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Faculty of Medicine School of Medicine Department of Surgery, Hepato-Biliary-Pancreas Surgery |
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NANASHIMA Atsushi
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Research Areas 【 display / non-display 】
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Life Science / General surgery and pediatric surgery
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Life Science / Digestive surgery
Papers 【 display / non-display 】
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Nanashima A., Eguchi S., Hisaka T., Kawasaki Y., Yamashita Y.I., Ide T., Kuroki T., Yoshizumi T., Kitahara K., Endo Y., Utsunomiya T., Kajiwara M., Sakoda M., Okamoto K., Nagano H., Takami Y., Beppu T.
Cancers 15 ( 6 ) 1740 2023.3
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Cancers
Background: This study aims to clarify the perioperative risk factors and short-term prognosis of central bisectionectomy (CB) for hepatocellular carcinoma (HCC). Methods: Surgical data from 142 selected patients out of 171 HCC patients who underwent anatomical CB (H458) between 2005 and 2020 were collected from 17 expert institutions in a single-arm retrospective study. Results: Morbidities recorded by the International Study Group of Liver Surgery (ISGLS) from grade BC post-hepatectomy liver failure (PHLF) and bile leakage (PHBL), or complications requiring intervention were observed in 37% of patients. A multivariate analysis showed that increased blood loss (iBL) > 1500 mL from PHLF (risk ratio [RR]: 2.79), albumin level < 4 g/dL for PHBL (RR, 2.99), involvement of segment 1, a large size > 6 cm, or compression of the hepatic venous confluence or cava by HCC for all severe complications (RR: 5.67, 3.75, 6.51, and 8.95, respectively) (p < 0.05) were significant parameters. Four patients (3%) died from PHLF. HCC recurred in 50% of 138 surviving patients. The three-year recurrence-free and overall survival rates were 48% and 81%, respectively. Conclusions: Large tumor size and surrounding tumor involvement, or compression of major vasculatures and the related iBL > 1500 mL were independent risk factors for severe morbidities in patients with HCC undergoing CB.
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Prognostic value of repeat hepatectomy for hepatocellular carcinoma pationts Reviewed International journal
Nanashima A., Tanoue, Y., Hiyoshi, M., Imamura, N., Yano, K., Hamada, T., Kitamura, E., Kai, K., Tahira, K. and Nagayasu, T.
Anticancer Research 42 ( 9 ) 4553 - 4561 2022.9
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
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Novel analysis using magnetic resonance cholangiography for patients with pancreaticobiliary maljunction Invited Reviewed
Nanashima A., Komi M., Imamura N., Yazaki S., Hiyoshi M., Hamada T., Yano K., Nishida T., Enzaki M., Sakae T.
Surgery Today 52 ( 3 ) 385 - 394 2022.3
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Surgery Today
Purpose: We used a novel diagnostic Fourier transform (FT) algorithm of the entire extrahepatic bile duct (EHBD) measured by magnetic resonance cholangiography (MRC) to evaluate subtle deformation of bile duct lumen, indicating the malignant potential of EHBD, in patients with pancreaticobiliary maljunction (PBMJ) and in a comparative group of controls without PBMJ. Methods: From the workstation, the EHBD lumen was traced automatically and a 2D diagram cross section was measured at 0.5 mm-longitudinal intervals. The FT-based integrated power spectral density function value (FTPSDI) of the diameter or area (mm2 or mm4/Hz) and the phase value distribution entropy (PVDE) were also measured. Results: There were 16 patients with undilated PBMJ and 7 with dilated PBMJ. The control group comprised 10 patients with a normal bile duct, 20 with bile duct carcinoma (BDC), and 1 with primary sclerosing cholangitis. Both the diameter and area of the dilated bile ducts and the ducts with early- or advanced-stage BDC were significantly greater than those of the normal duct (p < 0.05). The undilated type of PBMJ tended to have a larger FTPSDI diameter than a normal bile duct, which had a smaller diameter than the dilated type of PBMJ or BDC. BDC had a significantly larger FTPSDI diameter (p < 0.05) and the cutoff value for accuracy was 168 mm2 Hz−1. Conclusion: The novel mathematical FTPSDI is a promising indicator of whether preventive EHBD resection is necessary for patients with PBMJ, which can be widely applied in the early diagnosis of other biliary diseases.
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Kai K., Hamada T., Sakae T., Sato Y., Hiyoshi M., Inomata M., Suzuki Y., Nakamura S., Azuma M., Nanashima A.
