研究者詳細 - 七島　篤志

Liver hanging maneuver is suitable in major hepatectomy for liver malignancies over 5 cm 査読あり

Nanashima A., Hiyoshi M., Imamura N., Yano K., Hamada T., Kitamura E., Kawano F.

Turkish Journal of Surgery 38 ( 3 ) 215 - 220 2022年9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：Turkish Journal of Surgery

Objective: Hepatic transection through an anterior approach is required to successfully complete anatomical hepatectomy for large liver malignancies. The liver hanging maneuver (LHM) is an alternative procedure for transection on an adequate cut plane and may reduce intraoperative bleeding and transection times. Material and Methods: We examined the medical records of 24 patients with large liver malignancies (>5 cm) who had undergone anatomical hepatic resection with LHM (n= 9) or without LHM (n= 15) between 2015 and 2020. Patient demographics, preoperative hepatic function, surgical records, and post-hepatectomy outcomes were retrospectively compared between the LHM and non-LHM groups. Results: The prevalence of tumors >10 cm was significantly higher in the LHM group than in the non-LHM group (p< 0.05). Furthermore, LHM was significantly performed to right and extended right hepatectomies in the background normal liver (p< 0.05). Although transection times did not significantly differ between the two groups, the amount of intraoperative blood loss was slightly lower in the LHM group than in the non-LHM group (1.566 mL vs. 2.017 mL), and blood transfusion was not needed for patients in the LHM group. Post-hepatectomy liver failure and bile leakage were not observed in LHM. However, the length of hospitalization was slightly shorter in the LHM group than in the non-LHM group. Conclusion: LHM is useful for transecting an adequately cut plane in hepatectomy for liver tumors over 5 cm-in-size located on the right side and achieves better outcomes.

DOI： 10.47717/turkjsurg.2022.5731

手術手技舌骨下筋群･頸神経ワナを温存した食道癌頸部郭清術

Surgical outcomes of laparoscopic versus open repeat liver resection for liver cancers: A report from a nationwide surgical database in Japan 査読あり

Kaibori, M., Ichihara, N., Miyata, H., Kakeji, Y., Nanashima, A., Kitagawa, Y., Yamaue, H., Yamamoto, M. and Endo, I.

Journal of Hepato-Biliary-Pancreatic Sciences 29 ( 8 ) 833 - 842 2022年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

DOI： DOI: 10.1002/jhbp.1156

木片の杙創による右外腸骨静脈損傷を認めた1例査読あり

濵田朗子，河野文彰，宗像　駿，田代耕盛，武野慎祐，落合貴裕，七島篤志

日本腹部救急医学会雑誌 42 ( 5 ) 595 - 598 2022年7月

担当区分：最終著者,　責任著者記述言語：日本語掲載種別：研究論文（学術雑誌）

河野文彰, 武野慎祐, 田代耕盛, 池ノ上実, 七島篤志

手術 76 ( 8 ) 1323 - 1328 2022年7月

担当区分：最終著者記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：金原出版

DOI： 10.18888/op.0000002895

Spatiotemporal expression of HMGB2 regulates cell proliferation and hepatocyte size during liver regeneration 査読あり

Yano, K., Choijookhuu, N., Ikenoue, M., Fidya, Fukaya, T., Sato, K., Lee, D., Taniguchi, N., Chosa, E., Nanashima, A. and Hishikawa, Y.

Scientific Reports 12 ( 1 ) 11962 2022年7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：Scientific Reports

Liver regeneration is an extraordinarily complex process involving a variety of factors; however, the role of chromatin protein in hepatocyte proliferation is largely unknown. In this study, we investigated the functional role of high-mobility group box 2 (HMGB2), a chromatin protein in liver regeneration using wild-type and HMGB2-knockout (KO) mice. Liver tissues were sampled after 70% partial hepatectomy (PHx), and analyzed by immunohistochemistry, western blotting and flow cytometry using various markers of cell proliferation. In WT mice, hepatocyte proliferation was strongly correlated with the spatiotemporal expression of HMGB2; however, cell proliferation was significantly delayed in hepatocytes of HMGB2-KO mice. Quantitative PCR demonstrated that cyclin D1 and cyclin B1 mRNAs were significantly decreased in HMGB2-KO mice livers. Interestingly, hepatocyte size was significantly larger in HMGB2-KO mice at 36–72 h after PHx, and these results suggest that hepatocyte hypertrophy appeared in parallel with delayed cell proliferation. In vitro experiments demonstrated that cell proliferation was significantly decreased in HMGB2-KO cells. A significant delay in cell proliferation was also found in HMGB2-siRNA transfected cells. In summary, spatiotemporal expression of HMGB2 is important for regulation of hepatocyte proliferation and cell size during liver regeneration.

