Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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消化管リンパ腫の病態と治療 H.pylori未感染および既往感染の胃MALTリンパ腫症例の治療に関する検討

岩室雅也, 岡田裕之, 田中健大

Gastroenterological Endoscopy 63 ( Suppl.1 ) 742 - 742 2021.4

Peutz-Jeghers症候群の11例における胃病変に関する検討

里見拓也, 岩室雅也, 豊川達也, 森藤由記, 松枝和宏, 堀伸一郎, 吉岡正雄, 田中健大, 川野誠司, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.1 ) 936 - 936 2021.4

CTコロノグラフィー検査が診断に有用であった盲腸子宮内膜症の2例

小橋真由, 岩室雅也, 田中健大, 杉原雄策, 原田馨太, 平岡佐規子, 近藤喜太, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.1 ) 966 - 966 2021.4

消化管リンパ腫の病態と治療 H.pylori未感染および既往感染の胃MALTリンパ腫症例の治療に関する検討

岩室雅也, 岡田裕之, 田中健大

Gastroenterological Endoscopy 63 ( Suppl.1 ) 742 - 742 2021.4

CTコロノグラフィー検査が診断に有用であった盲腸子宮内膜症の2例

小橋真由, 岩室雅也, 田中健大, 杉原雄策, 原田馨太, 平岡佐規子, 近藤喜太, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.1 ) 966 - 966 2021.4

Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer: A multicenter retrospective study. International journal

Takuya Satomi, Seiji Kawano, Tomoki Inaba, Masahiro Nakagawa, Hirokazu Mouri, Masao Yoshioka, Shoichi Tanaka, Tatsuya Toyokawa, Sayo Kobayashi, Takehiro Tanaka, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Hiroyuki Okada

World journal of gastroenterology 27 ( 11 ) 1043 - 1054 2021.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer (GTC) in the reconstructed gastric tube. However, there are few reports on the treatment results of endoscopic submucosal dissection (ESD) for GTC. AIM: To evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter trial. METHODS: We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study group. The clinical indications of ESD for early gastric cancer were similarly applied for GTC after esophagectomy. ESD specimens were evaluated in 2-mm slices according to the Japanese Classification of Gastric Carcinoma with curability assessments divided into curative and non-curative resection based on the Gastric Cancer Treatment Guidelines. Patient characteristics, treatment results, clinical course, and treatment outcomes were analyzed. RESULTS: The median age of patients was 71.5 years (range, 57-84years), and there were 34 men and 4 women. The median observation period after ESD was 884 d (range, 8-4040 d). The median procedure time was 81 min (range, 29-334 min), the en bloc resection rate was 91.7% (44/48), and the curative resection rate was 79% (38/48). Complications during ESD were seen in 4% (2/48) of case, and those after ESD were seen in 10% (5/48) of case. The survival rate at 5 years was 59.5%. During the observation period after ESD, 10 patients died of other diseases. Although there were differences in the procedure time between institutions, a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure time. CONCLUSION: ESD for GTC after esophagectomy was shown to be safe and effective.

DOI： 10.3748/wjg.v27.i11.1043

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Dabigatran-induced esophagitis masking esophageal cancer. Reviewed International journal

Masaya Iwamuro, Hiroshi Matsushita, Takehiro Tanaka, Hiroyuki Okada

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 53 ( 2 ) 251 - 252 2021.2

Long-term outcomes of endoscopic versus surgical resection for MM-SM1 esophageal squamous cell carcinoma using propensity score analysis.

Kenji Yamauchi, Masaya Iwamuro, Masahiro Nakagawa, Ryuta Takenaka, Kazuhiro Matsueda, Tomoki Inaba, Masao Yoshioka, Tatsuya Toyokawa, Shouichi Tanaka, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Yasuhiro Shirakawa, Hiroyuki Okada

