Faculty Profiles - FUJIWARA Toshiyoshi

Tailoring Neoadjuvant Therapy for Rectal Cancer: A Single-center Study of Local Recurrence Patterns. International journal

Ryohei Shoji, Fuminori Teraishi, Yoshitaka Kondo, Yusuke Yoshida, Nobuhiko Kanaya, Yuki Matsumi, Kunitoshi Shigeyasu, Shunsuke Kagawa, Toshiyoshi Fujiwara

Anticancer research 45 ( 3 ) 1261 - 1271 2025.3

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

BACKGROUND/AIM: Postoperative local recurrence remains an important issue in rectal cancer, and the optimal treatment strategy, surgical approach, and prognosis after treatment are yet to be addressed. PATIENTS AND METHODS: We reviewed 21 patients who underwent surgical resection at our department for postoperative pelvic local recurrence of rectal cancer between January 2013 and December 2022, and performed a retrospective analysis of outcomes in terms of preoperative treatment and surgical approach. RESULTS: Of the 21 patients, four (19%) were treated with upfront surgery (Upfront surgery group), 13 (62%) with chemotherapy (Chemotherapy group), and four (19%) with neoadjuvant chemoradiotherapy (NACRT; NACRT group). The surgical approach was open laparotomy (Open group) in 10 (47.6%) patients and minimally invasive surgery (MIS, MIS group) in 11 (52.4%). Seventeen (81.0%) had a negative resection margin (RM). Overall median postoperative survival was 71 months and median relapse-free survival was 6.2 months. The most common form of recurrence was pelvic local re-recurrence in seven patients (33.3%). By preoperative treatment type, the RM securement rate was higher in the Chemotherapy and NACRT groups than in the Upfront surgery group, and the postoperative recurrence rate was lowest in the NACRT group. By surgical approach, intraoperative blood loss and incidence of Clavien-Dindo Grade 3 or higher postoperative adverse events were both significantly lower in the MIS group than in the Open group. CONCLUSION: Surgical intervention for postoperative recurrence of rectal cancer results in good survival, but short relapse-free survival. NACRT can deter local re-recurrence after resection, and MIS may contribute to reducing complications.

DOI： 10.21873/anticanres.17513

Short-term Safety of Robot-assisted Rectal Surgery in Patients Aged ≥75 Years: A Single-center Retrospective Study. International journal

Fuminori Teraishi, Yusuke Yoshida, Ryohei Shoji, Nobuhiko Kanaya, Yuki Matsumi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Shunsuke Kagawa, Toshiyoshi Fujiwara

Anticancer research 45 ( 3 ) 1291 - 1299 2025.3

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

BACKGROUND/AIM: The aging population challenges surgical management of rectal cancer. This study evaluated the short-term safety of robot-assisted rectal surgery (RARS) in patients aged 75 years and older, examining perioperative complications and surgical outcomes in this vulnerable population. PATIENTS AND METHODS: A single-center retrospective cohort study was conducted at Okayama University Hospital from September 2020 to December 2024, including 109 patients undergoing RARS. Patients were divided into older (≥75 years, n=19) and non-older (<75 years, n=90) groups. Surgical procedures utilized the da Vinci Xi system, with comprehensive assessment of perioperative characteristics and complications using the Clavien-Dindo classification. RESULTS: The older group demonstrated significantly higher American Society of Anesthesiologists classification (89.5% ≥2 vs. 58.9% in non-older group, p=0.036). Postoperative complications were more frequent in the older group (8 vs. 18 cases, p=0.04), though severe complications were similar to those in the non-older group. Median postoperative hospital stay was longer in the older group (12 vs. 9 days, p=0.01), but this difference disappeared when excluding stoma cases. Critically, no postoperative mortality was observed within 30 days in either group. CONCLUSION: Robot-assisted rectal surgery appears safe for patients aged 75 years and older. While the older group experienced more complications, these were predominantly manageable. The findings suggest that careful patient selection and experienced surgical teams can successfully employ robotic techniques in older patients while maintaining oncological standards.

DOI： 10.21873/anticanres.17516

Cancer-associated fibroblasts promote pro-tumor functions of neutrophils in pancreatic cancer via IL-8: potential suppression by pirfenidone. International journal

Tomohiko Yagi, Shunsuke Kagawa, Shohei Nogi, Atsuki Taniguchi, Masashi Yoshimoto, Kanto Suemori, Yasuo Nagai, Shuto Fujita, Shinji Kuroda, Satoru Kikuchi, Yoshihiko Kakiuchi, Fuminori Teraishi, Kosei Takagi, Toshiaki Ohara, Hiroshi Tazawa, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 74 ( 3 ) 96 - 96 2025.2

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

BACKGROUND: The mechanisms by which neutrophils acquire pro-tumor properties remain poorly understood. In pancreatic cancer, cancer-associated fibroblasts (CAFs) may interact with neutrophils, directing them to promote tumor progression. METHODS: To validate the association between CAFs and neutrophils, the localization of neutrophils was examined in clinically resected pancreatic cancer specimens. CAFs were produced by culturing in cancer-conditioned media, and the effects of these CAFs on neutrophils were examined. In vitro migration and invasion assays assess the effect of CAF-activated neutrophils on cancer cells. The factors secreted by the activated neutrophils were also explored. Finally, pirfenidone (PFD) was tested to determine whether it could suppress the pro-tumor functions of activated neutrophils. RESULTS: In pancreatic cancer specimens, neutrophils tended to co-localize with IL-6-positive CAFs. Neutrophils co-cultured with CAFs increased migratory capacity and prolonged life span. CAF-affected neutrophils enhance the migratory and invasive activities of pancreatic cancer cells. IL-8 is the most upregulated cytokine secreted by the neutrophils. PFD suppresses IL-8 secretion from CAF-stimulated neutrophils and mitigates the malignant traits of pancreatic cancer cells. CONCLUSION: CAFs activate neutrophils and enhance the malignant phenotype of pancreatic cancer. The interactions between cancer cells, CAFs, and neutrophils can be disrupted by PFD, highlighting a potential therapeutic approach.

DOI： 10.1007/s00262-025-03946-z

Association between accelerometer-measured light-intensity physical activity and tumor regression for male patients with esophageal cancer receiving neoadjuvant therapy: a retrospective cohort study.

Tomohiro Ikeda, Kazuhiro Noma, Masanori Konuma, Naoaki Maeda, Shunsuke Tanabe, Takayoshi Kawabata, Masashi Kanai, Masanori Hamada, Toshiyoshi Fujiwara, Toshifumi Ozaki

Esophagus : official journal of the Japan Esophageal Society 2025.2

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

BACKGROUND: Physical activity has the potential to promote tumor regression in patients with esophageal cancer receiving neoadjuvant chemotherapy (NAC); however, the benefits of light-intensity physical activity (LIPA) are unclear. This study aimed to investigate the impact of LIPA on tumor regression in male patients with esophageal cancer during NAC and its optimal cutoff value. METHODS: This retrospective single-center observational study included all male patients who underwent NAC or curative esophagectomy. We assessed the physical activity of patients using an accelerometer and calculated the time spent on LIPA. Tumor regression was defined as grade ≥ 1b according to the Japanese classification of esophageal cancer. The impact of LIPA on tumor regression was analyzed using multivariate analysis, and the optimal cutoff value was identified using the receiver operating characteristic curve. RESULTS: Sixty-nine male patients with esophageal cancer who underwent NAC were analyzed. The mean age was 68 years, mean body mass index was 22.4, and 80% of the patients were diagnosed with clinical stage 3 or 4 disease. Every extra 30-min increase in LIPA during the treatment phase was associated with tumor regression (adjusted OR 1.41 [1.02-2.04]). The optimal cutoff value of LIPA was 156.11 min/day, and patients with rich LIPA (≥ 156.11 min/day) were less likely to suffer from anorexia and malnutrition during NAC. CONCLUSION: This study demonstrated that LIPA during NAC has a potential of promoting tumor regression with a cutoff value of 156.5 min/day. Further clinical research is required to determine the prognostic benefits of LIPA in patients receiving NAC.

DOI： 10.1007/s10388-025-01108-9

Short-Term and Long-Term Outcomes of Robotic Gastrectomy for Gastric Cancer: A Single-Center, Single-Arm Prospective Study. International journal

Nobuhiko Kanaya, Shinji Kuroda, Yoshihiko Kakiutchi, Hajime Kashima, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Cureus 17 ( 2 ) e79063 2025.2

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

BACKGROUND: Robotic gastrectomy (RG) has emerged as a promising approach for gastric cancer (GC) treatment, offering advantages such as enhanced dexterity, improved visualization, and increased precision. However, its widespread adoption remains limited due to technical complexity, high costs, limited applications, and insufficient evidence. METHODS: We conducted a single-center, prospective study to evaluate the safety and feasibility of RG, including robotic total gastrectomy (RTG), robotic proximal gastrectomy (RPG), and robotic distal gastrectomy (RDG) with D1+ or D2 lymphadenectomy, in clinical stage I/II GC. The primary endpoint was the incidence of intraoperative and postoperative complications, while the secondary endpoints included surgical outcomes and long-term prognosis. RESULTS: Seven patients were enrolled. No intraoperative complications or conversions to open surgery occurred. The primary endpoint was met, with no major postoperative complications. RTG had a longer operative time and more lymph nodes dissected than RDG and RPG. The median postoperative hospital stay was 10 days. Recurrence was observed in two cases, one of which achieved long-term survival without chemotherapy. CONCLUSION: Our findings demonstrate the safety and feasibility of RG for early and advanced GC. Further multicenter studies with larger cohorts are needed to establish its oncological benefits and cost-effectiveness, facilitating broader clinical adoption.

DOI： 10.7759/cureus.79063

閉塞・穿通を伴う進行左側大腸癌に対する術前化学療法の治療成績

寺石文則, 伊木道子, 吉田有佑, 庄司良平, 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 78 ( 2 ) 107 - 107 2025.2

直腸癌術後骨盤内局所再発に対する予後向上を目指した集学的治療の治療成績

庄司良平, 寺石文則, 近藤喜太, 松三雄騎, 重安邦俊, 藤原俊義

日本大腸肛門病学会雑誌 78 ( 2 ) 105 - 105 2025.2

Novel treatment strategy targeting interleukin-6 induced by cancer associated fibroblasts for peritoneal metastasis of gastric cancer. International journal

Ema Mitsui, Satoru Kikuchi, Tomohiro Okura, Hiroshi Tazawa, Yuta Une, Noriyuki Nishiwaki, Shinji Kuroda, Kazuhiro Noma, Shunsuke Kagawa, Toshiaki Ohara, Junko Ohtsuka, Rieko Ohki, Toshiyoshi Fujiwara

Scientific reports 15 ( 1 ) 3267 - 3267 2025.1

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

Cancer-associated fibroblasts (CAFs) are a crucial component in the tumor microenvironment (TME) of peritoneal metastasis (PM), where they contribute to tumor progression and metastasis via secretion of interleukin-6 (IL-6). Here, we investigated the role of IL-6 in PM of gastric cancer (GC) and assessed whether anti-IL-6 receptor antibody (anti-IL-6R Ab) could inhibit PM of GC. We conducted immunohistochemical analysis of IL-6 and α-smooth muscle (α-SMA) expressions in clinical samples of GC and PM, and investigated the interactions between CAFs and GC cells in vitro. Anti-tumor effects of anti-IL-6R Ab on PM of GC were investigated in an orthotopic murine PM model. IL-6 expression was significantly correlated with α-SMA expression in clinical samples of GC, and higher IL-6 expression in the primary tumor was associated with poor prognosis of GC. Higher IL-6 and α-SMA expressions were also observed in PM of GC. In vitro, differentiation of fibroblasts into CAFs and chemoresistance were observed in GC cells cocultured with fibroblasts. Anti-IL-6R Ab inhibited the progression of PM in GC cells cocultured with fibroblasts in the orthotopic mouse model but could not inhibit the progression of PM consisting of GC cells alone. IL-6 expression in the TME was associated with poor prognosis of GC, and CAFs were associated with establishment and progression of PM via IL-6. Anti-IL-6R Ab could inhibit PM of GC by the blockade of IL-6 secreted by CAFs, which suggests its therapeutic potential for PM of GC.

DOI： 10.1038/s41598-025-88033-0

Impact of robotic surgery on postoperative pancreatic fistula for high-risk pancreaticojejunostomy after pancreatoduodenectomy. International journal

Tomokazu Fuji, Kosei Takagi, Yuzo Umeda, Kazuya Yasui, Motohiko Yamada, Yasuo Nagai, Toshiyoshi Fujiwara

Digestive surgery 1 - 21 2025.1

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

BACKGROUND: The safety and feasibility of robotic pancreatoduodenectomy (RPD) in high-risk patients with postoperative pancreatic fistula (POPF) have rarely been investigated, although the rate of POPF is lower than in open pancreatoduodenectomy (OPD). This study aimed to examine the impact of robotic surgery on POPF in high-risk patients after pancreatoduodenectomy (PD). METHODS: This retrospective analysis included 204 patients who underwent RPD between January 2018 and June 2023. Of the 204 patients, 126 with high-risk POPF were included. The outcomes of RPD and OPD were compared. Multivariate analyses were conducted to identify risk factors associated with the development of clinically relevant POPF (CR-POPF) after surgery. RESULTS: Of the 126 patients, 50 underwent RPD and 76 underwent OPD. The incidence of CR-POPF was significantly lower in the RPD group than in the OPD group (6.0% vs. 38.2%, P < 0.001). Multivariate analyses identified OPD as an independent risk factor associated with CR-POPF (odds ratio [OR]: 7.87, 95% confidence interval [CI]: 2.11-29.4, P = 0.002). CONCLUSIONS: This study demonstrated the impact of robotic surgery on POPF in high-risk patients after PD. These results suggest that RPD may be significantly associated with a decreased incidence of CR-POPF in high-risk anastomoses.