DOI： 10.1038/s41598-022-16258-4

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. and Satoshi Ieiri

Asian Journal of Endoscopic Surgery 15 ( 3 ) 693 - 696 2022年7月

記述言語：英語掲載種別：症例報告出版者・発行元：Asian journal of endoscopic surgery

INTRODUCTION: In recent years, dome resection, which preserves the splenic immunological function, has been the primary technique used to treat splenic cysts. We herein report a surgical technique using a needle grasper and indocyanine green (ICG) fluorescence to perform dome resection of a huge nonparasitic splenic cyst in a pediatric patient. PATIENT AND SURGICAL TECHNIQUE: A 13-year-old girl was incidentally diagnosed with a splenic cyst during follow-up for scoliosis. Abdominal enhanced computed tomography (CT) showed a 17 × 14 × 14 cm unifocal cyst. Laparoscopic dome resection was planned. The intraoperative findings showed that the spleen was distended, but there was no apparent prominence of the thin cyst wall on the surface of the spleen. An ICG fluorescence camera overlay revealed poor coloration in the thinning area. We punctured the area and aspirated the cyst contents. We grasped the cyst wall with a percutaneous needle grasper and dissected the cyst wall with a vessel sealing system. We placed anti-adhesion agent at the dissection line to prevent recurrence. DISCUSSION: ICG fluorescence was useful for identifying the thinning area of a splenic cyst. The use of a percutaneous needle grasper facilitated the performance of dome resection of a huge splenic cyst in a pediatric patient with minimal invasiveness and an improved cosmetic outcome.

DOI： 10.1111/ases.13052

Relationship of immunonutritional factor with changes in liver volume after portal vein embolization 査読あり

Nanashima, A., Tanoue, Y., Yano, K., Hiyoshi, M., Imamura, N., Hamada, T., Kai, K., Kitamura, E., Suzuki, Y., Tahira, K., Kawano, F. and Nagayasu, T.

Surgery Open Science 9 117 - 124 2022年6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：Surgery Open Science

Background: To identify predictors of changes in hepatic volumes after portal vein embolization, we examined the relationship with preoperative nutritional and immunological parameters. Patients and Methods: Ninety-three patients who underwent portal vein embolization were included. The control group comprised 13 patients who underwent right hepatectomy without portal vein embolization. Computed tomographic volumetric parameter was measured for changes in embolized and nonembolized liver. Correlation with various candidates of immunonutritional parameters was examined. Results: Difference in increased liver ratio was 9.1%. C-reactive protein levels significantly increased after portal vein embolization (P < .01), whereas albumin and total cholesterol levels significantly decreased, respectively (P < .01). The C-reactive protein/albumin ratio, prognostic nutritional index, Controlling Nutritional Status score, and modified Glasgow Prognostic Score were significantly different, respectively (P < .01). Prothrombin activity and total cholesterol level significantly correlated with the increased change in nonembolized liver (P < .05). The C-reactive protein and C-reactive protein/albumin ratio after portal vein embolization negatively correlated with hypertrophic ratio (P < .05). By comparing posthepatectomy outcomes between 64 patients undergoing portal vein embolization and 13 who did not, the prevalence of severe complications and mortality in the portal vein embolization group was not different from that in the non–portal vein embolization group. Liver activity at 15 minutes > 0.92 and increased liver volume ≥ 10% tended to correlate with lower prevalence of severe complications. Only increased intraoperative blood loss ≥ 1,500 mL was significantly associated with morbidity and mortality (P < .05). Conclusion: Contrary to our hypothesis, immunonutritional parameters, except C-reactive protein and C-reactive protein/albumin ratio, did not reflect hypertrophy after portal vein embolization. Although it is difficult to predict the hypertrophic degree, the strategy of scheduled hepatectomy should be switched in case of impaired inflammatory status after portal vein embolization.

DOI： 10.1016/j.sopen.2022.05.012

Using indocyanine green fluorescence in laparoscopic surgery to identify and preserve rare branching of the right hepatic artery in pediatric congenital biliary dilatation 査読あり

Masuya, R., Matsukubo, M., Nakame, K., Kai, K., Hamada, T., Yano, K., Imamura, N., Hiyoshi, M., Nanashima, A. and Ieiri S.

