NANASHIMA Atsushi

写真a

Affiliation

Faculty of Medicine School of Medicine Department of Surgery, Hepato-Biliary-Pancreas Surgery

Title

Professor

External Link

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Degree 【 display / non-display

  • 医学博士 ( 1997.5   長崎大学 )

Research Areas 【 display / non-display

  • Life Science / General surgery and pediatric surgery

  • Life Science / Digestive surgery

 

Papers 【 display / non-display

  • Postoperative Outcomes and Strategic Refinement in Intraductal Papillary Mucinous Neoplasm Management Reviewed

    Nanashima A, Imamura N, Hiyoshi M, Tsuchimochi Y, Wada T, Hamada T, Suzuki Y, Araki Y, Hosokawa A, Kawakami H.

    Cancer diagnosis & prognosis   6 ( 2 )   291 - 302   2026.3

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.21873/cdp.10528

  • Surgical Outcomes and Diagnostic Concordance in Patients With Pancreatic Neuroendocrine Tumors Undergoing Pancreatectomy: A Retrospective Cohort Study. Reviewed International journal

    Nanashima A, Hiyoshi M, Imamura N, Tsuchimochi Y, Wada T, Hamada T, Suzuki Y, Araki Y

    Cancer diagnosis & prognosis   6 ( 1 )   52 - 61   2026.1

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Cancer Diagnosis and Prognosis  

    Background/Aim: Pancreatic neuroendocrine tumors (PanNETs) are heterogeneous neoplasms for which surgical resection remains the only potentially curative therapy. However, preoperative diagnostic accuracy – particularly tumor grading – often varies, complicating treatment decisions. This study evaluated diagnostic concordance between preoperative assessments and postoperative pathology, as well as surgical outcomes and prognostic factors in patients undergoing pancreatectomy for PanNETs. Patients and Methods: We retrospectively reviewed the clinical records of 32 patients who underwent surgical resection for PanNETs. Patient demographics, tumor characteristics, surgical procedures, and postoperative outcomes were analyzed. Preoperative imaging and cytology-based diagnoses were compared with final pathological findings to evaluate diagnostic concordance. Prognostic factors were assessed using Kaplan–Meier survival analysis. Results: Histological grading of resected specimens showed G1 in 53%, G2 in 41%, and G3/NEC in 6%, with a 38% discordance rate from preoperative biopsy. Lymphatic, venous, and perineural invasions were identified in 16%, 44%, and 13% of cases. Lymph node metastasis occurred in 22%. Among 30 patients with follow-up >12 months, eight developed recurrence, most commonly in the liver. The 3-year and 5-year disease-free survival (DFS) rates were 78% and 69%, while overall survival (OS) rates were 96% and 91%. Tumor number >2 and histologic grade G3 were significantly associated with reduced DFS (p<0.05). Lymphatic invasion and metachronous liver metastasis were significantly associated with reduced OS (p<0.01 and p<0.05, respectively). Histological grading mismatch was not associated with survival outcomes. Conclusion: Pancreatectomy for PanNETs is a safe and effective treatment with favorable long-term outcomes. Histological factors such as tumor grade, lymphatic invasion, and tumor number significantly predict recurrence and survival.

    DOI: 10.21873/cdp.10506

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    PubMed

  • Comparison of postoperative results between types of pancreaticoenteral anastomosis after pancreaticoduodenectomy Reviewed International journal

    Nanashima A., Arai J., Imamura N., Hiyoshi M., Tsuchimochi Y., Wada T., Hamada T.

    Gland Surgery   14 ( 12 )   2440 - 2455   2025.12

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Gland Surgery  

    Background: Pancreatic anastomosis has been developed, and each anastomosis has its pros and cons. This study investigated the prevalence of postoperative complications, particularly pancreatic fistula (POPF), among five types of pancreatoenteric anastomoses to determine the optimal anastomosis for patients undergoing pancreatectomy. Methods: This study retrospectively and consecutively analyzed the data of 365 patients who underwent pancreatectomy with pancreaticoenteral anastomosis at two academic institutions from 1994 to 2024. Pancreaticogastrostomy via invagination was performed in 24 patients (group PG). For pancreaticojejunal anastomosis, we performed an end-to-end invagination procedure on eight patients (group PJI), two-layer suturing procedure on 96 patients (group PJT), Kakita procedure on 55 patients (group K), and modified Blumgart procedure on 182 patients (group B). Results: Group B had the shortest hospital stay and fastest resumption of oral intake. Groups PG and PJI exhibited higher grade B/C POPF rates and prolonged ascites. The potential benefits of group B included reduced hospitalization period and enhanced recovery owing to decreased POPF rates. Habitual alcohol consumption and high preoperative creatinine levels increased the risk of POPF, whereas external drainage issues and blood loss contributed to prolonged ascites. In particular, habitual alcohol consumption [relative risk (RR) =2.42], group K anastomosis (RR =2.79), soft pancreatic texture (RR =2.48), delayed oral intake (≥4 days; RR =2.78), and complete external drainage (RR =8.68) were independent predictors of POPF. Conclusions: Modified Blumgart procedure is an optimal pancreaticoenteral anastomosis technique for avoiding POPF. Early oral intake has emerged as a protective factor, highlighting its role in improving postoperative outcomes. Surgeons should prioritize intraoperative blood conservation, perioperative nutritional support, and appropriate anastomotic selection to enhance surgical success.

