論文 - 中目 和彦
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Nakame K., Kaji T., Onishi S., Murakami M., Nagano A., Matsui M., Nagai T., Yano K., Harumatsu T., Yamada K., Yamada W., Masuya R., Muto M., Ieiri S.
Journal of Vascular Access 11297298211008084 - 11297298211008084 2021年
担当区分：筆頭著者 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 Vascular Access
Purpose: Tunneled central venous catheter (tCVC) placement plays an important role in the management of pediatric patients. We adopted a real-time ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation. We evaluated the outcomes of tCVC placement via a US-guided supraclavicular approach. Methods: A retrospective study was performed for patients who underwent US-guided central venous catheterization of the internal jugular vein (IJV group) and brachiocephalic vein (BCV group) in our institution. The background information and outcomes were reviewed using medical records. Results: We evaluated 85 tCVC placements (IJV group: n = 59, BCV group: n = 26). Postoperative complications were recognized in 19 patients in the IJV group (catheter-related bloodstream infection (CRBSI), n = 14 (1.53 per 1000 catheter days); occlusion, n = 1 (1.7%, 1.09 per 1000 catheter days); accidental removal, n = 3 (5.2%, 0.33 per 1000 catheter days); and other, n = 1 (1.7%, 1.09 per 1000 catheter days)) and five patients in the BCV group (CRBSI, n = 2 (0.33 per 1000 catheter days); catheter damage, n = 1 (3.8%, 1.67 per 1000 catheter days); and accidental removal, n = 2 (7.7%, 0.33 per 1000 catheter days)). In the BCV group, despite that, the incidence of postoperative complications was lower (p = 0.205) and the period of placement was significantly longer in comparison to the IJV group (p = 0.024). Conclusion: US-guided placement of tunneled CVC though the BCV results in a low rate of postoperative complications despite longer CVC indwelling times compared to IJV insertion. Our results suggest that BCV insertion of tunneled CVC in children may offer advantages in terms of device performance and patient safety.
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Iwamoto Y., Onishi S., Sugita K., Nakame K., Kaji T., Yano K., Ogata M., Takada L., Kedoin C., Nagano A., Murakami M., Harumatsu T., Yamada K., Yamada W., Masuya R., Kawano T., Muto M., Ieiri S.
Pediatric Surgery International 40 ( 1 ) 207 2024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：Pediatric Surgery International
Purpose: Ultrasound-guided supraclavicular catheterization (UGSC) of the brachiocephalic vein (BCV) for long-term tunneled central venous catheter (tCVC) insertion may be safer than the internal jugular vein approach due to its superior field of view. We examined the clinical outcomes of tCVC insertions performed by junior residents through UGSC of the BCV. Patients and methods: From January 2018 to December 2023, we assessed clinical outcomes and compared the experience levels of surgeons conducting tCVC insertions. Surgeons were categorized into three groups: junior residency (JR), senior residency (SR), and board-certified pediatric surgeons (BCPS). Results: 177 tCVC insertions were done on 146 patients. Intraoperative complications included 6 cases of arterial puncture, 1 case of pneumothorax, 1 case of over insertion of catheter tip, and 1 case of suspected hemothorax. Distribution across groups was as follows: 28 cases (15.8%) in JR group, 92 (52.0%) in SR group, and 57 (32.2%) in BCPS group. Although the JR group exhibited longer operation times than the BCPS group, no significant differences in intraoperative complications were noted. Conclusion: Junior residents can safely perform UGSC for tCVC insertion. However, careful consideration of complications such as arterial or thoracic puncture is essential and case selection should be based on experience.
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Masuya R., Muraji T., Harumatsu T., Machigashira S., Iwamoto Y., Ogata M., Takada L., Nishida N., Kedoin C., Nagano A., Matsui M., Murakami M., Sugita K., Yano K., Onishi S., Yamada K., Yamada W., Matsukubo M., Kawano T., Muto M., Nakame K., Kaji T., Nanashima A., Ieiri S.
