Faculty Profiles - FUJIWARA Toshiyoshi

Papers - FUJIWARA Toshiyoshi

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最先端医療の今潰瘍性大腸炎におけるRNA編集の意義と臨床応用

近藤喜太, 金谷信彦, 高橋一剛, 重安邦俊, 藤原俊義

Medical Science Digest 50 ( 7 ) 402 - 403 2024.6

最先端医療の今潰瘍性大腸炎におけるRNA編集の意義と臨床応用

近藤喜太, 金谷信彦, 高橋一剛, 重安邦俊, 藤原俊義

Medical Science Digest 50 ( 7 ) 402 - 403 2024.6

局所環境とがん免疫膵臓癌のMHC低発現を改善するエピジェネティック制御剤の同定と樹状細胞併用p53ウイルス免疫療法への応用

陶守貫人, 田澤大, 山田元彦, 岡田尚大, 菊地覚次, 黒田新士, 野間和広, 浦田泰生, 香川俊輔, 藤原俊義

日本がん免疫学会総会・日本バイオセラピィ学会学術集会総会合同大会プログラム・抄録集 28回・37回 78 - 78 2024.6

Subtotal esophagectomy and concurrent reconstruction with free jejunal flap for primary esophageal cancer after pancreatoduodenectomy. Reviewed International journal

Kazuya Moriwake, Kazuhiro Noma, Kento Kawasaki, Tasuku Matsumoto, Masashi Hashimoto, Takuya Kato, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Surgical case reports 10 ( 1 ) 128 - 128 2024.5

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

BACKGROUND: Pancreatoduodenectomy and subtotal esophagectomy are widely considered the most invasive and difficult surgical procedures in gastrointestinal surgery. Subtotal esophagectomy after pancreatoduodenectomy is expected to be extremely difficult due to complicated anatomical changes, and selecting an appropriate intestinal reconstruction method will also be a difficult task. Therefore, perhaps because the method is considered impossible, there have been few reports of subtotal esophagectomy after pancreatoduodenectomy. CASE PRESENTATION: A 73-year-old man with a history of pancreatoduodenectomy was diagnosed with superficial thoracic esophageal squamous cell carcinoma. Definitive chemoradiation therapy was recommended at another hospital; however, he visited our department to undergo surgery. We performed the robot-assisted thoracoscopic subtotal esophagectomy. There were some difficulties with the reconstruction: the gastric tube could not be used, the reconstruction was long, and the organs reconstructed in the previous surgery had to be preserved. However, the concurrent reconstruction was achieved with the help of a free jejunal flap and vascular reconstruction. All reconstructions from the previous surgery, including the remnant stomach, were preserved via regional abdominal lymph node dissection. After reconstruction, intravenous indocyanine green showed that circulation in the reconstructed intestines was preserved. On postoperative day 1, no recurrent nerve paralysis was observed during laryngoscopy. The patient could start oral intake smoothly 2 weeks after surgery and did not exhibit any postoperative complications related to the reconstruction. The patient was transferred to another hospital on postoperative day 21. CONCLUSIONS: Owing to the free jejunal flap interposition method, we safely performed one stage subtotal esophagectomy and concurrent reconstruction, preservation of the remnant stomach, and pancreaticobiliary reconstruction in patients with a history of pancreatoduodenectomy. We believe that this method is acceptable and useful for patients undergoing complicated reconstruction.

DOI： 10.1186/s40792-024-01919-5

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BNCT pancreatic cancer treatment strategy with glucose-conjugated boron drug. Reviewed International journal

Takuya Fujimoto, Fuminori Teraishi, Noriyuki Kanehira, Tomoyuki Tajima, Yoshinori Sakurai, Natsuko Kondo, Masahiro Yamagami, Atsushi Kuwada, Akira Morihara, Mizuki Kitamatsu, Atsushi Fujimura, Minoru Suzuki, Yutaka Takaguchi, Kunitoshi Shigeyasu, Toshiyoshi Fujiwara, Hiroyuki Michiue