    DOI: 10.21037/gs-2025-380

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    PubMed

  • Impact of underlying liver etiology on post-hepatectomy survival outcomes in hepatocellular carcinoma patients Reviewed International journal

    Nanashima A., Arai J., Imamura N., Hiyoshi M., Tsuchimochi Y., Wada T.

    Translational Cancer Research   14 ( 12 )   8556 - 8566   2025.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Translational Cancer Research  

    Background: The underlying etiology of liver disease, such as metabolic dysfunction-associated steatotic liver diseases (MASLDs) or alcohol-related liver injury, significantly affects liver function and regenerative capacity. In hepatocellular carcinoma (HCC) patients undergoing hepatectomy, these background factors may influence postoperative outcomes and long-term survival. This study aimed to evaluate the impact of different etiologies of liver disease on survival outcomes following curative hepatectomy in patients with HCC. Methods: We retrospectively analyzed patients with HCC who underwent curative hepatectomy at two academic institutions. Background liver disease was classified according to etiology, including viral liver disease (VLD), alcohol-related liver disease (ALD), MASLD, and others. Survival outcomes were evaluated and compared across etiological groups at two institutions from 1994 to 2023. Results: Patients with VLD, ALD, and MASLD exhibited significantly elevated rates of advanced liver fibrosis (P<0.001), while vascular involvement was less frequent in MASLD cases. No significant differences in tumor stage, tumor markers, or postoperative complications were found among the etiologies. However, tumor recurrence was significantly more common in the VLD and ALD groups (P<0.001), and HCC-related deaths were most frequent in the VLD and other/unknown groups. MASLD patients presented the most favorable outcomes, with a 5-year recurrence-free survival (RFS) of 54% and a 10-year overall survival (OS) of 100%, significantly better than VLD (RFS 31%, OS 49%; P<0.01). Multivariate analysis revealed that VLD, vascular invasion, R1 margin, and poor liver function were independent predictors of recurrence and poor OS. Conversely, MASLD was not a significant risk factor for recurrence and was independently associated with better survival (P<0.05). Conclusions: MASLD-related HCC represents a distinct clinical entity with relatively indolent tumor behavior and better-preserved liver function. Recognizing the prognostic implications of MASLD-related HCC is essential for optimizing surgical indications and developing etiology-specific treatment strategies.

    DOI: 10.21037/tcr-2025-1809

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    CiNii Research

  • Managing uncontrolled bleeding in elective surgery: The role of damage control techniques Reviewed

    Nanashima A., Wada T., Kawano F., Hamada K., Taniguchi T., Furukawa K.

    International Journal of Surgery Case Reports   128   111040   2025.3

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:International Journal of Surgery Case Reports  

    Introduction: The main text introduction expands on the initial introduction by providing a more detailed discussion of massive bleeding in elective surgeries and its challenges. It describes how traditional hemostatic procedures are essential but may not always be sufficient, especially in uncontrolled coagulopathy despite aggressive transfusion. It then introduces DCS as a well-established approach in trauma surgery, emphasizing its role in stabilizing patients with hemorrhagic shock, coagulopathy, hypothermia, and acidosis. It highlights that DCS can be a lifesaving intervention when unexpected massive bleeding occurs and justifies its use in patients with unstable vital signs or increased intra-abdominal pressure by our two experienced cases presentation. Case 1. A 76-year-old obese male diagnosed with advanced transverse colon cancer with regional balky lymph node metastasis was identified at the root of the regional colic vein trunk. A robotic surgical approach was changed to open laparotomy because of bleeding tendency due to fatty mesentery. During the balky node dissection, the root of the vein was injured and induced massive bleeding during the compressive hemostatic procedure. As the hypotensive control rapidly became quite tricky, DCS by gauze packing and covered by the commercial dressing kit with open abdominal management (OAM). The second look operation, by supporting the Restrictive Endovascular Balloon Occlusion of the Aorta, repaired the superior mesenteric vein's injured parts. He survived for nine months. Case 2. The 72-year-old male patient was diagnosed as solitary 3 cm of hepatocellular carcinoma at S6 with alcoholic liver cirrhosis. The laparoscopic limited hepatic resection was changed to the open laparotomy due to the bleeding tendency at the transected parenchyma. After accomplishing limited resection, massive hepatic venous bleeding occurred; DCS was decided due to continuing hypotension, oozed hemorrhage, and low platelet level with metabolic acidosis by peri-hepatic gauze packing around the right liver. The second look operation for remnant hemostasis and the de-packing with abdominal closure could be achieved without severe events. The postoperative course showed no hepatic failure, and they recovered during a hospital stay. Discussion: It describes how conventional hemostatic procedures are essential but may not always be sufficient, especially in uncontrolled coagulopathy despite aggressive transfusion. DCS is a well-established approach in trauma surgery, emphasizing its role in stabilizing patients with hemorrhagic shock, coagulopathy, hypothermia, and acidosis. The role of DCS is well known even in elective surgery in unforeseen emergency situations such as hemodynamic instability, severe coagulopathy, and prolonged surgery over 24 h. It highlights that DCS can be a lifesaving intervention when unexpected massive bleeding occurs and justifies its use in patients with unstable vital signs or increased intra-abdominal pressure, where prolonged surgery is not feasible. It reinforces that DCS was successfully utilized in the reported cases, leading to favorable second-look operations. Conclusion: The main text introduction is a more comprehensive and structured expansion of the initial introduction. While the initial version introduces the problem concisely, the revised introduction elaborates on the challenges of massive bleeding, the principles of DCS, and its potential role in elective surgeries before transitioning into the case reports.

