Faculty Profiles - FUJIWARA Toshiyoshi

Papers - FUJIWARA Toshiyoshi

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高齢者,併存疾患を有する症例などハイリスク症例の胃癌に対するconversion手術の現況と成績年齢と全身状態から考えるStageIV胃癌に対するConversion手術の是非

垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 重安邦俊, 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 WS - 3 2024.4

ロボット支援腹腔鏡下低位前方切除術の導入期から習熟期にかけての短期治療成績の検討

寺石文則, 庄司良平, 賀島肇, 松三雄騎, 重安邦俊, 近藤喜太, 香川俊輔, 藤原俊義

日本大腸肛門病学会雑誌 77 ( 4 ) 239 - 239 2024.4

大腸癌肝転移におけるR0の意義を再考する多施設共同研究1,245切除例の解析

楳田祐三, 藤智和, 門田一晃, 児島亨, 佐藤太祐, 重安邦俊, 近藤喜太, 寺石文則, 藤原俊義

日本大腸肛門病学会雑誌 77 ( 4 ) 253 - 253 2024.4

薬物療法と手術を組み合わせた直腸癌遠隔転移症例の長期生存への取り組み

重安邦俊, 香川俊輔, 高橋利明, 梅田響, 松三雄騎, 菊地覚次, 垣内慶彦, 庄司良平, 近藤喜太, 黒田新士, 楳田祐三, 藤原俊義

日本大腸肛門病学会雑誌 77 ( 4 ) 238 - 238 2024.4

Surgical repair for a parahiatal hernia with an esophageal hiatal hernia: A case report and literature review

Yosuke Takahashi, Kazuhiro Noma, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Toshiyoshi Fujiwara

International Journal of Surgery Case Reports 117 2024.4

Publishing type：Research paper (scientific journal)

Introduction and importance: A parahiatal hernia (PH) is a rare diaphragmatic hernia (DH) adjacent to but separated from the esophageal hiatus. The surgical repair for PH needs primary suture closure or complicated hernioplasty and the addition of an anti-reflux procedure. This report describes a case of PH with a symptomatic esophageal hiatal hernia managed using three-dimensional (3D) laparoscopy. Case presentation: A 65-year-old woman with back pain and breathlessness was referred to our hospital for a DH. Computed tomography showed a diaphragmatic defect on the left side of the esophageal hiatus. Upper gastrointestinal endoscopy and 24-hour esophageal impedance-pH monitoring showed a symptomatic esophageal hiatal hernia. Laparoscopic repair for both hernias was performed using 3D laparoscopy. The DH orifice was located in the left crus of the diaphragm, and it was separated from the esophageal hiatus. These findings showed that this DH was a PH. The PH was repaired with primary suturing, and a hiatoplasty was performed. Toupet fundoplication was performed with a 270° posterior wrap of the gastric fornix. The patient has remained asymptomatic a year after surgery without any complications. Clinical discussion: 3D laparoscopy provides significant advantages in surgeries requiring precise suturing. PH repairs require complex procedures, including mesh repair or suturing. Approximately 44 % of PH cases also necessitate fundoplication. 3D laparoscopy was useful for the present case. Conclusions: A rare PH and a symptomatic type 1 hiatal hernia were repaired with 3D laparoscopy, which is helpful for PH treatment in cases requiring complicated procedures.

DOI： 10.1016/j.ijscr.2024.109565

Scopus

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Long-term activation of anti-tumor immunity in pancreatic cancer by a p53-expressing telomerase-specific oncolytic adenovirus. Reviewed International journal

Masashi Hashimoto, Shinji Kuroda, Nobuhiko Kanaya, Daisuke Kadowaki, Yusuke Yoshida, Masaki Sakamoto, Yuki Hamada, Ryoma Sugimoto, Chiaki Yagi, Tomoko Ohtani, Kento Kumon, Yoshihiko Kakiuchi, Kazuya Yasui, Satoru Kikuchi, Ryuichi Yoshida, Hiroshi Tazawa, Shunsuke Kagawa, Takahito Yagi, Yasuo Urata, Toshiyoshi Fujiwara