Esophagus : official journal of the Japan Esophageal Society 18 ( 1 ) 72 - 80 2021.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) confined to the muscularis mucosae (MM) or up to 200 µm of the submucosa (SM1) confers the risk for lymph node metastasis, and is defined as relative indication for endoscopic submucosal dissection (ESD) by the Japan Esophageal Society guidelines. Although additional surgical treatment after ESD is recommended, long-term outcomes of ESD compared with those of surgery have not been clarified. This study aimed to evaluate the long-term outcomes of ESD and surgery for cN0M0 relative indication lesions of ESCC. METHODS: Between 2006 and 2016, patients with relative indication lesions of ESCC who underwent ESD or surgery at nine participating hospitals were examined retrospectively. Using propensity score matching, we evaluated survival curves for and hazard ratios associated with endoscopic submucosal dissection and surgery. RESULTS: In total, 155 lesions in the ESD group and 106 lesions in the surgery group met the pathological criteria of relative indication for endoscopic resection. After matching, 50 matched pairs of patients who underwent ESD or surgery were selected. The 5-year overall survival rates were 84.5% [95% confidence interval (CI) 68-93] in the ESD group and 79% [95% CI 60-90] in the surgery group. The hazard ratio of mortality for ESD compared with that for surgery estimated by Cox regression analysis was 0.79 (95% CI 0.3-2.06, p = 0.63). CONCLUSIONS: Compared with surgery, ESD does not compromise long-term outcomes. ESD alone or ESD with chemotherapy and/or radiotherapy may be an option for the treatment of MM and SM1 ESCC.

DOI： 10.1007/s10388-020-00775-0

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Gastric Adenoma: A High Incidence Rate of Developing Carcinoma and Risk of Metachronous Gastric Cancer according to Long-Term Follow-Up. International journal

Yuki Okamoto, Hiromitsu Kanzaki, Takehiro Tanaka, Hiroyuki Sakae, Makoto Abe, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Digestion 102 ( 6 ) 878 - 886 2021

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Gastric adenomas are histologically defined as benign epithelial tumors. While some of them remain adenomas for a long time, others progress to carcinomas. However, long-term outcomes of such cases are not entirely clear. Here, we explored the risk factors and incidence of developing carcinoma from gastric adenoma as well as metachronous gastric cancer. METHODS: This study was conducted at a facility that adopted a follow-up strategy for gastric adenoma. Lesions histologically diagnosed as gastric intestinal-type adenomas between January 2004 and December 2016 were analyzed. Clinicopathological data were collected from patients' medical records, and histological changes from adenoma to carcinoma during endoscopic follow-up and risk factors of cancer development were evaluated. RESULTS: This study involved 409 lesions from 376 patients. The analysis of the development of gastric cancer from adenoma and metachronous gastric cancer was ultimately performed for 282 lesions from 258 patients and 269 lesions from 246 patients, respectively, due to different follow-up periods. The 5-year rate of carcinoma development was 34.0%. Risk factors for carcinoma development upon multivariate analysis were lesion size ≥15 mm and morphological depression. All cases with both factors developed gastric carcinoma, and 50.5% of those with either factor developed carcinoma within 5 years. Gastric adenoma was accompanied by metachronous gastric cancer in 1.5% of the patients annually. The only risk factor for metachronous gastric carcinoma was primary adenoma progressing to carcinoma during the follow-up period. DISCUSSION/CONCLUSION: Given the high rate of carcinoma development in patients with risk factors, resection of gastric adenoma should be considered during the initial examination. Careful observation and follow-up should also be conducted to detect not only changes in the primary adenoma but also the occurrence of metachronous carcinoma, especially in cases of adenoma progressing to carcinoma.

DOI： 10.1159/000515213

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A Case of Myoepithelial Hamartoma: Morphological Variation Supported by OCT4 Expression. International journal

Takehiro Tanaka, Kenji Nishida, Masaya Iwamuro, Satoru Kikuchi, Tadashi Yoshino

Case reports in gastrointestinal medicine 2021 6617370 - 6617370 2021

Language：English

In this report, we describe a patient with myoepithelial hamartoma, which is regarded as synonymous with adenomyosis and heterotopic pancreas. Endoscopy revealed a submucosal tumor in the antrum of the stomach. Subsequently, distal gastrectomy with Roux-en-Y reconstruction was performed. Histological findings of adenomyomatous lesion and heterotopic pancreatic tissue were observed in this lesion. The distribution of OCT4, which is a pluripotency marker, varied in each part.

