香, 八重樫 瑞典, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  95回   503 - 503  2023.02

ALS患者の嚥下機能と食形態および舌圧との関係

島田 崇史, 米澤 紗織, 伊藤 凌, 金子 千洋, 柿澤 良江, 小野 彰子, 宇夫方 直子, 小田 知靖, 梅邑 晃, 秋山 有史, 遠藤 龍人, 西村 行秀, 小林 琢也

学会誌JSPEN ( (一社)日本栄養治療学会 )  5 ( Suppl.1 ) 777 - 777  2023

教室における胃粘膜下腫瘍に対する腹腔鏡下手術の現状

馬場 誠朗, 秋山 有史, 鳥谷 洋右, 二階 春香, 八重樫 瑞典, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 1717 - 1717  2022.12

腹腔鏡下胃全摘術後Overlap再建法の工夫と手術成績

秋山 有史, 馬場 誠朗, 二階 春香, 佐々木 教之, 藤澤 良介, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 1766 - 1766  2022.12

膵癌における初期治療前の審査腹腔鏡の意義

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 安藤 太郎, 天野 怜, 岩佐 友寛, 琴畑 洋介, 八重樫 瑞典, 馬場 誠朗, 秋山 有史, 鈴木 信, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 1794 - 1794  2022.12

腹腔鏡下回盲部切除のポート挿入時に膀胱損傷を来した尿膜間遺残を認めた1例

畑中 智貴, 八重樫 瑞典, 高清水 清治, 熊谷 秀基, 奥津 美里, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 181 - 181  2022.12

腹腔鏡下横行結腸切除後間膜欠損による内ヘルニアの一例

奥津 美里, 八重樫 瑞典, 高清水 清治, 畑中 智貴, 熊谷 秀基, 梅邑 晃, 馬場 誠朗, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 309 - 309  2022.12

ロボット支援下食道切除術の手術成績の検討

秋山 有史, 馬場 誠朗, 二階 春香, 佐々木 教之, 藤澤 良介, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 1986 - 1986  2022.12

大腸領域におけるロボット支援手術教育の工夫(2) 当科におけるロボット支援手術と腹腔鏡手術の術者教育の現状と地方特有の問題

八重樫 瑞典, 高清水 清治, 畑中 智貴, 熊谷 秀基, 奥津 美里, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 2777 - 2777  2022.12

術前肝床側T1b胆嚢癌疑い症例における腹腔鏡下胆嚢床切除術

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 安藤 太郎, 天野 怜, 琴畑 洋介, 岩佐 友寛, 八重樫 瑞典, 馬場 誠朗, 秋山 有史, 鈴木 信, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 2560 - 2560  2022.12

減量・代謝改善手術におけるエビデンス 中長期的な糖尿病寛解予測スコアリングシステムの比較

梅邑 晃, 佐々木 章, 新田 浩幸, 二階 春香, 高橋 眞人, 熊谷 秀基, 棚橋 洋太, 片桐 弘勝, 菅野 将史, 武田 大樹, 安藤 太郎, 天野 怜, 鈴木 信, 馬場 誠朗, 秋山 有史

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 117 - 117  2022.12

高難度小児内視鏡外科手術の導入の現状と問題点

鈴木 信, 田金 恵, 小山 亮太, 小林 めぐみ, 八重樫 瑞典, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 秋山 有史, 新田 浩幸, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 157 - 157  2022.12

サクションボール・コアギュレーターを駆使した腹腔鏡下大腸癌手術

高清水 清治, 八重樫 瑞典, 奥津 美里, 熊谷 秀基, 畑中 智貴, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  27 ( 7 ) 2279 - 2279  2022.12

腹腔鏡下スリーブ状胃切除術前後における血清タンパク質の変動 プロテオーム解析を用いた検討

熊谷 秀基, 梅邑 晃, 二階 春香, 高橋 眞人, 八重樫 瑞典, 馬場 誠朗, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸, 佐々木 章

肥満研究 ( (一社)日本肥満学会 )  28 ( Suppl. ) 351 - 351  2022.11

ロボット支援下腹腔鏡下幽門側胃切除術の短期治療成績

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 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 )  55 ( Suppl.2 ) 178 - 178  2022.10

食道癌に対するロボット支援胸腔鏡下食道切除術の導入期における成績

馬場 誠朗, 秋山 有史, 遠藤 史隆, 藤澤 良介, 佐々木 教之, 二階 春香, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 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 )  55 ( Suppl.2 ) 183 - 183  2022.10

胃癌に対する腹腔鏡下噴門側胃切術後の体重減少率と摂取エネルギー量の検討

馬場 誠朗, 秋山 有史, 宇夫方 直子, 二階 春香, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

New Diet Therapy ( (一社)日本臨床栄養協会 )  38 ( 2 ) 201 - 201  2022.09

CT値を用いた骨格筋の脂肪浸潤解析による食道癌術前化学療法中のサルコペニアの評価

田金 恵, 秋山 有史, 馬場 誠朗, 二階 春香, 遠藤 史隆, 田村 明生, 家子 義郎, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 佐々木 章

New Diet Therapy ( (一社)日本臨床栄養協会 )  38 ( 2 ) 200 - 200  2022.09

Risk model for mortality associated with esophagectomy via a thoracic approach based on data from the Japanese National Clinical Database on malignant esophageal tumors.

Akira Sasaki, Hisateru Tachimori, Yuji Akiyama, Taro Oshikiri, Hiroaki Miyata, Yoshihiro Kakeji, Yuko Kitagawa

Surgery today    2022.07  [Domestic journal]

　View Summary

PURPOSE: Postoperative complications after esophagectomy can be severe or fatal and impact the patient's postoperative quality of life and long-term outcomes. The aim of the present study was to develop the best possible model for predicting mortality and complications based on the Japanese Nationwide Clinical Database (NCD). METHODS: Data registered in the NCD, on 32,779 patients who underwent esophagectomy via a thoracic approach for malignant esophageal tumor between January, 2012 and December, 2017, were used to create a risk model. RESULTS: The 30-day mortality rate after esophagectomy was 1.0%, and the operative mortality rate was 2.3%. Postoperative complications included pneumonia (13.8%), anastomotic leakage (13.2%), recurrent laryngeal nerve palsy (11.1%), atelectasis (4.9%), and chylothorax (2.5%). Postoperative artificial respiration for over 48 h was required by 7.8% of the patients. Unplanned intubation within 30 postoperative days was performed in 6.2% of the patients. C-indices evaluated using the test data were 0.694 for 30-day mortality and 0.712 for operative mortality. CONCLUSIONS: We developed a good risk model for predicting 30-day mortality and operative mortality after esophagectomy based on the NCD. This risk model will be useful for the preoperative prediction of 30-day mortality and operative mortality, obtaining informed consent, and deciding on the optimal surgical procedure for patients with preoperative risks for mortality.

DOI PubMed

食道切除術に対する術後肺炎予防のための周術期管理

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  77回   P147 - 7  2022.07

腹腔鏡下天蓋切除術時のインドシアニングリーン蛍光イメージング(Indocyanine green fluorescence imaging during laparoscopic deroofing)

岩佐 友寛, 新田 浩幸, 須藤 隆之, 藤原 久貴, 片桐 弘勝, 菅野 将史, 梅邑 晃, 武田 大樹, 天野 怜, 菊地 晃司, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 431 - 431  2022.05

高度肥満者に対する手術の工夫 さまざまな他疾患で手術を要する高度肥満症患者に対する治療戦略

梅邑 晃, 新田 浩幸, 片桐 弘勝, 菅野 将史, 武田 大樹, 天野 怜, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 390 - 390  2022.05

COVID-19流行前後における大腸癌診療の現状

畑中 智貴, 大塚 幸喜, 八重樫 瑞典, 高清水 清治, 有吉 佑, 中村 侑哉, 平田 勇一郎, 佐々木 智子, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 469 - 469  2022.05

臓器移植医療の実際 胆管狭窄症減少を目指した生体肝移植手術手技と管理

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 長瀬 勇人, 天野 怜, 菊地 晃司, 馬場 誠朗, 八重樫 瑞典, 鈴木 信, 秋山 有史, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 324 - 324  2022.05

術前放射線化学療法の進歩 切除を目指したUR-LA膵癌に対する化学放射線療法

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 長瀬 勇人, 天野 怜, 菊地 晃司, 八重樫 瑞典, 馬場 誠朗, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 299 - 299  2022.05

LECS(腹腔鏡下内視鏡合同手術)の応用を考える 教室における内視鏡を併用した腹腔鏡手術の現状と今後の可能性

馬場 誠朗, 秋山 有史, 鳥谷 洋右, 二階 春香, 八重樫 瑞典, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 394 - 394  2022.05

Reduced port surgeryを極める 教室における臓器横断的なreduced port surgeryの実践

梅邑 晃, 新田 浩幸, 片桐 弘勝, 菅野 将史, 武田 大樹, 天野 怜, 須藤 隆之, 藤原 久貴, 菊地 晃司, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 344 - 344  2022.05

術前放射線化学療法の進歩 切除を目指したUR-LA膵癌に対する化学放射線療法

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 長瀬 勇人, 天野 怜, 菊地 晃司, 八重樫 瑞典, 馬場 誠朗, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 299 - 299  2022.05

Reduced port surgeryを極める 教室における臓器横断的なreduced port surgeryの実践

梅邑 晃, 新田 浩幸, 片桐 弘勝, 菅野 将史, 武田 大樹, 天野 怜, 須藤 隆之, 藤原 久貴, 菊地 晃司, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 344 - 344  2022.05

臓器移植医療の実際 胆管狭窄症減少を目指した生体肝移植手術手技と管理

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 長瀬 勇人, 天野 怜, 菊地 晃司, 馬場 誠朗, 八重樫 瑞典, 鈴木 信, 秋山 有史, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 324 - 324  2022.05

COVID-19流行前後における大腸癌診療の現状

畑中 智貴, 大塚 幸喜, 八重樫 瑞典, 高清水 清治, 有吉 佑, 中村 侑哉, 平田 勇一郎, 佐々木 智子, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 469 - 469  2022.05

腹腔動脈圧迫症候群併存の膵頭十二指腸切除術後出血の一例

天野 怜, 菊地 晃司, 長瀬 勇人, 武田 大樹, 菅野 将史, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 459 - 459  2022.05

右側結腸切除術を極める 当科における腹腔鏡下結腸右半切除を安全に行うための手術手技

八重樫 瑞典, 大塚 幸喜, 高清水 清治, 有吉 佑, 畑中 智貴, 平田 勇一郎, 佐々木 智子, 梅邑 晃, 片桐 弘勝, 秋山 有史, 鈴木 信, 岩谷 岳, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 336 - 336  2022.05

腹腔鏡下スリーブ状胃切除術が肥満患者の呼吸器系に及ぼす影響(Laparoscopic sleeve gastrectomy impacts on respiratory system in obese patients)

熊谷 秀基, 梅邑 晃, 屋成 信吾, 高橋 眞人, 二階 春香, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 429 - 429  2022.05

腹腔鏡下天蓋切除術時のインドシアニングリーン蛍光イメージング(Indocyanine green fluorescence imaging during laparoscopic deroofing)

岩佐 友寛, 新田 浩幸, 須藤 隆之, 藤原 久貴, 片桐 弘勝, 菅野 将史, 梅邑 晃, 武田 大樹, 天野 怜, 菊地 晃司, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 431 - 431  2022.05

腹腔動脈圧迫症候群併存の膵頭十二指腸切除術後出血の一例

天野 怜, 菊地 晃司, 長瀬 勇人, 武田 大樹, 菅野 将史, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 459 - 459  2022.05

上部消化器癌のconversion surgeryを極める T4食道癌に対するDCFによる導入化学療法後の胸腔鏡下conversion surgery

秋山 有史, 馬場 誠朗, 二階 春香, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 344 - 344  2022.05

原発不明扁平上皮癌の腹腔内転移(Intra-abdominal metastasis of squamous cell carcinoma of unknown primary)

奥津 美里, 秋山 有史, 馬場 誠朗, 二階 春香, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 柳川 直樹, 上杉 憲幸, 菅井 有, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 434 - 434  2022.05

原発不明扁平上皮癌の腹腔内転移(Intra-abdominal metastasis of squamous cell carcinoma of unknown primary)

奥津 美里, 秋山 有史, 馬場 誠朗, 二階 春香, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 柳川 直樹, 上杉 憲幸, 菅井 有, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 434 - 434  2022.05

右側結腸切除術を極める 当科における腹腔鏡下結腸右半切除を安全に行うための手術手技

八重樫 瑞典, 大塚 幸喜, 高清水 清治, 有吉 佑, 畑中 智貴, 平田 勇一郎, 佐々木 智子, 梅邑 晃, 片桐 弘勝, 秋山 有史, 鈴木 信, 岩谷 岳, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 336 - 336  2022.05

高度肥満者に対する手術の工夫 さまざまな他疾患で手術を要する高度肥満症患者に対する治療戦略

梅邑 晃, 新田 浩幸, 片桐 弘勝, 菅野 将史, 武田 大樹, 天野 怜, 馬場 誠朗, 秋山 有史, 岩谷 岳, 鈴木 信, 大塚 幸喜, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 390 - 390  2022.05

上部消化器癌のconversion surgeryを極める T4食道癌に対するDCFによる導入化学療法後の胸腔鏡下conversion surgery

秋山 有史, 馬場 誠朗, 二階 春香, 遠藤 史隆, 八重樫 瑞典, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 新田 浩幸, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 344 - 344  2022.05

閉塞性睡眠時無呼吸症候群に対する外科治療(スリープサージェリー) 腹腔鏡下スリーブ状胃切除術が閉塞性睡眠時無呼吸と膵β細胞に及ぼす効果

二階 春香, 梅邑 晃, 屋成 信吾, 高橋 眞人, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 331 - 331  2022.05

閉塞性睡眠時無呼吸症候群に対する外科治療(スリープサージェリー) 腹腔鏡下スリーブ状胃切除術が閉塞性睡眠時無呼吸と膵β細胞に及ぼす効果

二階 春香, 梅邑 晃, 屋成 信吾, 高橋 眞人, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 331 - 331  2022.05

LECS(腹腔鏡下内視鏡合同手術)の応用を考える 教室における内視鏡を併用した腹腔鏡手術の現状と今後の可能性

馬場 誠朗, 秋山 有史, 鳥谷 洋右, 二階 春香, 八重樫 瑞典, 遠藤 史隆, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 394 - 394  2022.05