Clinical Journal of Gastroenterology 17 ( 1 ) 198 - 203 2024.2
Authorship：Last author Language：English Publishing type：Case report Publisher：Clinical Journal of Gastroenterology
A 48-year-old woman underwent transcatheter arterial embolization (TAE) for a splenic artery aneurysm, which resulted in a partial splenic infarction in the middle lobe. Five years after TAE, a 20-mm diameter mass in the noninfarcted area of the spleen was detected on imaging, which grew to 25 mm in diameter after 6 months. MRI after gadolinium administration showed a 35 × 34 mm mass within the superior pole and 15 × 12 mm mass within the inferior pole. The patient underwent laparoscopic splenectomy and had an uneventful postoperative recovery. No evidence of recurrence was observed during the 2-year follow-up period after surgery. The mass was pathologically confirmed to be sclerosing angiomatoid nodular transformation (SANT) of the spleen. While some studies hypothesize that SANT is a response to vascular injury or trauma, to the best of our knowledge, there have been no previous reports of SANT occurring after procedures directly affecting splenic blood flow. Additionally, multifocal SANTs are reported to be very rare, accounting for only 4.7% of all reported SANTs of the spleen. We highlight a rare course of SANT of the spleen and discuss the possible relationship between blood flow abnormalities and the appearance of SANT.
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The crucial role of SETDB1 in structural and functional transformation of epithelial cells during regeneration after intestinal ischemia reperfusion injury Reviewed International coauthorship
Ikenoue M., Choijookhuu N., Yano K., Fidya , Takahashi N., Ishizuka T., Shirouzu S., Yamaguma Y., Kai K., Higuchi K., Sawaguchi A., Nanashima A., Hishikawa Y.
Histochemistry and Cell Biology 161 ( 4 ) 325 - 336 2024.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Histochemistry and Cell Biology
Su (var) 3–9, enhancer of seste, trithorax (SET)-domain bifurcated histone lysine methyltransferase (SETDB1) plays a crucial role in maintaining intestinal stem cell homeostasis; however, its physiological function in epithelial injury is largely unknown. In this study, we investigated the role of SETDB1 in epithelial regeneration using an intestinal ischemia/reperfusion injury (IRI) mouse model. Jejunum tissues were sampled after 75 min of ischemia followed by 3, 24, and 48 h of reperfusion. Morphological evaluations were performed using light microscopy and electron microscopy, and the involvement of SETDB1 in epithelial remodeling was investigated by immunohistochemistry. Expression of SETDB1 was increased following 24 h of reperfusion and localized in not only the crypt bottom but also in the transit amplifying zone and part of the villi. Changes in cell lineage, repression of cell adhesion molecule expression, and decreased histone H3 methylation status were detected in the crypts at the same time. Electron microscopy also revealed aberrant alignment of crypt nuclei and fusion of adjacent villi. Furthermore, increased SETDB1 expression and epithelial remodeling were confirmed with loss of stem cells, suggesting SETDB1 affects epithelial cell plasticity. In addition, crypt elongation and increased numbers of Ki-67 positive cells indicated active cell proliferation after IRI; however, the expression of PCNA was decreased compared to sham mouse jejunum. These morphological changes and the aberrant expression of proliferation markers were prevented by sinefungin, a histone methyltransferase inhibitor. In summary, SETDB1 plays a crucial role in changes in the epithelial structure after IRI-induced stem cell loss.
Books 【 display / non-display 】
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Fluorescence Guided in Surgery 2023
Hamada, T. and Nanashima, A.（ Role： Joint author , Therapeutic applications: Photodynamic therapy using porphyrin compounds）
SPRINGER 2023.11
Language：English Book type：Scholarly book
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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
Language：Japanese Book type：Scholarly book
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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 ）
Total pages：339 Responsible for pages：310-320 Language：Japanese Book type：Scholarly book
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新DS Now No.4 胆道癌･膵癌に対する標準手術−手技修得へのナビゲート− Reviewed
長友謙三，濵田剛臣，七島篤志（ Role： Joint author , 膵体部癌に対する膵体尾部切除術）
メジカルビュー社 2019.8 （ ISBN:978-4-7583-1653-8 ）
Total pages：184 Responsible for pages：136-156 Language：Japanese Book type：Scholarly book
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続・食道疾患症例集 こんな時どうする？ Reviewed
田代耕盛，武野慎祐，河野文彰，伊東 大，七島篤志，中村都英（ Role： Joint author , 抗凝固療法中に出血性ショックとなった食道癌症例に生じた難治性食道皮膚瘻）
海鳥社 2019.5 （ ISBN:978-4866560496 ）
Total pages：120 Responsible for pages：86-89 Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
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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 Invited Reviewed International coauthorship
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 2024.2
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：東京医学社
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ロボット支援手術：胆嚢・脾臓摘出術 Invited Reviewed International coauthorship
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 55 ( 5 ) 539 - 543 2023.5
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：東京医学社
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Recent advances in photodynamic imaging and therapy in hepatobiliary malignancies: clinical and experimental aspects Reviewed
Nanashima, A., Hiyoshi, M., Imamura, N., Yano, K., Hamada,T. and Kai, K.
