Papers - NANASHIMA Atsushi
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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：Lead author, 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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Kato H., Horiguchi A., Ohtsuka T., Nanashima A., Unno M., Wakai T., Miura F., Isayama H., Hirooka Y., Aoki T., Yamamoto H., Yasuda I., Endo I.
Journal of Hepato-Biliary-Pancreatic Sciences 32 ( 5 ) 339 - 349 2025.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Hepato-Biliary-Pancreatic Sciences
Purpose: This study aimed to clarify the current treatment status for biliary tract cancers based on data from the National Clinical Database (NCD) in Japan. Methods: Total 3895 cases of biliary tract cancers registered in the NCD during 2021 were included. We identified the rates of resection, R0 resection, postoperative complications, and incidences of lymph node metastasis for gallbladder carcinoma, perihilar cholangiocarcinoma, distal bile duct carcinoma, and ampullary carcinoma. Results: The number of biliary tract cancers registered in the NCD during 2021 was 3895 (1775 in extrahepatic bile duct carcinoma, 1422 in gallbladder carcinoma, and 698 in ampullary carcinoma). In gallbladder carcinoma, the resection (89.59%) and R0 resection rates (87.99%) were favorable, and the complication rate (6.05%) was lower than that of others. However, the postoperative complication rate could be higher in T3–T4 cases and when extrahepatic bile duct resection was performed concomitantly. Lymph node metastasis was frequently seen in 12.60% at the No. 13a lymph node. In perihilar cholangiocarcinoma, the R0 resection (69.82%) and complication rates (16.75%) were significantly lower and higher, respectively. In distal cholangiocarcinoma and ampullary carcinoma, metastasis was observed in approximately 2% and 10% of the dissected No. 16b1 para-aortic lymph nodes, respectively. In conclusion, although short-term surgical outcomes for biliary tract cancers in Japan might be acceptable, the significantly lower R0 resection and higher complication rates of perihilar cholangiocarcinomas indicate additional challenges for surgeons in the future and should continue to be monitored by the Japanese Society of Hepatobiliary and Pancreatic Surgery.
DOI： 10.1002/jhbp.12129
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Imamura, N., Nanashima, A, Tsuchimochi, Y., Hamada, T., Kawakami, H. and Hiyoshi, M.
Gland Surgery 14 ( 4 ) 714 - 725 2025.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Gland Surgery
Background: Neoadjuvant chemotherapy (NAC) has been increasingly used in recent years in patients with pancreatic ductal adenocarcinoma (PDAC). This has forced a change in the practice of preoperative biliary drainage (PBD) is performed in PDAC patients scheduled for pancreatoduodenectomy (PD). What has changed in the NAC era and what is the appropriate method of PBD? To address this question, this study retrospectively reviewed the surgical outcomes and details of PBD in NAC and upfront surgery (US) patients. Methods: The study included consecutive PDAC patients who underwent PD from 2013 to 2021 during the transition from US to NAC, when outcomes were comparable. Clinical factors such as patient background, preoperative examination, surgical procedure, and postoperative complications were compared between the NAC group (40 patients) and the US group (59 patients), and details of PBD such as PBD procedure and adverse events were compared between the NAC and US groups who received PBD (27 NAC patients, 33 US patients). In the comparison test between groups, Fisher’s exact test and Mann-Whitney U test were mainly used. In addition, the outcomes and patency periods of each of the 128 PBD procedures were examined for the 60 patients who underwent PBD. The log-rank test was performed using the Kaplan-Meier method to compare patency period by PBD procedure. Results: There were no differences in patient background between the NAC and US groups. Compared with the US group, the NAC group had higher preoperative albumin (ALB) levels and less blood loss, but there was no difference of postoperative complications (NAC vs. US, 35% vs. 46%, respectively, P=0.29). With respect to PBD, the NAC group had more initial metallic stent (MS) placement (NAC vs. US, 52% vs. 15%, respectively, P=0.009), and fewer PBD-related adverse events (NAC vs. US, 33% vs. 61%, respectively, P=0.04). In a comparison of outcomes by drainage method, the duration of patency was significantly longer with MS placement than plastic stent (PS) placement (median days of patency, MS vs. PS, 68 vs. 15 days, respectively, P<0.001). However, MS placement and PS placement were equally likely to require a delay in the surgical schedule due to PBD-related adverse events (MS vs. PS, 6% vs. 6%, respectively, P>0.99). Conclusions: Prolonged PBD with NAC did not adversely affect surgical outcomes. MS placement provides a long patency period and is currently useful in PBD for PDAC patients undergoing PD after NAC, which requires a prolonged preoperative period. However, MS placement also has adverse events, and further studies are needed.