Biomaterials 309 122605 - 122605 2024.5

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

Multidisciplinary therapy centered on radical surgery for resectable pancreatic cancer is expected to prolong prognosis, but relies on CA19-9 biomarker levels to determine treatment strategy. Boron neutron capture therapy (BNCT) is a chemoradiotherapy using tumor hyperaccumulator boron drugs and neutron irradiation. The purpose of this study is to investigate novel boron drug agents for BNCT for pancreatic cancer. Bioinformatics was used to evaluate the uptake of current boron amino acid (BPA) drugs for BNCT into pancreatic cancer. The expression of the amino acid transporter LAT1, a BPA uptake transporter, was low in pancreatic cancer and even lower in high CA19-9 pancreatic cancer. In contrast, the glucose transporter was high in high CA19-9 pancreatic cancers and inversely correlated with LAT1 expression. Considering the low EPR effect in pancreatic cancer, we synthesized a small molecule Glucose-BSH, which is boron BSH bound to glucose, and confirmed its specific uptake in pancreatic cancer. uptake of Glucose-BSH was confirmed in an environment compatible with the tumor microenvironment. The therapeutic efficacy and safety of Glucose-BSH by therapeutic neutron irradiation were confirmed with BNCT. We report Glucose-BSH boron drug discovery study of a Precision Medicine BNCT with application to high CA19-9 pancreatic cancer.

DOI： 10.1016/j.biomaterials.2024.122605

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Robotic isolated caudate lobe liver resection using the caudal approach for giant hepatic hemangioma (with video). Reviewed International journal

Ryutaro Kondo, Kosei Takagi, Yuzo Umeda, Toshiyoshi Fujiwara

Asian journal of surgery 2024.5

A multi-center, prospective, clinical study to evaluate the anti-reflux efficacy of laparoscopic double-flap technique (lD-FLAP Study). Reviewed

Shinji Kuroda, Michihiro Ishida, Yasuhiro Choda, Atsushi Muraoka, Shinji Hato, Tetsuya Kagawa, Norimitsu Tanaka, Toshiharu Mitsuhashi, Yoshihiko Kakiuchi, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Annals of gastroenterological surgery 8 ( 3 ) 374 - 382 2024.5

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

BACKGROUND: Double-flap technique (DFT) is a reconstruction procedure after proximal gastrectomy (PG). We previously reported a multi-center, retrospective study in which the incidence of reflux esophagitis (RE) (Los Angeles Classification ≥Grade B [LA-B]) 1 year after surgery was 6.0%. There have been many reports, but all of them were retrospective. Thus, a multi-center, prospective study was conducted. METHODS: Laparoscopic PG + DFT was performed for cT1N0 upper gastric cancer patients. The primary endpoint was the incidence of RE (≥LA-B) 1 year after surgery. The planned sample size was 40, based on an estimated incidence of 6.0% and an upper threshold of 20%. RESULTS: Forty patients were recruited, and 39, excluding one with conversion to total gastrectomy, received protocol treatment. Anastomotic leakage (Clavien-Dindo ≥Grade III) was observed in one patient (2.6%). In 38 patients, excluding one case of postoperative mortality, RE (≥LA-B) was observed in two patients (5.3%) 1 year after surgery, and the upper limit of the 95% confidence interval was 17.3%, lower than the 20% threshold. Anastomotic stricture requiring dilatation was observed in two patients (5.3%). One year after surgery, body weight change was 88.9 ± 7.0%, and PNI <40 and CONUT ≥5, indicating malnutrition, were observed in only one patient (2.6%) each. In the quality of life survey using the PGSAS-45 questionnaire, the esophageal reflux subscale score was 1.4 ± 0.6, significantly better than the public data (2.0 ± 1.0; p = 0.001). CONCLUSION: Laparoscopic DFT showed anti-reflux efficacy. Taken together with the acceptable incidence of anastomotic stricture, DFT can be an option for reconstruction procedure after PG.