DOI： 10.1159/000543737

Predictive marker for response to trifluridine/tipiracil plus bevacizumab in metastatic colorectal cancer patients. International journal

Toshiaki Takahashi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Sho Takeda, Hibiki Umeda, Kazuya Moriwake, Masashi Kayano, Yuya Sakurai, Shunsuke Nakamura, Masafumi Takahashi, Kaori Nitta, Kazuhiro Yoshida, Yuki Matsumi, Hiroyuki Michiue, Hideki Yamamoto, Hiroyuki Kishimoto, Fuminori Teraishi, Ryohei Shoji, Nobuhiko Kanaya, Hajime Kashima, Yoshihiko Kakiuchi, Shinji Kuroda, Shunsuke Kagawa, Toshiyoshi Fujiwara

BMC cancer 25 ( 1 ) 1 - 1 2025.1

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

OBJECTIVE: Trifluridine/tipiracil (FTD/TPI) is one of the options for late-line treatment of colorectal cancer (CRC). However, the specific patient populations that would particularly benefit from it remain unclear. This study attempted to identify predictive markers of chemotherapy efficacy with trifluridine/tipiracil (FTD/TPI), focusing on the RNA-editing enzyme adenosine deaminase acting on RNA 1 (ADAR1) expression and neutrophil-lymphocyte ratio (NLR). METHODS: To assess the effectiveness of FTD/TPI in CRC patients, we retrospectively analyzed 72 CRC patients at Okayama University Hospital from 2014 to 2022. RESULTS: Adding bevacizumab to FTD/TPI resulted in a more prolonged progression-free survival (PFS), consistent with the SUNLIGHT study findings (p = 0.0028). Among the participants, those with a high NLR had a shorter PFS (p = 0.0395). Moreover, high ADAR1 expression was associated with longer PFS (p = 0.0151). In multivariate analysis, low ADAR1 (HR = 3.43, p = 0.01) and absence of bevacizumab (HR = 4.25, p = 0.01) were identified as factors shortening PFS. The high ADAR1 group demonstrated fewer cases of progressive disease and a higher proportion of stable disease than the low ADAR1 group (p = 0.0288). Low NLR and high ADAR1 were predictive markers of prolonged PFS in the bevacizumab-treated group (p = 0.0036). CONCLUSION: Low NLR and high ADAR1 were predictive markers for a positive response to the FTD/TPI plus bevacizumab regimen associated with prolonged PFS. The FTD/TPI plus bevacizumab regimen should be proactively implemented in the low NLR and high ADAR1 subgroups.

DOI： 10.1186/s12885-024-13370-8

An effective surgical educational system in the era of robotic surgery: "Double-Surgeon Technique" in robotic gastrectomy for minimally invasive surgery. International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Yusuke Yoshida, Nobuhiko Kanaya, Hajime Kashima, Satoru Kikuchi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 410 ( 1 ) 20 - 20 2024.12

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

PURPOSE: Gastric cancer (GC) remains a major malignancy. Robotic gastrectomy (RG) has gained popularity due to various advantages. Despite those advantages, many hospitals lack the necessary equipment for RG and are still performing laparoscopic gastrectomy (LG) due to its established minimal invasiveness and safety. METHODS: This study assessed the effectiveness of the "Double-Surgeon Technique" (DST) for improving surgical education and proficiency with LG. The DST involves both a console-side surgeon and a patient-side surgeon working actively in RG, enhancing the skill acquisition needed for LG and potentially reducing surgical time. Assessment of this method was performed by surgical time, and cases were divided into three groups: first half (Phase 1: P1) and second half (P2) before the introduction of DST, and after the introduction of DST (P3). RESULTS: Two surgical trainees were trained using the DST. The learning curve in both reached a plateau in P2, but descended again in P3. For one trainee, surgical time for P3 was significantly reduced compared to P1 (p = 0.001) and P2 (p = 0.0027) despite the intervals between laparoscopic distal gastrectomy as the main surgeon in P3 being significantly longer than in P2 (p = 0.0094). Other surgical results in both trainees did not differ significantly. Further, no difference in induction phase results of RG were evident between surgeons and trainees with or without DST experience. CONCLUSION: Surgical education using the DST could be effective in the current context of the need for RG and LG.

DOI： 10.1007/s00423-024-03593-5

Association Between Change in Prognostic Nutritional Index During Neoadjuvant Therapy and Dental Occlusal Support in Patients with Esophageal Cancer Under Neoadjuvant Therapy: A Retrospective Longitudinal Pilot Study. International journal

Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Mami Inoue-Minakuchi, Aya Yokoi, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Toshiyoshi Fujiwara, Manabu Morita, Daisuke Ekuni

Nutrients 16 ( 24 ) 2024.12

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

Background: A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support. We have previously reported that low PNI is related to low FTUs. Objectives: The purpose of this study was to retrospectively examine whether the status of occlusal support relates to changes in PNI during neoadjuvant therapy in patients with esophageal cancer. Methods: This study included 34 patients who underwent neoadjuvant therapy before esophagectomy (32 men, 2 women; age, 36-82 years) in 2012 at Okayama University Hospital. Patients were divided into the good occlusal support group (FTUs ≥ 11, n = 18) or poor occlusal support group (FTUs < 11, n = 16), and changes in PNI during neoadjuvant therapy were investigated. Results: PNI decreased significantly after neoadjuvant therapy, particularly in the good occlusal support group, and became more dispersed after neoadjuvant therapy. Decreases in PNI after neoadjuvant therapy showed a significant positive correlation with good occlusal support by multiple regression analysis (p = 0.03). The proportions of patients provided with nutritional intervention (p = 0.02) or early dental intervention (p = 0.04) were lower in the good occlusal support group than in the poor occlusal support group. Conclusions: Even in patients with esophageal cancer with good occlusal support experienced significant declines in PNI during neoadjuvant therapy, potentially due to delayed nutritional and dental interventions. Early multidisciplinary interventions are thus recommended for all patients, regardless of preoperative dental or nutritional status.

DOI： 10.3390/nu16244383

Optimization of workflow processes for sustainable paternal involvement: case study of an academic "daddy surgeon" in Japan.

Nobuhiko Kanaya, Shinji Kuroda, Yoshitaka Kondo, Yuko Takehara, Yoshihiko Kakiuchi, Hitoshi Minagi, Masaki Sakamoto, Shunsuke Kagawa, Hitomi Kataoka, Toshiyoshi Fujiwara

Surgery today 2024.12

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

Work-life balance is often discussed in Japan. Yet surgeons find it challenging to take paternity leave because of their demanding surgical duties and a strong sense of responsibility. One Japanese male surgeon had his first paternity experience as a research fellow in the US. When he returned to Japan, he resumed his surgical training and started a research project to become an academic surgeon. When he and his wife were expecting their second child, they discussed his paternity participation before the delivery and decided on a sustainable paternity participation plan. By coordinating his responsibilities with his co-workers, he limited his attendance at work to daytime hours only for 1 month to manage paternity duties. This adjustment did not affect the number of main and assistant operations conducted that month and effective optimization of workflow processes decreased the extra workload for other team members. His experience suggests that the optimization of workflow processes can enhance personal life, including paternity participation. (150/150).

DOI： 10.1007/s00595-024-02959-y

Hemodynamic Assessment Using SPY Laser Fluorescence Imaging During Pancreatoduodenectomy with Common Hepatic Artery Resection. International journal

Tomokazu Fuji, Kosei Takagi, Kazuya Yasui, Takeyoshi Nishiyama, Motohiko Yamada, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Annals of surgical oncology 2024.12

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

BACKGROUND: Pancreatectomies combined with arterial resection can be indicated for pancreatic cancer. In a pancreatectomy with arterial resection, intraoperative confirmation of blood flow through reconstructed vessels is crucial. This study highlights the usefulness of SPY laser fluorescence imaging during a pancreatoduodenectomy with common hepatic artery resection (PD-CHAR). PATIENT AND METHODS: A 55-year-old man with borderline resectable pancreatic head cancer underwent a PD-CHAR. After confirming tumor resectability, reconstruction of the CHA to the proper hepatic artery was performed. Subsequently, the superior mesenteric vein was reconstructed. RESULTS: SPY laser fluorescence imaging demonstrated arterial blood perfusion to the liver through the reconstructed hepatic artery, followed by perfusion from the portal vein. The operation lasted 493 min, with an estimated blood loss of 400 mL. The postoperative course was uneventful with good arterial blood flow. CONCLUSION: The SPY Portable Handheld Imager could be valuable for visualizing blood flow in reconstructed vessels and assessing tissue perfusion during a pancreatectomy combined with vascular reconstruction.

DOI： 10.1245/s10434-024-16659-x

Robot-Assisted Laparoscopic Resection With the Transanal Approach for Massive Rectal Gastrointestinal Stromal Tumor: A Case Report. International journal

Yusuke Yoshida, Fuminori Teraishi, Ryohei Shoji, Yuki Matsumi, Toshiyoshi Fujiwara

Cureus 16 ( 12 ) e76352 2024.12

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

Rectal gastrointestinal stromal tumors (GISTs) are often asymptomatic and may be detected as giant tumors. This may require highly invasive surgery for radical resection. Here, we describe a 74-year-old man with a locally advanced non-metastatic GIST in the right anterolateral wall of the lower rectum. The tumor was giant (128 × 93 mm), and invasion into adjacent organs (right seminal vesicle and prostate gland) was suspected. Although neoadjuvant chemotherapy (NAC) with imatinib reduced the tumor size, it was still giant, 80 mm in diameter. Therefore, we performed super-low anterior resection using a robot-assisted laparoscopic approach with the transanal approach. The bi-directional approach enabled safe and precise surgery, is expected to increase the rate of anorectal preservation as well as R0 resection, and may prevent a decline in quality of life.

DOI： 10.7759/cureus.76352

Rare internal hernia following pancreatoduodenectomy: A case report. International journal

Teruyuki Tsujii, Kosei Takagi, Yasuo Nagai, Kazuya Yasui, Tomokazu Fuji, Toshiyoshi Fujiwara

International journal of surgery case reports 126 110673 - 110673 2024.11

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

INTRODUCTION: Pancreatoduodenectomy (PD) is a complex procedure with a high morbidity rate. Internal hernia following PD is a rare but potentially life-threatening complication. Herein, we describe a rare case of internal hernia after PD. PRESENTATION OF CASE: A 76-year-old man who underwent subtotal stomach-preserving PD 7 years ago presented with vomiting and abdominal pain. Abdominal computed tomography revealed an internal hernia. Because conservative treatment failed, surgical intervention was performed. Intraoperative findings revealed efferent loop herniation in the space between the afferent loop near the Braun anastomosis and transverse mesocolon. The hernia was repositioned and the mesenteric defect was closed. DISCUSSION: This is an extremely rare case of an internal hernia that developed 7 years after PD. As conservative management provides a little chance for improvement, precise diagnosis and prompt re-intervention are essential for the management of internal hernia. In this case, the hernial orifice developed in the space between the afferent and efferent loops and the transverse mesocolon. Internal hernia could be a differential diagnosis in patients with ileus after PD. CONCLUSION: This study provided a detailed description of an extremely rare case of internal hernia following PD. Therefore, internal hernias should be considered in patients undergoing PD.

DOI： 10.1016/j.ijscr.2024.110673

Subjective global assessment for nutritional screening and its impact on surgical outcomes: A prospective study in older patients with colorectal cancer. International journal

Fuminori Teraishi, Yusuke Yoshida, Ryohei Shoji, Nobuhiko Kanaya, Yuki Matsumi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Shunsuke Kagawa, Rie Tamura, Yoshikazu Matsuoka, Hiroshi Morimatsu, Toshiharu Mitsuhashi, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 409 ( 1 ) 356 - 356 2024.11

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

PURPOSE: Our perioperative management center provides preoperative intervention and functional and nutritional assessments for colorectal cancer patients aged over 75 years. This study evaluated the associations of preoperative nutritional status with postoperative outcomes and prognosis in colorectal cancer patients aged 75 years or older. METHODS: This was a prospective, observational study of 71 colorectal cancer patients aged 75 years or older who underwent surgery between July 2020 and September 2022. The Subjective Global Assessment (SGA) was evaluated as a nutritional index. The patients were classified into three groups: SGA-A (well nourished), B (moderately malnourished), and C (severely malnourished), and the correlations with postoperative outcomes and prognosis were examined. RESULTS: The median age of the 71 patients (34 males, 37 females) was 78 (75-92) years, and their median body mass index (BMI) was 22.3 (13.4-31.9) kg/m2. Forty-eight patients had colon cancer, and 23 had rectal cancer. On the SGA, 28 patients were SGA-A, 25 SGA-B, and 18 SGA-C. The SGA-B/C group had significantly higher BMI (p < 0.01) and more ICU admissions (p = 0.02). The G8 score was significantly lower (p = 0.03) in the SGA-B/C group, suggesting coexisting functional decline. In terms of postoperative outcomes, the SGA-B/C group had a significantly longer postoperative hospital stay (p = 0.04). The 3-year OS rates for all stages were 100% in the SGA-A group and 49.7% in the SGA-B/C group (p = 0.03), while the 3-year OS rates for patients excluding Stage IV were 100% in the SGA-A group and 68.5% in the SGA-B/C group, not significantly different (p = 0.14). The 3-year RFS rate was 95.5% in the SGA-A group and 65.3% in the SGA-B/C group (p = 0.15). CONCLUSION: The SGA is a promising nutritional index associated with short-term outcomes in older patients undergoing colorectal cancer surgery. The SGA can be assessed in a few minutes during an outpatient visit, making it useful for routine clinical use.