DOI： 10.21037/gs-2024-507
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Non-Cytotoxic photodynamic therapy with talaporfin sodium reduces the expression of CXCR4 and enhances chemotherapeutic efficacy in undifferentiated Reviewed
Kai,K., Ishizuka, T., Matsumoto, J., K Shimamawari, K., Mori, R., Fidya, Lkham-Erdene, B., Kubota, T., Ikenoue, M., Higuchi, K., Nanashima, A. and Hishikawa, Y.
Acta Histochemica et Cytochemica 58 ( 2 ) 2025.4
Language：English Publishing type：Research paper (scientific journal)
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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― Reviewed
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 ) 2025.4
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)
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非閉塞性腸間膜虚血症（NOMI）の治療戦略 -ICG蛍光造影法を用いた定型化を目指して- Reviewed
落合貴裕，河野文彰，池ノ上実，武野慎祐，七島篤志
Japanese Journal of Acute Care Surgery 2025.4
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)
DOI： 10.50840/jjacs.15-3
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Kinoshita S., Nakaura T., Yoshizumi T., Itoh S., Ide T., Noshiro H., Hamada T., Kuroki T., Takami Y., Nagano H., Nanashima A., Endo Y., Utsunomiya T., Kajiwara M., Miyoshi A., Sakoda M., Okamoto K., Beppu T., Takatsuki M., Noritomi T., Baba H., Eguchi S.
Hepatology Research 55 ( 4 ) 567 - 576 2025.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Hepatology Research
Aim: Microvascular invasion (MVI) affects the prognosis and treatment of hepatocellular carcinoma (HCC); however, its preoperative diagnosis is challenging. Analysis of computed tomography (CT) images using radiomics can detect MVI, but its effectiveness depends on the imaging conditions. We compared the efficacies of radiomics, clinical, and combined models for predicting MVI in HCC using nonstandardized scanning protocols. Methods: This multicenter study included 533 patients who underwent hepatic resection for HCC. Patients were divided randomly into training (n = 426) and test groups (n = 107). We manually extracted 3D CT features in hepatic arterial, portal venous, and venous phases. The radiomics model was trained by machine learning. A logistic regression model was developed based on clinical information, and a fused model was created integrating clinical information and radiomics prediction score (Rad_Score). We calculated areas under the receiver operating characteristic curves (AUCs) for the radiomics, clinical, and mixed models in the test groups. Results: The clinical model incorporated hepatitis B virus surface antigen, tumor diameter, and log-transformed α-fetoprotein and des-gamma-carboxyprothrombin. The AUCs of the radiomics and clinical models were comparable (p = 0.76). Rad_Score was not an independent significant factor in the fused model (p = 0.40) and its addition did not improve the accuracy of the clinical model alone (p = 0.51). Conclusions: A clinical model is as effective as a CT radiomics model for predicting MVI status in patients with HCC based on real-world scanning data, and integration of both models does not improve the predictive performance compared with a clinical model alone.
DOI： 10.1111/hepr.14149
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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
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.
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Nanashima A., Arai J., Hiyoshi M., Imamura N., Hamada T., Tsuchimochi Y., Shimizu I., Ochiai T., Kawakami H., Sato Y., Takashi W.
Turkish Journal of Surgery 41 ( 1 ) 5 - 18 2025.3
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Turkish Journal of Surgery
Objective: To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC). Material and Methods: This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021. Results: Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases. Conclusion: Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively.
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Higuchi Kazuhiro, Ikenoue Makoto, Ishizuka Takumi, Kai Kengo, Takahashi Nobuyasu, Kubota Toshiki, Shirouzu Shinichiro, Lkham-Erdene Baljinnyam, Aung Kham Mo, Nakai Michikazu, Sawaguchi Akira, Nanashima Atsushi, Hishikawa Yoshitaka
ACTA HISTOCHEMICA ET CYTOCHEMICA 58 ( 1 ) 9 - 18 2025.2
Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOCIETY OF HISTOCHEMISTRY AND CYTOCHEMISTRY
SET domain bifurcated 1 (SETDB1), a histone H3K9-specific methyltransferase, is crucial for heterochromatin formation and intestinal homeostasis, but its role in intestinal ischemia-reperfusion injury (IRI) remains unclear. This study investigated changes in SETDB1-mediated nuclear chromatin regulation in intestinal epithelial cells (IECs) using an IRI mouse model. Jejunal samples were collected after 75 min of ischemia followed by 24 hr of reperfusion. Sinefungin was administered as a histone methyltransferase inhibitor. Morphologic changes were evaluated using hematoxylin-eosin staining and electron microscopy, and cell-adhesion molecule expression, including ZO-1, E-cadherin, integrin-β4, and laminin, was evaluated using immunohistochemistry. Super-resolution microscopy analyzed intranuclear SETDB1 localization and heterochromatin formation in IECs. IRI-affected jejunum exhibited massive IEC detachment, dilated intercellular spaces, basement membrane damage, and decreased expression of E-cadherin and integrin-β4. Sinefungin prevented these changes, however. The proportion of IECs expressing nuclear SETDB1 throughout the euchromatin was significantly higher in IRI-affected jejunum (77.8%) than sham-treated (3.0%) or sinefungin-treated, IRI-affected jejunum (2.7%). The proportion of IECs with decreased heterochromatin was significantly higher in sinefungin-treated, IRI-affected jejunum (84.3%) than untreated IRI-affected jejunum (15.6%). These findings suggest that SETDB1-mediated chromatin regulation is pivotal in intestinal IRI and represents a potential therapeutic target.