DOI： 10.1002/ags3.12783

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【微小環境から読み解く胆膵癌】胆道癌制御性T細胞による肝内胆管癌の免疫微小環境の制御

吉田一博, 楳田祐三, 重安邦俊, 藤智和, 安井和也, 高木弘誠, 藤原俊義

肝胆膵 88 ( 5 ) 619 - 624 2024.5

橋本将志, 野間和広, 前田直見, 田邊俊介, 藤原俊義

日本臨床 82 ( 増刊3 食道癌2024 ) 473 - 477 2024.5

「多様な外科医が活躍する社会」の実現に向けて Academic daddy surgeonを目指した一外科医の試み

金谷信彦, 黒田新士, 坂本真樹, 垣内慶彦, 近藤喜太, 竹原裕子, 香川俊輔, 藤原俊義

日本外科系連合学会誌 49 ( 3 ) 276 - 276 2024.5

「多様な外科医が活躍する社会」の実現に向けて Academic daddy surgeonを目指した一外科医の試み

金谷信彦, 黒田新士, 坂本真樹, 垣内慶彦, 近藤喜太, 竹原裕子, 香川俊輔, 藤原俊義

日本外科系連合学会誌 49 ( 3 ) 276 - 276 2024.5

食道癌原発巣内のTertiary lymphoid structure(TLS)と術前栄養学的指標の検討

國友知義, 野間和広, 河崎健人, 橋本将志, 藤智和, 前田直見, 菊地覚次, 近藤喜太, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 124回 PS - 3 2024.4

p53-Armed Oncolytic Virotherapy Improves Radiosensitivity in Soft-Tissue Sarcoma by Suppressing BCL-xL Expression. Reviewed

Tadashi Komatsubara, Hiroshi Tazawa, Joe Hasei, Toshinori Omori, Kazuhisa Sugiu, Yusuke Mochizuki, Koji Demiya, Aki Yoshida, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Acta medica Okayama 78 ( 2 ) 151 - 161 2024.4

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

Soft-tissue sarcoma (STS) is a heterogeneous group of rare tumors originating predominantly from the embryonic mesoderm. Despite the development of combined modalities including radiotherapy, STSs are often refractory to antitumor modalities, and novel strategies that improve the prognosis of STS patients are needed. We previously demonstrated the therapeutic potential of two telomerase-specific replication-competent oncolytic adenoviruses, OBP-301 and tumor suppressor p53-armed OBP-702, in human STS cells. Here, we demonstrate in vitro and in vivo antitumor effects of OBP-702 in combination with ionizing radiation against human STS cells (HT1080, NMS-2, SYO-1). OBP-702 synergistically promoted the antitumor effect of ionizing radiation in the STS cells by suppressing the expression of B-cell lymphoma-X large (BCL-xL) and enhancing ionizing radiation-induced apoptosis. The in vivo experiments demonstrated that this combination therapy significantly suppressed STS tumors' growth. Our results suggest that OBP-702 is a promising antitumor reagent for promoting the radiosensitivity of STS tumors.

DOI： 10.18926/AMO/66924

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鏡視下手術に対する最適な静脈血栓塞栓症予防鏡視下食道癌手術における血栓症の現状と課題

河崎健人, 野間和広, 國友知義, 橋本将志, 藤智和, 前田直見, 菊地覚次, 近藤喜太, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 124回 WS - 4 2024.4

上部消化管外科におけるロボット手術のトラブルシューティング(ヒヤリハットを含む) ロボット支援食道癌手術におけるトラブルシューティングに対するわれわれの工夫

白川靖博, 桂佑貴, 宇根悠太, 吉本匡志, 真島宏聡, 澤田紘幸, 石田道拡, 吉田龍一, 佐藤大祐, 丁田泰宏, 吉満政義, 中野敢友, 井谷史嗣, 松川啓義, 塩崎滋弘, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本外科学会定期学術集会抄録集 124回 WS - 8 2024.4