腹腔鏡下スリーブ状胃切除術が肥満患者の呼吸器系に及ぼす影響(Laparoscopic sleeve gastrectomy impacts on respiratory system in obese patients)

熊谷 秀基, 梅邑 晃, 屋成 信吾, 高橋 眞人, 二階 春香, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 429 - 429  2022.05

当科における食道癌に対するNivolumabの治療成績

遠藤 史隆, 秋山 有史, 馬場 誠朗, 二階 春香, 佐々木 教之, 藤澤 良介, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 5  2022.04

当院における胃粘膜下腫瘍に対する治療選択の現状と課題

二階 春香, 秋山 有史, 鳥谷 洋右, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 3  2022.04

当院における胃粘膜下腫瘍に対する治療選択の現状と課題

二階 春香, 秋山 有史, 鳥谷 洋右, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 3  2022.04

UR-LA膵癌に対する新たな治療戦略

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 天野 怜, 菊地 晃司, 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 )  122回   DP - 6  2022.04

胃癌に対する胃全摘術後早期のOral Nutritional Supplementsの安全性の検討

馬場 誠朗, 秋山 有史, 遠藤 史隆, 二階 春香, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 5  2022.04

食道扁平上皮癌に対する放射線照射後の悪性狭窄への緩和的金属ステント留置の安全性の検討

藤澤 良介, 秋山 有史, 田金 恵, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 広勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 4  2022.04

UR-LA膵癌に対する新たな治療戦略

武田 大樹, 新田 浩幸, 片桐 弘勝, 菅野 将史, 梅邑 晃, 天野 怜, 菊地 晃司, 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 )  122回   DP - 6  2022.04

【消化吸収と臓器相関】減量・代謝改善手術によるメタボリック症候群治療

佐々木 章, 梅邑 晃, 石岡 秀基, 高橋 眞人, 二階 春香, 馬場 誠朗, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸

消化器・肝臓内科 ( (有)科学評論社 )  11 ( 4 ) 389 - 395  2022.04

当科における食道癌に対するNivolumabの治療成績

遠藤 史隆, 秋山 有史, 馬場 誠朗, 二階 春香, 佐々木 教之, 藤澤 良介, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 5  2022.04

胃癌に対する胃全摘術後早期のOral Nutritional Supplementsの安全性の検討

馬場 誠朗, 秋山 有史, 遠藤 史隆, 二階 春香, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 5  2022.04

食道扁平上皮癌に対する放射線照射後の悪性狭窄への緩和的金属ステント留置の安全性の検討

藤澤 良介, 秋山 有史, 田金 恵, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 広勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 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 )  122回   DP - 4  2022.04

食道癌に対する多職種チーム介入による合併症予防の取り組み

秋山 有史, 岩谷 岳, 藤澤 良介, 佐々木 教之, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 大塚 幸喜, 新田 浩幸, 木村 祐輔, 肥田 圭介, 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 )  122回   DP - 4  2022.04

肝胆膵領域における再生医療研究の最前線 肝臓手術におけるMultilineage-Differentiating Stress-Enduring Cells(Muse細胞)動態の解析

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 長瀬 勇人, 天野 怜, 菊地 晃司, 秋山 有史, 鈴木 信, 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 )  122回   WS - 4  2022.04

肝胆膵領域における再生医療研究の最前線 肝臓手術におけるMultilineage-Differentiating Stress-Enduring Cells(Muse細胞)動態の解析

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 長瀬 勇人, 天野 怜, 菊地 晃司, 秋山 有史, 鈴木 信, 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 )  122回   WS - 4  2022.04

食道癌に対する多職種チーム介入による合併症予防の取り組み

秋山 有史, 岩谷 岳, 藤澤 良介, 佐々木 教之, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 大塚 幸喜, 新田 浩幸, 木村 祐輔, 肥田 圭介, 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 )  122回   DP - 4  2022.04

2,3期進行胃癌における癌周囲間質の免疫組織化学的特徴および予後との関連性の検討

杉本 亮, 上杉 憲幸, 刑部 光正, 伊藤 一洋, 橋元 麻生, 秋山 有史, 柳川 直樹, 佐々木 章, 菅井 有

日本病理学会会誌 ( (一社)日本病理学会 )  111 ( 1 ) 226 - 226  2022.03

腹腔鏡下スリーブ状胃切除術後の胸腔容積の変化と呼吸機能改善効果

石岡 秀基, 梅邑 晃, 屋成 信吾, 高橋 眞人, 二階 春香, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

肥満研究 ( (一社)日本肥満学会 )  27 ( Suppl. ) 357 - 357  2022.03

2,3期進行胃癌における癌周囲間質の免疫組織化学的特徴および予後との関連性の検討

杉本 亮, 上杉 憲幸, 刑部 光正, 伊藤 一洋, 橋元 麻生, 秋山 有史, 柳川 直樹, 佐々木 章, 菅井 有

日本病理学会会誌 ( (一社)日本病理学会 )  111 ( 1 ) 226 - 226  2022.03

ロボット支援下腹腔鏡下幽門側胃切除術の治療成績(Short-term outcomes of robot-assisted laparoscopic distal gastrectomy)

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 藤澤 良介, 佐々木 教之, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  94回   447 - 447  2022.03

減量・代謝改善手術が脂肪酸代謝に与える影響

高橋 眞人, 梅邑 晃, 屋成 信吾, 石岡 秀基, 二階 春香, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

肥満研究 ( (一社)日本肥満学会 )  27 ( Suppl. ) 303 - 303  2022.03

リピドミクス解析から見た減量・代謝改善手術の治療効果と肥満関連健康障害改善のメカニズム

梅邑 晃, 新田 浩幸, 二階 春香, 屋成 信吾, 高橋 眞人, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 石垣 泰, 佐々木 章

肥満研究 ( (一社)日本肥満学会 )  27 ( Suppl. ) 347 - 347  2022.03

減量・代謝改善手術の導入要件と適応基準

佐々木 章, 梅邑 晃, 二階 春香, 屋成 信吾, 高橋 眞一, 石岡 秀基, 八重樫 瑞典, 馬場 誠朗, 片桐 弘勝, 鈴木 信, 秋山 有史, 新田 浩幸

肥満研究 ( (一社)日本肥満学会 )  27 ( Suppl. ) 154 - 154  2022.03

Side-Overlap法を用いた腹腔鏡下噴門側胃切除術の治療成績

馬場 誠朗, 秋山 有史, 遠藤 史隆, 藤澤 良介, 佐々木 教之, 二階 春香, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  94回   237 - 237  2022.03

腹腔鏡下スリーブ状胃切除術における非アルコール性脂肪性肝炎の炎症改善効果

二階 春香, 梅邑 晃, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

肥満研究 ( (一社)日本肥満学会 )  27 ( Suppl. ) 306 - 306  2022.03

消化管転移をきたした乳癌の2例

奥津 美里, 馬場 誠朗, 秋山 有史, 二階 春香, 杉本 亮, 遠藤 史隆, 石田 和茂, 小松 英明, 岩谷 岳, 新田 浩幸, 大塚 幸喜, 上杉 憲幸, 杉村 好彦, 菅井 有, 肥田 圭介, 佐々木 章

日本消化器病学会東北支部例会・日本消化器内視鏡学会東北支部例会プログラム・抄録集 ( 日本消化器病学会-東北支部 )  212回・167回   162 - 162  2022.01

腸内細菌環境整備のニューノーマルand MIRAI 高度肥満症患者に対する腹腔鏡下スリーブ状胃切除術後の口腔内・腸内細菌叢の変化と減量・代謝改善効果

梅邑 晃, 秋山 有史, 鈴木 信, 佐々木 章

学会誌JSPEN ( (一社)日本臨床栄養代謝学会 )  4 ( Suppl.1 ) 104 - 104  2022

食道癌術後の早期経口摂取の安全性の検討

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 藤澤 良介, 佐々木 教之, 梅邑 晃, 鈴木 信, 佐々木 章

学会誌JSPEN ( (一社)日本臨床栄養代謝学会 )  4 ( Suppl.1 ) 314 - 314  2022

Laparoscopic distal pancreatectomy for metastatic melanoma originating from the choroidal membrane: a case report.

Shigeaki Baba, Yuji Akiyama, Fumitaka Endo, Haruka Nikai, Ryo Sugimoto, Akira Umemura, Hirokatsu Katagiri, Yasushi Hasegawa, Takeshi Iwaya, Hiroyuki Nitta, Keisuke Koeda, Tamotsu Sugai, Akira Sasaki

Surgical case reports   7 ( 1 ) 268 - 268  2021.12  [International journal]

　View Summary

BACKGROUND: Metastatic melanoma originating from the choroidal membrane is extremely rare. Here, we report a case of laparoscopic distal pancreatectomy for malignant melanoma that developed after heavy-particle therapy for malignant choroidal melanoma. CASE PRESENTATION: A 43-year-old Japanese woman underwent 70 Gy heavy-particle radiotherapy for a right choroidal malignant melanoma. Positron emission tomography-computed tomography examination was performed 4 years after treatment, when contrast accumulation was observed on the posterior wall of the stomach. Endoscopic ultrasonography and computed tomography showed a mass with contrast enhancement in contact with the stomach wall. Based on the imaging findings, a gastrointestinal stromal tumor of the posterior wall of the lower gastric corpus with extramural growth was suspected. Laparoscopic surgery was performed under general anesthesia. A black-pigmented tumor originating from the pancreas was discovered. Following an intraoperative diagnosis of metastasis of malignant melanoma, a laparoscopic distal pancreatectomy was performed. The pathological diagnosis was pancreatic metastasis of malignant melanoma. The patient was treated with adjuvant immune checkpoint inhibitors and chemotherapy after surgery, which led to long-term survival. CONCLUSIONS: Including this case, only eight case reports on pancreatic resection for metastatic ocular malignant melanoma have been reported. The ocular malignant melanoma with distant metastasis has a poor prognosis. Therefore, in our case, careful follow-up is required. A single pancreatic metastasis from a malignant melanoma of the choroid can be successfully managed by laparoscopic radical resection of the pancreas, and molecularly targeted adjuvant chemotherapy.

DOI PubMed

成人特発性胃軸捻転に対して腹腔鏡下胃固定術、胃瘻造設術を施行した一例

田金 恵, 秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 石井 勇吾, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO072 - 3  2021.12

肥満外科手術の現状と課題 減量・代謝改善手術の現状、課題と今後の展望

佐々木 章, 梅邑 晃, 二階 春香, 屋成 信吾, 高橋 眞一, 石岡 秀基, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) PD4 - 2  2021.12

減量・代謝改善手術が血中ケトン体濃度に与える影響

高橋 眞人, 梅邑 晃, 屋成 信吾, 石岡 秀基, 二階 春香, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO240 - 8  2021.12

肥満外科手術の最新のエビデンス 日本人高度肥満症患者の肝生検の病理組織学的検討から見た新たな知見とその意義

梅邑 晃, 新田 浩幸, 二階 春香, 屋成 信吾, 高橋 眞人, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 鈴木 信, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) SY4 - 2  2021.12

ロボット支援腹腔鏡下噴門側胃切除術の導入と今後の課題

馬場 誠朗, 秋山 有史, 遠藤 史隆, 二階 春香, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO139 - 3  2021.12

ロボット支援下食道切除術の短期治療成績

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 佐々木 教之, 藤澤 良介, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO247 - 6  2021.12

下大静脈右縁での肝挙上操作を用いた前方アプローチによる腹腔鏡下肝右葉切除

片桐 弘勝, 新田 浩幸, 菊地 晃司, 天野 怜, 真壁 健二, 長瀬 勇人, 武田 大樹, 梅邑 晃, 菅野 将史, 秋山 有史, 岩谷 岳, 大塚 幸喜, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO054 - 6  2021.12

年齢・膀胱容量が気膀胱下膀胱尿管新吻合術に与える影響

鈴木 信, 田金 恵, 小林 めぐみ, 梅邑 晃, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 調 憲, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO071 - 3  2021.12

胃癌リンパ節再発と胃GISTとの鑑別を要した小網原発GISTの一例

石井 勇吾, 秋山 有史, 田金 恵, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO120 - 8  2021.12

腹腔鏡下胃全摘術後のOverlap再建の治療成績

秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 佐々木 教之, 藤澤 良介, 梅邑 晃, 片桐 弘勝, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO134 - 1  2021.12

減量・代謝改善手術の治療効果からみたMAFLDの発症メカニズムと脂肪酸代謝の関連について

梅邑 晃, 二階 春香, 屋成 信吾, 高橋 眞人, 石岡 秀基, 新田 浩幸, 鈴木 信, 岩谷 岳, 秋山 有史, 片桐 弘勝, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) SP1 - 3  2021.12

尿膜管切除術に対する腹腔鏡アプローチ手術の現況 臍下部弧状切開による単孔式尿膜管切除術

鈴木 信, 田金 恵, 小林 めぐみ, 梅邑 晃, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 調 憲, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) CSY5 - 6  2021.12

腹腔鏡下スリーブ状胃切除術の効果と限界 肥満症外科手術認定施設における肥満関連健康障害を改善させる取り組み

二階 春香, 梅邑 晃, 新田 浩幸, 片桐 弘勝, 鈴木 信, 秋山 有史, 岩谷 岳, 大塚 幸喜, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) WS15 - 7  2021.12

肝静脈根部に挟まれるように近接する腫瘍に対する腹腔鏡下肝切除の有用性・安全性に関する検討

天野 怜, 新田 浩幸, 菊地 晃司, 眞壁 健二, 武田 大樹, 梅邑 晃, 菅野 将史, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  26 ( 7 ) MO055 - 1  2021.12

当院で施行したDenver型腹腔-静脈シャント留置後のDIC治療

天野 怜, 菊地 晃司, 武田 大樹, 梅邑 晃, 菅野 将史, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

Japanese Journal of Acute Care Surgery ( 日本Acute Care Surgery学会 )  11 ( 1 ) 143 - 143  2021.11

小児外科専門医不在・不足地域での小児外科医療 岩手県における小児外科医療の現状

鈴木 信, 田金 恵, 梅邑 晃, 片桐 弘勝, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  82 ( 増刊 ) S172 - S172  2021.10

舌下神経麻痺による構音障害を契機に発見された骨転移を伴う進行胃癌の一例

石井 勇吾, 秋山 有史, 田金 恵, 二階 春香, 遠藤 史隆, 馬場 誠朗, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  82 ( 増刊 ) S609 - S609  2021.10

W-ED tubeによる減圧および栄養管理が有用であった特発性食道破裂術後縫合不全の一例

田金 恵, 秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 石井 勇吾, 梅邑 晃, 片桐 弘勝, 鈴木 信, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  82 ( 増刊 ) S954 - S954  2021.10

Early dynamics of circulating tumor DNA predict chemotherapy responses for patients with esophageal cancer.