Surgery Today 82 ( 10 ) 1510 - 1513 2022年5月

記述言語：英語掲載種別：症例報告出版者・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.

DOI： 10.1007/s00595-022-02516-5

Impact of the number of board-certified pediatric surgeons per pediatric population on the outcomes of laparoscopic fundoplication for neurologically impaired patients 査読あり

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. and Ieiri, S.

Journal of Laparoendoscopic & Advanced Surgical Techniques 32 ( 5 ) 571 - 575 2022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

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.

DOI： 10.1089/lap.2021.0713

Curative remnant total pancreatectomy for recurrent pancreatic acinar cell carcinoma: A case report 査読あり

Hiyoshi, M., Kai, K., Hamada, T., Yano, K., Imamura, N. and Nanashima, A.

International Journal of Surgery Case Reports 94 107091 - 107091 2022年5月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：症例報告出版者・発行元：International Journal of Surgery Case Reports

Introduction and importance: Acinar cell carcinoma (ACC) of the pancreas is a rare pancreatic cancer subtype (incidence, 0.5–2%) with unclear epidemiology and prognosis. Sometimes, repeat resection including total pancreatectomy is required for recurrence. We report a case of ACC recurring in the remnant pancreatic head after distal pancreatectomy that was successfully cured by remnant pancreatic resection following combination therapy with nab-paclitaxel (nab-PTX) and gemcitabine (GEM). Case presentation: A 64-year-old woman was referred for pancreatic tumour treatment. CT revealed a 46-mm tumour in the pancreatic body, and endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) indicated ACC. Distal pancreatectomy was performed, and the final diagnosis was ACC. CT 18 months later showed a 34-mm tumour in the remnant pancreatic head revealed as ACC by EUS-FNA. Portal vein invasion was apparent, so neoadjuvant chemotherapy with nab-PTX and GEM was administered, and remnant pancreatic resection (total pancreatectomy) was performed. No recurrence or distant metastasis was present more than 6 months later. Clinical discussion: Mean survival time for ACC is 18–47 months, and prognosis is good compared with pancreatic ductal adenocarcinoma (PDAC). ACC tends to extend and grow along the main pancreatic duct, which increases the recurrence rate to 50–60%. EUS and EUS-FNA were useful for evaluating tumour extension and diagnosis. Repeat pancreatic resection that included total pancreatectomy was feasible and could be performed safely. Conclusion: ACC has a better prognosis than PDAC but with a higher recurrence rate. Aggressive surgical resection that included remnant total pancreatotomy with chemotherapy was useful in treating ACC.

DOI： 10.1016/j.ijscr.2022.107091

Integrin α6A (ITGA6A)-type Splice Variant in Extracellular Vesicles Has a Potential as a Novel Marker of the Early Recurrence of Pancreatic Cancer

弓部置換術後の大動脈食道瘻に対し，分割的に食道切除術と再建，大網充填術を施行し救命した1例査読あり

内勢由佳子，田代耕盛，宗像　駿，北村英嗣，濵田朗子，河野文彰，武野慎祐，森　晃佑，阪口修平，石井廣人，古川貢之，七島篤志

Japanese Journal of Acute Care Surgery 12 ( 1 ) 95 - 99 2022年4月

担当区分：最終著者記述言語：日本語掲載種別：症例報告

Asada T., Nakahata S., Fauzi Y.R., Ichikawa T., Inoue K., Shibata N., Fujii Y., Imamura N., Hiyoshi M., Nanashima A., Morishita K.

Anticancer Research 42 ( 4 ) 1763 - 1775 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：Anticancer Research

Background/Aim: Pancreatic ductal adenocarcinoma (PDAC) is one of the most common cancers worldwide, with a poor prognosis. Owing to the difficulty of early diagnosis, the aim of this study was to isolate biomarkers from extracellular vesicles (EVs) that can lead to early diagnosis. Materials and Methods: EVs in the culture supernatant were isolated from a pancreatic cancer cell line (PK-1) and expanded by using two-dimensional gel electrophoresis, and protein identification from each spot was performed by using matrix-assisted laser desorption ionization mass spectrometry. The identified proteins were classified and compared with previously reported results for EVs from murine pancreatic cancer PAN02 cells, and their expression specificity was examined using PDAC cell lines and patient-derived PDAC tissues. In addition, the significance of selected biomarker(s) was examined based on the changes in biomarkers in the blood EVs of PDAC patients after surgery. Results: We found that the ITGA6A splice variant was predominantly expressed in several pancreatic cancer cell lines and blood EVs from patients with PDAC, whereas the ITGA6B splice variant was predominantly expressed in EVs from the blood of normal volunteers. In the expression pattern of ITGA6 in EVs from blood samples of two PDAC patients before and after resection surgery, the expression of ITGA6A in EVs significantly decreased after surgery and increased several months before clinical recurrence. Furthermore, the increased expression of ITGA6A in EVs occurred much earlier than that of CA19-9. Conclusion: Determination of ITGA6A expression in blood EVs in PDAC patients could be a useful blood marker for the early diagnosis of PDAC recurrence.