British journal of cancer 130 ( 7 ) 1187 - 1195 2024.4

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

BACKGROUND: Pancreatic cancer is an aggressive, immunologically "cold" tumor. Oncolytic virotherapy is a promising treatment to overcome this problem. We developed a telomerase-specific oncolytic adenovirus armed with p53 gene (OBP-702). METHODS: We investigated the efficacy of OBP-702 for pancreatic cancer, focusing on its long-term effects via long-lived memory CD8 + T cells including tissue-resident memory T cells (TRMs) and effector memory T cells (TEMs) differentiated from effector memory precursor cells (TEMps). RESULTS: First, in vitro, OBP-702 significantly induced adenosine triphosphate (ATP), which is important for memory T cell establishment. Next, in vivo, OBP-702 local treatment to murine pancreatic PAN02 tumors increased TEMps via ATP induction from tumors and IL-15Rα induction from macrophages, leading to TRM and TEM induction. Activation of these memory T cells by OBP-702 was also maintained in combination with gemcitabine+nab-paclitaxel (GN) in a PAN02 bilateral tumor model, and GN + OBP-702 showed significant anti-tumor effects and increased TRMs in OBP-702-uninjected tumors. Finally, in a neoadjuvant model, in which PAN02 cells were re-inoculated after resection of treated-PAN02 tumors, GN + OBP-702 provided long-term anti-tumor effects even after tumor resection. CONCLUSION: OBP-702 can be a long-term immunostimulant with sustained anti-tumor effects on immunologically cold pancreatic cancer.

DOI： 10.1038/s41416-024-02583-0

PubMed

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Double-surgeon techniqueによるロボット支援下膵切除術

高木弘誠, 楳田祐三, 藤智和, 安井和也, 山田元彦, 木村次郎, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SF - 2 2024.4

外科と救急のダブルボード取得を目指した外科救急連携コース

黒田新士, 安井和也, 岡崎幹生, 小谷恭弘, 枝園忠彦, 小林純子, 中尾篤典, 笠原真悟, 豊岡伸一, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SP - 6 2024.4

【消化器良性疾患に対する外科治療update】肝胆膵巨大肝嚢胞に対する外科治療update

藤智和, 楳田祐三, 高木弘誠, 安井和也, 木村次郎, 山田元彦, 永井康雄, 藤原俊義

外科 86 ( 4 ) 347 - 354 2024.4

Language：Japanese Publisher：(株)南江堂

＜文献概要＞単純性肝嚢胞のほとんどは治療を要しないが,巨大な嚢胞では周囲臓器の圧排による症状を認めることがあり治療介入が行われる.腹腔鏡下嚢胞開窓術は侵襲も少なく短期成績が良好で第一選択として広く行われている.開窓部の閉鎖による再発を防ぐためには十分な嚢胞壁切開が必要であり,インドシアニングリーン蛍光法を用いた術中ナビゲーションが胆道損傷回避に有用である.

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00393&link_issn=&doc_id=20240416110010&doc_link_id=10.15106%2Fj_geka86_347&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka86_347&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

ロボット支援下膵頭十二指腸切除術は術後膵液瘻High risk症例のPOPFを減少させる

藤智和, 高木弘誠, 楳田祐三, 安井和也, 木村次郎, 永井康夫, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SF - 6 2024.4

高齢者大腸癌における周術期リハビリテーションの個別化を目指した術前機能評価の有用性の検証

寺石文則, 庄司良平, 賀島肇, 松三雄騎, 近藤喜太, 黒田新士, 野間和広, 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 PS - 8 2024.4

Fibroblast activation protein-targeted near-infrared photoimmunotherapy depletes immunosuppressive cancer-associated fibroblasts and remodels local tumor immunity. Reviewed International journal

Masaaki Akai, Kazuhiro Noma, Takuya Kato, Seitaro Nishimura, Hijiri Matsumoto, Kento Kawasaki, Tomoyoshi Kunitomo, Teruki Kobayashi, Noriyuki Nishiwaki, Hajime Kashima, Satoru Kikuchi, Toshiaki Ohara, Hiroshi Tazawa, Peter L Choyke, Hisataka Kobayashi, Toshiyoshi Fujiwara