Ryosuke Fujisawa, Takeshi Iwaya, Fumitaka Endo, Masashi Idogawa, Noriyuki Sasaki, Hayato Hiraki, Shoichiro Tange, Tomomi Hirano, Yuka Koizumi, Masakazu Abe, Tomoko Takahashi, Mizunori Yaegashi, Yuji Akiyama, Mari Masuda, Akira Sasaki, Fumiaki Takahashi, Yasushi Sasaki, Takashi Tokino, Satoshi S Nishizuka

Carcinogenesis   42 ( 10 ) 1239 - 1249  2021.09  [International journal]

　View Summary

We investigated whether early circulating tumor DNA (ctDNA) changes, measured using digital PCR (dPCR), can predict later chemotherapy responses in esophageal squamous cell cancer (ESCC). We compared the dynamics of ctDNA and tumor volumes during chemotherapy in 42 ESCC. The accuracy of predictions of later chemotherapy responses were evaluated by the ratio of the variant allele frequency (VAF) of ctDNA (post-/pre-ctDNA) and the total tumor volume (post-/pre-volume) before and after an initial chemotherapy cycle using a receiver-operating characteristic curve analysis. Total positive and negative objective responses (ORs) were defined as either >50% or ≤50% reductions, respectively, in the total tumor volume at the end of first-line chemotherapy. Mutation screening of 43 tumors from 42 patients revealed 96 mutations. The pretreatment dPCR-ctDNA data were informative in 38 patients, using 70 selected mutations (1-3 per patient). The areas under the curve (AUCs) for the post-/pre-volume and post-/pre-ctDNA levels used in predicting the total OR were 0.85 and 0.88, respectively. The optimal cutoff value of post-/pre-ctDNA was 0.13. In 20 patients with post-/pre-volume ≥50%, the total OR could be predicted by the post-/pre-ctDNA with high accuracy; the AUC by post-/pre-ctDNA was higher than that by post-/pre-volume (0.85 vs 0.76, respectively). Patients with low post-/pre-ctDNA (n = 18) had a significantly better overall survival rate than those with high post-/pre-ctDNA (n = 20; P = 0.03). Early ctDNA changes after an initial cycle of chemotherapy predict later responses to treatment with high accuracy in ESCC patients.

DOI PubMed

食道癌盲腸転移の一例

田金 恵, 秋山 有史, 馬場 誠朗, 遠藤 史隆, 二階 春香, 岩谷 岳, 杉本 亮, 木村 祐輔, 肥田 圭介, 菅井 有, 佐々木 章

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 )  75回   246 - 246  2021.09

減量・代謝改善手術の呼吸機能に対する効果

屋成 信吾, 梅邑 晃, 二階 春香, 片桐 弘勝, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  76回   P270 - 4  2021.07

安全な腹腔鏡下スリーブ状胃切除術実施を目指した周術期の多職種連携

高橋 眞人, 梅邑 晃, 二階 春香, 屋成 信吾, 片桐 弘勝, 木村 聰元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  46 ( 3 ) 390 - 390  2021.05

metabolic syndromeに対する外科治療の現状と展開 腹腔鏡下スリーブ状胃切除術における肥満2型糖尿病の長期改善効果と膵β細胞機能

梅邑 晃, 二階 春香, 新田 浩幸, 片桐 弘勝, 菅野 将史, 武田 大樹, 眞壁 健二, 木村 聰元, 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 )  121回   PD - 3  2021.04

閉塞性睡眠時無呼吸に対する減量・代謝改善手術の効果

屋成 信吾, 梅邑 晃, 二階 春香, 片桐 弘勝, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  121回   PS - 8  2021.04

Circulating tumor DNAの初期変動を用いた食道癌化学療法効果予測に関する検討

藤澤 良介, 岩谷 岳, 遠藤 史隆, 佐々木 教之, 二階 春香, 馬場 誠朗, 秋山 有史, 開 勇人, 小泉 優香, 阿部 正和, 片桐 弘勝, 木村 聡元, 大塚 幸喜, 井戸川 雅史, 新田 浩幸, 佐々木 章, 佐々木 泰史, 時野 隆至, 西塚 哲

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  121回   SF - 1  2021.04

生体肝移植後胆道狭窄症に対する予防と対策

片桐 弘勝, 新田 浩幸, 菅野 将史, 梅邑 晃, 武田 大樹, 眞壁 健二, 有吉 佑, 木村 拓, 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 )  121回   SF - 7  2021.04

日本人高度肥満患者における高度肝線維化予測因子の検討

二階 春香, 梅邑 晃, 片桐 弘勝, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  121回   PS - 5  2021.04

腹腔鏡下スリーブ状胃切除術後の口腔内・腸内細菌叢の変化と減量・代謝改善効果

石岡 秀基, 梅邑 晃, 片桐 弘勝, 木村 聰元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  121回   SF - 5  2021.04

脾臓Side population細胞の幹細胞移植細胞としての利用

木村 拓, 高原 武志, 眞壁 健二, 武田 大樹, 梅邑 晃, 菅野 将史, 片桐 弘勝, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 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 )  121回   PS - 8  2021.04

Cutaneous metastasis from esophageal basaloid squamous cell carcinoma: A case report.

Fumitaka Endo, Yuji Akiyama, Masazumi Onishi, Noriyuki Uesugi, Tamotsu Sugai, Akira Sasaki

International journal of surgery case reports   80   105621 - 105621  2021.03  [International journal]

　View Summary

INTRODUCTION AND IMPORTANCE: Basaloid squamous cell carcinoma (BSCC) of the esophagus is a relatively rare histologic variant of squamous cell carcinoma. Here, we reported a case of solitary cutaneous metastasis as the first symptom of esophageal BSCC and was successfully treated with multidisciplinary treatment. CASE PRESENTATION: A 67-year-old man visited a local hospital with symptoms of dysphagia and cutaneous nodules on his left shoulder. Fluorine-18 fluorodeoxyglucose positron emission tomography revealed hypermetabolic accumulations in the middle thoracic esophagus, right recurrent laryngeal nerve lymph node, and epidermis of the left shoulder. Esophagogastroscopy revealed an ulcerative and infiltrating type tumor in the middle thoracic esophagus. Based on histopathologic examination of the endoscopic biopsy and the resected cutaneous tumor, the patient was diagnosed as esophageal BSCC with cutaneous metastasis. The patient was treated with chemotherapy followed by chemoradiotherapy. The therapeutic effect was a complete response, which was sustained for 39 months. CLINICAL DISCUSSION: Review of previous literature in the PubMed database revealed only been two case reports on cutaneous metastasis of BSCC. Advanced BSCC of the esophagus with distant metastasis has a poor prognosis. Therefore, in our case, future careful follow-up is required. CONCLUSION: Esophageal BSCC with cutaneous metastasis can be successfully managed by multidisciplinary treatment, including local resection of the cutaneous metastasis, systemic chemotherapy, and chemoradiotherapy.

DOI PubMed

肝切除術における腹腔鏡下手術の有用性と問題点 当科における腹腔鏡下肝切除術の適応と手術手技

新田 浩幸, 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

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  25 ( 7 ) SY7 - 1  2021.03

Surgical outcomes of 118 complex laparoscopic liver resections: a single- center experience.

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

Journal of hepato-biliary-pancreatic sciences   27 ( 12 ) 942 - 949  2020.12  [Domestic journal]

　View Summary

BACKGROUND: Indications for laparoscopic liver resection (LLR) are continuously expanding. The Japanese Society of Hepato-Biliary-Pancreatic Surgery defines highly difficult hepatectomy as a procedure involving one or more sections (except for left lateral sectionectomy) or anatomical segmentectomy. This study aimed to assess the outcomes of complex LLR procedures and compare their technical difficulties, about which only a little is known to date. METHODS: We performed a retrospective review of the operative outcomes of 118 consecutive patients who underwent pure laparoscopic complex hepatectomy. The surgical outcomes, including operative times, blood loss amounts, and postoperative morbidity rates, were compared among complex LLR procedures. RESULTS: The overall median operative time was 280 minutes, and the median intraoperative blood loss was 86 mL. Two patients required conversion to open laparotomy (1.7%). The postoperative major morbidity rate was 11.0% Posterosuperior segmentectomy, right hemihepatectomy, and anterior sectionectomy required the longest operative times. Anterior and posterior sectionectomy resulted in the highest blood loss, and right hemihepatectomy and anterior sectionectomy resulted in the most complications. CONCLUSIONS: The surgical difficulties associated with complex LLR procedures vary. It is critical to recognize the specific risks and cautionary points to ensure patient safety and provide proper systemic training to surgeons.

DOI PubMed

Primary esophageal malignant melanoma successfully treated with anti-PD-1 antibody for retroperitoneal recurrence after esophagectomy: A case report.

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

International journal of surgery case reports   75   152 - 156  2020.09  [Refereed]  [International journal]

　View Summary

INTRODUCTION: Primary malignant melanoma of the esophagus (PMME) is a rare disease with a poor prognosis. Here, we report a case of retroperitoneal recurrence of PMME successfully treated with the anti-programmed cell death 1 antibody, nivolumab. PRESENTATION OF CASE: A 70-year-old male with dysphagia was referred to our hospital. Esophagogastroscopy showed an elevated tumor in the lower thoracic esophagus. A histopathological examination of the biopsy revealed poorly differentiated squamous cell carcinoma. The patient was diagnosed with clinical T3N1M0 stage III esophageal squamous cell carcinoma and was treated with neoadjuvant chemotherapy followed by radical esophagectomy. A postoperative histopathological examination revealed that atypical cells with a brown pigment were scattered in the tumor. Immunohistochemical staining demonstrated positive expression of human melanoma black 45, melan A, and S100. A pathological diagnosis of PMME was confirmed. Sixteen months after surgery, abdominal computed tomography revealed solitary retroperitoneal recurrence in the lateral portion of the ascending colon. Fluorine-18 fluorodeoxyglucose positron emission tomography (PET) showed hypermetabolic accumulation with a maximum standardized uptake value of 5.8. The patient was treated with nivolumab (240 mg) every two weeks. After eight courses of nivolumab, abnormal accumulation of the retroperitoneal mass disappeared on PET, and this therapeutic effect continued for 20 months. CONCLUSIONS: Nivolumab was effective for recurrence of PMME in our case. There are few reports of treatment with nivolumab for PMME. Further studies are necessary to establish the usefulness of nivolumab for PMME in the future.

DOI PubMed

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 )   2020.08  [Refereed]

　View Summary

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

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  2020.08

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  2020.08

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  2020.08

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  2020.08

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  2020.08

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  2020.08

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  2020.08

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  2020.07  [Refereed]  [International journal]

　View Summary

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  2020.07  [Refereed]  [Domestic journal]

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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  2020.06  [Refereed]  [Domestic journal]

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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  2020.04  [Refereed]  [Domestic journal]

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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  2020.01  [Refereed]  [Domestic journal]

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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  [Refereed]  [International journal]

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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  [Refereed]  [International journal]

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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  2019.11

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  2019.09

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  2019.07

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  2019.07

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  2019.07

食道胃接合部癌術後再発に対しラムシルマブ+ナブパクリタキセル療法施行中に胸部大動脈解離を発症した一例

二階 春香, 秋山 有史, 佐藤 慧, 遠藤 史隆, 馬場 誠朗, 千葉 丈広, 岩谷 岳, 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   P59 - 2  2019.07

【上部】肥満外科と代謝機能改善 臓器連関の改善から見た腹腔鏡下スリーブ状胃切除術の治療効果

梅邑 晃, 佐々木 章, 二階 春香, 新田 浩幸, 高原 武志, 長谷川 康, 馬場 誠朗, 秋山 有史, 岩谷 岳, 大塚 幸喜

日本消化器外科学会総会 ( (一社)日本消化器外科学会 )  74回   WS6 - 7  2019.07

0-Ip+II型食道癌肉腫の2例

佐々木 教之, 岩谷 岳, 秋山 有史, 千葉 丈広, 馬場 誠朗, 遠藤 史隆, 佐藤 慧, 二階 春香, 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   P8 - 1  2019.07

当院における進行食道癌に対する術前化学療法の現状と治療成績

秋山 有史, 岩谷 岳, 遠藤 史隆, 二階 春香, 馬場 誠朗, 千葉 丈広, 木村 祐輔, 肥田 圭介, 佐々木 章

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 )  73回   161 - 161  2019.06

当科における高齢者に対する食道癌手術の安全性の検討

遠藤 史隆, 秋山 有史, 二階 春香, 馬場 誠朗, 千葉 丈広, 岩谷 岳, 肥田 圭介, 佐々木 章

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 )  73回   208 - 208  2019.06

当科における術前化学療法後のセンチネルリンパ節生検の検討

小松 英明, 石田 和茂, 川岸 涼子, 松井 雄介, 佐藤 麻生, 秋山 有史, 高原 武志, 木村 聡元, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 水野 大, 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 )  119回   PS - 3  2019.04

進行食道癌に対する術前DCF療法と食道切除術の治療成績

秋山 有史, 岩谷 岳, 遠藤 史隆, 二階 春香, 佐藤 慧, 馬場 誠郎, 千葉 丈広, 木村 聡元, 高原 武志, 大塚 幸喜, 新田 浩幸, 水野 大, 木村 祐輔, 肥田 圭介, 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 )  119回   PS - 6  2019.04

十二指腸乳頭部癌に対する膵頭十二指腸切除術の短期成績及び長期成績の検討

高清水 清治, 高原 武志, 安藤 太郎, 菅野 将史, 片桐 弘勝, 新田 浩幸, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 水野 大, 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 )  119回   PS - 3  2019.04

上部消化管癌におけるCirculating tumor DNA検査に関する検討

岩谷 岳, 遠藤 史隆, 千葉 丈広, 八重樫 瑞典, 佐々木 教之, 佐藤 慧, 秋山 有史, 佐々木 章, 西塚 哲

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  119回   SF - 6  2019.04

脳転移指向性乳癌細胞株を用いた脳転移予測バイオマーカー探索

石田 和茂, 佐藤 麻生, 松井 雄介, 小松 英明, 木村 聡元, 高原 武志, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 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 )  119回   SF - 6  2019.04

高度侵襲肝臓手術患者におけるMuse細胞とその遊走因子測定の臨床的有用性

片桐 弘勝, 安藤 太郎, 高清水 清治, 菅野 将史, 長谷川 康, 高原 武志, 新田 浩幸, 木村 聡元, 秋山 有史, 岩谷 岳, 大塚 幸喜, 水野 大, 佐々木 章, 西塚 哲

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  119回   PS - 4  2019.04

教室における膵神経内分泌腫瘍の治療成績

安藤 太郎, 高清水 清治, 菅野 将史, 片桐 弘勝, 長谷川 康, 高原 武志, 新田 浩幸, 秋山 有史, 大塚 幸喜, 水野 大, 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 )  119回   PS - 2  2019.04

胆道癌に対する膵頭十二指腸切除後の膵液瘻発生予測因子に関する検討

與那嶺 直人, 安藤 太郎, 高清水 清治, 菅野 将史, 片桐 弘勝, 長谷川 康, 高原 武志, 新田 浩幸, 秋山 有史, 岩谷 岳, 大塚 幸喜, 水野 大, 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 )  119回   PS - 7  2019.04

食道扁平上皮癌患者におけるCirculating tumor DNAと既存検査の比較

遠藤 史隆, 岩谷 岳, 千葉 丈広, 八重樫 瑞典, 佐々木 教之, 佐藤 慧, 秋山 有史, 佐々木 章, 西塚 哲

日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  119回   PS - 1  2019.04

Nivolumab投与後に意識障害を発症し、有害事象としての脳炎を疑った胃癌の1症例

遠藤 史隆, 秋山 有史, 千葉 丈広, 馬場 誠朗, 佐藤 慧, 二階 春香, 肥田 圭介, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  91回   497 - 497  2019.02

Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report.