Surgery Today 54 ( 5 ) 452 - 458 2024年5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 Today
Purpose: We compared the clinical features of patients with biliary atresia (BA) associated with a bleeding tendency (BT) at the time of the diagnosis with those of patients without a bleeding tendency (NBT). Methods: The patients’ background characteristics, age in days at the first visit, Kasai portoenterostomy (KPE), and postoperative course were retrospectively analyzed. Results: Nine of the 93 BA patients (9.7%) showed a BT, including 7 with intracranial hemorrhaging (ICH), 1 with gastrointestinal bleeding, and 1 with a prothrombin time (PT) of 0%. The age at the first visit was 62 ± 12 days old for BT patients and 53 ± 27 days old for NBT patients (p = 0.4); the age at KPE was 77 ± 9 days old for BT patients and 65 ± 24 days old for NBT patients (p = 0.2); the time from the first visit to surgery was 13 ± 7 days for BT patients and 11 ± 10 days for NBT patients (p = 0.5); and the native liver survival rate was 56% for BT patients and 58% for NBT patients (p = 1), with no significant difference in any of the parameters. The neurological outcomes of survivors of ICH were favorable. Conclusions: Appropriate BT correction allowed early KPE even after ICH, resulting in native liver survival rates comparable to those of NBT patients without significant neurological complications.
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特集 小児領域におけるGLP-2アナログ製剤(テデュグルチド)の応用 総論 GLP-2の基礎研究
矢野 圭輔, 杉田 光士郎, 武藤 充, 大西 峻, 岩元 祐実子, 緒方 将人, 高田 倫, 祁答院 千寛, 村上 雅一, 松久保 眞, 川野 孝文, 中目 和彦, 加治 建, 家入 里志
小児外科 56 ( 4 ) 320 - 325 2024年4月
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小児血液・悪性固形腫瘍患者に対する鎖骨上アプローチを用いた腕頭静脈穿刺による中心静脈カテーテル挿入術の検討 査読あり
中目 和彦, 桝屋 隆太, 永澤 俊, 中川 緑, 山田 愛, 木下 真理子, 上村 幸代, 盛武 浩, 家入 里志, 七島 篤志
日本小児外科学会雑誌 60 ( 2 ) 158 - 165 2024年4月
担当区分：筆頭著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：特定非営利活動法人 日本小児外科学会
【目的】中心静脈カテーテル（CVC）は小児血液・悪性固形腫瘍患者の治療において使用される．近年，安全なCVC挿入法としてin-plane法を用いた超音波（US）ガイド下鎖骨上アプローチによる腕頭静脈穿刺CVC挿入術が報告されている．【方法】小児血液・悪性固形腫瘍患者を対象にout-of-plane法を用いて内頸静脈にトンネル型CVCを挿入した群（IJV群）とin-plane法を用いて腕頭静脈に挿入した群（BCV群）について患者背景，手術成績，合併症を後方視的に比較検討した．【結果】34名の患者に対し，計40回（IJV群：n＝15，BCV群：n＝25）のトンネル型CVCが挿入された．患者背景，術前血液凝固検査値は両群間に有意差はなかった．手術時間中央値（IQR）はIJV群：30分（27～33），BCV群：25.8分（22～27）であり，BCV群で有意に手術時間が短縮された（p＝0.0026）．術中合併症はIJV群で1例（6.7％）認め，BCV群では認めなかった．CVC維持管理中の合併症はIJV群：10例（66.7％），BCV群：17例（68％）であり，両群間で有意差は認めなかった．カテーテル関連血流感染はIJV群：10例（66.7％），BCV群：12例（52％）に認め，有意差はみられなかった．CVC留置期間中央値（IQR）はIJV群：273日（172～363.5），BCV群：152日（101～280）であり有意差を認めなかった．【結論】リアルタイム超音波ガイド下鎖骨上アプローチによる腕頭静脈穿刺術は小児血液・悪性固形患者に対しても安全な手技と考えられた．
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Kedoin C., Muto M., Nagano A., Matsui M., Sugita K., Baba T., Miyoshi K., Masuya R., Murakami M., Yano K., Onishi S., Harumatsu T., Yamada W., Yamada K., Matsukubo M., Kawano T., Kuda M., Nakame K., Torikai M., Ieiri S.