DOI： 10.1007/s00423-024-03548-w

The required experience of open pancreaticoduodenectomy before becoming a specialist in hepatobiliary and pancreatic surgeons: a multicenter, cohort study of 334 open pancreaticoduodenectomies. International journal

Tomokazu Fuji, Yuzo Umeda, Kosei Takagi, Masayoshi Hioki, Ryuichi Yoshida, Yoshikatsu Endo, Kazuya Yasui, Daisuke Nobuoka, Toshiharu Mitsuhashi, Toshiyoshi Fujiwara

BMC surgery 24 ( 1 ) 366 - 366 2024.11

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

BACKGROUND: Open pancreaticoduodenectomy (OPD) is an essential surgical procedure for expert hepato-biliary-pancreatic (HBP) surgeons. However, there is no standard for how many surgeries must be performed by a surgeon in training before they are considered to have enough experience to ensure surgical safety. METHODS: Cumulative Sum (CUSUM) analysis was performed using the surgical data of OPDs performed during the training period of board-certified expert surgeons of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. RESULTS: Fourteen HBP surgeons participated in this study and performed 334 OPDs during their training period. The median (interquartile range) values for operative time, blood loss, and length of hospital stay were 455 (397-519) minutes, 450 (234--716) ml, and 28 (21-38) days, respectively. CUSUM analysis showed inflection points at 20 surgeries performed for operative time. After 20 procedures, operative time was significantly shorter (461 min vs. 425 min, p = 0.021) and blood loss was significantly lower (470 ml vs. 340 ml, p = 0.038). No significant differences between within 20 and after 21 procedures were found in the complication rate (53% vs. 48%, p = 0.424) and rate of in-hospital deaths (1.5% vs.1.4%. p = 0.945). Up to 20 surgeries, PDAC and another malignant tumor had longer operative time than benign/low malignant diseases (486 min vs. 472 min vs. 429 min, p < 0.001), and higher blood loss (500 ml vs. 502 ml vs. 355 ml, p < 0.001). Mortality rate was higher at PDAC cases (5% vs. 0% vs. 0%, p = 0.01). After the 21 procedures, these outcomes were improved and no differences in by primary disease were observed. Multivariable analysis showed that within 20 surgeries were independent risk factors of longer operative time (HR2.6, p = 0.013) and higher blood loss (HR2.0, p = 0.049). CONCLUSIONS: To stabilize the surgical outcome of OPD for malignant disease, at least 20 surgeries should be performed at a certified institution during surgeon training. TRIAL REGISTRATION: Clinical trial number: Not applicable.

DOI： 10.1186/s12893-024-02677-9

Laparoscopic resection for oesophageal duplication cyst: A case report. International journal

Tomohiro Hamazaki, Kazuhiro Noma, Kento Kawasaki, Masashi Hashimoto, Shunsuke Tanabe, Toshiyoshi Fujiwara

International journal of surgery case reports 126 110572 - 110572 2024.11

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

INTRODUCTION: Oesophageal duplication cyst is a congenital malformation and rare tumour, clinically manifesting as dysphagia, epigastric pain, or respiratory distress. Duplicate cysts associated with abscess formation or mediastinal penetration and malignancies have been reported, necessitating surgical resection. PRESENTATION OF CASE: A 55-year-old woman had chest discomfort for 1 year. Preoperative imaging, including computed tomography (CT), upper gastrointestinal endoscopy, and endoscopic ultrasound, revealed a tumour extending from the anterior wall to the lesser curvature of the near the oesophagogastric junction (OGJ) and a suspected mural nodule within the tumour. Contrast-enhanced CT revealed a cystic nodule on the wall of the lesser curvature of the OGJ, with an unclear boundary between the cystic nodule and the oesophageal wall. Magnetic resonance imaging showed an isointense signal on T1-weighted imaging and hyperintensity on T2-weighted imaging. Laparoscopic lower oesophagectomy and proximal gastrectomy with lymph node dissection were performed to the confirm mucinous cyst. Pathological findings revealed a cystic lesion in the muscularis propria of the OGJ filled with mucinous components and lined with multilayered columnar epithelial cells. The cyst was diagnosed as a duplicate without malignancy. DISCUSSION: Since the border between the cyst and the oesophageal walls was unclear, and the cyst potentially contained a malignant component, instead of cystectomy, lower oesophagectomy and proximal gastrectomy with lymph node dissection were performed with oesophagogastric anastomosis using the double-flap technique, tailored specifically for OGJ cancer. CONCLUSIONS: Oesophageal duplication cysts are rare. Lower oesophagectomy and proximal gastrectomy are selective surgical approaches for cyst duplication at the OGJ.

DOI： 10.1016/j.ijscr.2024.110572

Dendritic cell maturation is induced by p53-armed oncolytic adenovirus via tumor-derived exosomes enhancing systemic antitumor immunity. International journal

Tomoko Ohtani, Shinji Kuroda, Nobuhiko Kanaya, Yoshihiko Kakiuchi, Kento Kumon, Masashi Hashimoto, Chiaki Yagi, Ryoma Sugimoto, Satoru Kikuchi, Shunsuke Kagawa, Hiroshi Tazawa, Yasuo Urata, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 74 ( 1 ) 12 - 12 2024.11

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

Dendritic cells (DCs) are crucial in cancer immunity, because they activate cytotoxic T cells by presenting tumor antigens. Recently, oncolytic virus therapy has been recognized as a systemic immune stimulator. We previously developed a telomerase-specific oncolytic adenovirus (OBP-301) and a p53-armed OBP-301 (OBP-702), demonstrating that these viruses strongly activate systemic antitumor immunity. However, their effects on DCs remained unclear. In the present study, the aim was to elucidate the mechanisms of DC activation by OBP-702, focusing particularly on tumor-derived exosomes. Exosomes (Exo53, Exo301, or Exo702) were isolated from conditioned media of human or murine pancreatic cancer cell lines (Panc-1, MiaPaCa-2, and PAN02) after treatment with Ad-p53, OBP-301, or OBP-702. Exo702 derived from Panc-1 and MiaPaCa-2 cells significantly upregulated CD86, CD80, CD83 (markers of DC maturation), and IFN-γ in DCs in vitro. Similarly, Exo702 derived from PAN02 cells upregulated CD86 and IFN-γ in bone marrow-derived DCs in a bilateral PAN02 subcutaneous tumor model. This DC maturation was inhibited by GW4869, an inhibitor of exosome release, and anti-CD63, an antibody targeting the exosome marker. Intratumoral injection of OBP-702 into PAN02 subcutaneous tumors significantly increased the presence of mature DCs and CD8-positive T cells in draining lymph nodes, leading to long-lasting antitumor effects through the durable activation of systemic antitumor immunity. In conclusion, tumor-derived exosomes play a significant role in DC maturation following OBP-702 treatment and are critical for the systemic activation of antitumor immunity, leading to the abscopal effect.

DOI： 10.1007/s00262-024-03849-5

Gastro-tracheal fistula following esophageal cancer surgery through the retrosternal route: a case report. International journal

Seitaro Nishimura, Kazuhiro Noma, Kento Kawasaki, Masashi Hashimoto, Takuya Kato, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Surgical case reports 10 ( 1 ) 252 - 252 2024.11

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

BACKGROUND: Gastro-tracheal fistula is a rare but serious complication after esophageal surgery, often requiring long-term treatment and invasive procedures. Gastro-tracheal fistula usually occurs through the posterior mediastinal route and rarely through the retrosternal route. No previous reports have described gastro-tracheal fistula after retrosternal route reconstruction was cured by conservative treatment. CASE PRESENTATION: A 70-year-old man with lower thoracic esophageal cancer underwent thoracoscopic esophagectomy in the prone position and gastric tube reconstruction through the retrosternal route with neck anastomosis after neoadjuvant chemotherapy. Despite anastomotic leakage on postoperative day 10, his general condition was stable, and he was managed conservatively with antibiotics and gastric tube decompression. On day 29, he presented with high fever and a gastro-tracheal fistula was observed by esophagography. Conservative management was continued because the patient remained stable. On day 48, esophagography showed that the fistula was undetectable. The patient was able to take fluids orally. He progressed well on an oral diet and was transferred to a different hospital. CONCLUSIONS: A gastro-tracheal fistula, although rare, can occur after retrosternal route reconstruction. When a patient is stable, gastro-tracheal fistula after retrosternal route reconstruction may be cured by conservative treatment.

DOI： 10.1186/s40792-024-02052-z

Risk model for predicting failure to rescue after hepatectomy: Cohort study of 1371 consecutive patients. International journal

Jiro Kimura, Kosei Takagi, Yuzo Umeda, Tomokazu Fuji, Kazuya Yasui, Motohiko Yamada, Takeyoshi Nishiyama, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Hepatology research : the official journal of the Japan Society of Hepatology 2024.11

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

AIM: Although hepatectomy is a complex surgical procedure, its incidence among older patients has increased due to global aging. However, few studies have focused on the association between age and failure to rescue (FTR) posthepatectomy. This study aimed to investigate the association between age and FTR and develop a risk model for FTR following hepatectomy. METHODS: We analyzed a total of 1371 consecutive patients who underwent primary hepatectomy between July 2003 and September 2022. The patients were divided into three groups according to their age: young-old (<65 years), pre-old (65-74 years), and old group (≥75 years). Additionally, the associations among age, FTR, and risk factors for FTR were investigated. Subsequently, a risk model was developed to predict the FTR. RESULTS: Of the 1371 patients, 373 (27.2%) experienced major complications, and FTR occurred in 15 patients. The older group showed a higher FTR rate (8.4%) than the young-old (1.3%) and pre-old (4.3%) groups (p = 0.03). Multivariate analyses indicated that older age (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.00-1.15; p = 0.045) and American Society of Anesthesiologists Physical Status score ≥3 (OR 4.35; 95% CI 1.24-15.2; p = 0.02) were independent predictive factors for FTR. The risk model exhibited an accuracy with an area under the curve of 0.80 (95% CI 0.69-0.92). Calibration plots of the model revealed a concordance index of 0.73. CONCLUSIONS: This study identified an association between age, FTR, and risk factors for FTR posthepatectomy. Together, our risk model is a clinically relevant, internally validated, and useful tool for predicting FTR posthepatectomy.

DOI： 10.1111/hepr.14134

Primary ileal myeloid sarcoma presenting with bowel obstruction: a case report. International journal

Hitoshi Minagi, Nobuhiko Kanaya, Yoshitaka Kondo, Yoshihiko Kakiuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Satoru Kikuchi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Surgical case reports 10 ( 1 ) 229 - 229 2024.10

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

BACKGROUND: Myeloid sarcoma (MS) is an extramedullary tumor constituted by myeloid blasts or immature myeloid cells. It frequently occurs in conjunction with acute myeloid leukemia (AML); however, it can exceptionally manifest in patients without leukemia. Here, we present a rare case of primary MS originating in the small bowel without evidence of bone marrow involvement. CASE REPRESENTATION: A 33 year-old female with no relevant medical history was admitted to our hospital with recurrent abdominal pain. Computed tomography (CT) revealed bowel obstruction due to thickening of the ileum wall, which was suspected to be an ileal tumor. Initially, ectopic endometriosis was suspected because of abdominal pain associated with the menstrual cycle and changes observed on a follow-up CT scan. The lesion could not be detected by double-balloon endoscopy. Despite conservative treatment, the obstruction persisted, and laparoscopic partial ileal resection was performed, which revealed extensive involvement of the ileum and mesentery. Additionally, the mesentery of the resected ileum was extremely thickened. Histopathological and immunohistochemical examinations of the surgical specimen indicated ileal MS. Bone marrow aspiration after discharge was negative for cytological findings of leukemia, leading to a final diagnosis of primary ileal MS. Her postoperative course was uneventful, and she is currently undergoing systemic chemotherapy tailored to AML at another hospital. CONCLUSIONS: Even though MS of the small bowel is rare and may not be considered preoperatively, similar surgical treatment to that of other small bowel malignancies can ensure proper postoperative diagnosis and appropriate chemotherapy. Given the potential need for chemotherapy, ensuring surgical safety that allows for its rapid initiation is critical.

DOI： 10.1186/s40792-024-02030-5

大腸癌に対する樹状細胞ワクチン療法と腫瘍融解アデノウイルスの併用効果

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

癌と化学療法 51 ( 10 ) 1035 - 1037 2024.10

Language：Japanese Publisher：(株)癌と化学療法社

樹状細胞(DC)ワクチン療法は,細胞傷害性Tリンパ球を強力に誘導する癌免疫療法として広く研究されている。しかし臨床における有効性は十分確立されていない。著者らは,癌抑制遺伝子p53を搭載した腫瘍融解アデノウイルス製剤OBP-702を開発し,p53誘導を介した抗腫瘍効果や腫瘍免疫の活性化を明らかにしてきた。本研究では,大腸癌に対するp53導入DCワクチンとOBP-702の併用効果について検討した。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00296&link_issn=&doc_id=20241023220015&doc_link_id=%2Fab8gtkrc%2F2024%2F005110%2F016%2F1035-1037%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2024%2F005110%2F016%2F1035-1037%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Endoscopic lavage for an infected pelvic hematoma in a patient with pelvic sepsis after anterior pelvic exenteration.

Ryohei Shoji, Fuminori Teraishi, Yoshitaka Kondo, Toshihiro Inokuchi, Hideaki Kinugasa, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 17 ( 4 ) e13384 2024.10

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

Anastomotic leakage and subsequent pelvic sepsis are serious complications after surgery for pelvic malignancies, particularly challenging due to the large pelvic cavity dead space post-exenteration. We report a 47-year-old man treated for a severely infected pelvic hematoma and sepsis following anastomotic leakage after anterior pelvic exenteration. Post robot-assisted exenteration for locally advanced sigmoid colon cancer treated with neoadjuvant chemotherapy, a pelvic abscess from anastomotic dehiscence was identified. Initial CT-guided drainage and subsequent laparoscopic drainage were performed. On postoperative day 22, a bleeding left internal iliac pseudoaneurysm required embolization. Despite these efforts, the sepsis worsened due to an enlarged, infected hematoma. Endoscopic lavage, in collaboration with skilled endoscopists, successfully removed the hematoma, leading to an improved inflammatory response, and the patient was discharged. Endoscopic lavage proved to be the safest and most effective treatment for pelvic sepsis with an infected hematoma after various attempted interventions.

DOI： 10.1111/ases.13384

[Combined Efficacy of Dendritic Cell Vaccine and Oncolytic Adenovirus in Colorectal Cancer].

Naohiro Okada, Hiroshi Tazawa, Motohiko Yamada, Kanto Suemori, Satoru Kikuchi, Shinji Kuroda, Kazuhiro Noma, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 51 ( 10 ) 1035 - 1037 2024.10

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

Dendritic cell(DC)vaccine therapy has been widely studied as cancer immunotherapy that potently induces cytotoxic T lymphocytes. However, their efficacy in clinical practice has not yet been established. We have developed an oncolytic adenovirus OBP-702 carrying the tumor suppressor gene p53 and have demonstrated its therapeutic potential to induce cytopathic effect and activate antitumor immunity via p53 induction. In this study, we investigated the combined effect of p53-transduced DC vaccine and OBP-702 in colorectal cancer.