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

Surgical case reports   4 ( 1 ) 144 - 144  2018.12  [Refereed]  [International journal]

　View Summary

BACKGROUND: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. CASE PRESENTATION: An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery. CONCLUSIONS: GIST should be considered in the differential diagnosis of tumors growing in the mediastinum.

DOI PubMed

Exome sequence analysis of carcinomatous and sarcomatous elements of an esophageal carcinosarcoma

Sasaki Noriyuki, Iwaya Takeshi, Endo Fumitaka, Konosu Masafumi, Akiyama Yuji, Sasaki Yasushi, Tokino Takashi, Nishizuka Satoshi

CANCER SCIENCE   109   216  2018.12  [Refereed]

Patient-specific circulating tumor DNA monitoring using digital PCR in esophageal squamous cell cancer patients

Iwaya Takeshi, Endo Fumitaka, Sasaki Yasushi, Yaegashi Mizunori, Sato Kei, Sasaki Noriyuki, Akiyama Yuji, Sasaki Akira, Masuda Mari, Tokino Takashi, Nishizuka Satoshi

CANCER SCIENCE   109   708  2018.12  [Refereed]

腸回転異常症を伴った多発結腸癌に対して腹腔鏡補助下右半結腸切除術を施行した1例

早野 恵, 須藤 隆之, 藤原 久貴, 梅邑 晃, 木村 聡元, 高原 武志, 秋山 有史, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  23 ( 7 ) DP65 - 9  2018.12

Evaluation of the need for routine feeding jejunostomy for enteral nutrition after esophagectomy.

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

Journal of thoracic disease   10 ( 12 ) 6854 - 6862  2018.12  [Refereed]  [International journal]

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Background: Previous studies have shown that enteral nutrition (EN) helps reduce severe postoperative complications after esophagectomy. However, the incidence of jejunostomy-related complications is approximately 30%. We evaluated the operative outcomes in patients who did not receive EN via feeding jejunostomy after esophagectomy. Methods: We retrospectively reviewed 76 consecutive patients with esophageal cancer who received radical esophagectomy. Operative outcomes were compared between 33 patients who received postoperative EN via feeding jejunostomy (group A; from May 2014 to September 2015) and 43 patients who did not receive EN via feeding jejunostomy (group B; from September 2015 to December 2017). Results: The American Society of Anesthesiologists performance status score of the patients in group B was significantly higher than that of patients in group A (P=0.002). The postoperative morbidity rate was comparable between the two groups (group A, 30.3% vs. group B, 44.2%, P=0.217). No significant between-group differences were observed in the incidence of infectious complications, postoperative hospital stay, readmission within 30 days after discharge, or pneumonia after discharge within 6 months. The incidence of bowel obstruction was significantly higher in group A than in group B (group A, 9.1% vs. group B, 0%, P=0.044). Two patients in group B required nutritional support via total parenteral nutrition due to bilateral vocal cord palsy or pneumonia. Conclusions: Jejunostomy-related bowel obstruction in the patients with feeding jejunostomy was significantly higher than that in the patients without jejunostomy. There was no increase in postoperative complications (including pneumonia) in the patients who did not receive EN via feeding jejunostomy. Our results suggest that routine feeding jejunostomy may not be necessary for all patients undergoing esophagectomy.

DOI PubMed

当科における腹腔鏡下噴門側胃切除の再建法 Side-Overlap法

佐藤 慧, 秋山 有史, 二階 春香, 遠藤 史隆, 馬場 誠明, 千葉 丈広, 木村 聡元, 高原 武志, 岩谷 岳, 大塚 幸喜, 新田 浩幸, 水野 大, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  23 ( 7 ) OS199 - 2  2018.12

Thoracoscopic esophagectomy with total meso-esophageal excision reduces regional lymph node recurrence.

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

Langenbeck's archives of surgery   403 ( 8 ) 967 - 975  2018.12  [Refereed]  [International journal]

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PURPOSE: We investigated the operative outcomes of thoracoscopic esophagectomy (TE) in the prone position, using the concept of total meso-esophageal excision for esophageal cancer. METHODS: The medical records of 140 consecutive patients with esophageal cancer who underwent radical esophagectomy by TE were reviewed retrospectively, and operative outcomes were compared between patients treated before (non-meso-esophagus; non-ME group) and after (ME group) the introduction of total meso-esophageal excision (ME). RESULTS: There were no significant differences between the groups in postoperative morbidity (non-ME group vs. ME group, 28.3% vs. 41.4%, p = 0.119), 30-day mortality (non-ME group vs. ME group, 0% vs. 1.1%; p = 0.433), and in-hospital mortality (non-ME group vs. ME group, 1.9% vs. 0%, p = 0.199). Although overall survival and relapse-free survival did not differ significantly between the groups, the overall recurrence rate was significantly lower in the ME group than the non-ME group (non-ME group vs. ME group, 43.4% vs. 23%, p = 0.011). In particular, the rate of regional lymph node recurrence in the mediastinum was lower in the ME group (non-ME group vs. ME group, 11.3% vs. 2.3%; p = 0.026). CONCLUSIONS: Our results suggest that the ME procedure might be one of the procedures that reduce regional lymph node recurrence in the mediastinum without any deterioration in short-term outcomes.

DOI PubMed

化学放射線療法後PET-CT陽性を示した病理学的完全奏効食道癌の1例

梅邑 晃, 秋山 有史, 岩谷 岳, 杉本 亮, 菅井 有, 千葉 丈広, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  79 ( 11 ) 2246 - 2251  2018.11

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症例は64歳,女性.嚥下困難を主訴に受診し,上部消化管内視鏡検査(esophagogastroduodenoscopy:EGD)で胸部食道に2型腫瘍を認め,生検で扁平上皮癌であった.治療前診断T3N1M0 Stage IIIとして,biweekly DCFによる導入化学療法を開始したが高度肝障害を認め中止し,low dose FP療法を併用した化学放射線療法(chemoradiotherapy:CRT)を施行した.後治療を1年間継続しPET-CT検査を施行したところ局所に集積を認めた.EGDやCT検査で腫瘍の確定診断は得られず,食道癌再燃と診断し救済手術を施行したが,病理学的完全奏効であった.本症例のように,原発巣の遺残や再発の確定診断を得られない場合にPET-CT検査が有用であるとの報告があるが,感度や特異度,腫瘍のviability評価や治療の効果判定に関しては更なる検討が必要である.(著者抄録)

Digital PCRを用いた食道癌患者における症例特異的血漿中遊離DNAモニタリング(Patient-specific circulating tumor DNA monitoring using digital PCR in esophageal squamous cell cancer patients)

岩谷 岳, 遠藤 史隆, 佐々木 泰史, 八重樫 瑞典, 佐藤 慧, 佐々木 教之, 秋山 有史, 佐々木 章, 増田 万里, 時野 隆至, 西塚 哲

日本癌学会総会記事 ( 日本癌学会 )  77回   930 - 930  2018.09  [Refereed]

食道癌肉腫の遺伝子変異解析(Exome sequence analysis of carcinomatous and sarcomatous elements of an esophageal carcinosarcoma)

佐々木 教之, 岩谷 岳, 遠藤 史隆, 鴻巣 正史, 秋山 有史, 佐々木 泰史, 時野 隆至, 西塚 哲

日本癌学会総会記事 ( (一社)日本癌学会 )  77回   326 - 326  2018.09

Outcomes of esophagectomy after chemotherapy with biweekly docetaxel plus cisplatin and fluorouracil for advanced esophageal cancer: a retrospective cohort analysis.

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

World journal of surgical oncology   16 ( 1 ) 122 - 122  2018.07  [Refereed]  [International journal]

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BACKGROUND: Docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy can cause severe adverse events, including neutropenia and febrile neutropenia. The feasibility of DCF therapy is a concern, particularly for elderly patients, patients with moderate organ disorders, and patients suffering from malnutrition caused by dysphagia or insufficient oral intake. We introduced a biweekly DCF therapy (bDCF) for the purpose of reducing severe adverse events for these fragile patients. This study investigated the feasibility and outcome of an esophagectomy after bDCF therapy for patients with advanced esophageal squamous cell carcinoma. METHODS: Fifty-nine patients with esophageal carcinoma underwent an esophagectomy after DCF or bDCF therapy as primary chemotherapy. DCF was administered to 37 patients in the DCF group, whereas bDCF was administered to 22 patients in the bDCF group. RESULTS: Patients in the bDCF group were significantly older than those in the DCF group (p = 0.016). Heart and pulmonary comorbidities were significantly more common in the bDCF than in the DCF group (p < 0.001 and p = 0.039, respectively). Grade 3 or 4 neutropenia was less frequent in the bDCF than in the DCF group (40.9 vs. 81.1%, p = 0.002). Anorexia was more frequent in the DCF group than in the bDCF group (18.9 vs. 0%, p = 0.030). The clinical response rate of the bDCF group was significantly higher than that of the DCF group (86.4 vs. 62.2%, p = 0.047). There was no significant between-group difference in the postoperative morbidity rate (bDCF 45.5% vs. DCF 32.4%) or in the histological therapeutic effect. CONCLUSION: The results demonstrate that primary bDCF therapy for high-risk patients with advanced esophageal cancer is feasible and safe in both chemotherapeutic and perioperative periods without a reduction in the efficacy of DCF therapy.

DOI PubMed

Therapeutic response monitoring using digital PCR for patient-specific circulating tumor DNA identified by an esophageal squamous cell carcinoma-specific sequencing panel.

Iwaya Takeshi, Endo Fumitaka, Sasaki Yasushi, Akiyama Yuji, Sasaki Akira, Masuda Mari

JOURNAL OF CLINICAL ONCOLOGY   36 ( 15 )  2018.05  [Refereed]

DOI

Exploitation of a liquid biopsy system using circulating tumor DNA in esophageal cancer patients.

Iwaya Takeshi, Endo Fuinitaka, Sasaki Yasushi, Yaegashi Mizunori, Chiba Takehiro, Akiyama Yuji, Masuda Mar, Yamada Tesshi, Tokino Takashi, Nishizuka Satoshi

CANCER SCIENCE   109   953  2018.01  [Refereed]

Investigation of operative outcomes of thoracoscopic esophagectomy after triplet chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for advanced esophageal squamous cell carcinoma.

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

Surgical endoscopy   32 ( 1 ) 391 - 399  2018.01  [Refereed]  [International journal]

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BACKGROUND: Preoperative chemotherapy with cisplatin and 5-fluorouracil (CF) has become the standard treatment for resectable stage II/III thoracic esophageal carcinoma in Japan. Recently, preoperative triplet chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF) has been reported to be effective for locally advanced esophageal cancer. Thoracoscopic esophagectomy (TE) has been increasingly accepted worldwide for the treatment of esophageal cancer. We conducted a retrospective study to evaluate the safety and outcomes of TE after DCF therapy for patients with advanced esophageal cancer. METHODS: The medical records of 63 consecutive patients with esophageal squamous cell carcinoma who underwent thoracoscopic surgery after chemotherapy were reviewed. Thirty-four patients received neoadjuvant chemotherapy with CF, and 29 received DCF as first-line chemotherapy. RESULTS: The clinical T stage was significantly higher in the DCF group than in the CF group (p < 0.0001), including 17 patients with T4. Lymph node metastasis was more frequent in the DCF group (p = 0.0005), and the clinical stage of the tumor was significantly higher in the DCF group than in the CF group (p = 0.0001). No significant difference existed between the two groups in operation time for the thoracic procedure (DCF 277.2 min vs. CF 302 min). Blood loss during the thoracic procedure was less in the DCF group than in the CF group (DCF 46.9 mL vs. CF 88.8 mL; p = 0.0056). No significant differences existed between the two groups in postoperative morbidity (DCF 34.5% vs. CF 47%) or mortality (DCF 0% vs. CF 2.9%) rates. CONCLUSIONS: Our study suggests that TE after DCF therapy for advanced esophageal cancer is as safe as TE after CF therapy.

