研究者詳細 - 藤原　俊義

論文 - 藤原　俊義

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西脇紀之, 野間和広, 大原利章, 河崎健人, 赤井正明, 小林照貴, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 田澤大, 白川靖博, 藤原俊義

日本分子腫瘍マーカー研究会誌 36 32 - 33 2021年

リアルタイムイメージングによる予後不良間葉型大腸癌の治療抵抗性EMTマーカーの発現の時空間的意義

三村直毅, 矢野修也, 田澤大, 家田偉史, 岡林弘樹, 重安邦俊, 武田正, 吉田一博, 寺石文則, 楳田祐三, 香川俊輔, 藤原俊義

日本分子腫瘍マーカー研究会誌 36 18 - 20 2021年

記述言語：日本語出版者・発行元：日本分子腫瘍マーカー研究会

上皮間葉転換(EMT)可視化プローベを用い、間葉型大腸癌がhybrid E/Mで最も化学療法抵抗性であるかをイメージングによって明らかにするとともに、時間的にEMTマーカーを追跡した。Vimentinプロモーター下に赤色蛍光タンパク遺伝子(rfp)がドライブさせるEMT可視化プローベを作成した。大腸癌細胞株HCT116、RKOにEMT可視化プローベを導入した。大腸癌の代表的な抗癌剤5-FU、オキサリプラチン(L-OHP)、シスプラチン(CDDP)、イリノテカン(CPT-11)を曝露させた。その結果、RKOではL-OHP、CDDP、5-FUの順で赤色を呈するEMTを起こし、HCT116では5-FU、L-OHP、CDDPの順でEMTを起こした。また、時間軸では化学療法後48時間するとEMTを起こし赤色になったが、化学療法終了後48時間経過するとEMTを起こし無色に戻った。化学療法施行前にEMT阻害剤で前治療しておくと、化学療法に曝露しても赤色にならず(EMTは阻害され)、さらに化学療法への感受性も増加していた。

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Differences In Attitudes And Practices Of Cancer Pain Management Between Medical Oncologists And Palliative Care Physicians

Toshiki Kunitomi, Junichirou Nasu, Daisuke Minami, Takayuki Iwamoto, Hiroyuki Nishie, Shinya Saito, Toshiyoshi Fujiwara, Junji Matsuoka

Acta Medica Okayama 75 ( 4 ) 431 - 437 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University

This study aimed to evaluate whether there are differences in the attitudes and practices of cancer pain management between medical oncologists and palliative care physicians. An online nationwide survey was used to collect responses from board-certified medical oncologists and palliative care physicians in Japan. The survey questionnaire comprised 30 questions. The differences in responses between medical oncologists and palliative care physicians were examined. Out of the 1,227 questionnaires sent, 522 (42.5%) were returned. After applying the exclusion criteria, 445 questionnaires (medical oncologists: n=283
palliative care physicians: n=162) were retained for analysis. Among the questions about potential barriers to optimal cancer pain management, both medical oncologists and palliative care physicians considered the reluctance of patients to take opioids due to fear of adverse effects as the greatest barrier. Significantly different ratings between medical oncologists and palliative care physicians were observed on 5 of the 8 questions in this area. Significantly different ratings were observed for all questions concerning pain specialists and their knowledge. For effective cancer pain management, it is important to account for differences in attitudes and practice between medical oncologists and palliative care physicians.

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

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年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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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周術期管理チーム介入後の高齢者大腸癌症例のアウトカムの検証 PERIO介入によりアウトカムは向上したか

寺石文則, 杉本龍馬, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 香川俊輔, 藤原俊義

日本消化器外科学会総会 75回 P210 - 3 2020年12月

OS延長を目指した局所進行直腸癌に対するoxaliplatinを用いた術前化学放射線療法の治療成績

武田正, 寺石文則, 重安邦俊, 矢野修也, 近藤喜太, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P135 - 6 2020年12月

プレシジョンメディシン時代に備えた大腸癌リンパ節郭清範囲の統一化

矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P147 - 1 2020年12月

フェルカルボトランを用いた胃癌腹膜播種に対する磁気温熱療法

松三雄騎, 岸本浩行, 香川哲也, 矢野修也, 重安邦俊, 岡林弘樹, 大原利章, 田澤大, 藤原俊義

日本消化器外科学会総会 75回 P077 - 3 2020年12月

直腸癌術前後の白血球数は予防的回腸人工肛門の閉塞やHigh output stoma発症を予測する指標となる

重安邦俊, 小松泰浩, 武田正, 矢野修也, 近藤喜太, 寺石文則, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P129 - 1 2020年12月

フェルカルボトランを用いた胃癌腹膜播種に対する磁気温熱療法

松三雄騎, 岸本浩行, 香川哲也, 矢野修也, 重安邦俊, 岡林弘樹, 大原利章, 田澤大, 藤原俊義

日本消化器外科学会総会 75回 P077 - 3 2020年12月

Short-term and long-term outcomes in living donors for liver transplantation: Cohort study. 国際誌

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Nobuyuki Watanabe, Takashi Kuise, Kazuhiro Yoshida, Kazuya Yasui, Tatsuo Matsuda, Toshiyoshi Fujiwara, Takahito Yagi