RNA編集酵素ADAR1に基づく大腸癌肝転移の残肝再発リスク層別化の検討

高橋利明, 重安邦俊, 中村峻輔, 高橋政史, 萱野真史, 新田薫, 森分和也, 安井和也, 松三雄騎, 藤智和, 近藤喜太, 寺石文則, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 62回 P80 - 2 2024.10

潰瘍性大腸炎においてRNA編集解析が発癌予測バイオマーカーとなりうる

森分和也, 重安邦俊, 萱野真史, 新田薫, 中村峻輔, 高橋利明, 高橋政史, 金谷信彦, 松三雄騎, 近藤喜太, 寺石文則, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 62回 P43 - 2 2024.10

膵癌が誘導する癌関連線維芽細胞サブタイプは腫瘍融解ウイルスに異なる感受性を示す

永井康雄, 田澤大, 藤田修斗, 高橋洋祐, 菊地覚次, 黒田新士, 大原利章, 野間和広, 浦田泰生, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 O66 - 4 2024.10

マクロピノサイトーシスは膵癌関連膵星細胞の腫瘍融解ウイルスへの感受性を増強する

西山岳芳, 田澤大, 永井康雄, 庄司良平, 菊地覚次, 黒田新士, 大原利章, 野間和広, 田中啓祥, 狩野光伸, 浦田泰生, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 O66 - 6 2024.10

食道扁平上皮癌オルガノイドの樹立と個別化治療のための薬剤耐性実験モデル

竹田泰茂, 野間和広, 賀島肇, 清水彰人, 松本祐, 高橋達也, 前田直見, 田邊俊介, 大原利章, 田澤大, 中川裕, 藤原俊義

日本癌治療学会学術集会抄録集 62回 O75 - 6 2024.10

FAPを標的とした近赤外線光免疫療法によるCAF-rich腫瘍への化学療法抵抗性の克服

西村星多郎, 野間和広, 松本佑, 竹田泰茂, 高橋達也, 松本聖, 河崎健人, 國友知義, 賀島肇, 加藤卓也, 菊地覚次, 大原利章, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 62回 O76 - 2 2024.10

高齢がん患者に対するがん診療高齢大腸癌患者における主観的包括的栄養評価(SGA)の有用性単施設前向き観察研究

寺石文則, 吉田有佑, 庄司良平, 松三雄騎, 重安邦俊, 近藤喜太, 香川俊輔, 田村利枝, 松岡義和, 藤原俊義

日本癌治療学会学術集会抄録集 62回 CCWS1 - 6 2024.10

発生部位からみた肉腫の適切な外科的切除縁とは?-領域横断的な認識の統合- 後腹膜脂肪肉腫に対する外科的切除縁の最適化

近藤喜太, 金谷信彦, 庄司良平, 松三雄騎, 垣内慶彦, 重安邦俊, 菊地覚次, 黒田新士, 田辺俊介, 野間和広, 寺石文則, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 OWS3 - 2 2024.10

NTRK融合遺伝子とERBB2 amplificationが合併したマイクロサテライト安定型大腸癌

重安邦俊, 高橋利明, 山本英喜, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 ICCJ3 - 6 2024.10

食道癌の集学的治療～高齢化社会とICI時代の先鞭をつける～高齢者食道癌患者に対する免疫チェックポイント阻害薬+化学療法

橋本将志, 野間和広, 松本聖, 河崎健人, 國友知義, 田上幸憲, 前田直見, 菊地覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 OSY8 - 7 2024.10

膵癌の更なる早期発見、早期診断に向けて Ct-DNA内KRAS mutation profileとCA19-9値による膵癌予後予測診断と治療戦略

安井和也, 吉田龍一, 宮本耕吉, 重安邦俊, 高木弘誠, 藤智和, 黒田新士, 藤原俊義

日本癌治療学会学術集会抄録集 62回 OSY9 - 4 2024.10

RNA編集酵素ADAR1に基づく大腸癌肝転移の残肝再発リスク層別化の検討

高橋利明, 重安邦俊, 中村峻輔, 高橋政史, 萱野真史, 新田薫, 森分和也, 安井和也, 松三雄騎, 藤智和, 近藤喜太, 寺石文則, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 62回 P80 - 2 2024.10

CA19-9高値悪性腫瘍へのプレシジョン中性子捕捉療法(BNCT)

金平典之, 寺石文則, 田嶋智之, 大曽根達則, 後藤和義, 櫻井良憲, 近藤夏子, 森原聡, 高口豊, 北松瑞生, 宝田剛士, 重安邦俊, 鈴木実, 藤原俊義, 道上宏之

日本癌治療学会学術集会抄録集 62回 O55 - 5 2024.10

潰瘍性大腸炎においてRNA編集解析が発癌予測バイオマーカーとなりうる

森分和也, 重安邦俊, 萱野真史, 新田薫, 中村峻輔, 高橋利明, 高橋政史, 金谷信彦, 松三雄騎, 近藤喜太, 寺石文則, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 62回 P43 - 2 2024.10

Robot-Assisted Pancreaticoduodenectomy Using the Anterior Superior Mesenteric Artery-First Approach for Pancreatic Cancer. International journal

Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Motohiko Yamada, Takeyoshi Nishiyama, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Annals of surgical oncology 2024.9

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

BACKGROUND: The superior mesenteric artery (SMA)-first approach for pancreatic cancer (PC) is common surgical technique in pancreaticoduodenectomy. To date, few studies have reported SMA-first approach in robot-assisted pancreaticoduodenectomy (RPD). Herein, we present the anterior SMA-first approach for PC during RPD. PATIENT AND METHOD: A 75-year-old man with resectable PC underwent RPD after neoadjuvant chemotherapy. As pancreatic head tumor contacted with the superior mesenteric vein (SMV), the anterior SMA approach was applied. After the mesenteric Kocher maneuver, the jejunum was divided and the left side of the SMA was dissected. Subsequently, the anterior plane of the SMA was dissected. Following the division of branches from the mesenteric vessels, the SMA was taped, and the circumferential dissection around the SMA was performed to detach the pancreatic neck from the SMA completely. Finally, the dissection between the SMV and the tumor was performed under vascular control to remove the specimen. CONCLUSIONS: The anterior SMA-first approach can be optional in patients with PC undergoing RPD. This unique approach allows for the circumferential dissection around the SMA during RPD.

DOI： 10.1245/s10434-024-16305-6

The Liver Transection Area Is a Novel Predictor for Surgical Difficulty in Laparoscopic Liver Resection. International journal

Motohiko Yamada, Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Jiro Kimura, Takeyoshi Nishiyama, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Journal of clinical medicine 13 ( 19 ) 2024.9

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

Background: A difficulty scoring system was developed to estimate the surgical outcomes of laparoscopic liver surgery (LLS); however, the effect of the liver transection area (LTA) on LLS outcomes have not been previously examined. Therefore, this study investigated the predictive significance of the LTA for LLS. Methods: This retrospective study included 106 patients who underwent LLS in our hospital between January 2012 and December 2023. The association of the LTA with the surgical difficulty level and operative time was investigated. Multivariate analyses were performed to identify factors predicting surgical difficulty in LLS. Results: The median LTA and operative time were 62.5 (IQR, 36.0-91.8) cm2 and 250 (IQR, 195-310) minutes, respectively. The LTA was significantly associated with surgical difficulty as evaluated using the IWATE Criteria. Moreover, the LTA significantly correlated with operative time (r2 = 0.19, p < 0.001). The multivariable analyses found that the LTA (≥59 cm2) (odds ratio [OR], 6.07; 95% confidence interval [CI], 2.38-16.6; p < 0.001) and the type of LLS (≥segmentectomy) (OR, 3.79; 95% CI, 1.35-11.4; p = 0.01) were significant factors associated with surgical difficulty. Conclusions: The LTA is a useful parameter that reflects the difficulty of LLS.

DOI： 10.3390/jcm13195686

p53-armed oncolytic virotherapy induces abscopal effect in osteosarcoma by promoting immunogenic cell death. Reviewed International journal

Koji Demiya, Hiroshi Tazawa, Hiroya Kondo, Miho Kure, Yusuke Mochizuki, Tadashi Komatsubara, Aki Yoshida, Koji Uotani, Joe Hasei, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Molecular therapy. Oncology 32 ( 3 ) 200845 - 200845 2024.9

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

Osteosarcoma (OS), the most frequent primary malignant tumor of bone in children and adolescents, is refractory to immune checkpoint inhibitors due to its poor antitumor immune response. Chemotherapy and virotherapy induce immunogenic cell death (ICD) and antitumor immune responses, leading to the abscopal effect in untreated tumors. We previously demonstrated the antitumor activity of the telomerase-specific replication-competent oncolytic adenoviruses OBP-301 and p53-armed OBP-702 in human OS cells. Here, we show the therapeutic potential of chemotherapeutic drugs (doxorubicin, cisplatin) and telomerase-specific oncolytic adenoviruses (OBP-301, p53-armed OBP-702) to induce ICD in human OS cells (U2OS, MNNG/HOS, SaOS-2) and murine OS cells (NHOS). OBP-702 induced more profound ICD via the secretion of adenosine triphosphate (ATP) and high-mobility group box protein B1 (HMGB1) compared with chemotherapy and OBP-301 in human OS cells. Murine NHOS cells were also more sensitive to OBP-702 than OBP-301. Subcutaneous NHOS tumor models demonstrated that intratumoral injection of OBP-702 significantly increased the tumor infiltration of cytotoxic CD8+ T cells and induced the abscopal effect against non-treated tumors compared with OBP-301. Our results suggest that OBP-702 is a promising antitumor reagent to induce ICD with secretion of ATP and HMGB1 and the abscopal effect against OS.

DOI： 10.1016/j.omton.2024.200845

Central pancreatectomy of the remnant pancreas without reconstruction after pancreatoduodenectomy. International journal

Kinji Hirono, Kosei Takagi, Motohiko Yamada, Jiro Kimura, Tomokazu Fuji, Kazuya Yasui, Takeyoshi Nishiyama, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Surgical case reports 10 ( 1 ) 214 - 214 2024.9

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

BACKGROUND: There are several reports on the safety and feasibility of pancreatoduodenectomy (PD) without reconstruction of the small remnant pancreas. However, a few studies have explored central pancreatectomy (CP) for non-reconstructed small remnant pancreases after PD. This study presents a case of CP without pancreatic reconstruction after PD. CASE PRESENTATION: A 58-year-old man with cerebral palsy underwent PD for distal cholangiocarcinoma. Three years postoperatively, a 12-mm tumor was detected in the remnant pancreatic body and diagnosed as a pancreatic neuroendocrine neoplasm. Surgical resection was performed, because the tumor was enlarged and chemotherapy resistant. The afferent loop with pancreatojejunostomy anastomosis was dissected, and CP, including pancreatojejunostomy anastomosis, was performed. Given the remnant pancreas was hard and atrophic, the pancreatic tail was transected using a stapler without reconstructing the small remnant pancreas. The patient experienced no postoperative complications including postoperative pancreatic fistula, and the endocrine function of the pancreas was preserved. CONCLUSIONS: We present a case of remnant pancreatic CP that did not require reconstruction after PD. Preservation of the small remnant pancreas without reconstruction during CP may be feasible to maintain endocrine function in select patients after PD.

DOI： 10.1186/s40792-024-02018-1

Ramucirumab in second‑line advanced colorectal cancer therapy: A study on therapeutic outcomes and hepatic sinusoidal platelet aggregation. Reviewed International journal

Keisuke Kimura, Yosuke Katata, Yuzo Umeda, Takehiro Tanaka, Shuya Yano, Kazuhiro Yoshida, Toshiyoshi Fujiwara, Yoshiko Mori, Takeshi Yamada, Takeshi Nagasaka

Oncology letters 28 ( 3 ) 439 - 439 2024.9

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

The present study investigated the role of ramucirumab (RAM) in treating liver metastases (LMs) as a second-line or salvage treatment in patients with advanced CRC. Of the 36 patients, 21 (58%) received RAM plus folinic acid, fluorouracil and irinotecan (FOLFIRI) as second-line treatment, whereas 15 (42%) received it in a salvage setting. The median overall survival time was 23 months [95% confidence interval (CI), 12-34 months] for those in the second-line treatment group and 8 months (95% CI, 5-19 months) for those in the salvage treatment group. Of the 36 patients, 14 (39%) underwent surgical resection of LMs during chemotherapy. A total of 6 patients underwent surgical resection for LMs for the first time during second-line RAM plus FOLFIRI (RAM-LM); of the remaining 8 patients, 6 underwent resection of LMs during first-line bevacizumab (BEV)-based chemotherapy (BEV-LM). Immunohistochemical analysis of CD42b showed that the platelet aggregation score (CD42b score), which ranges from 0 (absence of deposition) to 3 (presence of linear deposition), tended to decrease with the increasing duration of treatment with both RAM and BEV. Although there was no significant difference in the mean duration of anti-VEGF antibody treatment between the BEV-LM and RAM-LM groups, the median CD42b score was higher in the RAM-LM group (median CD42b score, 3; range, 0-3) compared with that in the BEV-LM group (median CD42b score, 1; range, 0-3; P=0.01), suggesting that RAM induces a different degree of platelet aggregation in liver sinusoids compared to BEV.