Journal of Pediatric Surgery 59 ( 4 ) 566 - 570 2024年4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：Journal of Pediatric Surgery
Background: Most cases of intestinal malrotation appear in neonates with bilious vomiting due to midgut volvulus, whereas in cases that develop beyond infancy, the initial symptoms vary. This study investigated the clinical features of these two populations and identified issues that should be considered in daily practice. Methods: A retrospective chart review was conducted from January 1, 2010, to December 31, 2022. Data on patients with intestinal malrotation were collected in an anonymized fashion from five pediatric surgical hub facilities in the Southern Kyushu and Okinawa areas of Japan. Results: Of the 80 subjects, 57 (71.3%) were neonates (Group N) and 23 (28.7%) were infants and schoolchildren (Group I). The frequencies of initial symptoms, such as abdominal distention (Group N: 19.3% vs. Group I: 13.0%), bilious vomiting (59.6% vs. 43.5%), and hematochezia (8.8% vs. 21.7%), were not skewed by the age of onset (p = 0.535, 0.087, and 0.141, respectively). Midgut volvulus was significantly more frequent in Group N (71.9% [41/57] vs. 34.8% [8/23]; p = 0.005), while the degree of torsion was greater in group I (median 360° [interquartile range: 180–360°] vs. 450° [360–540°]; p = 0.029). Although the bowel resection rate was equivalent (7.0% [4/57] vs. 4.3% [1/23]; p = 1.000), half of the patients in Group N presented with 180° torsion. The neonatal intestine has been highlighted as being more susceptible to ischemia than that in older children. Conclusions: The incidence of midgut volvulus is higher in neonates than in older children. Even relatively mild torsion can cause ischemic bowel changes during the neonatal period. Level of Evidence: LEVEL III.
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特集 胆道閉鎖症の研究update 患児末梢血中の母親由来キメラ細胞の検出とその臨床的意義
桝屋 隆太, 連 利博, Sami B.Kanaan, 春松 敏夫, 武藤 充, 東間 未来, 矢内 俊裕, Anne M Stevens, J Lee Nelson, 中目 和彦, 七島 篤志, 家入 里志
小児外科 56 ( 2 ) 117 - 121 2024年2月
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Masuya R., Nakame K., Kai K., Tsuchimochi Y., Hamada T., Imamura N., Hiyoshi M., Nanashima A., Ieiri S.
Asian Journal of Endoscopic Surgery 17 ( 1 ) e13264 2024年1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：Asian Journal of Endoscopic Surgery
A 15-year-old girl with recurrent upper abdominal pain was diagnosed with congenital biliary dilatation. Abdominal enhanced computed tomography (CT) showed the anterior segmental branch of the right hepatic artery (RHA) running across the ventral aspect of the dilated common hepatic duct (CHD). Laparoscopic extrahepatic dilated biliary duct excision and Roux-en-Y hepaticojejunostomy were planned. Intraoperatively, the dilated CHD was observed to bifurcate into the ventral and dorsal ducts, between which the anterior segmental branch of the RHA crossed through the CHD. The CHD rejoined on the distal side as one duct. We transected the CHD just above the cystic duct. The patency of the ventral and dorsal sides of the bifurcated CHD was confirmed. Laparoscopic hepaticojejunostomy was performed at the distal side of the rejoined CHD, without sacrificing the anterior segmental branch of the RHA. There was no postoperative blood flow impairment in the right hepatic lobe or anastomotic stenosis.
DOI： 10.1111/ases.13264
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Muto M., Sugita K., Murakami M., Ikoma S., Kawano M., Masuya R., Matsukubo M., Kawano T., Machigashira S., Nakame K., Torikai M., Ikee T., Noguchi H., Ibara S., Ieiri S.
Pediatric Surgery International 39 ( 1 ) 125 2023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：Pediatric Surgery International
Purpose: Management of persistently patent ductus arteriosus (PDA) in extremely low-birth-weight infants (ELBWIs) requires attention due to the risk of tissue hypoperfusion. We investigated the association between PDA and gastrointestinal perforation. Methods: We performed a retrospective chart review from 2012 to 2021. Preterm (≤ 32 weeks) ELBWIs with PDA after birth who developed necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and idiopathic gastric perforation were included; ELBWIs with congenital heart disease were excluded. Data were analyzed using chi-squared tests with Yates; correction, and Student’s t test. Results: Five hundred thirty-five preterm ELBWIs were analyzed, including 20 with NEC, 22 with FIP, and 1 with gastric perforation. In NEC and FIP, the ductus arteriosus remained open in 40% (4/10) and 63.6% (14/22) of cases, respectively, and cyclo-oxygenase inhibitor treatment showed poor efficacy (p = 0.492 and 0.240). The incidence of perforation in NEC (4/9 vs. 6/11, p = 0.653), mortality in NEC (3/4 vs. 3/6, p = 0.895) and FIP (6/14 vs. 3/8, p = 0.838) did not differ according to whether the PDA persisted or resolved. Conclusion: The presentation of PDA did not affect the mortality or morbidity of ELBWIs. However, it is essential to consider the possibility of gastrointestinal perforation due to decreased organ blood flow caused by ductal steal.