DOI： 10.1267/ahc.24-00061
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Nanashima A., Hiyoshi M., Imamura N., Hamada T., Tsuchimochi Y., Shimizu I., Ochiai T., Ichihara A., Hamada K., Ichiki N., Kai K., Higuchi K.
Translational Cancer Research 14 ( 1 ) 461 - 472 2025.1
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Translational Cancer Research
Background: Progression of chronic liver dysfunction influenced by long-term chemotherapy or repeated hepatectomy might be related to patient overall survival as well as tumor factors in colorectal liver metastasis (CLM) patients. Our aim of this study was to clarify the relationship between fibrotic liver damage and malignant behaviors of CLM malignancy or its long-term survivals by the retrospective cohort study. Methods: We examined the relationship between tumor-related factors or six liver fibrosis-associated parameters, including platelet count, hyaluronic acid (HA), mac-2 binding protein glycosylation isomer (M2BPGi), type IV collagen 7S (T4C7), aspartate aminotransferase-to-platelet ratio index (APRI), The fibrosis-4 (Fib-4) index, and clinicopathological parameters, surgical records, and postoperative patient survival in the 45 consecutive patients with CLM who underwent radical hepatectomy. Results: Fibrotic parameters were platelet count of 23.0±8.5 ×104/μL, HA level of 68.9±82.3 ng/mL, M2BPGi of 0.87±0.48 ng/mL, and type IV collagen level of 5.74±3.76 ng/mL. Platelet count was significantly correlated with HA level (P<0.05) and tended to be correlated with M2BPGi levels (P=0.056). HA level was significantly associated with albumin level (P<0.05). Overall survival in this series showed five-year overall survivors after hepatectomy in 44 patients (98%), but cancer-related deaths were observed in only one patient. Patients with higher grades and increased bilirubin levels demonstrated significantly lower cancer-free survival (P<0.05), but fibrotic parameters were not associated with prognostic factors. Conclusions: Fibrotic markers indicating chemotherapy or repeated surgical liver injury were not significant predictive factors reflecting cancer malignant behaviors or patient overall survival, contrary to our hypothesis. The current overall survival status using various modalities for cancer recurrence is satisfactory under our present perioperative management.
DOI： 10.21037/tcr-24-1138
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Islam M.N., Nabekura H., Ueno H., Nishida T., Nanashima A., Sakoda H., Zhang W., Nakazato M.
Scientific Reports 14 ( 1 ) 24782 2024.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Scientific Reports
Liver-expressed antimicrobial peptide 2 (LEAP2) is a peptide that counteracts the hunger hormone ghrelin-induced functions. Recently, we showed that vertical sleeve gastrectomy (VSG) did not alter the serum LEAP2 concentration in individuals with obesity. Here, we investigated the effects of VSG in both chow diet (CD)-fed and high-fat diet (HFD)-fed mice. In CD-fed mice, VSG increased plasma LEAP2 levels and hepatic Leap2 mRNA levels while decreasing body weight, blood glucose levels, and ghrelin levels. Intraperitoneal (ip) administration of ghrelin reversed these changes. These effects were found in both male and female mice. In contrast, VSG or weight loss in HFD-induced obese mice decreased LEAP2 levels. After fasting, the plasma LEAP2 concentration was in the following order: hepatic vein > abdominal aorta > portal vein. A high glucose concentration robustly increased the plasma LEAP2 concentration in the hepatic vein and abdominal aorta but not in the portal vein. In addition, corn oil or palmitate increased LEAP2 expression and secretion. The increase in LEAP2 levels after the meal tolerance test was delayed in the human subjects with diabetes. Our data suggest that various factors (metabolic, hormonal, and nutritional) regulate LEAP2, and the liver is the predominant site for the production and secretion of LEAP2. Furthermore, the interaction between ghrelin and LEAP2 is involved in the pathogenesis of obesity and diabetes.