    DOI: 10.1016/j.ijscr.2025.111040

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Books 【 display / non-display

  • 消化器難治療癌シリーズV 肝細胞癌

    七島篤志( Role: Joint author ,  おわりに)

    株式会社協和企画  2024.4 

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    Language:Japanese Book type:Scholarly book

  • おわりに.

    七島篤志( Role: Sole author ,  消化器難治療癌シリーズV 肝細胞癌)

    一般財団法人日本消化器病学会  2024.4 

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  • Therapeutic applications: Photodynamic therapy using porphyrin compounds

    Hamada T., Nanashima A.( Role: Sole author)

    Fluorescence-Guided Surgery: From Lab to Operation Room  2023.11  ( ISBN:9789811973727, 9789811973710

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    Language:English Book type:Scholarly book

    As a result of recent advances in endoscopes and optical fibers, optical engineering has been introduced to medical treatment in these years. Photodynamic therapy (PDT) is a promising treatment method that irradiates a tumor with a highly tumor-accumulating photosensitive agent and a laser with a specific wavelength and shows a cell-killing effect only on tumor cells with high drug concentration. It has already been applied clinically in the fields of pulmonary and digestive surgery, neurosurgery, ophthalmology, dermatology, and urology. As described in other chapters, photodynamic diagnosis (PDD), which is a method to diagnose the localization of tumors by irradiating biological tissues with light and detecting the fluorescence generated by photosensitive agents accumulated in tumors, is also being actively studied and applied clinically.

    DOI: 10.1007/978-981-19-7372-7_33

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  • 肝胆膵高難度外科手術[Web動画付]第3版

    旭吉雅秀,七島篤志( Role: Joint author ,  胆道再建)

    医学書院  2023.6 

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    Language:Japanese Book type:Scholarly book

  • 術中イメージング実践ガイド -ラボからオペ室まで- Reviewed

    濵田剛臣,七島篤志( Role: Joint author ,  Ⅲ術中蛍光イメージングの実際[開発編]: 4. 治療への応用(1): ポルフィリン化合物を用いた光線力学的治療)

    メジカルビュー  2020.9  ( ISBN:978-4758315371

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    Total pages:339   Responsible for pages:310-320   Language:Japanese Book type:Scholarly book

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  • 論説 シン・私の考える~医学教育に使えた名言・格言〜Quotes and aphorisms that could be used in surgical and medical education

    七島篤志

    宮崎県医師会医学会誌   49 ( 2 )   117 - 123   2025.9

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    Authorship:Lead author, Corresponding author   Language:Japanese   Publishing type:Rapid communication, short report, research note, etc. (scientific journal)  

  • その他 地方都市施設におけるacute care surgeryのあり方とは?―当院の10年を振り返って見えてきた課題と対策―

    河野文彰,田代耕盛,池ノ上実,宗像 駿,鈴木康人,武野慎祐,古川貢之,落合秀信,七島篤志

    Japanese Journal of Acute Care Surgery   15 ( 1 )   97 - 100   2025.4

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    Authorship:Last author   Language:Japanese   Publishing type:Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)  

    DOI: https://doi.org/10.50840/jjacs.15-1

  • 特集 臓器損傷治療の工夫【手術手技】腹部開放創陰圧治療法システムによるopen abdominal management Invited Reviewed

    桝屋隆太, 中目和彦, 宗像 駿, 河野文彰, 武野慎祐, 七島篤志, 家入里志

    小児外科   57 ( 2 )   231 - 235   2025.2

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    Language:Japanese   Publishing type:Article, review, commentary, editorial, etc. (scientific journal)  

    DOI: https://doi.org/10.24479/ps.0000001110

  • ストーマ術後ケアVR活用:宮大などベンチャー設立へ.