Current Oncology 28 ( 5 ) 4067 - 4079 2021.10
Authorship：Lead author, Corresponding author Language：English Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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Rare resected eight cases of duodenal adenocarcinomas Reviewed
Nanashima A., Tanoue Y., Imamura N., Hiyoshi M., Yano K., Hamada T., Nishida T., Kai K., Suzuki Y., Sato Y., Nakashima K., Hosokawa A., Nagayasu T.
International Journal of Surgery Case Reports 86 106384 2021.9
Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction: Duodenal adenocarcinoma is a rare malignancy; recently, it has been found to be accompanied by operative indications. Methods: Nine consecutive rare cases were diagnosed with duodenal carcinoma (DC), in which clinicopathological characteristics were retrospectively examined. Age was ranged over middle-aged males and females. No clinical onset with severe symptoms was observed, and the specific treatment for accompanied diseases or habits was not found. Outcomes: One case of two T1 stage DCs that underwent pancreas-sparing duodenectomy. Stage II DC was diagnosed in three cases, and stage III DC was diagnosed in four cases. Pancreaticoduodenectomy (PD) mainly occurred in seven patients, and duodenectomy was limited in two patients. All operations were safely performed, and the postoperative course showed no severe morbidity. Histological findings showed R0 resection in eight cases and R1 at the retroperitoneal dissecting part in one case. Five patients with advanced-stage DC underwent adjuvant chemotherapy; however, four patients showed tumor recurrence within 12 months. With additional strong chemotherapy, eight patients survived up to 84 months, and one died of liver metastasis at 43 months after surgery. Three representative cases of mucosal invasion with widespread pancreas-sparing duodenectomy and advanced-stage DC cases undergoing duodenectomy or PD are shown. Conclusion: In the field of upper digestive tract surgery, duodenal adenocarcinoma and various applications of surgery or adjuvant chemotherapy for long-term survival are important.
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【胆膵内視鏡による重度合併症の現況と適切な対応】外科治療を依頼される外科医の観点 −ERCPによる十二指腸損傷への対応− Reviewed
旭吉雅秀，七島篤志
日本消化器病学会雑誌 118 ( 8 ) 736 - 741 2021.8
Authorship：Last author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
Presentations 【 display / non-display 】
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The 14th Congress of Japan Society for The Acute Care Surgery: A Congress Report
Nanashima Atsushi, Kawano Fumiaki, Ochiai Hidenobu, Nagano Takehiko
Japanese Journal of Acute Care Surgery 2023 The Japanese Society for the Acute Care Surgery
Event date： 2023
Language：Japanese Presentation type：Oral presentation (general)
We herein describe the congress report regarding the 14th Congress of Japan Society for The Acute Care Surgery held in Aoshima, Miyazaki between September 30th and October 1st in 2022.
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A Case of the External Iliac Vein Injury Caused by a Stab Wound
Hamada Roko, Kawano Fumiaki, Munakata Shun, Tashiro Kousei, Takeno Shinsuke, Ochiai Hidenobu, Nanashima Atsushi
Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 2022.7.31 Japanese Society for Abdominal Emergency Medicine
Event date： 2022.7.31
Language：Japanese Presentation type：Oral presentation (general)
We report a case of injury of the external iliac vein caused by a stab wound. A 55-year-old man presented with a piece of wood stuck in his right abdomen. Physical examination revealed that he was in a state of shock and he was urgently transferred to our emergency department. We suspected gastrointestinal perforation and right external iliac arteriovenous injury based on the findings of CT, and decided to perform emergency surgery. Intraoperative exploration revealed that a piece of wood had penetrated the small intestine and the right external iliac vein. We controlled bleeding by compression and repaired the veins. After the operation, right external iliac vein thrombosis was observed, which resolved with anticoagulant therapy. Traumatic iliac vein injury is relatively rare, but since it is often fatal, prompt and appropriate treatment is necessary.