DOI： 10.3892/ol.2024.14572

【免疫療法のバイオマーカー探索】PD-L1陽性癌関連線維芽細胞の免疫チェックポイント阻害剤のバイオマーカーとしての可能性

間質のコラーゲン産生は胃癌における腫瘍融解ウイルス療法の治療抵抗性を増強する(Stromal collagen type 1 deposition promotes resistance to oncolytic virotherapy in gastric cancer)

大倉友博, 田澤大, 菊地覚次, 黒田新士, 大原利章, 野間和広, 大塚旬子, 大木理恵子, 浦田泰生, 香川俊輔, 藤原俊義, 藤原俊義

日本癌学会総会記事 83回 P - 2252 2024.9

HIF-PHD阻害薬による偽性低酸素はMSS大腸癌の充腫瘍免疫応答を増強する(Pseudohypoxia by HIF-PHD inhibitors activates tumor immune response for MSS colorectal cancer)

大原利章, 陳悦華, 濱田祐輔, 賀島肇, 菊地覚次, 野間和広, 田澤大, 藤澤真義, 藤原俊義, 松川昭博

日本癌学会総会記事 83回 E - 2017 2024.9

河崎健人, 野間和広, 藤原俊義

癌と化学療法 51 ( 9 ) 865 - 868 2024.9

Language：Japanese Publisher：(株)癌と化学療法社

近年は本邦でも食道癌に対する免疫チェックポイント阻害剤(immune checkpoint inhibitors:ICIs)の適応が拡がっており,切除不能進行・再発食道癌に対する一次治療からのICIsの使用が推奨されている。一方で,癌関連線維芽細胞(cancer-associated fibroblasts:CAFs)は癌微小環境を構成する主要な細胞であり,その存在は予後不良因子として報告されている。CAFsは腫瘍促進的な機能を有しており,近年では腫瘍免疫との関連も報告されている。われわれは,食道癌臨床検体においてprogrammed cell death ligand 1(PD-L1)陽性CAFsの存在を確認し,予後不良因子であることを報告した。また,癌細胞とCAFsは互いにPD-L1発現を上昇させ,腫瘍内を免疫抑制状態へ誘導していることを示した。このような癌微小環境下においては,PD-L1陽性CAFsを治療標的とすることで,より効率よく腫瘍縮小効果を期待できる可能性がある。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00296&link_issn=&doc_id=20240920170003&doc_link_id=%2Fab8gtkrc%2F2024%2F005109%2F003%2F0865-0868%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2024%2F005109%2F003%2F0865-0868%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

The state of robotic vs. open pancreatoduodenectomy. International journal

Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Motohiko Yamada, Takeyoshi Nishiyama, Yasuo Nagai, Noriyuki Kanehira, Toshiyoshi Fujiwara

Gland surgery 13 ( 8 ) 1344 - 1348 2024.8

Overcoming immunotherapy resistance and inducing abscopal effects with boron neutron immunotherapy (B-NIT). Reviewed International journal

Takuya Fujimoto, Osamu Yamasaki, Noriyuki Kanehira, Hirokazu Matsushita, Yoshinori Sakurai, Naoya Kenmotsu, Ryo Mizuta, Natsuko Kondo, Takushi Takata, Mizuki Kitamatsu, Kazuyo Igawa, Atsushi Fujimura, Yoshihiro Otani, Makoto Shirakawa, Kunitoshi Shigeyasu, Fuminori Teraishi, Yosuke Togashi, Minoru Suzuki, Toshiyoshi Fujiwara, Hiroyuki Michiue

Cancer science 2024.8

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

Immune checkpoint inhibitors (ICIs) are effective against many advanced malignancies. However, many patients are nonresponders to immunotherapy, and overcoming this resistance to treatment is important. Boron neutron capture therapy (BNCT) is a local chemoradiation therapy with the combination of boron drugs that accumulate selectively in cancer and the neutron irradiation of the cancer site. Here, we report the first boron neutron immunotherapy (B-NIT), combining BNCT and ICI immunotherapy, which was performed on a radioresistant and immunotherapy-resistant advanced-stage B16F10 melanoma mouse model. The BNCT group showed localized tumor suppression, but the anti-PD-1 antibody immunotherapy group did not show tumor suppression. Only the B-NIT group showed strong tumor growth inhibition at both BNCT-treated and shielded distant sites. Intratumoral CD8+ T-cell infiltration and serum high mobility group box 1 (HMGB1) levels were higher in the B-NIT group. Analysis of CD8+ T cells in tumor-infiltrating lymphocytes (TILs) showed that CD62L- CD44+ effector memory T cells and CD69+ early-activated T cells were predominantly increased in the B-NIT group. Administration of CD8-depleting mAb to the B-NIT group completely suppressed the augmented therapeutic effects. This indicated that B-NIT has a potent immune-induced abscopal effect, directly destroying tumors with BNCT, inducing antigen-spreading effects, and protecting normal tissue. B-NIT, immunotherapy combined with BNCT, is the first treatment to overcome immunotherapy resistance in malignant melanoma. In the future, as its therapeutic efficacy is demonstrated not only in melanoma but also in other immunotherapy-resistant malignancies, B-NIT can become a new treatment candidate for advanced-stage cancers.

DOI： 10.1111/cas.16298

Comprehensive geriatric assessment as an indicator of postoperative recovery in older patients with colorectal cancer. Reviewed International journal

Fuminori Teraishi, Ryohei Shoji, Yoshitaka Kondo, Shunsuke Kagawa, Rie Tamura, Yoshikazu Matsuoka, Hiroshi Morimatsu, Toshiharu Mitsuhashi, Toshiyoshi Fujiwara

Journal of geriatric oncology 101837 - 101837 2024.7

Near-infrared Photoimmunotherapy Targeting Cancer-Associated Fibroblasts in Patient-Derived Xenografts Using a Humanized Anti-Fibroblast Activation Protein Antibody. Reviewed International journal

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

Molecular cancer therapeutics 23 ( 7 ) 1031 - 1042 2024.7

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

Esophageal cancer remains a highly aggressive malignancy with a poor prognosis, despite ongoing advancements in treatments such as immunotherapy. The tumor microenvironment, particularly cancer-associated fibroblasts (CAF), plays a crucial role in driving the aggressiveness of esophageal cancer. In a previous study utilizing human-derived xenograft models, we successfully developed a novel cancer treatment that targeted CAFs with near-infrared photoimmunotherapy (NIR-PIT), as an adjuvant therapy. In this study, we sought to translate our findings toward clinical practice by employing patient-derived xenograft (PDX) models and utilizing humanized mAbs, specifically sibrotuzumab, which is an antihuman fibroblast activation protein (FAP) Ab and already being investigated in clinical trials as monotherapy. PDX models derived from patients with esophageal cancer were effectively established, preserving the expression of key biomarkers such as EGFR and FAP, as observed in primary tumors. The application of FAP-targeted NIR-PIT using sibrotuzumab, conjugated with the photosensitizer IR700DX, exhibited precise binding and selective elimination of FAP-expressing fibroblasts in vitro. Notably, in our in vivo investigations using both cell line-derived xenograft and PDX models, FAP-targeted NIR-PIT led to significant inhibition of tumor progression compared with control groups, all without inducing adverse events such as weight loss. Immunohistologic assessments revealed a substantial reduction in CAFs exclusively within the tumor microenvironment of both models, further supporting the efficacy of our approach. Thus, our study demonstrates the potential of CAF-targeted NIR-PIT employing sibrotuzumab as a promising therapeutic avenue for the clinical treatment of patients with esophageal cancer.

DOI： 10.1158/1535-7163.MCT-23-0527

BRAF-mutant microsatellite-stable rectal cancer with acquired KRAS mutation leading to drug resistance in liver metastasis. Reviewed International journal

Kunitoshi Shigeyasu, Hideki Yamamoto, Toshiaki Takahashi, Kazuya Moriwake, Masashi Kayano, Sho Takeda, Yuki Matsumi, Yuzo Umeda, Yoshitaka Kondo, Fuminori Teraishi, Kazuya Yasui, Tomokazu Fuji, Shunsuke Kagawa, Toshiyoshi Fujiwara

International cancer conference journal 13 ( 3 ) 189 - 192 2024.7

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

BRAF-mutant microsatellite-stable colorectal cancer (CRC), metastasized to distant sites, is associated with a poor prognosis. However, the BEACON CRC regimen, comprising a BRAF inhibitor, MEK inhibitor, and anti-EGFR antibody, offered a prolonged prognosis. Nonetheless, resistance to this regimen may occur, as observed in our reported case of CRC, where a KRAS mutation was identified in addition to the BRAF V600E mutation. Here, we present a case of 74-year-old woman with rectal cancer (pT4bN1bM0 Stage IIIc) harboring the BRAF V600E mutation. After resection of the primary tumor and during adjuvant chemotherapy using CAPOX (capecitabine and oxaliplatin), liver and lung metastases became apparent, and a companion diagnosis test revealed the presence of a BRAF V600E mutation. The new lesions were deemed resistant to the CAPOX regimen, and we decided to introduce encorafenib and cetuximab. After resection of liver metastases, encorafenib and cetuximab were reintroduced, but a new lesion appeared in hepatic S7, indicating resistance to the encorafenib and cetuximab regimen. The resistant liver metastasis was subsequently resected. To elucidate the resistance mechanism, we conducted a comprehensive analysis using the FoundationOne CDx cancer gene panel test, revealing the presence of a KRAS Q61H mutation alongside the BRAF V600E mutation. Subsequent liquid biopsy after liver recurrence confirmed the persistence of the KRAS Q61H mutation. Our results highlight the significance of cancer genome profiling tests (CGP tests) and liquid biopsies in guiding treatment strategies for BRAF-mutant colorectal cancer. Therefore, CGP testing offers valuable information for treatment, even if it does not lead to new drug administrations.

DOI： 10.1007/s13691-024-00678-2

Rare case of rectal carcinoid with synchronous primary carcinoid tumors of the lung misdiagnosed as lung metastases. Reviewed International journal

Fuminori Teraishi, Rhohei Shoji, Toshiyoshi Fujiwara

JGH open : an open access journal of gastroenterology and hepatology 8 ( 7 ) e70003 2024.7

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

A 68-year-old woman was referred to our hospital for rectal surgery after a pathological diagnosis of rectal carcinoid with venous invasion following endoscopic submucosal dissection of a 5 mm-sized submucosal tumor in the lower rectum. Chest CT showed nodules in the left upper lobe and right lower lobe, but positron emission tomography and somatostatin receptor scintigraphy showed no hyperaccumulation in the lung nodules. CT-guided needle biopsy was performed on the nodular lesion in the left upper lobe, which showed focal growth of tumor cells with a high N/C ratio and positive synaptophysin, leading to a diagnosis of pulmonary metastasis of rectal carcinoid. Since the patient was asymptomatic and did not wish to undergo surgery or chemotherapy, she was followed up strictly with sufficient informed consent. Three years have passed since the diagnosis, and there is no tendency for the lung metastasis to increase, and no other new lesions have been observed. The disease had not progressed and remained stable. Therefore, immunohistological analysis of the lung biopsy specimen was performed again, which was positive for TTF-1 and negative for CDX2. Consequently, the diagnosis was changed to primary lung carcinoid tumors, and the patient remains under follow-up with no disease progression.

DOI： 10.1002/jgh3.70003

下部消化管新規内科治療が台頭する時代の炎症性腸疾患に対する外科治療の意義手術適応クローン病患者において術前の栄養学的・免疫学的指標の改善が術後合併症を軽減する

Moriwake Kazuya, Kondo Yoshitaka, Sakamoto Masaki, Kanaya Nobuhiko, Kakiuchi Yoshihiko, Shigeyasu Kunitoshi, Kuroda Shinji, Teraishi Fuminori, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本消化器外科学会総会 79回 345 - 345 2024.7

当院におけるMSI-high大腸癌に対するPembrolizumabの使用経験

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

日本消化器外科学会総会 79回 2231 - 2231 2024.7

下部消化管大腸癌集学的治療について高齢化社会における大腸癌患者の長期生存を目指した遠隔転移制御戦略

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 596 - 596 2024.7

若手外科医に対する外科手術教育に対しCadaver Surgical Trainingが果たす役割

近藤喜太, 金谷信彦, 重安邦俊, 前田直見, 田辺俊介, 黒田新士, 野間和広, 寺石文則, 楳田祐三, 藤原俊義

日本消化器外科学会総会 79回 2356 - 2357 2024.7

術前治療後の局所進行直腸癌に対するロボット支援手術の短期～中期治療成績

寺石文則, 庄司良平, 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

日本消化器外科学会総会 79回 2317 - 2317 2024.7

術前治療後の局所進行直腸癌に対するロボット支援手術の短期～中期治療成績

寺石文則, 庄司良平, 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

日本消化器外科学会総会 79回 2317 - 2317 2024.7

若手外科医に対する外科手術教育に対しCadaver Surgical Trainingが果たす役割

近藤喜太, 金谷信彦, 重安邦俊, 前田直見, 田辺俊介, 黒田新士, 野間和広, 寺石文則, 楳田祐三, 藤原俊義

日本消化器外科学会総会 79回 2356 - 2357 2024.7

下部消化管大腸癌集学的治療について高齢化社会における大腸癌患者の長期生存を目指した遠隔転移制御戦略

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 596 - 596 2024.7

当院におけるMSI-high大腸癌に対するPembrolizumabの使用経験

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

日本消化器外科学会総会 79回 2231 - 2231 2024.7

私が目指すScientific Surgeonとその現状と未来

金谷信彦, 黒田新士, 近藤喜太, 坂本真樹, 垣内慶彦, 菊地覚次, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 668 - 668 2024.7

食道癌周術期管理の最前線:多職種における新たな試み入院から外来まで切れ目なくサポートする多部門連係による食道癌周術期管理

田辺俊介, 野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 前田直見, 菊地覚次, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 78回 26 - 26 2024.7

ロボット支援食道がん手術における課題解決のためのわれわれの取り組み

白川靖博, 桂佑貴, 井谷史嗣, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 78回 11 - 11 2024.7

胸腔鏡下手術からロボット支援手術における微細解剖コンセプトに基づく上縦隔リンパ節郭清定型化の変遷

白川靖博, 桂佑貴, 石田道拡, 丁田泰宏, 井谷史嗣, 松川啓義, 塩崎滋弘, 田辺俊介, 野間和広, 藤原俊義

日本消化器外科学会総会 79回 2187 - 2188 2024.7

当院における高齢者食道癌患者に対する周術期治療戦略

河崎健人, 野間和広, 國友知義, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 79回 2089 - 2089 2024.7

浸潤性膵管癌に対する膵切除断端の検討

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

日本消化器外科学会総会 79回 1865 - 1865 2024.7

超低肺機能患者に対する食道癌術後の新たな肺炎リスク因子の可能性

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, 田邊俊介, 楳田祐三, 藤原俊義

日本消化器外科学会総会 79回 1342 - 1342 2024.7

食道癌周術期管理における栄養管理法の検討

國友知義, 野間和広, 河崎健人, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 79回 1204 - 1204 2024.7

切除可能膵癌に対する術前化学療法は高齢者に本当に必要か?