DOI： 10.21873/anticanres.15653

Biliary atresia: graft-versus-host disease with maternal microchimerism as an etiopathogenesis 査読あり

Masuya R., Muraji T., Harumatsu T., Muto M., Nakame K., Nanashima A., Ieiri S.

Transfusion and Apheresis Science 61 ( 2 ) 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.

DOI： 10.1016/j.transci.2022.103410

Biliary atresia: graft-versus-host disease with maternal microchimerism as an etiopathogenesis 査読あり

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

DOI： 10.1016/j.transci.2022.103410

Integrin α6A (ITGA6A)-type Splice Variant in Extracellular Vesicles Has a Potential as a Novel Marker of the Early Recurrence of Pancreatic Cancer 査読あり

Asada T., Nakahata S., Fauzi Y.R., Ichikawa T., Inoue K., Shibata N., Fujii Y., Imamura N., Hiyoshi M., Nanashima A., Morishita K.

Anticancer Research 42 ( 4 ) 1763 - 1775 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：Anticancer Research

DOI： 10.21873/anticanres.15653

開腹手術を必要とした経肛門直腸異物の1例査読あり

樋口和宏，末田秀人，佐野浩一郎，真方寿人，市来伸彦，七島篤志

宮崎県医師会医学会誌 46 ( 1 ) 42 - 45 2022年3月

担当区分：最終著者記述言語：日本語掲載種別：症例報告

術後1年および5年無再発生存中の大腸MiNENの2例査読あり

市来伸彦，池田拓人，市原明子，濵田朗子，大田勇輔，七島篤志

日本臨床外科学会雑誌 83 ( 3 ) 542 - 549 2022年3月

担当区分：最終著者,　責任著者記述言語：日本語掲載種別：研究論文（学術雑誌）

Knowledge survey regarding blast wound education of student doctors at a local academic medical university in Japan 査読あり

Kawano F., Munakata S., Tashiro K., Ikenoue M., Furukawa K., Ochiai H., Nakamura K., Nanashima A.

Turkish Journal of Surgery 38 ( 1 ) 74 - 80 2022年3月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Turkish Journal of Surgery

Objective: To improve knowledge about blast injury for medical student doctors or surgeons. In the modern uncertain era, education and training programs for blast injuries for medical student doctors or surgeons are recently necessary worldwide. Material and Methods: To understand primary corresponding ability to treat blast injuries, leading to improvement of the trauma education curriculum, a retrospective study by a knowledge survey was performed between 2018 and 2019. The subject had the title of Student Doctor (SD) at university. Results: The answers of 183 participants who answered the interview questionnaire with 16 questions were summarized. Although most SDs received basic lectures for trauma medicine and majority of SDs knew about mass casualty incidents and primary treatment, the existence of knowledge on soft targets is limited. One-fourth of the SDs knew the characteristics of blast wounds. Most SDs understood priority triage for a conscious person with massive bleeding from a limb with hemostasis to save lives. The 17% selected cardiopulmonary resuscitation first and 72% of SDs could explain hemorrhagic shock; however, only four could explain adequate hemostatic procedures. Most had no interest regarding necessity of their knowledge in the field of serious blast trauma wounds. Conclusion: Experience in trauma surgery training from stages in SDs and authorized education are important for raising students’ knowledge of unexpected serious blast incidents.

DOI： 10.47717/TURKJSURG.2022.5537

Queries regarding the optimal indication of infrahepatic inferior vena cava clamping and proposal for examining the hepatic venous pressures or accompanied Trendelenburg position to improve this procedure 査読あり

Nanashima A.

Journal of Hepato-Biliary-Pancreatic Sciences 29 ( 3 ) e15 - e16 2022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：Journal of Hepato-Biliary-Pancreatic Sciences

DOI： 10.1002/jhbp.1042