|
所属 |
医学部 医学科 外科学講座肝胆膵外科学分野 |
|
職名 |
教授 |
|
外部リンク |
|
|
関連SDGs |
|
論文 【 表示 ／ 非表示 】
-
Postoperative Outcomes and Strategic Refinement in Intraductal Papillary Mucinous Neoplasm Management 査読あり
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年3月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
DOI： 10.21873/cdp.10528
-
Nanashima A, Hiyoshi M, Imamura N, Tsuchimochi Y, Wada T, Hamada T, Suzuki Y, Araki Y
Cancer diagnosis & prognosis 6 ( 1 ) 52 - 61 2026年1月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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
-
Nanashima A., Arai J., Imamura N., Hiyoshi M., Tsuchimochi Y., Wada T., Hamada T.
Gland Surgery 14 ( 12 ) 2440 - 2455 2025年12月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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
-
Nanashima A., Arai J., Imamura N., Hiyoshi M., Tsuchimochi Y., Wada T.
Translational Cancer Research 14 ( 12 ) 8556 - 8566 2025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：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.
-
Managing uncontrolled bleeding in elective surgery: The role of damage control techniques 査読あり
Nanashima A., Wada T., Kawano F., Hamada K., Taniguchi T., Furukawa K.
International Journal of Surgery Case Reports 128 111040 2025年3月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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.
書籍等出版物 【 表示 ／ 非表示 】
-
消化器難治療癌シリーズV 肝細胞癌
七島篤志（ 担当： 共著 , 範囲: おわりに）
株式会社協和企画 2024年4月
記述言語：日本語 著書種別：学術書
-
おわりに.
七島篤志（ 担当： 単著 , 範囲: 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年4月
記述言語：日本語 著書種別：学術書
-
Therapeutic applications: Photodynamic therapy using porphyrin compounds
Hamada T., Nanashima A.（ 担当： 単著）
Fluorescence-Guided Surgery: From Lab to Operation Room 2023年11月 （ ISBN:9789811973727, 9789811973710 ）
記述言語：英語 著書種別：学術書
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.
-
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（ 担当： 共著 , 範囲: 胆道再建）
医学書院 2023年6月
記述言語：日本語 著書種別：学術書
-
術中イメージング実践ガイド －ラボからオペ室まで－ 査読あり
濵田剛臣，七島篤志（ 担当： 共著 , 範囲: 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年9月 （ ISBN:978-4758315371 ）
総ページ数：339 担当ページ：310-320 記述言語：日本語 著書種別：学術書
MISC 【 表示 ／ 非表示 】
-
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年9月
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：速報，短報，研究ノート等（学術雑誌）
-
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年4月
担当区分：最終著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
-
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 招待あり 査読あり
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年2月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
-
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年11月
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（その他）
-
【診療】鏡視下甲状腺手術の現状と課題 招待あり
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年11月
担当区分：最終著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
講演・口頭発表等 【 表示 ／ 非表示 】
-
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
開催年月日： 2025年12月11日 - 2025年12月13日
記述言語：日本語 会議種別：口頭発表（一般）
-
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
開催年月日： 2025年11月20日 - 2025年11月22日
記述言語：日本語 会議種別：シンポジウム・ワークショップ パネル（公募）
-
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
開催年月日： 2025年11月20日 - 2025年11月22日
記述言語：日本語 会議種別：口頭発表（一般）
-
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
開催年月日： 2025年11月14日 - 2025年11月15日
記述言語：日本語 会議種別：口頭発表（一般）
-
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
開催年月日： 2025年11月7日 - 2025年11月8日
記述言語：日本語 会議種別：口頭発表（一般）
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
-
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
研究課題/領域番号：24K11937 2024年04月 - 2027年03月
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)
担当区分：研究分担者
-
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
研究課題/領域番号：23K08052 2023年04月 - 2026年03月
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
担当区分：研究分担者
-
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
研究課題/領域番号：22K08806 2022年04月 - 2025年03月
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
担当区分：研究代表者
-
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
研究課題/領域番号：26461857 2014年04月 - 2017年03月
科学研究費補助金 基盤研究(C)
担当区分：研究分担者
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
研究課題/領域番号：26461045 2014年04月 - 2017年03月
科学研究費補助金 基盤研究(C)
担当区分：研究分担者
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
その他競争的資金獲得実績 【 表示 ／ 非表示 】
-
胆管癌治療を目的としたレザフィリンを用いた光線力学的療法の開発研究
2019年01月 - 2021年12月
一般財団法人 日本消化器病学会 臨床研究助成金
七島篤志
担当区分：研究代表者
-
切除不能胆管癌における内視鏡を用いた光線力学療法の安全性と有用性に関する臨床試験
2018年03月
民間財団等 内視鏡医学研究振興財団研究助成金
資金種別：競争的資金
寄附金・講座・研究部門 【 表示 ／ 非表示 】
-
外科学講座肝胆膵外科学・消化管、内分泌、小児外科学分野研究奨学金
2025年03月
-
外科学講座肝胆膵外科学・消化管、内分泌、小児外科学分野研究奨学金
2025年01月
-
外科学講座肝胆膵外科学・消化管、内分泌、小児外科学分野研究奨学金
2024年10月
-
外科学講座肝胆膵外科学・消化管、内分泌、小児外科学分野研究奨学金
2024年07月
-
外科学講座肝胆膵外科学・消化管、内分泌、小児外科学分野研究奨学金
2024年07月