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医学部 附属病院 肝胆膵外科 |
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A Preliminary Pathological Evaluation of Extracellular Volume Fraction with Contrast-enhanced Computed Tomography as a Novel Quantitative Parameter of Pancreatic Fibrosis. 査読あり
Kai K, Hiyoshi M, Imamura N, Hamada T, Yano K, Sato Y, Sakae T, Komi M, Nakamura T, Choijookhuu N, Hishikawa Y, Nanashima A
Internal Medicine (Tokyo, Japan) 62 ( 8 ) 1107 - 1115 2023年4月
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An alternative option of the retroperitoneal laparoscopic approach for limited hepatectomy for recurrent hepatocellular carcinoma at the transected edge after previous hepatectomy. 査読あり
Hamada T, Yano K, Kitamura E, Hiyoshi M, Imamura N, Kai K, Tahira K, Kawano F, Ohta Y, Nanashima A
Asian Journal of Endoscopic Surgery 2023年3月
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Retroperitoneal-first dissection approach at the dorsal space for a huge serous cystic neoplasm of the pancreatic tail: a case report.
Nanashima A, Takamori H, Imamura N, Tahira K, Kitamura E, Hiyoshi M, Hamada T, Tsuchimochi Y, Komori H, Kamoto T
Surgical case reports 9 ( 1 ) 2 2023年1月
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Kai K., Hamada T., Sato Y., Hiyoshi M., Imamura N., Yano K., Ikeda T., Ichihara A., Ogata S., Choijookhuu N., Hishikawa Y., Hosokawa A., Nanashima A.
Journal of Oncology 2023 1440257 2023年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Oncology
Background. Oxaliplatin (OX)-based chemotherapy induces sinusoidal obstruction syndrome (SOS) in the nontumorous liver parenchyma, which can increase the risk of liver resection due to colorectal liver metastasis (CRLM). The extracellular volume (ECV) calculated from contrast-enhanced computed tomography (CT) has been reported to reflect the morphological change of hepatic fibrosis. The present retrospective study aimed to evaluate the ECV fraction as a predictive factor for OX-induced SOS. Methods. Our study included 26 patients who underwent liver resection for CRLM after OX-based chemotherapy with a preoperative dynamic CT of appropriate quality. We investigated the relationship between the pathological SOS grade and the ECV fraction. Results. Overall, 26 specimens from the patients were graded with the SOS classification of Rubbia-Brandt et al. as follows: grade 0, n = 17 (65.4%); grade 1, n = 4 (15.4%); and grade 2, n = 5 (19.2%). No specimens showed grade 3 SOS. In a univariate analysis, the ECV fraction in grade 0 SOS was significantly lower than that in grade 1 + 2 SOS (26.3 ± 3.4% vs. 30.6 ± 7.0%; P = 0.025). The cutoff value and AUC value of the ECV fraction to distinguish between grades 0 and 1 + 2 were 27.5% and 0.771, respectively. Conclusions. Measurement of the ECV fraction was found to be a potential noninvasive diagnostic method for determining early-stage histopathological sinusoidal injury induced by OX-based chemotherapy.
DOI： 10.1155/2023/1440257
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Ono S., Adachi T., Ohtsuka T., Kimura R., Nishihara K., Watanabe Y., Nagano H., Tokumitsu Y., Nanashima A., Imamura N., Baba H., Chikamoto A., Inomata M., Hirashita T., Furukawa M., Idichi T., Shinchi H., Maruyama Y., Nakamura M., Eguchi S.
Surgery 172 ( 6 ) 1782 - 1790 2022年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Surgery (United States)
Background: Patients diagnosed with resectable pancreatic ductal adenocarcinoma often experience early recurrence even after upfront R0 resection. This study aimed to define early recurrence and identify preoperative risk factors for early recurrence after upfront pancreaticoduodenectomy in patients with resectable pancreatic ductal adenocarcinoma of the pancreatic head. Methods: This multicenter, retrospective study involved 500 patients who underwent pancreaticoduodenectomy resectable pancreatic ductal adenocarcinoma of the pancreatic head at 10 institutions between 2007 and 2016. Preoperative, intraoperative, and postoperative clinicopathological results were compared between early and non-early recurrence groups. Predictors of early recurrence were determined using statistical analyses. Results: Log-rank tests revealed a significant difference (P < .001) between recurrence within 3 to 6 months and 6 to 9 months. Early recurrence was subsequently defined as recurrence within 6 months. Patients were categorized into early recurrence (n = 104) and non-early recurrence groups (n = 389). The median overall survival of the early and non-early recurrence groups was 8.6 months and 42.6 months (P < .001), respectively. Preoperatively, high carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion, and diabetes mellitus were identified as independent predictive risk factors for early recurrence according to multivariate analysis. Comparing survival rates among patients with 3, 2, 1, or none of these factors, the median overall survival was 17.6 (n = 90), 21.2 (n = 184), 47 (n = 141), and 61.5 (n = 73) months, respectively. Conclusion: The optimal period that defines the early recurrence for resectable pancreatic ductal adenocarcinoma of the pancreatic head is 6 months. Tumor size ≥20 mm, preoperative carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion of the tumor, and the presence of diabetes mellitus are independently associated with early recurrence.
MISC 【 表示 ／ 非表示 】
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Rare resected eight cases of duodenal adenocarcinomas
Nanashima A., Tanoue Y., Imamura N., Hiyoshi M., Yano K., Hamada T., Nishida T., Kai K., Suzuki Y., Sato Y., Nakashima K., Hosokawa A., Nagayasu T.