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特集 検査･処置･手術の合併症:予防と対策 手術･治療 胆道拡張症
杉田 光士郎, 岩元 祐実子, 緒方 将人, 高田 倫, 村上 雅一, 春松 敏夫, 大西 峻, 桝屋 隆太, 川野 孝文, 武藤 充, 中目 和彦, 家入 里志
小児外科 55 ( 11 ) 1228 - 1233 2023年11月
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Proctoring System of Pediatric Laparoscopic Surgery for Choledochal Cyst 査読あり
Murakami M., Yamada K., Onishi S., Harumatsu T., Baba T., Kuda M., Miyoshi K., Koga Y., Masuya R., Kawano T., Muto M., Hayashida M., Nakame K., Shinyama S., Kuwabara J., Tatsuta K., Yanagi Y., Hirose R., Shono T., Migita M., Kaji T., Takatsuki M., Nanashima A., Matsufuji H., Ieiri S.
Journal of Laparoendoscopic and Advanced Surgical Techniques 33 ( 11 ) 1109 - 1113 2023年11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：Journal of Laparoendoscopic and Advanced Surgical Techniques
Background: Endoscopic surgery also has been becoming widespread in the field of pediatric surgery. However, most disease treated by pediatric surgery in a single institution are small number of cases. Besides, the variety of operative procedures that need to be performed in this field is quite wide. For these reasons, pediatric surgeons have limited opportunities to perform endoscopic surgery. Therefore, it is difficult to introduce advanced endoscopic surgery at a single local hospital. To educate pediatric surgeons in local hospitals, for widespread advanced pediatric endoscopic surgery safely, and to eliminate the need for patient centralization, we have introduced a proctoring system. We compared the surgical results of our institution, a center hospital, with other local institutions, to investigate the feasibility of our proctoring system. Methods: The experienced pediatric surgeon of our institution visits local hospitals to provide onsite coaching and supervises pediatric surgeons on the learning curve. All patients who underwent laparoscopic cyst excision and hepaticojejunostomy for choledochal cysts, one of the advanced pediatric endoscopic surgeries was retrospectively reviewed. Results: Thirty-four cases were evaluated (14 cases in our institution, 20 cases in 9 other institutions). The procedures of all 34 cases were performed by surgeons with 0–2 cases of experience in the procedure. There were no open conversion cases. There was no significant difference in the operative date. There was 1 case (6.7%) of postoperative complications during hospitalization at our institution and 3 cases (14.3%) at other institutions (P = .47). Two cases of late complications (13.3%) occurred at our institution, whereas 6 cases (28.6%) occurred at other institutions (P = .28). Conclusion: With the proctoring system, the performance and completion of advanced pediatric endoscopic surgery at local institutions was feasible. This has important implications given the ever-growing demand for pediatric endoscopic surgery and the increasing need for competent pediatric endoscopic surgeons.
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特集 ロボット支援手術 胆囊･脾臓摘出術 国際共著
中目 和彦, Laurent Fourcade, Alexis Arnaud, 桝屋 隆太, 七島 篤志, 家入 里志
小児外科 55 ( 5 ) 539 - 543 2023年5月
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Muto M., Murakami M., Masuya R., Fukuhara M., Shibui Y., Nishida N., Kedoin C., Nagano A., Sugita K., Yano K., Onishi S., Harumatsu T., Yamada K., Yamada W., Kawano T., Matsukubo M., Izaki T., Nakame K., Kaj T., Hirose R., Nanashima A., Ieiri S.
