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.
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Masuya R., Muto M., Nakame K., Murakami M., Sugita K., Yano K., Onishi S., Harumatsu T., Yamada K., Yamada W., Matsukubo M., Kaji T., Nanashima A., Ieiri S.
Journal of Laparoendoscopic and Advanced Surgical Techniques 32 ( 5 ) 571 - 575 2022年5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：Journal of Laparoendoscopic and Advanced Surgical Techniques
Background and Aim: The distribution of board-certified pediatric surgeons (BCPSs) in Japan is highly biased. While Prefecture M has one of the smallest numbers of BCPSs per pediatric population, neighboring Prefecture K has one of the largest numbers of BCPSs per pediatric population. We examined the effect of BCPSs population on laparoscopic surgery and postoperative management and outcomes. Materials and Methods: We compared postoperative duration to full-dose enteral nutrition, postoperative hospital stay, and complications of neurologically impaired patients who underwent laparoscopic fundoplication in two prefectures from 2006 to 2019. Results: Laparoscopic fundoplication was performed in 17 patients in Prefecture M and 63 in K. The mean operative time was 248.8 ± 79.9 minutes in Prefecture M and 260.8 ± 94.8 in K (P = .64). The median number of days to full-dose enteral nutrition was 11.5 in Prefecture M and 10 in K (P = .29). The median postoperative hospital stay was 14 days in Prefecture M and 15 days in K (P = .38). Postoperative complications occurred in 7 cases in Prefecture M and in 10 in K. The incidence was significantly higher in Prefecture M than in K (P = .041). Conclusion: Areas with insufficient numbers of BCPSs have a higher risk of complications in laparoscopic surgery than areas with sufficient numbers.
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Biliary atresia: graft-versus-host disease with maternal microchimerism as an etiopathogenesis 査読あり 国際誌
Masuya R., Muraji T., Harumatsu T., Muto M., Nakame K., Nanashima A., Ieiri S.
Transfusion and Apheresis Science 61 ( 2 ) 103410 - 103410 2022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：Transfusion and Apheresis Science
Biliary atresia (BA) is an inflammatory disease of the biliary system in newborns and infants. The etiology is largely unknown. Approximately half of BA patients require liver transplantation by 20 years of age, even after surgical correction due to progressive fibrosis of the liver. Regarding the disease mechanism, there is circumstantial evidence to support the hypothesis of graft-versus-host disease because of the existence of maternal cells in the liver (maternal microchimerism, MMC), histopathological similarity of the liver and an intense maternal response to the BA patient with mixed lymphocyte culture. Immune dysregulation with decreased Treg and increased Th1 and Th17 cells are the pathogenic features of BA, which are homologous to the pathogenic features of GvHD. Further elucidation of the etiopathogenetic mechanism of BA is warranted for development of new therapeutic strategies for native liver survival.
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Yamada A., Kinoshita M., Kamimura S., Nakame K., Moritake H.
Journal of Pediatric Hematology/Oncology 44 ( 2 ) E589 - E592 2022年3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 Hematology/Oncology
Neuroblastoma with bone metastasis is well known to have an extremely poor prognosis. We experienced the case of a patient with adrenal ganglioneuroblastoma (GNB) with metastases of subcutaneous nodules, a lymph node, and multiple bones. A pathologic examination of tumors from different sites revealed both GNB and ganglioneuroma. A genetic comparison between these tumors identified the same molecular signatures, suggesting the possibility of spontaneous differentiation in the remaining GNB. The patient has been healthy without aggressive chemotherapy, and the patient's pathologic urinary catecholamines normalized. Even if unusual, we have to recognize probable spontaneous differentiation from neuroblastoma to GNB and then to ganglioneuroma, even in sites of bone metastasis.
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Retroperitoneal teratomas in children: a single institution experience 査読あり
Kawano T., Sugita K., Kedoin C., Nagano A., Matsui M., Murakami M., Kawano M., Yano K., Onishi S., Harumatsu T., Yamada K., Yamada W., Masuya R., Matsukubo M., Muto M., Machigashira S., Nakame K., Mukai M., Kaji T., Ieiri S.