DOI： 10.1155/2021/6617370

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[Clinical characteristics of five patients with gastric emphysema]. Reviewed

Masaya Iwamuro, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Keisuke Hori, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 118 ( 9 ) 851 - 858 2021

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

Gastric emphysema is a rare condition in which gas from a nonbacterial source accumulates within the gastric wall. In this study, we retrospectively analyzed the cases of five patients who were diagnosed with gastric emphysema at the Okayama University Hospital between January 2010 and April 2021, to reveal the clinical features of the disease. Based on their reviews, we revealed that:i) gastric emphysema occurred in hospitalized bedridden patients (n=5), such as those during/after endotracheal intubation (n=3), those undergoing gastric tube placement (n=3), those undergoing percutaneous endoscopic gastrostomy (n=1), and those undergoing treatment for cerebral infarction (n=1);ii) gastric emphysema was accompanied by the accumulation of gas in the portal (n=4) or gastric veins (n=1);iii) gastric emphysema was accompanied by colon wall thickness increase (n=4);iv) esophagogastroduodenoscopy showed redness, erosions, coarse mucosa, and/or ulcers (n=5);v) a clear boundary between the damaged area and the intact mucosa was observed (n=5);vi) the anterior wall of the stomach was less affected (n=4);vii) mucosal damage was predominant in the gastric folds, whereas the furrow of the mucosa was less affected;and viii) treatment with enteral nutrition suspension and the administration of proton pump inhibitors and antibiotics resulted in the recovery of patients from gastric emphysema (n=5). These results indicate that patients with gastric emphysema have distinct clinical, endoscopic, and radiological features. Furthermore, our results show that these patients can be conservatively managed.

DOI： 10.11405/nisshoshi.118.851

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Clinical and phenotypical characteristics of submucosal invasive carcinoma in non-ampullary duodenal cancer. International journal

Katsunori Matsueda, Hiromitsu Kanzaki, Ryuta Takenaka, Masahiro Nakagawa, Kazuhiro Matsueda, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Tomohiro Toji, Takehiro Tanaka, Takahito Yagi, Toshiyoshi Fujiwara, Hiroyuki Okada

PloS one 16 ( 8 ) e0256797 2021

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The rare incidence of submucosal invasive non-ampullary duodenal carcinoma has led to scant information in literature; therefore, we compared the clinicopathological features between submucosal invasive carcinoma (SM-Ca), mucosal carcinoma (M-Ca), and advanced carcinoma (Ad-Ca). MATERIALS: We retrospectively analyzed 165 patients with sporadic non-ampullary duodenal carcinomas (SNADCs) from four institutions between January 2003 and December 2018. The SNADCs were divided to three groups according to histological diagnosis: SM-Ca, M-Ca, and Ad-Ca. The clinicopathological characteristics and mucin phenotypes were compared between groups. RESULTS: Among the 165 SNADCs, 11 (7%) were classified as SM-Ca, 70 (42%) as M-Ca, and 84 (51%) as Ad-Ca. We found that all SM-Ca (P = 0.013) and most Ad-Ca (P = 0.020) lesions were located on the oral-Vater; however, an almost equal distribution of M-Ca lesions was found between the oral- and anal-Vater. No significant difference was observed between the tumor diameter of M-Ca and SM-Ca; however, 45% (5/11) of SM-Ca were ≤10 mm. A total of 73% (8/11) of SM-Ca were classified as gastric phenotype and no lesions were classified as intestinal phenotype; whereas most M-Ca were classified as intestinal phenotype (67%, 8/12). CONCLUSIONS: SM-Ca lesions were all located on the oral-Vater and were highly associated with the gastric mucin phenotype, which were different from the features of most M-Ca.