Journal of Laparoendoscopic and Advanced Surgical Techniques 33 ( 5 ) 518 - 521 2023年5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：Journal of Laparoendoscopic and Advanced Surgical Techniques
Purpose: Severely neurologically impaired patients sometimes require anti-reflux surgery with preceding gastrostomy. We apply a traction technique for laparoscopic fundoplication (LF) without gastrostomy takedown (GTD) in such cases. We conducted a multicenter review to assess the feasibility of our approach. Materials and Methods: In brief, the traction technique involves left-lateral-traction of the stomach body, right-lateral-traction of the round ligament of the liver, and elevation of the left liver lobe to create a sufficient field for manipulating the forceps. Patients who underwent LF with Nissen's procedures in 2010-2022 were retrospectively reviewed. Data were analyzed by a one-way analysis of variance. Results: The operative approaches included the traction technique (n = 16; Group 1), GTD and reconstruction (n = 5; Group 2), and LF followed by gastrostomy (n = 92; Group 3). In comparison with Group 1, significant differences were only found in pneumoperitoneum time (Group 1 versus Group 2 versus Group 3: 174.4 minutes versus 250.4 minutes versus 179.5 minutes; P = .0179). Operating time (222.7 minutes versus 303.0 minutes versus 239.7 minutes; P = .0743), duration to full-strength enteral nutrition (10.4 days versus 17.2 days versus 11.0 days; P = .0806), and length of hospital stay (17.2 days versus 31.0 days versus 18.5 days; P = .3247) were equivalent. No re-fundoplication was required in Group 1. Conclusion: The traction technique secures the operative quality and outcome of LF without GTD.
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A case of a galactocele that presented as a mammary mass in a boy 査読あり
Masuya R., Tominaga Y., Nakame K., Nanashima A., Ieiri S.
Pediatrics International 65 ( 1 ) e15705 2023年1月
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ウレアプラズマ肺炎を契機に顕在化した超早産児肺リンパ管拡張症の一例
榊原 康平, 山田 直史, 児玉 由紀, 小畑 静, 都築 康恵, 村岡 純輔, 青木 良則, 山下 理絵, 中目 和彦, 金子 政時, 桂木 真司, 都築 諒, 佐藤 勇一郎
日本周産期・新生児医学会雑誌 59 ( 1 ) 116 - 121 2023年
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本周産期・新生児医学会
肺リンパ管拡張症（Pulmonary lymphangiectasia；PL）は肺リンパ管拡張を特徴とし，肺胞拡張障害をきたして重篤な呼吸不全を起こす疾患である．今回，ウレアプラズマ肺炎を契機に呼吸状態が増悪し，剖検でPLと診断された症例を報告する． 症例は超低出生体重児（在胎23週2日，610g，男児）．母体は，妊娠23週1日に胎胞形成，23週2日に経腟分娩となった．児はサーファクタント投与後，安定化した状態で人工呼吸管理を行っていた．日齢15にCRP上昇と肺野の透過性低下が認められた．各種抗菌薬治療では改善なく，日齢30の気管内分泌物ウレアプラズマ培養陽性により，アジスロマイシン水和物を開始した．CRPは著減したが，呼吸不全は悪化して日齢44に死亡した．病理解剖では，肺リンパ管がびまん性に拡張したPLと診断した．臨床的にはウレアプラズマ肺炎を契機に顕在化したPLと考えられた．
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Physical growth and social prognosis of esophageal atresia after 15 years of age 査読あり
Masuya R., Muto M., Sugita K., Murakami M., Yano K., Harumatsu T., Onishi S., Yamada K., Yamada W., Matsukubo M., Kawano T., Machigashira S., Nakame K., Torikai M., Mukai M., Kaji T., Ieiri S.
Annals of Pediatric Surgery 18 ( 1 ) 2022年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Annals of Pediatric Surgery
Background: The mortality rate of esophageal atresia (EA) has significantly improved, but late complications remain problematic. We evaluated the physical growth, late complications, and social prognosis of postoperative patients with EA who have reached 15 years of age. Methods: EA patients who were treated at our institution from 1984 to 2003 were enrolled. The follow-up, physical growth at the last visit, late complications and treatment, academic status, and employment situation were evaluated. Results: Twenty-nine EA patients were registered, and the 23 surviving patients (79.3%) were followed. Anthropometry at the latest visit tended to be below the standard values. Fundoplication was performed in 6 (26.1%) of 9 (39.1%) patients with gastroesophageal reflux. Anastomotic stenosis was found in 12 patients (52.2%), and 2 (8.7%) were treated with re-anastomosis. Thirteen patients were attending a regular school, and one was attending a school for disabled children. Four had jobs from 18 years of age. Follow-up was aborted during early childhood in nine patients. Conclusions: The physical size of EA was smaller than in the healthy population of the same age. Late complications had not affected the physical growth but were sometimes recognized in adolescence. The social prognosis of the patients was largely favorable.