Surgery Today 52 ( 1 ) 144 - 150 2022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：Surgery Today
Purpose: Retroperitoneal teratomas (RPTs) are rare in infants. We report our experience of treating pediatric patients with RPTs over many years at a single institution, with the aim of developing a safe and secure operative strategy for RPTs in infants. Methods: We reviewed the medical records of patients who underwent treatment for RPTs in our institution between April, 1984 and December, 2017, to analyze their background and clinical data. The diagnosis of RPT was confirmed histologically in all patients. Results: The subjects of this retrospective analysis were 14 pediatric patients (female, n = 11; male, n = 4), ranging in age from 6 days to 12 years, 11 (73.3%) of whom were under 1 year of age. Complete surgical resection was performed in all patients. The tumor ruptured during surgery in four (26.7%) patients and perioperative vessel injuries occurred in six (40.0%) patients, resulting in nephrectomy in one (6.7%). Three (20.0%) patients suffered unilateral renal dysfunction as a surgical complication. Only one patient received postoperative chemotherapy. All patients were free of disease at the time of writing. Conclusion: Perioperative complications are not uncommon during surgery for RPTs, despite their benign nature. Preoperative imaging evaluation is important and operative management may be challenging. Because of the favorable prognosis and the frequency of adverse events in surgery, partial resection or split excision is sometimes unavoidable. Meticulous follow-up for recurrence is required for such patients.
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Onishi S., Kaji T., Nakame K., Yamada K., Murakami M., Sugita K., Yano K., Matsui M., Nagano A., Harumatsu T., Yamada W., Matsukubo M., Muto M., Ieiri S.
Surgery Today 52 ( 1 ) 92 - 97 2022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：Surgery Today
Purpose: Few studies have focused on the operative age for Hirschsprung’s disease (HD). We evaluated the optimal timing of surgery in HD patients based on their long-term bowel function. Methods: HD was diagnosed in 65 pediatric patients in our institute between 1992 and 2018. Twenty-five patients underwent the Soave–Denda procedure (SD) and 40 underwent transanal endorectal pull-through (TA). We divided these patients into two groups: those who underwent surgery at < 6 months of age (younger group) and those who underwent surgery at 6–12 months of age (older group). We assessed bowel function at 5, 7, and 9 years of age. Results: The bowel function of the patients who underwent the SD did not differ significantly between the groups. Similarly, the total bowel-function scores of the patients who underwent TA did not differ between the groups at any age. However, the soiling score at 7 years of age in the older group of patients who underwent TA was significantly lower than that in the younger group (p = 0.02). Conclusions: Our data suggest that to achieve optimal bowel function, TA should be performed at < 6 months of age.
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Masuya R., Matsukubo M., Nakame K., Kai K., Hamada T., Yano K., Imamura N., Hiyoshi M., Nanashima A., Ieiri S.
Surgery Today 1 - 4 2022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：Surgery Today
We describe a laparoscopic surgical technique using indocyanine green (ICG) fluorescence to identify and preserve rare arterial branching associated with pediatric congenital biliary dilatation. Congenital biliary dilatation with pancreaticobiliary maljunction was diagnosed in a 9-year-old girl, who presented with upper abdominal pain. Abdominal enhanced computed tomography (CT) showed that the accessory right hepatic artery (aRHA) branched from the posterior superior pancreaticoduodenal artery (PSPDA) and flowed through the right aspect of the dilated common bile duct (CBD) directly into the right lobe of the liver. We performed laparoscopic dilated biliary duct resection and hepaticojejunostomy, administering ICG intravenously, at a dose of 0.6 mg/kg. The ICG fluorescence overlay mode showed an aRHA running along the right side of the dilated CBD. The aRHA was dissected from the CBD without injury. After finishing the anastomosis, the beating of the aRHA was preserved, confirming that blood flow had been maintained.
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Sugita K., Muto M., Oshiro K., Kuda M., Kinjyo T., Masuya R., Machigashira S., Kawano T., Nakame K., Torikai M., Ibara S., Kaji T., Ieiri S.