高齢者に対する周術期管理の新たなエビデンスの構築に向けて高齢者食道癌症例に対する安全性と根治性の両立を目指した集学的治療戦略

田辺俊介, 野間和広, 河崎健人, 國友知義, 橋本将志, 藤智和, 前田直見, 菊地覚次, 近藤喜太, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 124回 WS - 4 2024.4

Perineal Squamous Cell Carcinoma Arising in an Epidermal Cyst. Reviewed

Fuminori Teraishi, Yuki Matsumi, Kota Tachibana, Toshiyuki Watanabe, Toshiyoshi Fujiwara

Acta medica Okayama 78 ( 2 ) 197 - 200 2024.4

Language：English

A 90-year-old Japanese woman who had been aware of a subcutaneous mass on the right perineal region for 5 years was referred to our hospital for further examination and treatment because of the rapid growth of the mass and bleeding that began 3 months earlier. A biopsy of the mass revealed a diagnosis of well-differentiated squamous cell carcinoma. On preoperative examination, the tumor was 90×40 mm in size and was suspected to have partially invaded the levator ani muscle and external sphincter. Since a preoperative cardiac evaluation indicated severe aortic stenosis, we performed transcatheter aortic valve implantation. A radical resection was then performed with general anesthesia. The skin and subcutaneous tissue defects were reconstructed with a posterior gluteal-thigh propeller flap, and a sigmoid colostomy was created. The patient had a good postoperative course and was transferred to a rehabilitation facility 28 days after the surgery. Epidermal cysts are a common benign tumor, and clinicians should keep in mind that these cysts can become malignant.

DOI： 10.18926/AMO/66930

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Laparoscopic Resection Combined with a Transsacral Approach for a Recurrent Tailgut Cyst with a Refractory Fistula. Reviewed

Hajime Kashima, Fuminori Teraishi, Yuki Matsumi, Hiroshi Shimamura, Toshiyoshi Fujiwara

Acta medica Okayama 78 ( 2 ) 193 - 196 2024.4

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

Tailgut cyst is a rare cystic disease of the anterior sacral surface and the remains of an embryonic tail gut. Tailgut cysts have a potential for malignancy, and complete resection with an adequate surgical margin is necessary. Even if incomplete resection does not result in recurrence of malignant disease, there is a risk of local infection leading to refractory fistulas. The optimal treatment for such refractory recurrent lesions has not been reported. We describe a case in which the combination of laparoscopic and transsacral approaches was effective for resecting a recurrent refractory fistula after incomplete resection of a tail gut cyst.

DOI： 10.18926/AMO/66928

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Robot-assisted laparoscopic surgery for rectal cancer in a patient with a horseshoe kidney: A case report. Reviewed

Ryohei Shoji, Fuminori Teraishi, Yuki Matsumi, Hajime Kashima, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 17 ( 2 ) e13296 2024.4

Language：English

A 52-year-old, Japanese man presented to the hospital with a complaint of anal bleeding, and detailed examination resulted in a diagnosis of locally advanced rectal cancer. The patient underwent total neoadjuvant therapy followed by short-course radiation therapy and consolidation chemotherapy, which provided a partial response. After preoperative contrast-enhanced computed tomography showed a horseshoe kidney, robot-assisted, precise, laparoscopic, low anterior resection with D3 dissection and ileostomy construction was performed. The horseshoe renal isthmus was elevated surrounding the inferior mesenteric artery, and the left ureter and seminal vessels ran in front of the kidney. The hypogastric nerve traveled ventral to the horseshoe kidney. With robotic surgery, it was possible to perform more precise surgery while recognizing vascular and nerve anatomy in a rectal cancer patient with a horseshoe kidney due to good three-dimensional visibility and articulated forceps manipulation.

DOI： 10.1111/ases.13296

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後腹膜脂肪肉腫の臨床的知見と外科的治療戦略,外科技術の継承におけるカダバートレーニングの重要性

近藤喜太, 田辺俊介, 黒田新士, 重安邦俊, 菊地覚次, 野間和広, 寺石文則, 楳田祐三, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SF - 7 2024.4

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Papers - FUJIWARA Toshiyoshi