DOI： 10.1371/journal.pone.0256797

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Histologic Transformation from Follicular Lymphoma to Diffuse Large B-cell Lymphoma Detected during Colonoscopy. Reviewed

Masaya Iwamuro, Yasushi Yamasaki, Takehiro Tanaka, Noboru Asada, Ken-Ichi Matsuoka, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

Acta medica Okayama 75 ( 5 ) 625 - 629 2021

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

A 77-year-old Japanese woman who had been treated for follicular lymphoma for 8 years developed abdominal pain and intra-abdominal lymphadenopathies. Colonoscopy revealed an elevated lesion in the rectum, which presented as two humps with erosions. A diagnosis of histologic transformation of follicular lymphoma to diffuse large B-cell lymphoma was made by endoscopic biopsy. This case underscores the importance of endoscopy examinations and biopsy of newly emerged gastrointestinal lesions for the prompt diagnosis of histologic transformation, since salvage chemotherapy must be initiated quickly in such cases.

DOI： 10.18926/AMO/62775

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Four Cases of Desquamative Esophagitis Occurring after Hematopoietic Stem Cell Transplantation. Reviewed

Masaya Iwamuro, Daisuke Ennishi, Ken-Ichi Matsuoka, Takehiro Tanaka, Shotaro Okanoue, Yuka Obayashi, Hiroyuki Sakae, Yoshiro Kawahara, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 59 ( 23 ) 3015 - 3022 2020.12

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

We herein report four patients with desquamative esophagitis that developed one to nine days after peripheral blood stem cell transplantation (PBSCT). Three patients underwent allogeneic PBSCT for leukemia, and the other underwent autologous PBSCT for pineoblastoma. Esophagogastroduodenoscopy revealed mucosal sloughing and fresh blood in the esophagus. Fasting and intravenous proton pump inhibitor therapy in addition to blood transfusion improved the esophageal lesions within five to seven days in three patients. These cases indicate that desquamative esophagitis can occur in patients who receive hematopoietic stem cell transplantation. Although blood transfusions may be required, it can be resolved within seven days.

DOI： 10.2169/internalmedicine.4977-20

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Hemobilia after bile duct resection: perforation of pseudoaneurysm into intra-pancreatic remnant bile duct: a case report. International journal

Kazuhiro Yoshida, Yuzo Umeda, Masaya Iwamuro, Kazuyuki Matsumoto, Hironari Kato, Mayu Uka, Yusuke Matsui, Ryuichi Yoshida, Takashi Kuise, Kazuya Yasui, Kosei Takagi, Hiroyuki Araki, Takahito Yagi, Toshiyoshi Fujiwara

BMC surgery 20 ( 1 ) 307 - 307 2020.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Hemobilia occurs mainly due to iatrogenic factors such as impairment of the right hepatic or cystic artery, and/or common bile duct in hepatobiliary-pancreatic surgery. However, little or no cases with hemobilia from the intra-pancreatic remnant bile duct after bile duct resection (BDR) has been reported. Here, we report a case of massive hemobilia due to the perforation of psuedoaneurysm of the gastroduodenal artery (GDA) to the intra-pancreatic remnant bile duct after hepatectomy with BDR. CASE PRESENTATION: A 68-year-old male underwent extended right hepatectomy with BDR for gallbladder carcinoma. He presented with upper gastrointestinal bleeding 2 months after the initial surgery. Upper endoscopy identified a blood clot from the ampulla of Vater and simultaneous endoscopic balloon tamponade contributed to temporary hemostasis. Abdominal CT and angiography revealed a perforation of the psuedoaneurysm of the GDA to the intra-pancreatic remnant bile duct resulting in massive hemobilia. Subsequent selective embolization of the pseudoaneurysm with micro-coils could achieve complete hemostasis. He survived without any recurrence of cancer and bleeding. CONCLUSION: Hemobilia could occur in a patient with BDR due to perforation of the pseudoaneurysm derived from the GDA to the intra-pancreatic remnant bile duct. Endoscopic balloon tamponade was useful for a temporal hemostasis and a subsequent radiologic interventional approach.