Pediatric Surgery International 2022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：Pediatric Surgery International
Purpose: We compared cases of anemia in gastroschisis versus omphalocele and investigated this clinical question. Methods: A multicenter study of five pediatric surgery departments in southern Japan was planned. Sixty patients were collected between 2011 and 2020, with 33 (gastroschisis: n = 19, omphalocele: n = 14) who met the selection criteria ultimately being enrolled. Anemia was evaluated before discharge and at the first outpatient visit. Results: Despite gastroschisis cases showed more frequent iron administration during hospitalization than omphalocele (p = 0.015), gastroschisis cases tended to show lower hemoglobin values at the first outpatient visit than omphalocele cases (gastroschisis: 9.9 g/dL, omphalocele: 11.2 g/dL). Gastroschisis and the gestational age at birth were significant independent predictors of anemia at the first outpatient visit, (gastroschisis: adjusted odds ratio [OR] 19.00, p = 0.036; gestational age at birth: adjusted OR 0.341, p = 0.028). A subgroup analysis for gastroschisis showed that the ratio of anemia in the 35–36 weeks group (8/10, 80.0%) and the > 37 weeks group (6/6, 100%) was more than in the < 34 weeks group (0/3, 0.0%). Conclusions: Gastroschisis may carry an increased risk of developing anemia compared with omphalocele due to the difference of direct intestinal exposure of amnion fluid in utero.
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胃穿孔による汎発性腹膜炎を生じた急性胃軸捻転の1例 査読あり
桝屋 隆太, 中目 和彦, 楯 真由美, 黒木 純, 河野 文彰, 市原 明子, 池田 拓人, 武野 慎祐, 七島 篤志, 家入 里志
日本小児外科学会雑誌 57 ( 6 ) 1002 - 1007 2021年10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：特定非営利活動法人 日本小児外科学会
2歳女児．3日前から反復する嘔吐で加療されていた．急激な腹部膨満から消化管穿孔を疑われ当院へ搬送された．来院時顔面蒼白，活気不良，末梢冷感著明，脈拍数200/分，血圧60/42 mmHg，呼吸数43/分とショックを呈していた．腹部造影CTで多量のfree airおよび腹水を認め，胃軸捻転の所見を認めた．胃軸捻転による消化管穿孔と診断し緊急腹腔鏡手術を行った．腹腔鏡下に胃軸捻転を解除したが，穿孔部位が同定困難で開腹へ移行した．胃体上部大弯に付着した大網を剥離したところ同部位にピンホール状の穿孔を認めた．同部位を楔状に切除し胃を腹壁に固定した．遊走脾は認めなかった．術後DIC治療と胃蠕動改善に日数を要したが徐々に回復し，術後19日目に軽快退院した．その後再発なく経過している．急性胃軸捻転に伴い胃穿孔を生じた報告が散見される．重篤化して急激な経過をたどる報告もあるため，迅速な診断と治療を必要とする．
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Malignant perivascular epithelioid cell neoplasm in the liver: report of a pediatric case. 査読あり 国際誌
Baba T, Kawano T, Saito Y, Onishi S, Yamada K, Yamada W, Masuya R, Nakame K, Kawasaki Y, Iino S, Sakoda M, Kirishima M, Kaji T, Tanimoto A, Natsugoe S, Ohtsuka T, Moritake H, Ieiri S
Surgical case reports 7 ( 1 ) 212 - 212 2021年9月
記述言語：英語 掲載種別：研究論文（学術雑誌）
BACKGROUND: Perivascular epithelioid cell neoplasm (PEComa) in a child is very rare. We herein report the first malignant case of PEComa developing in the liver of a pediatric patient. CASE PRESENTATION: A 10-year-old boy visited a private clinic with prolonged fever of unknown etiology. Abdominal ultrasonography was performed to evaluate the fever's origin, revealing a large tumor in the liver. He was thus referred to a nearby hospital to investigate the tumor further. Enhanced computed tomography (CT) showed a 6.8 × 5.9 × 10.5-cm solid lesion on S4 and S5. On magnetic resonance imaging (MRI), the tumor had a low signal intensity on T1 imaging and high signal intensity on T2 imaging, with partial diffusion restriction. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed a marked uptake in the mass lesion with no evidence of metastasis. The patient was negative for all tumor markers, including AFP, CEA and PIVKA-II. The results of a needle biopsy suggested hepatocellular carcinoma. The tumor's rapid growth suggested malignancy. Hepatic segmentectomy (S4 + S5 + S8) was performed. The tumor was resected en bloc with a margin. Microscopically, the tumor showed atypical spindle, polygonal or oval-shaped cells with a high nuclear grade, and vascular invasion. Immunohistochemistry was positive for alpha-smooth muscle antigen (α-SMA), human melanin black-45 (HMB-45) and melan A. The pathological diagnosis was malignant PEComa. In the 6 months after surgery, the patient complained of shoulder pain. MRI showed a dumbbell-shaped tumor at the 2nd thoracic vertebrae, which was confirmed to be bone metastasis of PEComa. After chemotherapy, including ifosfamide and doxorubicin, vertebrectomy was performed. Two years later, thoracoabdominal CT showed a 10-cm solid mass occupying the pelvis and a 15-mm nodule in the middle lobe of the right lung. Under a diagnosis of peritoneal and lung metastases, they were surgically removed and metastasis of PEComa was pathologically confirmed. Four months after the 2nd relapse, pelvic metastasis appeared again and mTOR (mammalian target of rapamycin) inhibitor was initiated. To our knowledge, this is the first report of malignant hepatic PEComa in a pediatric patient. CONCLUSION: Although extremely rare, malignant hepatic PEComa can develop in a child.
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Masuya R., Miyoshi K., Nakame K., Nanashima A., Ieiri S.
International Journal of Surgery Case Reports 86 106300 - 106300 2021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：International Journal of Surgery Case Reports
Introduction: The right hepatic artery crossing the ventral side of the common hepatic duct is a relatively frequent abnormality. This aberrant right hepatic artery not only interferes with dissection of the common bile duct and hepaticojejunostomy for choledochal cyst but can also cause postoperative anastomotic stenosis. Case presentation: A 14-year-old patient presented with upper abdominal pain and was diagnosed with a choledochal cyst (Type IVA in Todani Classification) and pancreaticobiliary maljunction. Abdominal enhanced computed tomography showed aberrant right hepatic artery located at the ventral side of the common hepatic duct. Laparoscopic choledochal cyst resection and hepaticojejunostomy were planned. Intraoperative findings also showed the aberrant right hepatic artery crossing the common hepatic duct ventrally as detected on preoperative computed tomography. Laparoscopic dorsal side repositioning of the aberrant right hepatic artery was performed because it appeared to compress the common hepatic duct and risked causing postoperative anastomotic stenosis. We performed laparoscopic hepaticojejunostomy by replacing the aberrant right hepatic artery dorsally to facilitate suturing and prevent postoperative anastomotic stenosis. The postoperative course was uneventful, with no findings suggestive of anastomotic stenosis. Discussion: The abnormality of the right hepatic artery is reported to be a primary cause of anastomotic stenosis after hepaticojejunostomy. Once anastomotic stenosis or stricture develops, it is often difficult to treat. The prevention of the stenosis is important. Conclusions: In choledochal cyst with aberrant right hepatic artery, dorsal repositioning is effective for preventing postoperative anastomotic stenosis and cholestasis.
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A case of facial cellulitis caused by group B streptococcus in an extremely low birthweight infant 査読あり
Muraoka J., Kodama Y., Higashi M., Yamada N., Yamashita R., Nakame K., Kaneko M., Sameshima H.