DOI PubMed

Establishment of a method for calculating standard splenic volume and its use in the evaluation of functional hepatic reserve

Seika Nakamura, Takeshi Takahara, Yasushi Hasegawa, Hirokatsu Katagiri, Shouji Kanno, Yuji Akiyama, Takeshi Iwaya, Hiroyuki Nitta, Kouki Otsuka, Keisuke Koeda, Akira Sasaki

Biomedical Research (India) ( Scientific Publishers of India )  29 ( 7 ) 1459 - 1464  2018

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Background and aim: To objectively assess splenic volume preoperatively, the Standard Splenic Volume (SSV) was calculated for each patient. Whether it could be used to evaluate the functional hepatic reserve less invasively before major hepatectomy was then examined. Patients and methods: SSV was calculated for 70 patients who had undergone surgery, excluding liver surgery, for benign disease or early-stage cancer. The postoperative clinical courses of 63 patients who had undergone a sectionectomy or hemihepatectomy were then retrospectively investigated by comparing the preoperative splenic volume with each patient’s SSV. Results: The following equation was obtained: SSV (cm3)=177.7 × Body Surface Area (BSA)-179.9. None of the patients in the preoperative Splenic Volume (SV)/SSV< 1.1 group had total Bilirubin (T-Bil) levels ≥ 1.2 mg/dl in late postoperative period. In contrast, nine (30%) of the patients in the preoperative SV/SSV ≥ 1.1 group (n=30) had T-Bil levels ≥ 1.2 mg/dl in late postoperative period. Conclusion: By comparing the preoperative SV and SSV of patients, objective assessments of the patients’ preoperative portal venous pressure were obtained noninvasively. We believe that this ratio may provide useful information for evaluating functional hepatic reserve at the time of initial surgery for diseases that may require repeat hepatectomies or multidisciplinary treatment.

DOI

Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy.

Yuji Akiyama, Takeshi Iwaya, Fumitaka Endo, Yoshihiro Shioi, Motoi Kumagai, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Yusuke Kimura, Kenji Suzuki, Akira Sasaki

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer   25 ( 12 ) 3733 - 3739  2017.12  [Refereed]  [International journal]

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PURPOSE: We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer. METHODS: We retrospectively reviewed 85 consecutive patients with esophageal cancer who underwent radical esophagectomy via right thoracotomy or thoracoscopic surgery with gastric tube reconstruction. Twenty-one patients were enrolled in the non-intervention group (group N) from May 2011 to September 2012, 31 patients in the perioperative rehabilitation group (group R) from October 2012 to April 2014, and 33 patients in the multidisciplinary support team group (group S) from May 2014 to September 2015. RESULTS: Morbidity rates were 38, 45.2, and 42.4% for groups N, R, and S, respectively. Although there were no significant differences in the incidence of pneumonia among the groups, the durations of fever and C-reactive protein positivity were shorter in group S. Moreover, postoperative oral intake commenced earlier [5.9 (5-8) days] and postoperative hospital stay was shorter [19.6 (13-29) days] for group S. CONCLUSIONS: The intervention by a perioperative multidisciplinary support team for radical esophagectomy was effective in preventing the progression and prolongation of pneumonia as well as earlier ambulation, oral feeding, and shortening of postoperative hospitalization.

DOI PubMed

[A Case of Para-Aortic Lymph Node Metastasis of Rectal Cancer Successfully Treated Using Multidisciplinary Therapy].

Tomoki Hatanaka, Koki Otsuka, Toshimoto Kimura, Masanori Hakozaki, Mizunori Yaegashi, Megumu Kamishima, Takanori Miyake, Kiyoharu Takashimizu, Kei Sato, Hitoshi Fujii, Teppei Matsuo, Takeshi Takahara, Yuji Akiyama, Takeshi Iwaya, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Akira Sasaki

Gan to kagaku ryoho. Cancer & chemotherapy   44 ( 12 ) 1613 - 1616  2017.11  [Refereed]  [Domestic journal]

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A 66-year-old man diagnosed with rectal cancer underwent high anterior resection and received adjuvant chemotherapy (UFT plus UZEL). One year after the surgery, lung and para-aortic lymph node(PLN)metastases were identified. We chose mFOLFOX6 for first-line chemotherapy. After 7 courses, we changed the regimen to sLV5FU2 because of Grade 3 neuropathy. After 5 courses, to treat progressive disease(PD), we changed the regimen to FOLFIRI. Then, the patient had stable disease (SD), and surgical excision was performed for both lung and lymph node recurrence without adjuvant chemotherapy. Six years after the excision, a CT scan revealed PLNagain. We chose FOLFIRI plus cetuximab. After 9 courses, the lymph nodes decreased in size and there was no other recurrence; thus we performed resection. However, a third PLNrecurrence was identified 20 months after the resection. Chemotherapy has continued for 47 courses, and he has maintained SD for more than 2 years.

PubMed

[Fluorescence-Imaging of Nerves - A Novel Trial of Intraoperative Nerve-Preservation].

Fumitaka Endo, Akio Sugitachi, Keisuke Koeda, Takeshi Iwaya, Yuji Akiyama, Akira Umemura, Toshimoto Kimura, Takeshi Takahara, Hiroyuki Nitta, Koki Ootsuka, Masaru Mizuno, Yusuke Kimura, Akira Sasaki

Gan to kagaku ryoho. Cancer & chemotherapy   44 ( 12 ) 1467 - 1469  2017.11  [Refereed]  [Domestic journal]

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Nerve-preservation technique during surgery is important. Intraoperative nerve injury often causes permanent palsy or numbness and/or neurogenic functional disorders. To evade such intraoperative nerve injuries, we proposed a novel manner to specifically visualize peripheral nerve fibers. Low-toxic agents clinically available, amphotericin B(AmB)or fluorescein isothiocyanate(FITC)were used as neuro-indicators. In in vitro, we used Schwann cells as nerve models to basically confirm these agents effectively functioned as neural markers. In in vivo, we examined whether this novel method was clinically applicable. The Schwann cells reacted with AmB or FITC emitted blue or yellow-green fluorescence in a dark environment. The rat nerve models also fluorescently glimmered in blue-tone when each agent was given. These data suggested that we could clinically discriminate nerve fibers from the surrounding tissues. Our fluorescent-imaging methods warrant further studies for clinical applications.

PubMed

高齢者進行胃癌に対する腹腔鏡下胃切除術の短期成績

肥田 圭介, 千葉 丈広, 天野 怜, 梅邑 晃, 馬場 誠朗, 秋山 有史, 高原 武志, 岩谷 岳, 新田 浩幸, 大塚 幸喜, 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 )  50 ( Suppl.2 ) 473 - 473  2017.10

Laparoscopic repair of parahiatal hernia after esophagectomy: a case report.

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

Surgical case reports   3 ( 1 ) 91 - 91  2017.08  [Refereed]  [International journal]

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BACKGROUND: Diaphragmatic hernia is a potential complication of esophagectomy, which usually occurs as a hiatal hernia and more frequently after minimally invasive esophagectomy. Parahiatal hernia is a rare form of diaphragmatic hernia, and to the best of our knowledge, parahiatal hernia after esophagectomy has not been previously reported. Here, we report a case of parahiatal hernia after esophagectomy that was successfully managed laparoscopically. CASE PRESENTATION: A 73-year-old man underwent thoracoscopic esophagectomy for esophageal cancer with gastric tube reconstruction via the posterior mediastinum. Postoperative morbidity was ileus, which required conservative treatment, and intestinal obstruction for which operation with laparotomy was necessary. He was admitted with abdominal pain and vomiting at 15 months after esophagectomy. Abdominal X-ray revealed colon gas in the intrathoracic space. A barium enema examination showed a transverse colon incarcerated in the intrathoracic space. The patient was preoperatively diagnosed with hiatal hernia after esophagectomy, and laparoscopic hernia repair was performed. During the surgery, the hiatus was found to be intact, and the defect was clearly separated from the left crus of the diaphragm. Parahiatal hernia was the operative diagnosis. The incarcerated colon was repositioned in the abdominal cavity, and the defect was repaired using a composite mesh. CONCLUSIONS: Laparoscopic surgery was found to be effective for the diagnosis and repair of parahiatal hernia.

DOI PubMed

Stability of cervical esophagogastrostomy via hand-sewn anastomosis after esophagectomy for esophageal cancer

Yuji Akiyama, T. Iwaya, F. Endo, Y. Shioi, T. Chiba, T. Takahara, K. Otsuka, H. Nitta, K. Koeda, M. Mizuno, Y. Kimura, A. Sasaki

Diseases of the Esophagus ( John Wiley and Sons Inc. )  30 ( 5 )  2017.05  [Refereed]

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The aim of the present study is to evaluate the outcome of hand-sewn esophagogastric anastomosis during radical esophagectomy for esophageal cancer. The outcomes of 467 consecutive esophageal cancer patients who underwent cervical esophagogastric anastomosis using interrupted and double-layered sutures after radical esophagectomy via right thoracotomy or thoracoscopic surgery were retrospectively reviewed. Anastomotic leakage, including conduit necrosis, occurred in 11 of 467 patients (2.4%) 7 of 11 (63.6%) cases experienced only minor leakage, whereas the other four (36.4%) patients had major leakage that required surgical or radiologic intervention, including two patients of conduit necrosis. Anastomotic leakages were more frequently observed after retrosternal reconstruction compared with the posterior mediastinal route (P < 0.0001). The median time to healing of leakage was 40 days (range: 14-97 days). Two patients (2/467, 0.4%) died in the hospital due to sepsis caused by the leakage and conduit necrosis. Twelve patients (2.6%) developed anastomotic stenosis, which was improved by dilatation in all patients. Hand-sewn cervical esophagogastric anastomosis is a stable and highly safe method of radical esophagectomy for esophageal cancer.

DOI PubMed

特異な経過で発見されたintraductal tubulopapillary neoplasmの1例

梅邑 晃, 新田 浩幸, 高原 武志, 長谷川 康, 眞壁 健二, 岩谷 岳, 秋山 有史, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本外科系連合学会誌 ( 日本外科系連合学会 )  42 ( 3 ) 587 - 587  2017.05

切除不能進行・再発胃癌二次治療に対するラムシルマブの有用性

千葉 丈広, 肥田 圭介, 天野 怜, 瀬川 武紀, 西成 悠, 高原 武志, 秋山 有史, 岩谷 岳, 西塚 哲, 木村 祐輔, 大塚 幸喜, 新田 浩幸, 水野 大, 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 )  117回   PS - 3  2017.04

食道扁平上皮癌治療経過における血液腫瘍マーカーの有用性の検討

遠藤 史隆, 岩谷 岳, 秋山 有史, 塩井 義裕, 天野 総, 高原 武志, 西塚 哲, 新田 浩幸, 大塚 幸喜, 肥田 圭介, 水野 大, 木村 祐輔, 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 )  117回   PS - 8  2017.04

Target sequenceによる食道癌変異遺伝子同定効率に関する検討

岩谷 岳, 遠藤 史隆, 西塚 哲, 秋山 有史, 塩井 義裕, 高原 武志, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 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 )  117回   SF - 5  2017.04

腹腔鏡下肝切除における手術難易度規定因子

長谷川 康, 新田 浩幸, 高原 武志, 板橋 英教, 梅邑 晃, 真壁 健二, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 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 )  117回   PS - 6  2017.04

骨格筋面積評価を用いた噴門側胃切除後と胃全摘術との比較

西成 悠, 肥田 圭介, 天野 怜, 瀬川 武紀, 石田 馨, 千葉 丈広, 秋山 有史, 岩谷 岳, 新田 浩幸, 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 )  117回   PS - 8  2017.04

食道癌に対する周術期多職種サポートチーム介入の効果

秋山 有史, 岩谷 岳, 遠藤 史隆, 塩井 義裕, 高原 武志, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 木村 祐輔, 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 )  117回   PS - 3  2017.04

術前サルコペニアを有する高齢者胃癌患者に対する周術期管理の工夫

肥田 圭介, 千葉 丈広, 西成 悠, 瀬川 武紀, 天野 怜, 高原 武志, 秋山 有史, 岩谷 岳, 西塚 哲, 木村 祐輔, 新田 浩幸, 大塚 幸喜, 水野 大, 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 )  117回   PS - 1  2017.04

当院における切除不能進行胃癌に対するSOX療法の検討(An experience of oxaliplatin plus S-1 in first-line treatment for advanced gastric cancer)

西成 悠, 肥田 圭介, 天野 怜, 瀬川 武紀, 石田 馨, 千葉 丈広, 秋山 有史, 岩谷 岳, 佐々木 章

日本胃癌学会総会記事 ( (一社)日本胃癌学会 )  89回   325 - 325  2017.03

Downregulation of ST6GALNAC1 is associated with esophageal squamous cell carcinoma development.

Takeshi Iwaya, Genta Sawada, Suburu Amano, Kohei Kume, Chie Ito, Fumitaka Endo, Masafumi Konosu, Yoshihiro Shioi, Yuji Akiyama, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Satoshi Nishizuka, Akira Sasaki, Koshi Mimori

International journal of oncology   50 ( 2 ) 441 - 447  2017.02  [Refereed]  [International journal]

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Tylosis is an inherited disorder characterized by abnormal palmoplantar skin thickening and a highly elevated risk of esophageal squamous cell carcinoma (ESCC). Analyses of tylosis in families have localized the responsible gene locus to a region of chromosome 17q25.1. Frequent loss of heterozygosity (LOH) in 17q25.1 was also observed in the sporadic form of ESCC. A putative tumor suppressor gene for ESCC may exist at this locus. We investigated the expression patterns of genes on 17q25.1 in tumor and corresponding normal tissues from patients with sporadic ESCC using RNA sequence analysis. For candidate genes, quantitative real-time reverse transcription-PCR (qRT-PCR), direct sequence, LOH and methylation analyses were performed using 93 clinical ESCC samples and 10 cell lines. A significant downregulation of ST6GALNAC1 was demonstrated in ESCC tissues compared to its expression in normal tissues by qRT-PCR (n=93, p<0.0001). Frequent LOH (17/27, 62.9%) and hyper‑methylation in ST6GALNAC1 were also observed in all cell lines. Our results indicated that ST6GALNAC1 was downregulated in sporadic ESCC via hyper-methylation and LOH, and it may be a candidate responsible gene for ESCC. Furthermore, recent studies suggest that multiple genes on chromosome 17q25 are involved in ESCC development.

DOI PubMed

Peripheral vein infusions of amino acids facilitate recovery after esophagectomy for esophageal cancer: Retrospective cohort analysis.