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特集 小児外科を取り巻く最新テクノロジー 蛍光ナビゲーション画像誘導
大西 峻, 桝屋 隆太, 西田 ななこ, 長野 綾香, 村上 雅一, 矢野 圭輔, 杉田 光士郎, 春松 敏夫, 山田 耕嗣, 山田 和歌, 川野 孝文, 武藤 充, 中目 和彦, 家入 里志
小児外科 54 ( 10 ) 982 - 988 2022年10月
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Circulating maternal chimeric cells have an impact on the outcome of biliary atresia 査読あり
Masuya R., Muraji T., Kanaan S.B., Harumatsu T., Muto M., Toma M., Yanai T., Stevens A.M., Nelson J.L., Nakame K., Nanashima A., Ieiri S.
Frontiers in Pediatrics 10 1007927 2022年9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：Frontiers in Pediatrics
Introduction: We aimed to quantify the DNA of maternal chimeric (MC) cells in the peripheral blood of the BA patients and investigated the impact on the outcome. Methods: Patients with progressive jaundice because of no bile flow, which necessitated liver transplantation, or who showed inadequate bile flow with or without episodes of cholangitis and progressive hepatic fibrosis and portal hypertension were classified into the poor group. Those with adequate bile flow with completely normal liver function tests beyond 2 years were classified into the good group. The qPCR were separately carried out in buffy coat samples and plasma samples, targeting the non-inherited maternal HLA alleles in the DNA samples. Results: MC-DNA was present in the buffy coat (10–328 gEq per 106 host cells) in seven patients. There was no MC-DNA in the remaining five patients. MC-DNA (214–15,331 gEq per 106 host cells) was observed in the plasma of five patients. The quantity of MC-DNA in the buffy coat showed a significant difference between the two prognostic groups (p = 0.018), whereas there was no significant difference in the quantity of MC-DNA in plasma (p = 0.205). MC-DNA in the buffy coat was significantly associated with the outcome (p = 0.028), whereas MC-DNA in the plasma did not influence the outcome (p = 0.56). Conclusions: Poor outcomes in BA were correlated with circulating maternal chimeric lymphocytes.
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Laparoscopic dome resection for pediatric nonparasitic huge splenic cyst safely performed using indocyanine green fluorescence and percutaneous needle grasper. 査読あり
Masuya R, Nakame K, Tahira K, Kai K, Hamada T, Yano K, Imamura N, Hiyoshi M, Nanashima A, Ieiri S
Asian journal of endoscopic surgery 15 ( 3 ) 693 - 696 2022年7月
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The evaluation of eye gaze using an eye tracking system in simulation training of real-time ultrasound-guided venipuncture. 査読あり 国際誌
Tatsuru K, Keisuke Y, Shun O, Mayu M, Ayaka N, Masakazu M, Koshiro S, Toshio H, Koji Y, Waka Y, Makoto M, Mitsuru M, Kazuhiko N, Satoshi I
The journal of vascular access 23 ( 3 ) 360 - 364 2022年5月
記述言語：英語 掲載種別：研究論文（学術雑誌）
PURPOSE: Real-time ultrasound (RTUS)-guided central venipuncture using the short-axis approach is complicated and likely to result in losing sight of the needle tip. Therefore, we focused on the eye gaze in our evaluation of the differences in eye gaze between medical students and experienced participants using an eye tracking system. METHODS: Ten medical students (MS group), five residents (R group) and six pediatric surgeon fellows (F group) performed short-axis RTUS-guided venipuncture simulation using a modified vessel training system. The eye gaze was captured by the tracking system (Tobii Eye Tacker 4C) and recorded. The evaluation endpoints were the task completion time, total time and number of occurrences of the eye tracking marker outside US monitor and success rate of venipuncture. RESULT: There were no significant differences in the task completion time and total time of the tracking marker outside the US monitor. The number of occurrences of the eye tracking marker outside US monitor in the MS group was significantly higher than in the F group (MS group: 9.5 ± 3.4, R group: 6.0 ± 2.9, F group: 5.2 ± 1.6; p = 0.04). The success rate of venipuncture in the R group tended to be better than in the F group. CONCLUSION: More experienced operators let their eye fall outside the US monitor fewer times than less experienced ones. The eye gaze was associated with the success rate of RTUS-guided venipuncture. Repeated training while considering the eye gaze seems to be pivotal for mastering RTUS-guided venipuncture.