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経肛門的小腸バルーン内視鏡で術前に病理診断した小腸原発悪性黒色腫の1例 Reviewed
清水一晃，内勢由佳子，市来伸彦，濵田聖暁，市原明子，七島篤志，中村恵理子，都築 諒
日本臨床外科学会雑誌 85 ( 11 ) 1551 - 1555 2024.10
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)
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Hosokawa A., Tamura H., Ichihara A., Imamura N., Kai K., Fukushima T., Nanashima A., Komohara Y.
Anticancer Research 44 ( 9 ) 4119 - 4125 2024.9
Language：English Publishing type：Case report Publisher：Anticancer Research
Background/Aim: Immune checkpoint inhibitors are effective in treating microsatellite instability-high (MSI-H) metastatic colorectal cancer (CRC). Pathological complete response to immune checkpoint inhibitors for MSI-H metastatic CRC have been described in several reports. Liver metastasis is known to predict resistance to ani-programmed death 1 (PD-1)/PD-1 ligand 1 (PD-L1) therapy in several cancers, including CRC. Case Report: Herein, we report the case of a 23-year-old man with MSI-H colorectal liver metastasis who exhibited a pathological complete response to pembrolizumab following systemic chemotherapies. Pathological examination of the primary lesion revealed strong HLA-class I and HLA-DR expression in cancer cells. Elevated PD-L1 expression was observed in areas of increased CD8-postive T cell infiltration. Additional pathological study of regional lymph nodes showed increased PD-L1 and CD169 expression. Conclusion: A detailed pathological examination revealed PD-L1 expression not only in the primary CRC lesion but also in regional lymph nodes. Recent studies have highlighted the significance of regional lymph nodes in anti-cancer immune responses. Therefore, pathological studies using resected lymph nodes might be beneficial for predicting the response of anti-PD-1/PD-L1 therapy.
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臨床研究 術前治療後に骨盤内臓全摘術を施行した局所進行直腸癌の治療成績 Reviewed
市原明子，市来伸彦，千代反田顕，濵田聖暁，武野慎祐，七島篤志，賀本敏行，細川 歩，陣内 崇，池田拓人
宮崎医師会医学会誌 48 ( 2 ) 129 - 136 2024.9
Language：Japanese Publishing type：Research paper (scientific journal)
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A case of late-presenting congenital diaphragmatic hernia diagnosed at 5 years with acute abdomen. Reviewed
Masuya R, Nakame K, Munakata S, Takeno S, Nanashima A, Ieiri S
Surgical Case Reports 10 ( 1 ) 177 2024.7
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Acceptance of Virtual Reality Simulation Training for Stoma Care by Healthcare Providers: A Pilot Questionnaire Study After Viewing Prototype Imagings. Reviewed
Kai K, Shinoda H, Takeiri E, Hamada T, Chikubu M, Kodama Y, Higuchi K, Nanashima A
Cureus 16 ( 7 ) e65465 2024.7
Language：English Publishing type：Research paper (scientific journal)
DOI： 10.7759/cureus.65465
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Soyama A., Yamamoto H., Eguchi S., Nanashima A., Kakeji Y., Kitagawa Y., Nakamura M., Endo I.
Journal of Hepato-Biliary-Pancreatic Sciences 31 ( 7 ) 425 - 436 2024.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Hepato-Biliary-Pancreatic Sciences
Background: Although curative resection with vascular reconstruction improves the prognosis of blood-invading locally advanced hepatobiliary tumors, the mortality and morbidity of the procedure remains unclear. This study aimed to clarify the risk factors associated with mortality and morbidity in patients undergoing liver resection with vascular reconstruction. Methods: This retrospective observational study included 1215 patients undergoing hepatectomy of more than one section with vascular reconstruction, except for left lateral sectionectomy registered in the National Clinical Database (NCD) between 2015 and 2019. The rates of surgical mortality and relevant clinical factors were evaluated. Results: Among the four types of vascular reconstruction, portal venous reconstruction was frequently performed in 724 patients (59.6% of the enrolled patients). Surgical mortality was 8.1%. Patients with hepatic artery reconstruction had the highest surgical mortality rate of 15.8%. In other types of reconstruction, surgical mortality was 9.1% in the portal vein, 5.2% in inferior vena cava, and 4.9% in hepatic vein. Factors significantly associated with surgical mortality include age, sex (male), preoperative comorbidity (American Society of Anesthesiologists grade >3, respiratory distress, diabetes, preoperative pneumonia, weight loss, and obstructive jaundice), poorer liver functional reserve (indocyanine green retention rate at 15 min and prothrombin time/international normalized ratio >1.1) and accompanying biliary reconstruction. Conclusions: The NCD revealed the detailed status of liver resection combined with vascular reconstruction in Japan. Based on the results of this analysis, understanding the factors that influence the outcome and postoperative course of each procedure will provide patients with accurate information and opportunities to improve future outcomes.
DOI： 10.1002/jhbp.1435