Masafumi Konosu, Takeshi Iwaya, Yusuke Kimura, Yuji Akiyama, Yoshihiro Shioi, Fumitaka Endo, Hiroyuki Nitta, Koki Otsuka, Keisuke Koeda, Akira Sasaki

Annals of medicine and surgery (2012)   14   29 - 35  2017.02  [Refereed]  [International journal]

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BACKGROUND: To investigate the efficacy of amino acid administration via peripheral veins in addition to conventional enteral feeding following esophagectomy. MATERIALS AND METHODS: Retrospective analysis of data pertaining to 33 patients with esophageal cancer who underwent radical esophagectomy and satisfied the required nutrition control. Patients were divided into the amino acid group (n = 17) and control group (n = 16). Primary outcomes were albumin (Alb) and prealbumin (PreAlb) levels, urinary 3-methylhistidine/creatinine (3-MeHis/Cre) ratios, nitrogen balance, and weight; postoperative complications were noted as secondary outcomes. RESULTS: Alb levels were significantly higher in the amino acid group on postoperative day (POD)-14 (3.4 ± 0.3 vs. 3.1 ± 0.4 mg/dL in the control group, p = 0.018) and at 1 month after surgery (3.8 ± 0.4 vs. 3.5 ± 0.3 mg/dL, p = 0.045). No significant differences were observed in PreAlb and urinary 3-MeHis/Cre rates between the treatment groups. Body weights at 3 months postoperatively were decreased by 6% and 3% in the control and amino acid groups, respectively. CONCLUSION: Peripheral venous administration of amino acids soon after surgical stress is an effective method for nutritional control.

DOI PubMed

完全直腸脱に対するsingle-incision plus one puncture laparoscopic rectopexy(Single-incision plus one puncture laparoscopic rectopexy for full-thickness rectal prolapse)

梅邑 晃, 須藤 隆之, 中村 聖華, 藤原 久貴, 秋山 有史, 岩谷 岳, 新田 浩幸, 大塚 幸喜, 肥田 圭介, 高原 武志, 木村 祐輔, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) OS168 - 2  2016.12

難易度の高い症例に対する腹腔鏡下肝切除のアプローチ 肋間ポートを使用しないS7/8領域の腹腔鏡下肝切除術

長谷川 康, 新田 浩幸, 高原 武志, 板橋 英教, 梅邑 晃, 真壁 健二, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) PD4 - 6  2016.12

胸腔鏡下食道切除術後に発生した横隔膜ヘルニアに対して腹腔鏡下ヘルニア根治術を施行した1例

遠藤 史隆, 秋山 有史, 岩谷 岳, 塩井 義裕, 高原 武志, 新田 浩幸, 大塚 幸喜, 肥田 圭介, 水野 大, 木村 祐輔, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) DP9 - 2  2016.12

早期胃癌に対する機能温存手術のメリットとデメリット 腹腔鏡下幽門保存胃切除の長期成績に関する検討

千葉 丈広, 肥田 圭介, 西成 悠, 瀬川 武紀, 天野 怜, 高原 武志, 秋山 有史, 岩谷 岳, 西塚 哲, 木村 祐輔, 新田 浩幸, 大塚 幸喜, 水野 大, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) RS15 - 4  2016.12

傍腹直筋切開法による頭背側腫瘍に対する腹腔鏡下肝切除の視野確保

眞壁 健二, 新田 浩幸, 高原 武志, 長谷川 康, 板橋 英教, 梅邑 晃, 畑中 智貴, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) OS78 - 1  2016.12

腹腔鏡下胃切除術の肝圧排法における肝機能障害の検討

西成 悠, 肥田 圭介, 天野 怜, 瀬川 武紀, 石田 馨, 千葉 丈広, 高原 武志, 秋山 有史, 岩谷 岳, 木村 祐輔, 新田 浩幸, 大塚 幸喜, 水野 大, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) OS76 - 2  2016.12

肝原発血管筋脂肪腫に対して腹腔鏡下肝左葉切除を施行した1例

畑中 智貴, 高原 武志, 長谷川 康, 板橋 英教, 梅邑 晃, 眞壁 健二, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 新田 浩幸, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) DP100 - 2  2016.12

高度進行胃癌に対する腹腔鏡下胃空腸バイパス術の検討

瀬川 武紀, 肥田 圭介, 天野 怜, 西成 悠, 千葉 丈広, 高原 武志, 秋山 有史, 岩谷 岳, 西塚 哲, 木村 祐輔, 新田 浩幸, 大塚 幸喜, 水野 大, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) OS84 - 7  2016.12

再肝切除における腹腔鏡下肝切除の位置づけ

高原 武志, 新田 浩幸, 長谷川 康, 真壁 健二, 武田 大樹, 片桐 弘勝, 梅邑 晃, 板橋 英教, 秋山 有史, 岩谷 岳, 西塚 哲, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) OS153 - 2  2016.12

反回神経麻痺を起こさせない工夫と治療成績 胸腔鏡下食道切除術における反回神経麻痺予防のための工夫と治療成績

秋山 有史, 岩谷 岳, 遠藤 史隆, 塩井 義裕, 千葉 丈広, 高原 武志, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 木村 祐輔, 佐々木 章

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  21 ( 7 ) WS14 - 5  2016.12

当院における後期高齢者に対する食道癌の治療成績と超高齢者治療への可能性

遠藤 史隆, 岩谷 岳, 秋山 有史, 塩井 義裕, 高原 武志, 西塚 哲, 新田 浩幸, 大塚 幸喜, 肥田 圭介, 水野 大, 木村 祐輔, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  77 ( 増刊 ) 530 - 530  2016.10

肝膵同時切除の適応と手技の工夫 当科でのHPDの治療成績と現在の方針 膵液漏発生頻度をPD症例(soft pancreas)と比較する

高原 武志, 新田 浩幸, 長谷川 康, 真壁 健二, 武田 大樹, 梅邑 晃, 片桐 弘勝, 板橋 英教, 畑中 智貴, 秋山 有史, 岩谷 岳, 西塚 哲, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  77 ( 増刊 ) 356 - 356  2016.10

腹腔鏡下肝胆膵脾手術 困難性評価 腹腔鏡下肝切除における新しい難易度評価システム

長谷川 康, 新田 浩幸, 高原 武志, 板橋 英教, 梅邑 晃, 真壁 健二, 畑中 智貴, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  77 ( 増刊 ) 354 - 354  2016.10

術前HCCとの鑑別が困難であったParagangliomaの一例

畑中 智貴, 高原 武志, 新田 浩幸, 長谷川 康, 眞壁 健二, 梅邑 晃, 板橋 英教, 秋山 有史, 岩谷 岳, 大塚 幸喜, 肥田 圭介, 佐々木 章

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  77 ( 増刊 ) 821 - 821  2016.10

食道肺瘻合併進行食道癌に対しバイパス手術が有効であった1例

遠藤 史隆, 岩谷 岳, 秋山 有史, 塩井 義裕, 天野 総, 木村 祐輔, 佐々木 章

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 )  70回   208 - 208  2016.07

DCF療法(docetacel/cisplatin/5-FU併用療法)とBi-weekly DCF療法における有害事象に関する検討

塩井 義裕, 岩谷 岳, 秋山 有史, 遠藤 史隆, 木村 祐輔, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 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 )  71回   P3 - 5  2016.07

当院におけるERASに基づく胸部食道癌周術期管理

遠藤 史隆, 岩谷 岳, 秋山 有史, 塩井 義裕, 新田 浩幸, 大塚 幸喜, 肥田 圭介, 水野 大, 木村 祐輔, 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 )  71回   P3 - 1  2016.07

Downregulation of TMPRSS11B in squamous cell carcinoma

Suburu Amano, Takeshi Iwaya, Satoshi Nishizuka, Kohei Kume, Chie Ito, Yuji Akiyama, Yoshihiro Shioi, Fumitaka Endo, Akira Sasaki

CANCER RESEARCH ( AMER ASSOC CANCER RESEARCH )  76  2016.07  [Refereed]

DOI

胸腔鏡下食道切除術における合併症軽減のための工夫

秋山 有史, 岩谷 岳, 遠藤 史隆, 塩井 義裕, 高原 武志, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 木村 祐輔, 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 )  71回   P2 - 2  2016.07

進行食道癌に対する導入DCF療法後後治療に関する検討

岩谷 岳, 秋山 有史, 塩井 義裕, 遠藤 史隆, 木村 祐輔, 大塚 幸喜, 新田 浩幸, 肥田 圭介, 水野 大, 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 )  71回   P3 - 3  2016.07

Multiple genes on chromosome 17q25 were involved in sporadic esophageal squamous cell carcinoma development

Takeshi Iwaya, Suburu Amano, Fumitaka Endo, Yuji Akiyama, Yoshihiro Shioi, Kohei Kume, Satoshi Nishizuka, Chie Ito, Akira Sasaki, Koshi Mimori

CANCER RESEARCH ( AMER ASSOC CANCER RESEARCH )  76  2016.07  [Refereed]

DOI

食道癌に対する周術期の多職種チーム医療介入の成果

秋山 有史, 岩谷 岳, 遠藤 史隆, 塩井 義裕, 肥田 圭介, 木村 祐輔, 佐々木 章

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 )  70回   76 - 76  2016.07

Intracorporeal reconstruction after laparoscopic pylorus-preserving gastrectomy for middle-third early gastric cancer: a hybrid technique using linear stapler and manual suturing.

Keisuke Koeda, Takehiro Chiba, Hironobu Noda, Yutaka Nishinari, Takenori Segawa, Yuji Akiyama, Takeshi Iwaya, Satoshi Nishizuka, Hiroyuki Nitta, Koki Otsuka, Akira Sasaki

Langenbeck's archives of surgery   401 ( 3 ) 397 - 402  2016.05  [Refereed]  [International journal]

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PURPOSE: Laparoscopy-assisted pylorus-preserving gastrectomy has been increasingly reported as a treatment for early gastric cancer located in the middle third of the stomach because of its low invasiveness and preservation of pyloric function. Advantages of a totally laparoscopic approach to distal gastrectomy, including small wound size, minimal invasiveness, and safe anastomosis, have been recently reported. Here, we introduce a new procedure for intracorporeal gastro-gastrostomy combined with totally laparoscopic pylorus-preserving gastrectomy (TLPPG). METHODS: The stomach is transected after sufficient lymphadenectomy with preservation of infrapyloric vessels and vagal nerves. The proximal stomach is first transected near the Demel line, and the distal side is transected 4 to 5 cm from the pyloric ring. To create end-to-end gastro-gastrostomy, the posterior wall of the anastomosis is stapled with a linear stapler and the anterior wall is made by manual suturing intracorporeally. We retrospectively assessed the postoperative surgical outcomes via medical records. The primary endpoint in the present study is safety. RESULTS: Sixteen patients underwent TLPPG with intracorporeal reconstruction. All procedures were successfully performed without any intraoperative complications. The mean operative time was 275 min, with mean blood loss of 21 g. With the exception of one patient who had gastric stasis, 15 patients were discharged uneventfully between postoperative days 8 and 11. CONCLUSIONS: Our novel hybrid technique for totally intracorporeal end-to-end anastomosis was performed safely without mini-laparotomy. This technique requires prospective validation.

DOI PubMed

食道悪性腫瘍手術における周術期管理チームが周術期に与える効果

塩井 義裕, 岩谷 岳, 秋山 有史, 鴻巣 正史, 遠藤 史隆, 木村 祐輔, 大塚 幸喜, 新田 浩幸, 柏葉 匡寛, 肥田 圭介, 水野 大, 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 )  116回   PS - 2  2016.04

食道扁平上皮癌におけるTransmembrane Protease Serine 11Bの発現異常

天野 総, 岩谷 岳, 西塚 哲, 伊藤 千絵, 秋山 有史, 塩井 義裕, 遠藤 史隆, 木村 祐輔, 鴻巣 正史, 杉立 彰夫, 伊勢 一哉, 大塚 幸喜, 新田 浩幸, 柏葉 匡寛, 肥田 圭介, 水野 大, 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 )  116回   OP - 6  2016.04

当科における食道癌肉腫症例の検討

遠藤 史隆, 岩谷 岳, 秋山 有史, 塩井 義裕, 天野 総, 鴻巣 正史, 木村 祐輔, 西塚 哲, 新田 浩幸, 大塚 幸喜, 柏葉 匡寛, 肥田 圭介, 水野 大, 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 )  116回   PS - 3  2016.04

食道癌に対する腹臥位胸腔鏡下食道切除術の手術成績

秋山 有史, 岩谷 岳, 塩井 義裕, 遠藤 史隆, 千葉 丈広, 大塚 幸喜, 新田 浩幸, 柏葉 匡寛, 肥田 圭介, 水野 大, 木村 祐輔, 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 )  116回   PS - 8  2016.04

進行食道癌に対する一次化学療法に関する検討

岩谷 岳, 秋山 有史, 塩井 義裕, 遠藤 史隆, 木村 祐輔, 鴻巣 正史, 天野 総, 大塚 幸喜, 新田 浩幸, 柏葉 匡寛, 肥田 圭介, 水野 大, 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 )  116回   PS - 2  2016.04

Successfully treated advanced esophageal cancer with left axillary lymph node metastasis and synchronous right breast cancer: a case report.

Yuji Akiyama, Takeshi Iwaya, Yoshihiro Shioi, Fumitaka Endo, Kazushige Ishida, Masahiro Kashiwaba, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Yusuke Kimura, Akira Sasaki

Surgical case reports   1 ( 1 ) 94 - 94  2015.12  [Refereed]  [International journal]

　View Summary

The incidence of double cancer of the esophagus and breast is rare, and axillary lymph node metastasis (ALM) in esophageal cancer is also very rare. We report a case of advanced esophageal cancer with left ALM and synchronous right breast cancer. A 64-year-old woman was admitted to our hospital with dysphagia. The clinical diagnosis was esophageal cancer (T3N0M1 stage IV) and right breast cancer (T1cN0M0 stage I). She was initially treated with triple chemotherapy with docetaxel, cisplatin, and 5-fluorouracil. The primary lesion in the esophagus achieved almost complete response as assessed by esophageal endoscopy. A computed tomography scan showed that the left ALM reduced in size and that stable disease was achieved for the right breast cancer. She underwent partial mastectomy of the right breast and bilateral axillary lymph node dissection. The histopathological diagnosis of the breast cancer was T1cN1M0 stage IIA. The lymph nodes from the left axilla contained metastatic cells from the squamous cell carcinoma of the esophagus. Complete response was achieved for the primary lesion in the esophagus following chemoradiotherapy (CRT), and the patient has been relapse free 2 years after treatment. Thus, we report the successful treatment of synchronous double cancers of the esophagus with left ALM and right breast by combination therapy with chemotherapy, CRT, and surgery.