    七島篤志

    宮崎日日新聞   23 - 23   2024.11

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    Authorship:Lead author, Corresponding author   Language:Japanese   Publishing type:Article, review, commentary, editorial, etc. (other)  

  • 【診療】鏡視下甲状腺手術の現状と課題 Invited

    河野文彰,池ノ上実,宗像 駿,武野慎祐,七島篤志

    宮崎県医師会医学会誌   48 ( 1 )   42 - 47   2024.11

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    Authorship:Last author   Language:Japanese   Publishing type:Article, review, commentary, editorial, etc. (scientific journal)  

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Presentations 【 display / non-display

  • 術前CTにて脾静脈の走行異常を認識し、安全に腹腔鏡下胃切除術を施行した胃癌の1例.

    樋口和宏,宗像 駿,千代反田顕,池ノ上実,河野文彰,武野慎祐,七島篤志

    第38回日本内視鏡外科学会総 

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    Event date: 2025.12.11 - 2025.12.13

    Language:Japanese   Presentation type:Oral presentation (general)  

  • パネルディスカッション5-1直腸癌に対する術前治療の功罪1:直腸癌に対する術前治療の短期成績と適応症例の検討:当院におけるCRT およびTNT の後ろ向き評価よびTNT の後ろ向き評価.

    濵田朗子,山田和之介,武野慎祐,市原明子,市来伸彦,千代反田顕,坂元紀彦,古島理紗子,七島篤志

    第87回日本臨床外科学会学術集会 

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    Event date: 2025.11.20 - 2025.11.22

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

  • Virtual Realityは外科教育を変えるか?:医学生に対する無菌手技および手術理解、心理状態に関する比較研究.

    樋口和宏,甲斐健吾,濵田剛臣,七島篤志

    第87回日本臨床外科学会学術集会 

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    Event date: 2025.11.20 - 2025.11.22

    Language:Japanese   Presentation type:Oral presentation (general)  

  • 当院で経験した痔瘻癌の3例.

    市原明子,岩本和樹,原 大介,濵田朗子,山田和之介,武野慎祐,七島篤志

    第80回日本大腸肛門病学会学術集会 

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    Event date: 2025.11.14 - 2025.11.15

    Language:Japanese   Presentation type:Oral presentation (general)  

  • 陰圧閉鎖療法により治療し得た鼠径部術後難治性リンパ漏の1例.

    千代反田顕,樋口和宏,宗像 駿,池ノ上実,河野文彰,武野慎祐,七島篤志,藤田 環,伊東憲子,鬼頭雄也,伊東 大

    第38回日本外科感染症学会 

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    Event date: 2025.11.7 - 2025.11.8

    Language:Japanese   Presentation type:Oral presentation (general)  

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Works 【 display / non-display

  • 新しい肝がんの腫瘍マーカー

    2011

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    Work type:Artistic work  

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Grant-in-Aid for Scientific Research 【 display / non-display

  • PDP効果に基づく胃癌腹膜播種に対する簡便かつ安全な光治療の開発

    Grant number:24K11937  2024.04 - 2027.03

    独立行政法人日本学術振興会  科学研究費基金  基盤研究(C)

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    Authorship:Coinvestigator(s) 

  • GVHD誘導マウスでのサイトカイン阻害による胆道閉鎖症の炎症標的型治療法の開発

    Grant number:23K08052  2023.04 - 2026.03

    独立行政法人日本学術振興会  科学研究費基金  基盤研究(C)

    桝屋 隆太

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    Authorship:Coinvestigator(s) 

  • クリック反応技術と軸配位子糖鎖連結ポルフィリン錯体を融合した革新的PDTの開発

    Grant number:22K08806  2022.04 - 2025.03

    独立行政法人日本学術振興会  科学研究費基金  基盤研究(C)

    七島篤志

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    Authorship:Principal investigator 

  • FDG PET腫瘍診断と腫瘍遺伝子変異の関連に基づくテーラーメイド医療の開発

    Grant number:26461857  2014.04 - 2017.03

    科学研究費補助金  基盤研究(C)

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    Authorship:Coinvestigator(s) 

    FDG PET腫瘍診断と腫瘍遺伝子変異の関連に基づくテーラーメイド医療の開発

  • 臨床実用を目指した癌幹細胞標的光線力学的療法の基礎研究

    Grant number:26461045  2014.04 - 2017.03

    科学研究費補助金  基盤研究(C)

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    Authorship:Coinvestigator(s) 

    臨床実用を目指した癌幹細胞標的光線力学的療法の基礎研究

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