Journal of Infection and Chemotherapy 27 ( 9 ) 1369 - 1372 2021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：Journal of Infection and Chemotherapy
Group B streptococcus (GBS) is an important pathogen that causes neonatal sepsis and meningitis, which have high mortality and morbidity. Cellulitis is a rare presentation of late-onset neonatal GBS infection. We report the case of an extremely low birthweight infant with facial cellulitis caused by late-onset GBS infection. A 590-g male neonate was delivered by Cesarean section at 23 gestational weeks due to intrauterine GBS infection. Although he was effectively treated with 2 weeks of antimicrobial therapy for early-onset GBS sepsis, he subsequently developed facial and submandibular cellulitis caused by GBS at 44 days of age. He was treated with debridement and antibiotic therapy, and after 2 months his facial involvement had improved, but cosmetic issues remained. Neonatal GBS infection requires a prompt sepsis workup followed by the initiation of empiric antibiotic therapy. Additionally, lifesaving surgical debridement is sometimes necessary for cellulitis, even in premature infants.
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超低出生体重児の術後生存率と発達予後とは一致していない
武藤 充, 杉田 光士郎, 茨 聡, 桝屋 隆太, 松久 保眞, 川野 孝文, 町頭 成郎, 中目 和彦, 鳥飼 源史, 林田 良啓, 向井 基, 池江 隆正, 下野 隆一, 家入 里志
日本周産期・新生児医学会雑誌 57 ( Suppl. ) P279 - P279 2021年6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：(一社)日本周産期・新生児医学会
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超低出生体重児の術後生存率と発達予後とは一致していない
武藤 充, 杉田 光士郎, 茨 聡, 桝屋 隆太, 松久 保眞, 川野 孝文, 町頭 成郎, 中目 和彦, 鳥飼 源史, 林田 良啓, 向井 基, 池江 隆正, 下野 隆一, 家入 里志
日本周産期・新生児医学会雑誌 57 ( Suppl. ) P279 - P279 2021年6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：(一社)日本周産期・新生児医学会
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A case of facial cellulitis caused by group B streptococcus in an extremely low birthweight infant 査読あり
Naoshi Yamada
Journal of Infection and Chemotherapy 27 1369 - 1372 2021年5月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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A case of facial cellulitis caused by group B streptococcus in an extremely low birthweight infant 査読あり
Kazuhiko Nakame
Journal of Infection and Chemotherapy 27 1369 - 1372 2021年5月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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内視鏡手術の利点と問題点;合併症、中・長期成績、医療経済、教育 腹腔鏡下胆道拡張症手術の患者集約化は必要か?プロクターによる手術成績の施設間検討 査読あり
村上 雅一, 矢野 圭輔, 春松 敏夫, 大西 峻, 山田 耕嗣, 久田 正昭, 古賀 義法, 林田 真, 桝屋 隆太, 中目 和彦, 新山 新, 桑原 淳, 竜田 恭介, 柳 祐典, 廣瀬 龍一郎, 生野 猛, 右田 美里, 松藤 凡, 武藤 充, 加治 建, 家入 里志
日本小児外科学会雑誌 57 ( 2 ) 246 - 246 2021年4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：(一社)日本小児外科学会
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Muto M., Sugita K., Ibara S., Masuya R., Matuskubo M., Kawano T., Saruwatari Y., Machigashira S., Sakamoto K., Nakame K., Shinyama S., Torikai M., Hayashida Y., Mukai M., Ikee T., Shimono R., Noguchi H., Ieiri S.
Pediatric Surgery International 37 ( 3 ) 411 - 417 2021年3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: Necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI) are major diseases that cause gastrointestinal disorders in extremely low-birth-weight infants (ELBWIs). We conducted a review to compare the postoperative outcomes of ELBWIs with these diseases in our neonatal intensive-care unit. Methods: A retrospective chart review of ELBWIs surgically treated for NEC (n = 31), FIP (n = 35), and MRI (n = 16) in 2001–2018 was undertaken. This period was divided into early (2001–2005), middle (2006–2010), and late (2011–2018) periods. Data were analyzed with the Cochran-Armitage test. Statistical significance was defined as p < 0.05. Results: The survival rates in ELBWIs with NEC (early/middle/late: 36.4%/42.9%/61.5%; p = 0.212) and FIP (20%/50%/70.6%; p = 0.012) improved over time; all patients with MRI survived. The neuropsychological development of 24 cases was assessed with the Kyoto Scale of Psychological Development in the Postural-Motor, Cognitive-Adaptative, and Language-Social domains. The mean developmental quotient of all domains was 68.4 (range 18–95) at corrected 1.5 years of age and 69.1 (range 25–108) at chronological 3 years of age, both were considered as poor development. There was no improvement over time (p = 0.899). Conclusion: Ideal neuropsychological development was not observed with the improvement of survival rate. Less-invasive surgical intervention and adequate postoperative care are required to encourage further development.