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河野 文彰, 武野 慎祐, 田代 耕盛, 池ノ上 実, 七島 篤志
手術 2022.7.15 金原出版
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Uchise Yukako, Tashiro Kousei, Munakata Shun, Kitamura Eiji, Hamada Roko, Kawano Fumiaki, Takeno Shinsuke, Mori Kousuke, Sakaguchi Shuhei, Ishii Hirohito, Furukawa Koji, Nanashima Atsushi
Japanese Journal of Acute Care Surgery 2022 The Japanese Society for the Acute Care Surgery
Event date： 2022
Language：Japanese Presentation type：Oral presentation (general)
A 73 y.o.-male underwent the arch aortic replacement for type A acute aortic dissection. Two years after operation, the computed tomography showed the rupture of thoracic aortic aneurysm and thoracic endovascular aortic repair （TEVAR） was urgently performed. Aorto-esophageal fistula （AEF） subsequently occurred at day 5 after TEVAR. Therefore, we urgently performed esophagectomy under right thoracotomy with accompanied fistulectomy, followed by omentopexy and esophageal reconstruction using gastric conduit 12 days later. To secure AEF patients, the immediate bleeding and infectious control is required. Although urgent artificial blood vessel replacement with esophagectomy with fistulectomy of AEF is desirable, the strategy of surgical intervention depends on the patient’s organ functions or systemic status. Omentopexy is an effective option to reinforce the postoperative infectious control and, additionally, the intraoperative ICG fluorescence angiography may improve to evaluate the omental vascularity by our experience.
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ICHIKI Nobuhiko, IKEDA Takuto, ICHIHARA Akiko, HAMADA Roko, OTA Yusuke, NANASHIMA Atsushi
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 2022 Japan Surgical Association
Event date： 2022
Language：Japanese Presentation type：Oral presentation (general)
Two cases of mixed neuroendocrine carcinoma and non-neuroendocrine neoplasm (MiNEN) are presented. A 50-year-old woman noticed an abdominal mass. Transverse colon cancer [cT3N2bM0 cStage IIIc] was diagnosed by computed tomography and colonoscopy. Right hemi-colectomy and lymphadenectomy were performed. Pathological examination showed combined features of adenocarcinoma and neuroendocrine carcinoma. The pathological diagnosis was MiNEN, pT3N0M0 pStage IIa. The patient received 8 courses of adjuvant CapeOX chemotherapy. At 12-month follow-up, the patient was well with no evidence of recurrence. A 72-year-old man was found to be positive for fecal occult blood. Colonoscopy showed a sigmoid colon polyp. The patient underwent endoscopic mucosal resection (EMR) of the polyp. The pathological diagnosis was MiNEN with deep submucosal (SM) invasion. Based on these findings, additional resection (laparoscopic sigmoidectomy and D3 lymph node dissection) was performed. The pathological diagnosis was MiNEN, pT1bN1M0 pStage IIIa. However, the patient did not wish to receive chemotherapy. At 60-month follow-up, the patient was well, with no evidence of recurrence. Although the prognosis of MiNEN is quite poor, multidisciplinary treatment resulted in a relatively good course. These cases are reported with a review of the literature.
Works 【 display / non-display 】
Grant-in-Aid for Scientific Research 【 display / non-display 】
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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
Authorship：Coinvestigator(s)
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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 科学研究費補助金 基盤研究(C)
七島篤志
Authorship：Principal investigator
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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)
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
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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)
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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糖鎖連結クロリンを用いたあたらし光線力学的療法による胆管癌の次世代局所治療法の開発
Grant number：25462120 2013.04 - 2016.03
科学研究費補助金 基盤研究(C)
Authorship：Principal investigator
光線力学的療法は、切除不能胆管癌に対する補助化学療法として効果が期待できる。一方で、光線過敏症などの副作用もあり、腫瘍特異成・抗腫瘍効果が高く副作用の少ない光感受性物質の開発がのぞまれる。新規光感受性物質と期待される糖鎖連結クロリンを用いた胆道癌に対する光線力学的療法について、現在使用されているタラポルフィリンナトリウム（レザフィリン）と比較検討した。細胞を用いた実験では、殺細胞効果・アポトーシス誘導効果が高いことが分かり、糖鎖連結クロリンが新規光感受性物質として期待できるという結果を得た。