International journal of surgery (London, England) 84 147 - 153 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Although perioperative outcomes following donor hepatectomy (DH) have been reported, little is known about the long-term outcomes in living donors of liver transplantation. The aim of this study was to investigate the short-term and long-term outcomes following DH. METHODS: A total of 408 living donors who underwent DH between 1996 and 2019 were analyzed in this retrospective study, focusing on short-term outcomes with respect to the operation period (era) and the graft type, as well as long-term outcomes. RESULTS: The overall incidence of postoperative complications was 40.4%. These included minor (30.4%), major (10.0%), and biliary (14.0%) complications. Short-term outcomes after DH slightly improved over time, and outcomes did not differ significantly between the graft types. With regards to long-term outcomes, the incidence of surgery-related complications such as keloids, incisional hernias, and mechanical bowel obstructions was 6.6% over a median follow-up of 7.2 years. In addition, some donors developed comorbidities such as lifestyle diseases and cancers during the follow-up period. CONCLUSIONS: Our study confirmed an improvement of perioperative outcomes in living donors. There was no significant association between the graft type and postoperative outcomes. Donors could develop various morbidities during long-term follow-up. Therefore, a careful perioperative management and long-term follow-up should be provided to living donors.

DOI： 10.1016/j.ijsu.2020.11.013

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食道癌に対する低侵襲手術の現況と展望

白川靖博, 野間和広, 河崎健人, 西江尚貴, 山田元彦, 前田直見, 田辺俊介, 西崎正彦, 藤原俊義

日本食道学会学術集会プログラム・抄録集 74回 8 - 8 2020年12月

プレシジョンメディシン時代に備えた大腸癌リンパ節郭清範囲の統一化

矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P147 - 1 2020年12月

観音開き法(上川法)再建における胃食道逆流予防と吻合部狭窄予防に重要な手技上のポイント

黒田新士, 西崎正彦, 菊地覚次, 高田暢夫, 垣内慶彦, 田辺俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 RSV6 - 1 2020年12月

ERASプロトコールにおける腹腔鏡下胃切除術後の最適な鎮痛法

菊地覚次, 黒田新士, 西崎正彦, 高田暢夫, 武田正, 垣内慶彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 RS21 - 6 2020年12月

[胃]胃切除後のQOL向上を目指したエビデンスの創生胃癌周術期の継続的な栄養指導が術後体重や栄養指標に与える影響

高田暢夫, 菊地覚次, 武田正, 垣内慶彦, 黒田新士, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 WS3 - 10 2020年12月

消化器外科におけるロボット支援下手術ロボット支援下低侵襲食道切除術の現状と展望(Robotic surgery in the field of gastroenterological surgery Current status and perspective of robot-assisted minimally invasive esophagectomy for cancer)

Shirakawa Yasuhiro, Noma Kazuhiro, Kawasaki Kento, Nishie Naoki, Yamada Motohiko, Maeda Naoaki, Tanabe Shunsuke, Kuroda Shinji, Umeda Yuzo, Fujiwara Toshiyoshi

日本消化器外科学会総会 75回 VSY9 - 3 2020年12月

Risk factor of mediastinal lymph node metastasis of Siewert type I and II esophagogastric junction carcinomas. 国際誌

Noriyuki Nishiwaki, Kazuhiro Noma, Tatsuo Matsuda, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 405 ( 8 ) 1101 - 1109 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Incidence of esophagogastric junction (EGJ) carcinoma has been increasing worldwide. Several studies revealed that the distance from the EGJ to the proximal edge of the primary tumor (esophageal invasion: EI) may be a significant indicator of metastasis in the mediastinal lymph nodes in patients with Siewert type II carcinomas. However, few studies have been conducted in patients with carcinomas located at Siewert type II sequentially to upper carcinomas (Siewert type I) for mediastinal metastasis regardless of histological types. METHODS: This was a single-center retrospective cohort study. EGJ carcinomas located at Siewert type I and II regions including both squamous cell carcinoma (SCC) and adenocarcinoma were analyzed in terms of lymph node metastasis patterns. RESULTS: We included 121 patients in this study. Thirty-three (27.3%) patients had SCC. In multivariate analysis, the distance of EI (> 20 mm) was an independent risk factor (OR 11.80, p = 0.005) for lower mediastinal lymph node metastasis. In terms of above the middle mediastinal metastasis, the distance of EI (> 30 m), histological type (SCC), and tumor size (> 40 mm) were risk factors in univariate analysis. Furthermore, EI was significant (OR 13.50, p = 0.026) in multivariate analysis. CONCLUSIONS: The distance of EI was the independent risk factor for mediastinal lymph node metastasis, especially > 20 mm related with a higher risk for mediastinal lymph node metastasis. Furthermore, EGJ carcinoma patients who have EI > 30 mm, large SCC carcinoma, and multiple lymph node metastasis might be considered the middle-upper mediastinal lymph node dissection by transthoracic approach.

DOI： 10.1007/s00423-020-02017-4

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周術期管理チーム介入後の高齢者大腸癌症例のアウトカムの検証 PERIO介入によりアウトカムは向上したか

寺石文則, 杉本龍馬, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 香川俊輔, 藤原俊義

日本消化器外科学会総会 75回 P210 - 3 2020年12月

OS延長を目指した局所進行直腸癌に対するoxaliplatinを用いた術前化学放射線療法の治療成績

武田正, 寺石文則, 重安邦俊, 矢野修也, 近藤喜太, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P135 - 6 2020年12月

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