DOI PubMed

Totally laparoscopic total gastrectomy for gastric cancer: literature review and comparison of the procedure of esophagojejunostomy.

Akira Umemura, Keisuke Koeda, Akira Sasaki, Hisataka Fujiwara, Yusuke Kimura, Takeshi Iwaya, Yuji Akiyama, Go Wakabayashi

Asian journal of surgery   38 ( 2 ) 102 - 12  2015.04  [Refereed]  [International journal]

　View Summary

There has been a recent increase in the use of totally laparoscopic total gastrectomy (TLTG) for gastric cancer. However, there is no scientific evidence to determine which esophagojejunostomy (EJS) technique is the best. In addition, both short- and long-term oncological results of TLTG are inconsistent. We reviewed 25 articles about TLTG for gastric cancer in which at least 10 cases were included. We analyzed the short-term results, relationships between EJS techniques and complications, long-term oncological results, and comparative study results of TLTG. TLTG was performed in a total of 1170 patients. The mortality rate was 0.7%, and the short-term results were satisfactory. Regarding EJS techniques and complications, circular staplers (CSs) methods were significantly associated with leakage (4.7% vs. 1.1%, p < 0.001) and stenosis (8.3% vs. 1.8%, p < 0.001) of the EJS as compared with the linear stapler method. The long-term oncological prognosis was acceptable in patients with early gastric cancers and without metastases to lymph nodes. Although TLTG tended to increase surgical time compared with open total gastrectomy and laparoscopy-assisted total gastrectomy, it reduced intraoperative blood loss and was expected to shorten postoperative hospital stay. TLTG is found to be safer and more feasible than open total gastrectomy and laparoscopy-assisted total gastrectomy. At present, there is no evidence to encourage performing TLTG for patients with advanced gastric cancer from the viewpoint of long-term oncological prognosis. Although the current major EJS techniques are CS and linear stapler methods, in this review, CS methods are significantly associated with leakage and stenosis of the EJS.

DOI PubMed

Thoracoscopic enucleation of esophageal benign tumors

Yusuke Kimura, Akira Sasaki, Toru Obuchi, Takeshi Iwaya, Yuji Akiyama, Masafumi Konosu, Fumitaka Endo, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Go Wakabayashi

Minimally Invasive Foregut Surgery for Malignancy: Principles and Practice ( Springer International Publishing )    177 - 181  2015.01  [Refereed]

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Benign esophageal tumors are rare, with a prevalence of 0.005–5.1 %, based on autopsy results, and account for < 1–10 % of all esophageal neoplasms. Leiomyomas constitute 70–80 % of these benign esophageal neoplasms. Other benign esophageal tumors, such as granular cell tumors or schwannomas, are extremely rare. Esophageal leiomyomas are usually detected in patients between 20 and 50 years of age, with a twofold male predominance, and most commonly occur in the lower third of the esophagus. At least 50 % of patients with esophageal leiomyomas are asymptomatic in symptomatic individuals, dysphagia is the most commonly reported symptom, followed by chest tightness and pain. These tumors are usually discovered, incidentally, during esophagography or endoscopic examination of the upper gastrointestinal tract for unrelated reasons. The treatment strategy for esophageal benign tumors, such as leiomyomas, involves continued monitoring of smaller tumors and surgical resection of larger or symptomatic tumors. Conventional, open thoracotomy for enucleation of this tumor type has been gradually replaced by less invasive thoracoscopic or laparoscopic approaches. In the present report, we describe our experience with patients undergoing surgical enucleation of esophageal leiomyomas via thoracoscopic or laparoscopic approaches.

DOI

Curative two-stage resection for synchronous triple cancers of the esophagus, colon, and liver: Report of a case.

Yuji Akiyama, Takeshi Iwaya, Masafumi Konosu, Yoshihiro Shioi, Fumitaka Endo, Hirokatsu Katagiri, Hiroyuki Nitta, Toshimoto Kimura, Koki Otsuka, Keisuke Koeda, Masahiro Kashiwaba, Masaru Mizuno, Yusuke Kimura, Akira Sasaki

International journal of surgery case reports   13   1 - 4  2015  [Refereed]  [International journal]

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INTRODUCTION: Cases of synchronous triple cancers of the esophagus and other organs curatively resected are rare. PRESENTATION OF CASE: A 73-year-old man was admitted to our hospital with bloody feces. He was diagnosed with synchronous triple cancers of the esophagus, colon, and liver. We selected a two-stage operation to safely achieve curative resection for all three cancers. The first stage of the operation comprised a laparoscopy-assisted sigmoidectomy and partial liver resection via open surgery. The patient was discharged without complications. Thirty days later, he was readmitted and thoracoscopic esophagectomy was performed. Although pneumonia-induced pulmonary aspiration occurred as a postoperative complication, it was treated conservatively. The patient was discharged on postoperative day 24. DISCUSSION: Esophagectomy is a highly invasive procedure; thus, simultaneous surgery for plural organs, including the esophagus, may induce life-threatening, severe complications. Two-stage surgery is useful in reducing surgical stress in high-risk patients. For synchronous multiple cancers, the planning of two-stage surgery should be considered for each cancer to maintain organ function and reduce the stress and difficulty of each stage. CONCLUSION: We successfully treated synchronous triple cancers, including esophageal cancer, by a two-stage operation.

DOI PubMed

Effectiveness of neoadjuvant chemotherapy with cisplatin and irinotecan followed by surgery on small-cell carcinoma of the esophagus: A case report.

Yuji Akiyama, Takeshi Iwaya, Yoshihiro Shioi, Fumitaka Endo, Takehiro Chiba, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Noriyuki Uesugi, Yusuke Kimura, Akira Sasaki

International journal of surgery case reports   17   121 - 5  2015  [Refereed]  [International journal]

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INTRODUCTION: Small-cell carcinoma of the esophagus (SCCE) is a rare disease with aggressive progression and a poor prognosis. A standard treatment strategy for SCCE is yet to be established. PRESENTATION OF CASE: A 40-year-old woman with dysphagia was admitted to our hospital. A clinical diagnosis of SCCE (T3N1N0 stage IIIA) was established. She was initially treated with chemotherapy using cisplatin (CDDP) and irinotecan (CPT-11). After two courses of treatment, the primary lesion in the esophagus was not detectable by esophageal endoscopy. Likewise, swelling of the right recurrent nerve lymph node present prior to treatment could not be detected. The chemotherapy resulted in a complete response. One month after the conclusion of chemotherapy, radical esophagectomy with three-field lymph node dissection was performed. Histopathological examination of the excised specimen revealed no residual tumor or lymph node metastasis. The patient was discharged from hospital 29 days after surgery with no complications. The patient is alive and has remained cancer-free for 48 months after the surgery. DISCUSSION: Systemic chemotherapy for SCCE in combination with surgery was treated after surgery in most reports. Neoadjuvant chemotherapy is advantageous from three viewpoints, namely achievement of downstaging, increasing complete resection rates, and a better completion of treatment compared with postoperative chemotherapy. Neoadjuvant chemotherapy following esophagectomy could be a useful treatment option for patients with limited disease (LD) of SCCE. CONCLUSION: We report a case of SCCE achieving a pathologically complete response with neoadjuvant chemotherapy using CDDP and CPT-11, and long-term survival followed by surgery.

DOI PubMed

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

Naoko Ito, Takeshi Iwaya, Kenichiro Ikeda, Yusuke Kimura, Yuji Akiyama, Masafumi Konosu, Kaoru Ishida, Hisataka Fujiwara, Koki Otsuka, Hiroyuki Nitta, Masahiro Kashiwaba, Keisuke Koeda, Satoshi Nishizuka, Masaru Mizuno, Akira Sasaki, Go Wakabayashi

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract   18 ( 9 ) 1547 - 56  2014.09  [Refereed]  [International journal]

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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  2014.07

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  2014.07

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  2014.07

[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  2013.11  [Refereed]

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  2013.11  [Refereed]  [International journal]

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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  2013.10

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  2013.10

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  2013.06

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  2013.06

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  [Refereed]

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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].

Masafumi Konosu, Yusuke Kimura, Takeshi Iwaya, Yuji Akiyama, Hisataka Fujiwara, Fumitaka Endo, Akio Sugitachi, Satoshi Nishizuka, Hiroyuki Nitta, Koki Otsuka, Masahiro Kashiwaba, Keisuke Koeda, Akira Sasaki, Masaru Mizuno, Go Wakabayashi

Gan to kagaku ryoho. Cancer & chemotherapy   39 ( 12 ) 1849 - 51  2012.11  [Refereed]  [Domestic journal]

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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  2012.06

A Case of Rectal GIST Treated with Imatinib Mesylate Neoadjuvant Therapy to Preserve the Anus and Curative Resection

KATO Kuniyuki, OTSUKA Koki, ITABASHI Tetsuya, AKIYAMA Yuji, YOSHIDA Masakazu, WAKABAYASHI Go

The Japanese journal of proctology ( The Japan Society of Coloproctology )  65 ( 4 ) 239 - 244  2012

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A 55-year-old woman was admitted to hospital with anal pain. Digital examination revealed a tumor with a smooth surface in the anterior wall of the rectum. A CT showed that the tumor was 112mm in diameter and was present in the pelvic cavity. A biopsy specimen was positive for c-kit gene product, thus the tumor was diagnosed as a GIST. An abdominoperineal resection and hysterectomy are generally essential for large rectal GIST. However, in this case the patient refused this operation. Neoadjuvant treatment with imatinib mesylate decreased the tumor size (43mm) and the anus was preserved by an ultralow anterior resection with intersphincteric resection, coloanal anastomosis. The tumor presented liquefaction degeneration, and the histological response evaluation was Grade3 (pCR). Although the primary treatment for large rectal GIST remains abdominoperineal resection, the present case suggests that imatinib may be useful as a neoadjuvant therapy.

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  2010.09  [Refereed]

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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].

Akio Sugitachi, Koki Otsuka, Kentaro Fujisawa, Tetsuya Itabashi, Yuji Akiyama, Akira Sasaki, Kenichiro Ikeda, Yasuo Yoshida, Yoshimori Takamori, Seiji Kurozumi, Takatoshi Mori, Go Wakabayashi

Gan to kagaku ryoho. Cancer & chemotherapy   34 ( 12 ) 2159 - 61  2007.11  [Refereed]  [Domestic journal]

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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  2007.11  [Refereed]

PubMed

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

Koki Otsuka, Yuji Akiyama, Tetsuya Itabashi, Akira Sasaki, Ken-ichiro Ikeda, Yoshimori Takamori, Seiji Kurozumi, Go Wakabayashi

Gan to kagaku ryoho. Cancer & chemotherapy   33 ( 12 ) 1866 - 8  2006.11  [Refereed]  [Domestic journal]

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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  2006.03

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  2006.03

CiNii

Gene expression profiles in human gastric cancer: expression of maspin correlates with lymph node metastasis

M Terashima, C Maesawa, K Oyama, S Ohtani, Y Akiyama, S Ogasawara, A Takagane, K Saito, T Masuda, N Kanzaki, S Matsuyama, Y Hoshino, M Kogure, M Gotoh, M Shirane, K Mori

BRITISH JOURNAL OF CANCER ( NATURE PUBLISHING GROUP )  92 ( 6 ) 1130 - 1136  2005.03  [Refereed]

　View Summary

To seek for a candidate gene that would regulate tumour progression and metastasis in gastric cancer, we investigated gene expression profiles by using DNA microarray. Tumour tissue and adjacent normal tissue were obtained from 21 patients with gastric cancer and then examined for their gene expression profiles by the Gene Chip (R) Human U95Av2 array, which includes 12 000 human genes and EST sequences. A total of 25 genes were upregulated and two genes were downregulated by at least four-fold in the tumour tissue. In a further analysis according to lymph node metastasis, the expressed levels of maspin, as well as carcinoembryonic antigen and nonspecific crossreacting antigen were significantly higher in tumours with lymph node metastasis than in those without it. Maspin expression in 85 gastric cancer patients was further investigated by using immunohistochemistry. Maspin expression was not observed in normal gastric epithelia without intestinal metaplasia. In contrast, maspin was expressed in 74 of 85 tumour tissues. There was a significant correlation between the incidence of maspin-positive tumour staining and lymph node metastasis. These results suggest that maspin has a potential role for tumour metastasis in gastric cancer.

DOI

Epigenetic status and aberrant expression of the maspin gene in human hepato-biliary tract carcinomas.

Kentaro Fujisawa, Chihaya Maesawa, Ryo Sato, Kei Wada, Satoshi Ogasawara, Yuji Akiyama, Masaru Takeda, Tomohiro Fujita, Koki Otsuka, Taro Higuchi, Kazuyuki Suzuki, Kazuyoshi Saito, Tomoyuki Masuda

Laboratory investigation; a journal of technical methods and pathology   85 ( 2 ) 214 - 24  2005.02  [Refereed]  [International journal]

　View Summary

We examined expression of maspin and the epigenetic status of its gene in 40 primary hepato-biliary tract carcinomas and 11 cell lines originating from hepato-pancreatico-biliary tract carcinomas. Aberrant maspin expression was frequently observed immunohistochemically in biliary tract carcinomas (22/25, 88%) but not in hepatocellular carcinomas (HCCs) (0/15, 0%). Aberrant maspin expression by five pancreatico-biliary tract carcinoma cell lines was closely associated with demethylation at the maspin promoter. Five of six HCC cell lines were maspin-negative and exhibited extensive hypomethylation and hypoacetylation at the maspin promoter. Treatment with 5-aza-2'-deoxycytidine did not activate maspin expression in these five maspin-negative HCC cell lines, whereas treatment with Trichostatin A (TSA) activated maspin expression in two of them. Treatment with TSA increased histone acetylation in some HCC cell lines. These results suggest that aberrant maspin expression in biliary tract carcinomas is closely associated with demethylation at the promoter region, but that some HCC cell lines additionally require histone acetylation. In addition, the fact that maspin-negative HCC cell lines remain after treatment with TSA suggests the existence of other repressive factors controlling maspin expression.