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

日本消化器外科学会総会 79回 1161 - 1161 2024.7

当院における高齢者食道癌とサルコペニアの検討

高橋政史, 野間和広, 松本眞琴, 河崎健人, 國友知義, 橋本将志, 前田直見, 田邊俊介, 楳田祐三, 藤原俊義

日本消化器外科学会総会 79回 736 - 736 2024.7

上部消化管上部消化管癌に対する更なる低侵襲・機能温存治療観音開き法再建後の吻合部狭窄および狭窄症状のリスク因子分析から見えた再建手技の理想型

黒田新士, 垣内慶彦, 菊地覚次, 賀島肇, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 573 - 573 2024.7

上部消化管術前治療+食道切除後の免疫チェックポイント阻害剤による補助療法の現状術前DCF療法を行った食道癌術後再発ハイリスク症例に対する補助療法の短期成績

橋本将志, 野間和広, 河崎健人, 國友知義, 前田直見, 菊地覚次, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 79回 490 - 490 2024.7

肝胆膵高難度腹腔鏡・ロボット支援下膵頭十二指腸切除術の現状と今後の展望 Two-surgeon techniqueを用いたロボット支援下膵頭十二指腸切除術

藤智和, 高木弘誠, 楳田祐三, 安井和也, 山田元彦, 永井康雄, 黒田新士, 野間和広, 寺石文則, 藤原俊義

日本消化器外科学会総会 79回 466 - 466 2024.7

上部消化管ロボット・内視鏡手術における上縦隔郭清手技ロボット支援手術による左上縦隔郭清の定型化

前田直見, 野間和広, 河崎健人, 國友知義, 橋本将志, 菊地覚次, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 79回 407 - 408 2024.7

Functional remodeling of intraperitoneal macrophages by oncolytic adenovirus restores anti-tumor immunity for peritoneal metastasis of gastric cancer. Reviewed International journal

Motoyasu Tabuchi, Satoru Kikuchi, Hiroshi Tazawa, Tomohiro Okura, Toshihiro Ogawa, Ema Mitsui, Yuta Une, Shinji Kuroda, Hiroki Sato, Kazuhiro Noma, Shunsuke Kagawa, Toshiaki Ohara, Junko Ohtsuka, Rieko Ohki, Yasuo Urata, Toshiyoshi Fujiwara

Molecular therapy. Oncology 32 ( 2 ) 200806 - 200806 2024.6

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

Intraperitoneal tumor-associated macrophages (TAMs) are involved in evading anti-tumor immunity and promoting the peritoneal metastasis (PM) of gastric cancer (GC). Oncolytic viruses are known to induce the activation of host anti-tumor immunity in addition to tumor lysis. This study investigated whether a wild-type p53-loading telomerase-specific oncolytic adenovirus (OBP-702) could elicit the remodeling of intraperitoneal macrophages and enhance the efficacy of immune therapy. Increased numbers of CD163 TAMs and few CD8+ lymphocytes were immunohistochemically observed in clinical samples with PM, which suggested that TAMs were associated with the suppression of anti-tumor immunity. OBP-702 induced immunogenic cell death and upregulated PD-L1 expression in human and murine GC cell lines. Intraperitoneal administration of OBP-702 increased recruitment of CD8+ lymphocytes into the PM via the functional remodeling of intraperitoneal macrophages from TAM toward a pro-inflammatory phenotype, resulting in significantly suppressed tumor growth for the in vivo model. Furthermore, the combination of intraperitoneal OBP-702 with anti-programmed cell death-1 antibody enhanced anti-tumor immunity and prolonged the survival of mice bearing PM. Intraperitoneal immunotherapy using OBP-702 restores anti-tumor immunity via the remodeling of intraperitoneal macrophages in addition to direct tumor lysis and cooperates with immune checkpoint inhibitors to suppress PM in GC.

DOI： 10.1016/j.omton.2024.200806

Senescent Fibroblasts Potentiate Peritoneal Metastasis of Diffuse-type Gastric Cancer Cells via IL-8-mediated Crosstalk. Reviewed International journal

Yuncheng Li, Hiroshi Tazawa, Yasuo Nagai, Shuto Fujita, Tomohiro Okura, Ryohei Shoji, Motohiko Yamada, Satoru Kikuchi, Shinji Kuroda, Toshiaki Ohara, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Anticancer research 44 ( 6 ) 2497 - 2509 2024.6

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

BACKGROUND/AIM: Diffuse-type gastric cancer (DGC) often forms peritoneal metastases, leading to poor prognosis. However, the underlying mechanism of DGC-mediated peritoneal metastasis is poorly understood. DGC is characterized by desmoplastic stroma, in which heterogeneous cancer-associated fibroblasts (CAFs), including myofibroblastic CAFs (myCAFs) and senescent CAFs (sCAFs), play a crucial role during tumor progression. This study investigated the CAF subtypes induced by GC cells and the role of sCAFs in peritoneal metastasis of DGC cells. MATERIALS AND METHODS: Conditioned medium of human DGC cells (KATOIII, NUGC-4) and human intestinal-type GC (IGC) cells (MKN-7, N87) was used to induce CAFs. CAF subtypes were evaluated by analyzing the expression of α-smooth muscle actin (α-SMA), senescence-associated β-galactosidase (SA-β-gal), and p16 in human normal fibroblasts (GF, FEF-3). A cytokine array was used to explore the underlying mechanism of GC-induced CAF subtype development. The role of sCAFs in peritoneal metastasis of DGC cells was analyzed using a peritoneally metastatic DGC tumor model. The relationships between GC subtypes and CAF-related markers were evaluated using publicly available datasets. RESULTS: IGC cells significantly induced α-SMA+ myCAFs by secreting transforming growth factor-β, whereas DGC cells induced SA-β-gal+/p16+ sCAFs by secreting interleukin (IL)-8. sCAFs further secreted IL-8 to promote DGC cell migration. In vivo experiments demonstrated that co-inoculation of sCAFs significantly enhanced peritoneal metastasis of NUGC-4 cells, which was attenuated by administration of the IL-8 receptor antagonist navarixin. p16 and IL-8 expression was significantly associated with poor prognosis of DGC patients. CONCLUSION: sCAFs promote peritoneal metastasis of DGC via IL-8-mediated crosstalk.

DOI： 10.21873/anticanres.17056

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

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

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

【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

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

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

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

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

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

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

【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

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

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.

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

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

【必携消化器・一般外科医のための外科解剖アトラス】食道・胃経裂孔アプローチによる食道胃接合部癌手術に必要な局所解剖

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

野間和広, 田辺俊介, 藤原俊義

手術 78 ( 4 ) 425 - 430 2024.3

胃体上部の多発穿孔により汎発性腹膜炎を呈し胃全摘術を余儀なくされた1例

賀島肇, 桑田和也, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本腹部救急医学会雑誌 44 ( 2 ) 363 - 363 2024.2

高齢者に対する薬物治療術前化学療法を要する高齢胃癌患者に対する治療戦略

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

日本胃癌学会総会記事 96回 203 - 203 2024.2

当施設のAYA世代大腸癌手術症例に関する検討

寺石文則, 山田元彦, 庄司良平, 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 ( 2 ) 131 - 131 2024.2

Minimum invasive surgeryでの胃切除術時における手ブレ軽減の工夫

皆木仁志, 垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 369 - 369 2024.2

上部胃癌に対する脾摘と脾門郭清の手技と成績脾門郭清における脾摘の有無によらない脾門アプローチの定型化

黒田新士, 垣内慶彦, 皆木仁志, 庄司良平, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 184 - 184 2024.2

高齢者/ハイリスク患者の低侵襲手術肥満症合併胃癌患者に対するロボット支援下胃切除のリンパ節郭清効果

賀島肇, 皆木仁志, 金谷信彦, 垣内慶彦, 菊地覚次, 黒田新士, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 215 - 215 2024.2

術後障害の評価と対策術後継続的な栄養指導による胃切除術後障害の軽減効果

菊地覚次, 半澤俊哉, 賀島肇, 庄司良平, 松三雄騎, 垣内慶彦, 黒田新士, 田辺俊介, 野間和広, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 175 - 175 2024.2

Circulating cell-free DNA methylation patterns as non-invasive biomarkers to monitor colorectal cancer treatment efficacy without referencing primary site mutation profiles. Reviewed International journal

Kazuya Yasui, Toshiaki Toshima, Ryo Inada, Yuzo Umeda, Shuya Yano, Hiroaki Tanioka, Akihiro Nyuya, Toshiyoshi Fujiwara, Takeshi Yamada, Yoshio Naomoto, Ajay Goel, Takeshi Nagasaka

Molecular cancer 23 ( 1 ) 1 - 1 2024.1

Language：English

This study investigates methylation patterns in circulating cell-free DNA (ccfDNA) for their potential role in colorectal cancer (CRC) detection and the monitoring of treatment response. Through methylation microarrays and quantitative PCR assays, we analyzed 440 samples from The Cancer Genome Atlas (TCGA) and an additional 949 CRC samples. We detected partial or extensive methylation in over 85% of cases within three biomarkers: EFEMP1, SFRP2, and UNC5C. A methylation score for at least one of the six candidate regions within these genes' promoters was present in over 95% of CRC cases, suggesting a viable detection method. In evaluating ccfDNA from 97 CRC patients and 62 control subjects, a difference in methylation and recovery signatures was observed. The combined score, integrating both methylation and recovery metrics, showed high diagnostic accuracy, evidenced by an area under the ROC curve of 0.90 (95% CI = 0.86 to 0.94). While correlating with tumor burden, this score gave early insight into disease progression in a small patient cohort. Our results suggest that DNA methylation in ccfDNA could serve as a sensitive biomarker for CRC, offering a less invasive and potentially more cost-effective approach to augment existing cancer detection and monitoring modalities, possibly supporting comprehensive genetic mutation profiling.

DOI： 10.1186/s12943-023-01910-y

Epidural versus patient-controlled intravenous analgesia on pain relief and recovery after laparoscopic gastrectomy for gastric cancer: randomized clinical trial. Reviewed International journal

Satoru Kikuchi, Takashi Matsusaki, Toshiharu Mitsuhashi, Shinji Kuroda, Hajime Kashima, Nobuo Takata, Ema Mitsui, Yoshihiko Kakiuchi, Kazuhiro Noma, Yuzo Umeda, Hiroshi Morimatsu, Toshiyoshi Fujiwara

BJS open 8 ( 1 ) 2024.1

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

BACKGROUND: Epidural analgesia (EDA) is a main modality for postoperative pain relief in major open abdominal surgery within the Enhanced Recovery After Surgery protocol. However, it remains unclear whether EDA is an imperative modality in laparoscopic gastrectomy (LG). This study examined non-inferiority of patient-controlled intravenous analgesia (PCIA) to EDA in terms of postoperative pain and recovery in patients who underwent LG. METHODS: In this open-label, non-inferiority, parallel, individually randomized clinical trial, patients who underwent elective LG for gastric cancer were randomized 1:1 to receive either EDA or PCIA after surgery. The primary endpoint was pain score using the Numerical Rating Scale at rest 24 h after surgery, analysed both according to the intention-to-treat (ITT) principle and per protocol. The non-inferiority margin for pain score was set at 1. Secondary outcomes were postoperative parameters related to recovery and adverse events related to analgesia. RESULTS: Between 3 July 2017 and 29 September 2020, 132 patients were randomized to receive either EDA (n = 66) or PCIA (n = 66). After exclusions, 64 patients were included in the EDA group and 65 patients in the PCIA group for the ITT analysis. Pain score at rest 24 h after surgery was 1.94 (s.d. 2.07) in the EDA group and 2.63 (s.d. 1.76) in the PCIA group (P = 0.043). PCIA was not non-inferior to EDA for the primary endpoint (difference 0.69, one side 95% c.i. 1.25, P = 0.184) in ITT analysis. Postoperative parameters related to recovery were similar between groups. More EDA patients (21 (32.8%) versus 1 (1.5%), P < 0.001) developed postoperative hypotension as an adverse event. CONCLUSIONS: PCIA was not non-inferior to EDA in terms of early-phase pain relief after LG.Registration number: UMIN000027643 (https://www.umin.ac.jp/ctr/index-j.htm).

DOI： 10.1093/bjsopen/zrad161

Fluorescence-guided assessment of bone and soft-tissue sarcomas for predicting the efficacy of telomerase-specific oncolytic adenovirus. Reviewed International journal

Koji Uotani, Hiroshi Tazawa, Joe Hasei, Tomohiro Fujiwara, Aki Yoshida, Yasuaki Yamakawa, Toshinori Omori, Kazuhisa Sugiu, Tadashi Komatsubara, Hiroya Kondo, Takuya Morita, Masahiro Kiyono, Suguru Yokoo, Toshiaki Hata, Toshiyuki Kunisada, Ken Takeda, Yasuo Urata, Toshiyoshi Fujiwara, Toshifumi Ozaki

PloS one 19 ( 2 ) e0298292 2024

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

Bone and soft-tissue sarcomas are rare malignancies with histological diversity and tumor heterogeneity, leading to the lack of a common molecular target. Telomerase is a key enzyme for keeping the telomere length and human telomerase reverse transcriptase (hTERT) expression is often activated in most human cancers, including bone and soft-tissue sarcomas. For targeting of telomerase-positive tumor cells, we developed OBP-301, a telomerase-specific replication-competent oncolytic adenovirus, in which the hTERT promoter regulates adenoviral E1 gene for tumor-specific viral replication. In this study, we present the diagnostic potential of green fluorescent protein (GFP)-expressing oncolytic adenovirus OBP-401 for assessing virotherapy sensitivity using bone and soft-tissue sarcomas. OBP-401-mediated GFP expression was significantly associated with the therapeutic efficacy of OBP-401 in human bone and soft-tissue sarcomas. In the tumor specimens from 68 patients, malignant and intermediate tumors demonstrated significantly higher expression levels of coxsackie and adenovirus receptor (CAR) and hTERT than benign tumors. OBP-401-mediated GFP expression was significantly increased in malignant and intermediate tumors with high expression levels of CAR and hTERT between 24 and 48 h after infection. Our results suggest that the OBP-401-based GFP expression system is a useful tool for predicting the therapeutic efficacy of oncolytic virotherapy on bone and soft-tissue sarcomas.