British journal of cancer 2024.3

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

BACKGROUND: Cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) play a critical role in tumor immunosuppression. However, targeted depletion of CAFs is difficult due to their diverse cells of origin and the resulting lack of specific surface markers. Near-infrared photoimmunotherapy (NIR-PIT) is a novel cancer treatment that leads to rapid cell membrane damage. METHODS: In this study, we used anti-mouse fibroblast activation protein (FAP) antibody to target FAP+ CAFs (FAP-targeted NIR-PIT) and investigated whether this therapy could suppress tumor progression and improve tumor immunity. RESULTS: FAP-targeted NIR-PIT induced specific cell death in CAFs without damaging adjacent normal cells. Furthermore, FAP-targeted NIR-PIT treated mice showed significant tumor regression in the CAF-rich tumor model accompanied by an increase in CD8+ tumor infiltrating lymphocytes (TILs). Moreover, treated tumors showed increased levels of IFN-γ, TNF-α, and IL-2 in CD8+ TILs compared with non-treated tumors, suggesting enhanced antitumor immunity. CONCLUSIONS: Cancers with FAP-positive CAFs in their TME grow rapidly and FAP-targeted NIR-PIT not only suppresses their growth but improves tumor immunosuppression. Thus, FAP-targeted NIR-PIT is a potential therapeutic strategy for selectively targeting the TME of CAF+ tumors.

DOI： 10.1038/s41416-024-02639-1

PubMed

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重度の低肺機能合併食道癌に対し多職種周術期管理により胸腔鏡下根治術を行い得た一例

松本眞琴, 野間和広, 高橋政史, 河崎健人, 國友知義, 橋本将志, 前田直見, 田辺俊介, 藤原俊義

日本臨床外科学会雑誌 85 ( 3 ) 460 - 460 2024.3

Role of robotic surgery as an element of Enhanced Recovery After Surgery protocol in patients undergoing pancreatoduodenectomy. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Tomokazu Fuji, Kazuya Yasui, Motohiko Yamada, Jiro Kimura, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 28 ( 3 ) 220 - 225 2024.3

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

BACKGROUND: Although the current trend in pancreatoduodenectomy (PD) has shifted from open surgery to minimally invasive surgery (MIS), evidence on the role of MIS as an element of Enhanced Recovery After Surgery (ERAS) in PD is limited. This study aimed to investigate the effect of robotic surgery using the ERAS protocol on the outcomes of patients undergoing PD. METHODS: This retrospective study included 252 patients who underwent open PD (OPD) or robotic PD (RPD) managed using the ERAS protocol between January 2017 and March 2023. Outcomes stratified by the surgical approach were compared. Multivariable analyses were performed to evaluate the effect of ERAS items, including robotic surgery, on outcomes after PD. RESULTS: Of 252 patients, 202 (80.2%) underwent OPD, and 50 (19.2%) underwent RPD. Multivariable analyses demonstrated that perioperative management center support (odds ratio [OR], 2.85; 95% CI, 1.14-7.72; P = .025), robotic surgery (OR, 6.40; 95% CI, 1.94-26.1; P = .002), early solid intake (OR, 2.84; 95% CI, 1.46-5.63; P = .002), and early drain removal (OR, 3.77; 95% CI, 2.04-7.06; P < .001) were significant ERAS items related to early discharge after PD. CONCLUSION: Our study demonstrated that employing the ERAS protocol for OPD and RPD is feasible and safe. Moreover, our results suggested the role of robotic surgery as an element of the ERAS protocol for PD. A combination of ERAS protocols and MIS may be safe and feasible for accelerating postoperative recovery after PD.

DOI： 10.1016/j.gassur.2023.12.017

PubMed

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大臀筋に浸潤した局所進行直腸癌に対してtotal neoadjuvant therapyが奏効した一例

坂本真樹, 寺石文則, 庄司良平, 金谷信彦, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 85 ( 3 ) 461 - 461 2024.3