PubMed

[A case of liver metastatic recurrence of gastric cancer effectively treated by combined chemotherapy of CPT-11 and CDDP].

Hisataka Fujiwara, Kiichi Aoki, Tsutomu Nakaya, Yuji Akiyama, Yusuke Kimura, Takeshi Iwaya, Kazuyoshi Saito

Gan to kagaku ryoho. Cancer & chemotherapy   31 ( 12 ) 2035 - 8  2004.11  [Refereed]  [Domestic journal]

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The patient was a 72-year-old female with gastric carcinoma. A liver metastatic recurrence was detected 27 months after operation. Although temporary partial responses were obtained by each effective chemotherapy, which was a combination chemotherapy with 5'-DFUR and TXT, TS-1 and TXL, the metastatic lesion proved refractory to all of them. Then we tried combination chemotherapy consisting of CDDP 30 mg/m2 and CPT-11 60 mg/m2, respectively (day 1 and 15, every 4 weeks). A partial response was achieved and continued for 8.5 months, and her complaints abated and quality of life improved. Although gastro-intestinal symptoms and bone marrow suppression were observed as side effects, they were within a tolerable range and did not interfere with the combination therapy. This regimen appears to be feasible and effective for recurrent gastric carcinoma refractory to other regimens.

PubMed

Human PinX1, a potent telomerase inhibitor, is not involved in human gastrointestinal tract carcinoma.

Yuji Akiyama, Chihaya Maesawa, Kei Wada, Kentaro Fujisawa, Tetsuya Itabashi, Yoshinori Noda, Takehisa Honda, Nobuhiro Sato, Kaoru Ishida, Akinori Takagane, Kazuyoshi Saito, Tomoyuki Masuda

Oncology reports   11 ( 4 ) 871 - 4  2004.04  [Refereed]  [International journal]

　View Summary

PinX1 was isolated as a Pin2/TRF1 binding protein that also binds to the telomerase catalytic subunit hTERT. The gene is a potent telomerase inhibitor and a putative tumor suppressor since it inhibits telomerase activity and affects tumorigenicity in nude mice. This study investigated aberrations of PinX1 gene in gastrointestinal tract carcinomas (GITCs). We examined mutations, mRNA expression and promoter methylation of PinX1 gene in 15 GITC cell lines, and 20 patients with primary GITC. We found a missense mutation at codon 254 (AGC/TGC) in a colon and an esophageal carcinoma cell line, and in cancerous and matching normal tissues of 2 patients with primary GITC (10%). It might be a benign polymorphism. No hyper-methylation was found in the promoter region and the treatment by 5-Aza-2'-deoxycytidine did not affect PinX1 mRNA expression level in any of the cell lines. It was concluded that the human PinX1 does not affect tumorigenesis of human GITC.

PubMed

Disruption of cell-type-specific methylation at the Maspin gene promoter is frequently involved in undifferentiated thyroid cancers.

Satoshi Ogasawara, Chihaya Maesawa, Masahide Yamamoto, Yuji Akiyama, Kei Wada, Kentaro Fujisawa, Taro Higuchi, Yuki Tomisawa, Nobuhiro Sato, Shigeatsu Endo, Kazuyoshi Saito, Tomoyuki Masuda

Oncogene   23 ( 5 ) 1117 - 24  2004.02  [Refereed]  [International journal]

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Cancer-associated DNA hypomethylation is as prevalent as cancer-linked hypermethylation, but the biological significance of DNA hypomethylation in carcinogenesis is less understood. The expression of Maspin (mammary serpin) in differentiated normal cells is regulated by epigenetic modifications in a cell-type-specific manner. Paradoxical Maspin expression due to epigenetic modification has been addressed in several cancer cell types. To elucidate the role of the Maspin gene in thyroid cancer, we studied methylation status in the promoter region and its expression in six human undifferentiated thyroid cancer cell lines and in specimens from 92 primary thyroid tumors, consisting of six follicular adenomas, 56 well-differentiated thyroid cancers (WDTCs), 17 poorly differentiated thyroid cancers (PDTCs) and 13 undifferentiated thyroid cancers (UDTCs). Three of the six cell lines overexpressed Maspin mRNA and its protein product, but the remaining three did not. The methylation status at the promoter region was inversely correlated with Maspin expression. In Maspin-negative cell lines, Maspin expression was induced by treatment with 5-aza-2'-deoxycytidine, a DNA demethylating agent. Immunoreactivity for Maspin protein was frequently detected in UDTCs (8/13, 62%) and PDTCs (7/17, 41%). Immunoreactivity for Maspin was diffusely positive in UDTCs, and was restricted to dedifferentiated components of the tumor in PDTCs. Positive immunoreactivity was infrequent in WDTCs (1/56, 2%), and all follicular adenomas and normal thyroid glands were completely negative. Their methylation status evaluated by the methylation-specific PCR method showed a good inverse correlation with their immunoreactivity in surgically resected specimens. Our data suggest that overexpression of Maspin by DNA hypomethylation is closely associated with morphological dedifferentiation in thyroid cancers.

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Cell-type-specific repression of the maspin gene is disrupted frequently by demethylation at the promoter region in gastric intestinal metaplasia and cancer cells.

Yuji Akiyama, Chihaya Maesawa, Satoshi Ogasawara, Masanori Terashima, Tomoyuki Masuda

The American journal of pathology   163 ( 5 ) 1911 - 9  2003.11  [Refereed]  [International journal]

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Maspin, a serine protease inhibitor, was originally reported as a tumor suppressor gene in breast and prostatic cancers. We examined maspin expression and/or the allele-specific methylation status in four gastric cancer cell lines, as well as normal, metaplastic, and cancerous epithelia obtained from 50 gastric cancer patients. Three gastric cancer cell lines exhibiting maspin overexpression showed hypomethylation at either both alleles or a haploid allele. Only one cell line (GCIY) was maspin-negative but maspin expression was reactivated after treatment with a demethylating agent, 5-aza-2'-deoxycytidine. Dense and diffuse immunoreactivity for maspin was observed in 40 (80%) of 50 gastric cancers and all gastric normal epithelia (GNE) with intestinal metaplasia (IM), but not in GNE without IM. We further analyzed the allele-specific methylation status in 10 of 50 cases subjected to immunohistochemistry by the crypt isolation technique followed by a bisulfite genome sequencing method. The maspin gene promoter region of all GNE without IM was hypermethylated on both alleles whereas those with IM frequently represented the haploid type of hypomethylation status. In six of seven gastric cancers in which crypt isolation was possible, demethylation frequently occurred and extended to both alleles. Maspin mRNA was amplified from GNE with IM and cancerous crypts but not from GNE without IM. These results suggest that demethylation at the maspin gene promoter disrupts the cell-type-specific gene repression in both GNE and gastric cancer.

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Randomized study of the benefits of preoperative corticosteroid administration on the postoperative morbidity and cytokine response in patients undergoing surgery for esophageal cancer.

Nobuhiro Sato, Keisuke Koeda, Kenichiro Ikeda, Yusuke Kimura, Kiichi Aoki, Takeshi Iwaya, Yuji Akiyama, Kaoru Ishida, Kazuyoshi Saito, Shigeatsu Endo

Annals of surgery   236 ( 2 ) 184 - 90  2002.08  [Refereed]  [International journal]

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OBJECTIVE: To investigate whether preoperative corticosteroid administration plays a role in attenuating postoperative morbidity. SUMMARY BACKGROUND DATA: There is as yet no consensus on the beneficial effects of steroids in alleviating surgical stress. METHODS: A total of 66 patients undergoing surgery for thoracic esophageal cancer were randomly categorized preoperatively into two groups of 33 patients each. One group was administered an intravenous infusion of methylprednisolone (10 mg/kg body weight) 30 minutes before the surgery (MP group), while the other group received a placebo infusion (control group). The primary endpoint was organ system failure during the first 7 days after surgery. Comparisons of surgery-related complications, cytokine responses, and blood counts were also made between the two groups. RESULTS: The percentage of patients in the MP group who had one or more organ system failures was 33%, significantly lower than the corresponding percentage of 61% in the control group. The surgery-related complication rate and long-term survival rate were similar in the two groups. The peak plasma levels of interleukin (IL)-1 receptor antagonist, IL-6, and IL-8 were significantly lower in the MP group than in the control group. Changes in the plasma levels of IL-10 were significantly larger in the MP group. No significant differences in the circulating lymphocyte and neutrophil counts were observed between the groups. CONCLUSIONS: The results suggest that prophylactic administration of corticosteroids is associated with a decrease in postoperative morbidity in patients undergoing invasive surgery. The laboratory data suggest that corticosteroids may attenuate surgical stress-induced inflammatory responses both directly by suppressing the release of proinflammatory cytokines and via inducing IL-10 synthesis.

DOI PubMed

Gastrointestinal stromal turnour of the oesophagus: significance of immunohistochemical and genetic analyses of the c-kit gene

S Iijima, C Maesawa, N Sato, K Ikeda, T Inaba, Y Akiyama, K Ishida, K Saito, T Masuda

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY ( LIPPINCOTT WILLIAMS & WILKINS )  14 ( 4 ) 445 - 448  2002.04  [Refereed]

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Oesophageal gastrointestinal stromal tumours (GISTs) are rare in comparison to those of the stomach and intestines. Recently, it has been clarified that mutations of the c-kit gene resulting in gain of function might be associated with histogenesis of this type of tumour arising in the stomach and intestines. We describe an oesophageal GIST on immunohistochemical and genetic analyses of the gene. A 71-year-old man had an intramural tumour of the middle third of the oesophagus. Tumour cells were composed predominantly of spindle-shaped and partially epithelioid cells. They were diffusely positive for CD117. Six base deletion resulting in in-frame mutation of the c-kit gene was confirmed at codon 556-558 (cag tgg aag to cag) of exon 11. Patients with mutations of the c-kit gene revealed worse prognoses in GISTs arising from other locations. A long-term follow-up observation is needed for the case. (C) 2002 Lippincott Williams Wilkins.

DOI PubMed

Influence of a human protease inhibitor on surgical stress induced immunosuppression.

Nobuhiro Sato, Shigeatsu Endo, Yusuke Kimura, Kenichirou Ikeda, Kiichi Aoki, Takeshi Iwaya, Yuji Akiyama, Yoshinori Noda, Kazuyoshi Saito

Digestive surgery   19 ( 4 ) 300 - 5  2002  [Refereed]  [International journal]

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BACKGROUND/AIM: Postoperative tissue injury and immunosuppression can occur after major surgery. In this study, we explore the potential benefits of administering a protease inhibitor to treat immunosuppression caused by surgical stress. METHODS: Sixteen patients with esophageal cancer were preoperatively allocated at random into two equal groups. A urinary trypsin inhibitor, ulinastatin (UTI), was intravenously administered to the treatment (UTI) group at a dose of 150,000 U every 12 h from the start of surgery until postoperative day 5, whereas the control group received a placebo. One unit of UTI was defined as the amount of UTI necessary to inhibit the activity of 2 microg of bovine pancreatic trypsin by 50%. We measured the plasma levels of polymorphonuclear neutrophil elastase, interleukin 8, circulating T lymphocyte subsets, and mitogenic activity and in vitro production of tumor necrosis factor alpha in lipopolysaccharide-stimulated whole blood. RESULTS: The postoperative serum value of polymorphonuclear neutrophil elastase was significantly lower in the UTI group, but the interleukin 8 concentrations did not significantly vary between the two groups. On the other hand, the severity of the postoperative immunosuppression was reduced in the UTI group, and immune functions, such as the numbers of T lymphocytes, the mitogenic activity of lymphocytes, and the level of tumor necrosis factor alpha production in whole blood, recovered significantly earlier in the UTI group. CONCLUSION: These data suggest that a protease-modulating therapy may be a new strategy for the treatment of surgical stress induced immune dysfunction.

DOI PubMed

Chemoradiotherapy followed by surgery for thoracic esophageal cancer potentially or actually involving adjacent organs

M Ogawa, K Ikeda, K Ishida, N Sato, K Koeda, K Aoki, Y Kimura, T Iwaya, S Ogasawara, S Iijima, Y Akiyama, R Nakamura, N Uesugi, C Maesawa, K Saito

RECENT ADVANCES IN DISEASES OF THE ESOPHAGUS ( MEDIMOND S R L )    727 - 730  2001  [Refereed]

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The usefulness of chemoradiotherapy (CRT) followed by surgery was evaluated in patients with clinically T4 esophageal squamous cell carcinoma. Thirty-seven patients received two courses of CRT which comprised cisplatin (70 mg/m(2)) on day 1, 5-fluorouracil (700 mg/m(2)) on days I to 4 and external irradiation (200 cGy/day, total 30 Gy). The response to CRT was complete response in 9 patients, partial response in 19. The median response duration in all responders was 172 days (56-2469). After CRT, 12 out of 13 operated patients could be completely resected. The median duration of survival were 304 days (84-3155) in all patients, 866 days (190-3155) in 13 resected patients and 187 days (84-2630) in 24 non-resected patients. Grade 3 hematological toxicity was noted in 13.5% and there was 1 toxicity-related death (sepsis).

Effects of perioperative great amount of glutamine supplementation by enteral route on amino acids metabolism in esophageal cancer surgery

K Ikeda, H Nitta, K Aoki, N Sato, K Ohtsuka, S Ogasawara, M Ogawa, S Iijima, Y Akiyama, K Ishida, K Saito

RECENT ADVANCES IN DISEASES OF THE ESOPHAGUS ( MEDIMOND S R L )    715 - 718  2001  [Refereed]

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To clarify the effects of perioperative glutamine (Gln) supplementation, 24 esophageal cancer patients were prospectively randomized to the both pre- and postoperative Gln-supplemented (Pre-Post) group (n=9), the only postoperative Gln-supplemented (Post) group (n=7) and the control (C) group (n=8). Preoperative Gln supplements induced a significant rise in plasma Gln (p<0.05). In all groups, the postoperative arterial Gln, Ala and BCAA levels significantly decreased (p<0.05) and no intergroup differences were observed. Gln and Ala release from skeletal muscle reduced in the Pre-Post or the Post group. Postoperative pneumonia in 4 patients (1 in the C, 2 in the Post, 1 in the Pre-Post), hyperbilirubinemia in 7 (4, 2, 1) and minor leakage in 3 (3, 0, 0, p<0.05) were observed.