DOI： 10.1371/journal.pone.0298292

Perioperative and Postoperative Continuous Nutritional Counseling Improves Quality of Life of Gastric Cancer Patient Undergoing Gastrectomy. Reviewed International journal

Shunya Hanzawa, Satoru Kikuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Ayako Takahashi, Yoshihiko Kakiuchi, Kosei Takagi, Shunsuke Tanabe, Kazuhiro Noma, Shunsuke Kagawa, Kenichi Shikata, Toshiyoshi Fujiwara

Nutrition and cancer 76 ( 6 ) 476 - 485 2024

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

Post-gastrectomy syndrome (PGS) and body weight loss (BWL) decrease quality of life (QOL) and survival of the patient undergoing gastrectomy. We have introduced perioperative and post-discharge continuous nutritional counseling (CNC) to prevent BWL and improve QOL after gastrectomy. In the present study, we evaluated the effect of CNC on QOL using the Post-gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Eighty-three patients with gastric cancer (GC) who underwent curative gastrectomy between March 2018 and July 2019 were retrospectively analyzed. Patients received either pre-discharge nutritional counseling alone (control group, n = 45) or CNC (CNC group, n = 38) after gastrectomy. QOL at 12 months after gastrectomy was compared between the two groups. In QOL assessment, change in body weight (-7.98% vs. -12.77%, p = 0.0057), ingested amount of food per meal (7.00 vs. 6.07, p = 0.042) and ability for working (1.89 vs. 2.36, p = 0.049) were significantly better in CNC group than control group. Multiple regression analysis showed that CNC was a significantly beneficial factor for abdominal pain subscale (p = 0.028), diarrhea subscale (p = 0.047), ingested amount of food per meal (p = 0.012), Ability for working (p = 0.031) and dissatisfaction at the meal (p = 0.047). Perioperative and postoperative CNC could improve QOL in the patient undergoing gastrectomy in addition to preventing postoperative BWL.

DOI： 10.1080/01635581.2024.2340782

ASO Author Reflections: The Role of Robotic Surgery in Patients with Portal Annular Pancreas. International journal

Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Yuzo Umeda, Toshiyoshi Fujiwara

Annals of surgical oncology 2023.12

Robotic Pancreatoduodenectomy in Portal Annular Pancreas Using a Hanging Maneuver with Indocyanine Green Fluorescence Imaging. Reviewed International journal

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

Annals of surgical oncology 2023.12

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

BACKGROUND: Sufficient knowledge and surgical management of portal annular pancreas (PAP) are essential for pancreatic surgery. As PAP is a relatively rare pancreatic anomaly, few studies have described surgical techniques for patients with PAP undergoing robotic pancreatoduodenectomy (RPD). PATIENTS AND METHODS: An 82-year-old female patient who underwent RPD presented with distal cholangiocarcinoma and type III PAP (the fusion of the uncinate process with the anteportal main pancreatic duct). After the Kocher maneuver and stomach transection, the pancreas was transected into the neck of the anteportal portion. The retroportal portion was dissected, encircled with hanging tape, and compressed. Blood supply from the mesenteric vessels was confirmed using indocyanine green (ICG) fluorescence imaging. Subsequently, the retroportal portion was stapled. CONCLUSIONS: This study demonstrates a unique surgical technique for type III PAP using the hanging maneuver with ICG fluorescence imaging. Surgeons should decide on the surgical strategy on the basis of the fusion and ductal anatomy of the pancreas.

DOI： 10.1245/s10434-023-14685-9

【胆道癌・膵臓癌の集学的治療におけるsupportive careの有用性について】胆道癌集学的治療における栄養指標の有用性

楳田祐三, 日置勝義, 吉田一博, 松田達雄, 児島亨, 佐藤太祐, 遠藤芳克, 藤智和, 高木弘誠, 安井和也, 木村真士, 石堂展宏, 大石正博, 稲垣優, 藤原俊義

胆と膵 44 ( 12 ) 1631 - 1637 2023.12

Language：Japanese Publisher：医学図書出版(株)

癌患者は,蛋白質の同化障害や異化亢進を特徴とする栄養不良に陥りやすく,筋肉量も減少しやすい。こうした担癌状態に伴う栄養不良,筋肉量低下・筋肉の質の低下といった二次性サルコペニアは,胆道癌において予後不良因子となることが報告されている。また手術後の感染性合併症の危険因子ともなるため,とくに胆道再建を伴う肝切除や膵頭十二指腸切除を要する胆道癌では注意を要する。胆道癌のさらなる治療予後向上には,腫瘍進行度のみならず,栄養状態を正確に評価し,リハビリ栄養療法を積極的に介入していくことが必要である。今回,肝内胆管癌切除例における栄養指標についての解析結果を踏まえ,胆道癌集学的治療における栄養評価と術前リハビリ栄養療法介入の意義について概説する。(著者抄録)

Fontan手術後の肝腺腫に対してロボット支援下肝切除術を施行した2例

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

日本内視鏡外科学会雑誌 28 ( 7 ) 1281 - 1281 2023.12

Clinical Impact of Prehabilitation on Elective Laparoscopic Surgery in Frail Octogenarians With Colorectal Cancer. Reviewed International journal

Fuminori Teraishi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Shunsuke Kagawa, Rie Tamura, Yoshikazu Matsuoka, Hiroshi Morimatsu, Toshiyoshi Fujiwara

Anticancer research 43 ( 12 ) 5597 - 5604 2023.12

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

BACKGROUND/AIM: The aim of the present study was to clarify the clinical impact of prehabilitation by the perioperative management center (PERIO) at our hospital in severely frail octogenarians with colorectal cancer. PATIENTS AND METHODS: We compared the clinicopathological characteristics of octogenarians who underwent surgery for colorectal cancer before the establishment of PERIO intervention (Control group) with those who received prehabilitation (PERIO group). All patients were classified as American Society of Anesthesiologists (ASA) class 3 or higher. The primary outcome was the incidence of postoperative complications. RESULTS: There were 21 patients in the Control group and 19 patients in the PERIO group. Operative time was significantly longer in the PERIO group (Control group, 200 min vs. PERIO group, 230 min; p=0.03) and blood loss was significantly higher in the PERIO group (Control group, 5 ml vs. PERIO group, 30 ml; p=0.02). Postoperative complications occurred in 10 patients (47.6%) in the Control group and 3 patients (15.8%) in the PERIO group and were significantly lower in the PERIO group (p=0.03). Postoperative hospital stay was 13 days (range=7-31 days) in the Control group and 11 days (range=8-70 days) in the PERIO group (p=0.39). The rate of discharge directly to home was 81% in the Control group and 93.3% in the PERIO group (p=0.29). CONCLUSION: In frail octogenarians with colorectal cancer of ASA class 3 or higher, the incidence of postoperative complications was significantly lower after PERIO intervention.

DOI： 10.21873/anticanres.16762

胃癌術後1年目に局所リンパ節再発との鑑別を要した腹腔内デスモイド腫瘍の1例

Fontan手術後の肝腺腫に対してロボット支援下肝切除術を施行した2例

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

日本内視鏡外科学会雑誌 28 ( 7 ) 1281 - 1281 2023.12

Double-surgeon techniqueによるロボット支援下肝切除術

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

日本内視鏡外科学会雑誌 28 ( 7 ) 2336 - 2336 2023.12

鼠径ヘルニア術後、膀胱上窩ヘルニアに対して腹腔鏡下根治術を施行した1例

萱野真史, 高木弘誠, 山田元彦, 近藤喜太, 木村次郎, 木村裕司, 安井和也, 藤智和, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1932 - 1932 2023.12

肥満症を伴った大腸癌に対する治療戦略高度肥満症を伴う結腸癌に対する多職種連携周術期管理と手術手技の工夫

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

日本内視鏡外科学会雑誌 28 ( 7 ) 1637 - 1637 2023.12

炎症性腸疾患に対する低侵襲手術の新しい工夫瘻孔形成を伴うクローン病低侵襲手術の効果とバイオ製剤導入時期の腸管機能温存への影響

近藤喜太, 金谷信彦, 庄司良平, 垣内慶彦, 菊地覚次, 重安邦俊, 田辺俊介, 黒田新士, 野間和広, 寺石文則, 楳田祐三, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2246 - 2246 2023.12

術者導入期でも安全な当院の鏡視下食道切除コンセプト

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

日本内視鏡外科学会雑誌 28 ( 7 ) 1535 - 1535 2023.12

食道癌112aoPリンパ節に対する腹腔鏡下経裂孔的アプローチによる系統的郭清

河崎健人, 野間和広, 國友知義, 橋本将志, 加藤卓也, 前田直見, 重安邦俊, 菊地寛次, 黒田新士, 近藤喜太, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1577 - 1577 2023.12

片山哲也, 垣内慶彦, 黒田新士, 近藤喜太, 菊地覚次, 重安邦俊, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会雑誌 56 ( 12 ) 677 - 684 2023.12

Language：Japanese Publisher：(一社)日本消化器外科学会

症例は44歳の男性で,胃癌に対して腹腔鏡下幽門側胃切除術,D2リンパ節郭清,Billroth-I法再建を施行し,病理組織診断はpT2N0M0 Stage IBであった.術後1年目のCTおよびPET-CTにて,#6リンパ節郭清領域にリンパ節再発を示唆する所見を認めたため腹腔鏡下腫瘤摘出術を施行し,病理組織診断でデスモイド腫瘍であった.デスモイド腫瘍は術前診断が困難であり,その発生機序の一因として手術による機械刺激が挙げられるため,胃癌術後に発生した際は再発との鑑別が困難である.再発リスクの低い症例では化学療法などを施行する前に,診断的治療を目的とした手術を行うことは有用であり,術中迅速検査などで再発が否定できるのであれば,他臓器合併切除は極力避けるべきである.胃癌術後にリンパ節再発との鑑別を要したデスモイド腫瘍の1例を経験した.(著者抄録)

縫合不全ゼロとストーマレスを目指したロボット支援腹腔鏡下低位前方切除術の定型化

寺石文則, 皆木仁志, 庄司良平, 金谷信彦, 賀島肇, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2650 - 2650 2023.12

結腸憩室炎に対する低侵襲手術 S状結腸、直腸RS部憩室炎に対する腹腔鏡手術の治療成績

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

日本内視鏡外科学会雑誌 28 ( 7 ) 3221 - 3221 2023.12

食道胃接合部癌に対する新規アプローチ縦隔腹部リンパ郭清と機能温存術後再建の両立を目指して

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

日本内視鏡外科学会雑誌 28 ( 7 ) 2266 - 2266 2023.12

ロボット支援手術による左上縦隔郭清の定型化

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

日本内視鏡外科学会雑誌 28 ( 7 ) 2646 - 2646 2023.12

食道癌に対する上縦隔リンパ節郭清ロボット支援手術を活かした食道癌上縦隔郭清の定型化

野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 重安邦俊, 菊地覚次, 近藤喜太, 黒田新士, 田辺俊介, 寺石文則, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1426 - 1426 2023.12

難治性胃食道逆流症・食道裂孔ヘルニアに対する外科治療高齢者食道裂孔ヘルニアの腹腔鏡手術の現状と手技の工夫

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

日本内視鏡外科学会雑誌 28 ( 7 ) 819 - 819 2023.12

高度進行食道癌に対するロボット支援手術の治療成績と今後の展望

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

日本内視鏡外科学会雑誌 28 ( 7 ) 1185 - 1185 2023.12

減量・代謝改善手術を安全かつ有効に行うためのちょっとした工夫腹腔鏡下スリーブ状胃切除における縫合補強材を用いた大彎側切離の安全性と手術時間短縮効果

賀島肇, 菊地覚次, 香川俊輔, 皆木仁志, 庄司良平, 金谷信彦, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 408 - 408 2023.12

縦隔鏡下食道切除術における手技と治療成績超ハイリスク食道癌症例への対応縦隔鏡下食道切除術の有効性と安全性

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

日本内視鏡外科学会雑誌 28 ( 7 ) 469 - 469 2023.12

[Novel Therapy Targeting the Cancer Microenvironment Using Near-Infrared Photoimmunotherapy Leading to Tumor Immune Activation].

Takuya Kato, Kazuhiro Noma, Aki Furusawa, Hisataka Kobayashi, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 50 ( 13 ) 1361 - 1363 2023.12

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

Near-infrared photoimmunotherapy(NIR-PIT)is a novel cancer treatment modality that employs antibody-IRDye700DX (IR700)conjugates. Recently, the clinical application of NIR-PIT has received approval in Japan for patients with inoperable head and neck cancer, specifically targeting the human epidermal growth factor receptor(hEGFR). Furthermore, NIR-PIT extends beyond the scope of tumor antigens and can be employed to eliminate specific host cells that contribute to the creation of immune-permissive environments supporting tumor growth. One of the distinguishing features of NIR-PIT is its ability to selectively eliminate various cell types within the tumor microenvironment(TME)by specifically targeting distinct antigens. By employing podoplanin(PDPN)-targeted NIR-PIT, PDPN-expressing fibroblasts were selectively eradicated, resulting in the suppression of tumor progression and a notable extension of overall survival. Additionally, we investigated the efficacy of depleting myeloid-derived suppressor cells(MDSCs)using NIR-PIT. This approach led to the selective elimination of MDSCs within tumors, and remarkable abscopal effects were observed in bilateral tumor models. Hence, NIR-PIT holds immense promise for the treatment of diverse cancer types by precisely targeting tumor cells, fibroblasts, and immune cells.