DOI： 10.1186/s12893-020-00981-8

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Three cases of diverticula-related granulation polyp in the colon

Masaya Iwamuro, Takehiro Tanaka, Tomohiro Toji, Shumpei Yamamoto, Mami Hirai, Shohei Oka, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

Gastroenterological Endoscopy 62 ( 12 ) 3057 - 3063 2020.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Gastroenterological Endoscopy Society

Granulation polyps are found in the colorectum often in association with postoperative anastomotic sites or scars after endoscopic resection. Meanwhile, few cases of granulation polyps that occur in relation to colonic diverticula have been reported. Herein, we report three cases of diverticula-related granulation polyps in the colon. In all three cases, a reddish polyp that protruded from a diverticulum was found in the sigmoid colon. White exudate and tortuous capillaries were observed on the surface of the polyps. On magnifying endoscopic observation, the surface structure was unclear or had disappeared. We speculate that these endoscopic features are specific to granulation polyps in the colon. It is noteworthy that in one patient with laryngeal cancer, the polyp was false-positive for a tumor on positron emission tomography, showing significant tracer accumulation. Differentiation of granulation polyp from cancer metastasis to the colon is important in such patients. It is essential to be able to make a precise diagnosis of diverticula-related granulation polyp in the colon based on endoscopic features.

DOI： 10.11280/gee.62.3057

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Reality of Gastric Cancer in Young Patients: The Importance and Difficulty of the Early Diagnosis, Prevention and Treatment.

Yoshiyasu Kono, Hiromitsu Kanzaki, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Acta medica Okayama 74 ( 6 ) 461 - 466 2020.12

Language：English Publishing type：Research paper (scientific journal)

Gastric cancer usually arises in middle-aged to older patients, and is rarely found in younger patients. The clin-ical characteristics, etiology, prognosis, preventive methods and treatment of gastric cancer in young patients have not been fully investigated because of its low prevalence. In this review, we discuss the current under-standing and clinical problems associated with gastric cancer in young patients. Helicobacter pylori (H. pylori), which is a major cause of gastric cancer, especially in older populations, is closely associated with gastric cancer in young patients as well as in older patients. Gastric cancer in young patients tends to be diagnosed at an advanced stage with alarm symptoms. However, young patients with advanced gastric cancer tend to have a favorable general condition and organ function, so they can tolerate intensive systematic chemotherapy. Unfortunately, the prognosis of gastric cancer in young patients with an advanced stage is not favorable. We should not take this rare disease lightly, given its poor prognosis if patients are diagnosed at an unresectable stage. The evaluation of the H. pylori infection status and performance of H. pylori eradication therapy to prevent gastric cancer in young patients as well as the development of more intensive chemotherapy regimens for unre-sectable gastric cancer in young patients are warranted.

DOI： 10.18926/AMO/61204

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憩室内に形成された大腸肉芽性ポリープの3例

岩室雅也, 田中健大, 都地友紘, 山本峻平, 平井麻美, 岡昌平, 平岡佐規子, 河原祥朗, 岡田裕之

Gastroenterological Endoscopy 62 ( 12 ) 3057 - 3063 2020.12

Language：Japanese Publisher：(一社)日本消化器内視鏡学会

大腸肉芽性ポリープは術後の吻合部や内視鏡治療後の創にみられることが多く,憩室に関連して発生した肉芽性ポリープの報告は少ない.今回筆者らは憩室関連肉芽性ポリープの3例を経験したので報告した.3例ともにS状結腸に憩室内から突出する発赤調ポリープを呈し,表面に白色付着物と蛇行する毛細血管を伴っていた.また拡大観察で表面構造は不明瞭または消失といった特徴を有しており,生検により肉芽性ポリープと診断した.また,1例ではポジトロン断層法検査でポリープに集積を認めた.上記の内視鏡所見を認める場合は,憩室関連肉芽性ポリープを鑑別に挙げるべきと考えられた.(著者抄録)

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咽頭癌CRT後の局所再発病変に対してサルベージESDを施行した一例

織田崇志, 安部真, 濱田健太, 榮浩行, 河野吉泰, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 岡田裕之, 丸中秀格

日本消化器病学会中国支部例会プログラム・抄録集 114回 114 - 114 2020.11

POEMが有効であったJackhammer esophagusの2例

榮浩行, 杉原雄策, 里見拓也, 岡上昇太郎, 濱田健太, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 眞部紀明, 岡田裕之

日本消化器病学会中国支部例会プログラム・抄録集 114回 114 - 114 2020.11

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Papers - IWAMURO Masaya