International Journal of Surgery Case Reports 86 106384 2021年9月
記述言語：日本語 掲載種別：速報，短報，研究ノート等（学術雑誌） 出版者・発行元：International Journal of Surgery Case Reports
Introduction: Duodenal adenocarcinoma is a rare malignancy; recently, it has been found to be accompanied by operative indications. Methods: Nine consecutive rare cases were diagnosed with duodenal carcinoma (DC), in which clinicopathological characteristics were retrospectively examined. Age was ranged over middle-aged males and females. No clinical onset with severe symptoms was observed, and the specific treatment for accompanied diseases or habits was not found. Outcomes: One case of two T1 stage DCs that underwent pancreas-sparing duodenectomy. Stage II DC was diagnosed in three cases, and stage III DC was diagnosed in four cases. Pancreaticoduodenectomy (PD) mainly occurred in seven patients, and duodenectomy was limited in two patients. All operations were safely performed, and the postoperative course showed no severe morbidity. Histological findings showed R0 resection in eight cases and R1 at the retroperitoneal dissecting part in one case. Five patients with advanced-stage DC underwent adjuvant chemotherapy; however, four patients showed tumor recurrence within 12 months. With additional strong chemotherapy, eight patients survived up to 84 months, and one died of liver metastasis at 43 months after surgery. Three representative cases of mucosal invasion with widespread pancreas-sparing duodenectomy and advanced-stage DC cases undergoing duodenectomy or PD are shown. Conclusion: In the field of upper digestive tract surgery, duodenal adenocarcinoma and various applications of surgery or adjuvant chemotherapy for long-term survival are important.
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胆管内腔発育型腫瘍の概念と実態：表層進展型胆道系腫瘍． 招待あり 査読あり
濵田剛臣，矢野公一，今村直哉，旭吉雅秀，藤井義郎，七島篤志
肝胆膵 75 ( 6 ) 1151 - 1158 2017年12月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
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十二指腸乳頭部癌−現状の問題点と今後の展望−：経十二指腸的乳頭部切除の手技と適応． 招待あり 査読あり
今村直哉，七島篤志，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎，武野慎祐，池田拓人，河野文彰，久保田良政，坂 哲臣，河上 洋
胆と膵 38 ( 7 ) 691 - 696 2017年7月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
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胆膵内視鏡自由自在〜基本手技を学び応用力をつける集中講座〜：ERCP関連手技編 乳頭処置 Bridge to Surgery 悪性肝門部領域胆管閉塞． 招待あり 査読あり
河上 洋，久保田良政，今村直哉，旭吉雅秀，藤井義郎，七島篤志
胆と膵 37 ( (臨増特大) ) 1279 - 1285 2016年11月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
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新たに定義された“肝門部領域胆管癌”の診断と治療: 術前胆道ドレナージ-経皮経肝胆道ドレナージ-. (共著)
藤井義郎，濱田朗子，西田卓弘，土持有貴，濱田剛臣，矢野公一，今村直哉，土屋和代，河野文彰，旭吉雅秀，大内田次郎，池田拓人，七島篤志
胆と膵 37 ( 1 ) 71 - 74 2016年1月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌） 出版者・発行元：医学図書出版(株)
講演・口頭発表等 【 表示 ／ 非表示 】
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転移性肝腫瘍に対する腹腔鏡下肝切除術の周術期成績の検討.
濵田剛臣，矢野公一，土持有貴，今村直哉，旭吉雅秀，七島篤志
第30回日本内視鏡外科学会総会 (京都) 日本内視鏡外科学会
開催年月日： 2017年12月7日 - 2017年12月9日
記述言語：日本語 会議種別：ポスター発表
開催地：京都
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臨床外科学会 国内外科研修報告報告.金属アレルギーを有する患者の内視鏡外科手術について．
今村直哉，七島篤志，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎
第9回膵臓内視鏡外科研究会 (京都) 膵臓内視鏡外科研究会
開催年月日： 2017年12月6日
記述言語：日本語 会議種別：口頭発表（一般）
開催地：京都
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新規約におけるBorderline resectable膵癌の治療成績の再検討.
今村直哉，七島篤志，池ノ上実，和田 敬，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎
第79回日本臨床外科学会総会 (東京) 日本臨床外科学会
開催年月日： 2017年11月23日 - 2017年11月25日
記述言語：日本語 会議種別：口頭発表（一般）
開催地：東京
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EUS-FNAが術前診断に有用であった嚢胞性変化を伴う膵腺房細胞癌の１切除例.
池ノ上実，清水一晃，緒方祥吾，和田 敬，濵田剛臣，矢野公一，今村直哉，旭吉雅秀，藤井義郎，田中弘之，秋山 裕，片岡寛章，七島篤志
第79回日本臨床外科学会総会 (東京) 日本臨床外科学会
開催年月日： 2017年11月23日 - 2017年11月25日
記述言語：日本語 会議種別：ポスター発表
開催地：東京
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シンポジウム1 外科と病理の協調 病理医は外科医からの疑問にどう応えるか：胆管内乳頭状腫瘍（IPNB）の胆道腫瘍における位置づけ.
七島篤志，今村直哉，佐藤勇一郎，角田順久，旭吉雅秀，藤井義郎
第22回日本外科病理学会学術集会 (栃木) 日本外科病理学会
開催年月日： 2017年11月10日 - 2017年11月11日
記述言語：日本語 会議種別：シンポジウム・ワークショップ パネル（公募）
開催地：栃木