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【出生前診断された小児外科疾患の鑑別と周産期管理】梨状窩嚢胞
町頭 成郎, 中目 和彦, 村上 雅一, 川野 正人, 矢野 圭輔, 山田 耕嗣, 川野 孝文, 加治 建, 上塘 正人, 茨 聡, 家入 里志
小児外科 53 ( 2 ) 121 - 125 2021年2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：(株)東京医学社
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腹腔鏡下噴門形成術後PT延長を認めた重症心身障がい児(者)の5例 査読あり
春松 敏夫, 村上 雅一, 矢野 圭輔, 馬場 徳朗, 大西 峻, 山田 耕嗣, 桝屋 隆太, 町頭 成郎, 中目 和彦, 向井 基, 加治 建, 家入 里志
学会誌JSPEN 2 ( Suppl.2 ) 30 - 31 2021年1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：(一社)日本臨床栄養代謝学会
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術後機能を考慮した小児呼吸器外科手術 先天性嚢胞性肺疾患を中心に 査読あり
家入 里志, 中目 和彦, 長野 綾香, 松井 まゆ, 矢野 圭輔, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 松久保 眞, 武藤 充, 加治 建, 村上 雅一, 杉田 光士郎
日本小児呼吸器学会雑誌 31 ( 2 ) 152 - 158 2021年1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：日本小児呼吸器学会
小児先天性嚢胞性肺疾患は肺実質内に先天性に気道以外に恒常的に嚢胞が存在する状態をいう。近年は出生前に胎児肺の異常として診断される症例も多く、生直後に呼吸器症状がない場合でも、90%以上の症例で幼児期までに反復する肺感染などを発症するため、乳児期、遅くも幼児期早期までに手術的に病変を切除すべきとされている。治療としては病変部の外科的切除が原則となるが、従来はそのほとんどの症例に対して開胸手術による切除が行われてきた。近年では内視鏡外科手術、つまり胸腔鏡手術で施行される症例が増えている。これは乳幼児・小児の狭小な胸腔内であっても拡大視効果が得られ精緻な手術が可能であること、また従来は成人用デバイスを流用した手術であったが、小児用の細径デバイスが開発され、新生児期であっても技術的に可能となったことが大きい要因である。出生前診断例の手術時期も含めて術後機能を考慮した小児呼吸外科手術の現状を解説する。(著者抄録)
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術後機能を考慮した小児呼吸器外科手術 先天性嚢胞性肺疾患を中心に 国際共著
家入里志，中目 和彦, 長野 綾香, 松井 まゆ, 矢野 圭輔, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 松久保 眞, 武藤 充, 加治 建, 村上 雅一, 杉田 光士郎
日本小児呼吸器学会雑誌 31 152 - 158 2021年
掲載種別：研究論文（学術雑誌）
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矢野 圭輔, 山田 和歌, 永井 太一朗, 大西 峻, 春松 敏夫, 山田 耕嗣, 武藤 充, 町頭 成郎, 中目 和彦, 向井 基, 加治 建, 家入 里志
日本小児外科学会雑誌 56 ( 7 ) 1190 - 1190 2020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：(一社)日本小児外科学会
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永井 太一朗, 矢野 圭輔, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 武藤 充, 町頭 成郎, 中目 和彦, 向井 基, 加治 建, 家入 里志
日本小児外科学会雑誌 56 ( 7 ) 1192 - 1192 2020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：(一社)日本小児外科学会
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小児に対するリアルタイム超音波ガイド下鎖骨上アプローチによるトンネル型中心静脈カテーテル挿入術 超音波ガイド下腕頭静脈穿刺による合併症軽減に関する検討 査読あり
中目 和彦, 長野 綾香, 松井 まゆ, 永井 太一朗, 村上 雅一, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 桝屋 隆太, 武藤 充, 加治 建, 家入 里志
日本小児外科学会雑誌 56 ( 5 ) 649 - 649 2020年9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：(一社)日本小児外科学会
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小児腸管機能不全の最新知見 短腸症候群の予後を拓くために必要なこととは 基礎・臨床研究から
武藤 充, 永井 太一朗, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 松久保 眞, 町頭 成郎, 中目 和彦, 向井 基, 加治 建, 家入 里志
日本外科学会定期学術集会抄録集 120回 SY - 1 2020年8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：(一社)日本外科学会
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短腸症候群モデルラットを用いたGLP-2のIFALDに対する予防効果の検討
矢野 圭輔, 加治 建, 大西 峻, 町頭 成郎, 永井 太一朗, 春松 敏夫, 山田 耕嗣, 松久保 眞, 武藤 充, 中目 和彦, 家入 里志
日本外科学会定期学術集会抄録集 120回 SF - 1 2020年8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：(一社)日本外科学会
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【小児外科臨床研究の基本と展望】腹壁疾患
松久保 眞, 杉田 光士郎, 中目 和彦, 長野 綾香, 松井 まゆ, 村上 雅一, 川野 正人, 矢野 圭輔, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 武藤 充, 加治 建, 野口 啓幸, 家入 里志
小児外科 52 ( 7 ) 749 - 757 2020年7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：(株)東京医学社
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松久保 眞, 杉田 光士郎, 中目 和彦, 長野 綾香, 松井 まゆ, 村上 雅一, 川野 正人, 矢野 圭輔, 大西 峻, 春松 敏夫, 山田 耕嗣, 山田 和歌, 武藤 充, 加治 建, 野口 啓幸, 家入 里志
小児外科 52 ( 7 ) 749 - 757 2020年7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：(株)東京医学社
1985年4月〜2020年3月までの鹿児島県における腹壁異常の手術症例69例の治療成績について後方視的検討を行った。なお、1985年4月〜2004年3月(前期)までは全例が鹿児島大学病院、2004年4月〜2020年3月(後期)までは鹿児島大学病院と鹿児島市立病院で診療された。対象の内訳は臍帯ヘルニア36例(男児19例、女児17例)、腹壁破裂33例(男児16例、女児17例)で、帝王切開での分娩は臍帯ヘルニア21例(58.3%)、腹壁破裂23例(70.0%)であった。術式は一期閉鎖術31例、silo造設のみ1例、silo造設後の二期閉鎖術37例であった。分娩様式や術式別の予後に有意差は認めなかった。死亡例は臍帯ヘルニア5例(13.9%)、腹壁破裂1例(3.0%)で、臍帯ヘルニア5例は染色体異常または重症合併奇形を認めた。出生前診断率、生存率は後期で増加していたが有意差は認めなかった。
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Hirschsprung病において手術時月齢が術後排便機能に与える影響についての検討 査読あり
大西 峻, 山田 耕嗣, 中目 和彦, 村上 雅一, 矢野 圭輔, 馬場 徳朗, 春松 敏夫, 山田 和歌, 桝屋 隆太, 川野 孝文, 町頭 成郎, 向井 基, 加治 建, 家入 里志
日本小児外科学会雑誌 56 ( 2 ) 238 - 238 2020年4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：(一社)日本小児外科学会
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Oral diatrizoate acid for meconium-related ileus in extremely preterm infants 査読あり
Kaori Michikata, Yuki Kodaa, Masatoki Kaneko, Hiroshi Sameshima, Tsuyomu Ikenoue, Seiro Machigashira, Motoi Mukai, Motofumi Torikai, Kazuhiko Nakame
Pediatrics International 60 ( 8 ) 714 - 718 2018年8月
記述言語：英語 掲載種別：研究論文（学術雑誌）
DOI： 10.1111/ped.13606