鼠径ヘルニア術後、膀胱上窩ヘルニアに対して腹腔鏡下根治術を施行した1例

萱野真史, 高木弘誠, 山田元彦, 近藤喜太, 木村次郎, 木村裕司, 安井和也, 藤智和, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1932 - 1932 2023.12

Double-surgeon techniqueによるロボット支援下肝切除術

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

日本内視鏡外科学会雑誌 28 ( 7 ) 2336 - 2336 2023.12

ロボット支援下vs.腹腔鏡下膵体尾部切除術 100例の経験から

安井和也, 高木弘誠, 楳田祐三, 藤智和, 吉田龍一, 木村裕司, 山田元彦, 木村次郎, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1941 - 1941 2023.12

低侵襲胃癌手術における脾門リンパ節郭清-脾摘か脾温存か、適応とアプローチの実際- 低侵襲アプローチによる脾温存脾門リンパ節郭清手技の定型化とその標準術式としての可能性

黒田新士, 菊地覚次, 垣内慶彦, 賀島肇, 金谷信彦, 庄司良平, 皆木仁志, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2681 - 2681 2023.12

腹腔鏡下胃切除術の際の12mmポート挿入方向の工夫による手ブレ軽減効果

皆木仁志, 垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 570 - 570 2023.12

左内頸静脈自家グラフト再建を施行した肝外門脈瘤の切除例

大倉友博, 楳田祐三, 藤智和, 吉田龍一, 高木弘誠, 安井和也, 木村次郎, 畑七々子, 三島顕人, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 84 ( 11 ) 1827 - 1827 2023.11

Intraperitoneal Administration of p53-armed Oncolytic Adenovirus Inhibits Peritoneal Metastasis of Diffuse-type Gastric Cancer Cells. Reviewed International journal

Naoto Hori, Hiroshi Tazawa, Yuncheng Li, Tomohiro Okura, Satoru Kikuchi, Shinji Kuroda, Toshiaki Ohara, Kazuhiro Noma, Masahiko Nishizaki, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Anticancer research 43 ( 11 ) 4809 - 4821 2023.11

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

BACKGROUND/AIM: Diffuse-type gastric cancer (GC) frequently exhibits peritoneal metastasis, leading to poor prognosis. However, efforts to develop antitumor strategies for preventing the peritoneal metastasis of GC have been unsuccessful. As diffuse-type GC cells often carry a genetic alteration in the tumor suppressor p53 gene, p53 restoration may be a potent strategy for preventing peritoneal metastasis of GC. In this study, we investigated the therapeutic potential of p53-expressing adenoviral vectors against peritoneal metastasis of diffuse-type GC cells. MATERIALS AND METHODS: Three diffuse-type human GC cell types with different p53 statuses (p53-wild type NUGC-4, p53-mutant type GCIY, and p53-null type KATOIII) were used to evaluate the therapeutic potential of p53 activation induced by the p53-expressing, replication-deficient adenovirus Ad-p53 and oncolytic adenovirus OBP-702. Viability, apoptosis, and autophagy of virus-treated GC cells were analyzed under normal and sphere-forming culture conditions using the XTT assay and western blot analysis. The in vivo antitumor effects of OBP-702 and Ad-p53 were assessed using xenograft tumor models involving peritoneal metastasis of NUGC-4 and GCIY cells. RESULTS: Under normal and sphere-forming culture conditions, OBP-702 induced a significantly greater antitumor effect in GC cells compared with Ad-p53 by strongly inducing p53-mediated apoptosis and autophagy and receptor tyrosine kinase suppression. In vivo experiments demonstrated that intraperitoneal administration of OBP-702 significantly suppressed the peritoneal metastasis of NUGC-4 and GCIY cells compared with Ad-p53, leading to prolonged survival of mice. CONCLUSION: Intraperitoneal administration of OBP-702 inhibits the peritoneal metastasis of GC cells by inducing p53-mediated cytopathic activity.

DOI： 10.21873/anticanres.16678

膵頭十二指腸切除術後の胸部食道癌に対して遊離空腸間置再建を伴うロボット支援下食道亜全摘術を施行し得た1例

森分和也, 野間和広, 松本佑, 河崎健人, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 11 ) 1829 - 1830 2023.11

病理組織学的に膵浸潤を認めた壁外発育型胃GISTの1例

新田薫, 垣内慶彦, 庄司良平, 重安邦俊, 菊地覚次, 近藤喜太, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 11 ) 1829 - 1829 2023.11

がん遺伝子パネル検査は大腸癌肝転移の外科治療を変えるか?

藤智和, 楳田祐三, 重安邦俊, 藤原俊義

日本消化器外科学会雑誌 56 ( Suppl.2 ) 336 - 336 2023.11

Prognostic nutritional index is a prognostic factor for patients with gastric cancer and esophagogastric junction cancer undergoing proximal gastrectomy with esophagogastrostomy by the double-flap technique: A secondary analysis of the rD-FLAP study. Reviewed International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Yasuhiro Choda, Shinya Otsuka, Satoshi Ueyama, Norimitsu Tanaka, Atsushi Muraoka, Shinji Hato, Yasuaki Kamikawa, Toshiyoshi Fujiwara

Surgical oncology 50 101990 - 101990 2023.10

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

PURPOSE: Although proximal gastrectomy (PG) is commonly used in patients with upper gastric cancer (GC) and esophagogastric junction (EGJ) cancer, long-term prognostic factors in these patients are poorly understood. The double-flap technique (DFT) is an esophagogastrostomy with anti-reflux mechanism after PG; we previously conducted a multicenter retrospective study (rD-FLAP) to evaluate the short-term outcomes of DFT reconstruction. Here, we evaluated the long-term prognostic factors in patients with upper GC and EGJ cancer. METHODS: The study was conducted as a secondary analysis of the rD-FLAP Study, which enrolled patients who underwent PG with DFT reconstruction, irrespective of disease type, between January 1996 and December 2015. RESULTS: A total of 509 GC and EGJ cancer patients were enrolled. Univariate and multivariate analyses of overall survival demonstrated that a preoperative prognostic nutritional index (PNI) < 45 (p < 0.001, hazard ratio [HR]: 3.59, 95% confidential interval [CI]: 1.93-6.67) was an independent poor prognostic factor alongside pathological T factor ([pT] ≥2) (p = 0.010, HR: 2.29, 95% CI: 1.22-4.30) and pathological N factor ([pN] ≥1) (p = 0.001, HR: 3.27, 95% CI: 1.66-6.46). In patients with preoperative PNI ≥45, PNI change (<90%) at 1-year follow-up (p = 0.019, HR: 2.54, 95%CI: 1.16-5.54) was an independent poor prognostic factor, for which operation time (≥300 min) and blood loss (≥200 mL) were independent risk factors. No independent prognostic factors were identified in patients with preoperative PNI <45. CONCLUSIONS: PNI is a prognostic factor in upper GC and EGJ cancer patients. Preoperative nutritional enhancement and postoperative nutritional maintenance are important for prognostic improvement in these patients.

DOI： 10.1016/j.suronc.2023.101990

膵臓癌間質に対する腫瘍融解アデノウイルス製剤の治療効果

永井康雄, 田澤大, 菊地覚次, 黒田新士, 野間和広, 浦田泰生, 香川俊輔, 藤原俊義

癌と化学療法 50 ( 10 ) 1102 - 1103 2023.10

Language：Japanese Publisher：(株)癌と化学療法社

膵臓癌は豊富な間質を有する予後不良な悪性疾患である。膵臓癌の間質環境にはがん関連線維芽細胞(CAFs)が存在し,悪性化の進展,治療抵抗性や再発に寄与している。しかし膵臓癌間質を制御する有効な治療法は未だ確立していない。著者らは,癌抑制遺伝子p53を搭載した腫瘍融解アデノウイルス製剤(OBP-702)を開発し,膵臓癌に対する治療効果を明らかにしてきた。本研究では,膵臓癌CAFに対するOBP-702の治療効果を検討する。(著者抄録)

[Therapeutic Effect of Oncolytic Adenovirus on Pancreatic Cancer Stroma].

Yasuo Nagai, Hiroshi Tazawa, Satoru Kikuchi, Shinji Kuroda, Kazuhiro Noma, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 50 ( 10 ) 1102 - 1103 2023.10

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

Pancreatic ductal adenocarcinoma(PDAC)is lethal malignancy with abundant stroma. Cancer-associated fibroblasts (CAFs) exist in the PDAC stroma and contribute to progression of malignant transformation, treatment resistance, and recurrence. However, effective treatment to control PDAC stroma has not been established. We have developed tumor suppressor gene p53-armed oncolytic adenovirus(OBP-702), and have clarified therapeutic effects on PDAC cells. In this study, we investigate the therapeutic effect of OBP-702 on PDAC CAF.

cT3br、cT4局所進行食道癌に対する低侵襲手術の妥当性ロボット支援下手術の特性を駆使して挑む局所進行食道癌症例に対する根治手術の有用性

田辺俊介, 野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 76回 EVS1 - 4 2023.10

食道癌サルベージ手術における気管壊死予防を重視した選択的リンパ節郭清

前田直見, 野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 田辺俊介, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 76回 EP10 - 3 2023.10

食道癌術後再建法と長期的なアウトカム食道癌根治切除術時後縦隔経路再建に伴う空腸瘻の功罪についての検討

國友知義, 野間和広, 河崎健人, 橋本将志, 加藤卓也, 前田直見, 田邉俊介, 櫻間教文, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 76回 EPD1 - 7 2023.10

食道癌術野内再発に対する治療戦略と成績

河崎健人, 野間和広, 國友知義, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 76回 EP9 - 5 2023.10

食道癌手術の周術期管理を考える食道癌外科治療の院内横断的周術期管理術前から術後までサポート

野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 藤原俊義

日本胸部外科学会定期学術集会 76回 EWS2 - 2 2023.10

反回神経麻痺ゼロを目指したベストアプローチ根治性と反回神経麻痺ゼロを目指した食道癌上縦隔リンパ節郭清の定型化

白川靖博, 桂佑貴, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本胸部外科学会定期学術集会 76回 CDPD1 - 2 2023.10

食道癌術後長期腸瘻サポートのリスク因子

橋本将志, 野間和広, 河崎健人, 加藤卓也, 前田直見, 菊地覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 61回 O31 - 2 2023.10

当院における高齢者食道癌に対する手術を基盤とした集学的治療

森分和也, 野間和広, 前田直見, 橋本将志, 加藤卓也, 菊地覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 寺石文則, 香川俊輔, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 61回 O7 - 6 2023.10

バイパス術の有効性の検証

松本祐, 野間和広, 前田直見, 橋本将志, 加藤卓也, 菊池覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 楳田祐三, 寺石文則, 香川俊輔, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 61回 O7 - 1 2023.10

症例報告からPrecision Medicineへ-第1部-(BRAF-mutant microsatellite stable rectal cancer with KRAS mutation in liver metastasis)

重安邦俊, 山本英喜, 楳田祐三, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 61回 ICCJ1 - 4 2023.10

当院における高齢者食道癌に対する手術を基盤とした集学的治療

日本癌治療学会学術集会抄録集 61回 O7 - 6 2023.10

バイパス術の有効性の検証

日本癌治療学会学術集会抄録集 61回 O7 - 1 2023.10

食道癌術後長期腸瘻サポートのリスク因子

日本癌治療学会学術集会抄録集 61回 O31 - 2 2023.10

症例報告からPrecision Medicineへ-第1部- 肝転移にKRAS変異を有するBRAF変異マイクロサテライト安定性直腸癌(BRAF-mutant microsatellite stable rectal cancer with KRAS mutation in liver metastasis)

重安邦俊, 山本英喜, 楳田祐三, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 61回 ICCJ1 - 4 2023.10

米国留学中に経験した出産育児と共稼ぎから見えた外科医のワークライフバランスへの提言

金谷信彦, 黒田新士, 竹原裕子, 皆木仁志, 垣内慶彦, 近藤喜太, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S65 - S65 2023.10

胃憩室を合併した高度肥満症に対して腹腔鏡下スリーブ状胃切除を施行した1例

廣砂賢祐, 賀島肇, 菊地覚次, 香川俊輔, 庄司良平, 金谷信彦, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S332 - S332 2023.10

免疫チェックポイント阻害剤導入後食道がんに対する治療戦略は変わったか食道癌術後再発に対する免疫チェックポイント阻害剤の成績

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

日本臨床外科学会雑誌 84 ( 増刊 ) S210 - S210 2023.10

肥満手術の現状と展望減量代謝改善手術(Bariatric Metabolic Surgery:BMS)チームの介入による術前減量効果と腹腔鏡下スリーブ状胃切除手術(Laparoscopic sleeve gastrectomy:LSG)による減量効果の関係

日本臨床外科学会雑誌 84 ( 増刊 ) S184 - S184 2023.10

術前化学療法時代の消化器がん周術期栄養管理を考える食道癌周術期管理における早期包括的介入の有用性

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

日本臨床外科学会雑誌 84 ( 増刊 ) S176 - S176 2023.10

鏡視下食道がん手術における反回神経麻痺防止の工夫(2) 反回神経麻痺予防のための術式定型化

日本臨床外科学会雑誌 84 ( 増刊 ) S163 - S163 2023.10

術後早期回復プログラムの課題を考える食道癌手術後の経口摂取と腸瘻造設に対する周術期管理の再評価と最適化を考える

國友知義, 野間かずひろ, 河崎健人, 橋本将志, 加藤卓也, 前田直見, 重安邦俊, 菊地覚次, 黒田新士, 近藤喜太, 田邉俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S133 - S133 2023.10

胸腔鏡下食道癌手術の教育 On-the-Job TrainingとOff-the-Job Trainingを駆使した効率的な修練課程

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

日本臨床外科学会雑誌 84 ( 増刊 ) S92 - S92 2023.10

鏡視下食道がん手術における反回神経麻痺防止の工夫(2) 反回神経麻痺予防のための術式定型化

日本臨床外科学会雑誌 84 ( 増刊 ) S163 - S163 2023.10

術前化学療法時代の消化器がん周術期栄養管理を考える食道癌周術期管理における早期包括的介入の有用性

日本臨床外科学会雑誌 84 ( 増刊 ) S176 - S176 2023.10

日本臨床外科学会雑誌 84 ( 増刊 ) S184 - S184 2023.10

胸腔鏡下食道癌手術の教育 On-the-Job TrainingとOff-the-Job Trainingを駆使した効率的な修練課程

日本臨床外科学会雑誌 84 ( 増刊 ) S92 - S92 2023.10

術後早期回復プログラムの課題を考える食道癌手術後の経口摂取と腸瘻造設に対する周術期管理の再評価と最適化を考える

日本臨床外科学会雑誌 84 ( 増刊 ) S133 - S133 2023.10

免疫チェックポイント阻害剤導入後食道がんに対する治療戦略は変わったか食道癌術後再発に対する免疫チェックポイント阻害剤の成績

日本臨床外科学会雑誌 84 ( 増刊 ) S210 - S210 2023.10

胃憩室を合併した高度肥満症に対して腹腔鏡下スリーブ状胃切除を施行した1例

日本臨床外科学会雑誌 84 ( 増刊 ) S332 - S332 2023.10

ライフイベント時に本当に必要な支援とは? 高いチーム力でダイバーシティとインクルージョンを目指す当院のキャリア支援

小林純子, 竹原裕子, 溝尾妙子, 菊地覚次, 三好健太郎, 黒田新士, 田邊俊介, 楳田祐三, 小谷恭弘, 杉本誠一郎, 岡崎幹生, 枝園忠彦, 豊岡伸一, 藤原俊義, 笠原真悟

日本臨床外科学会雑誌 84 ( 増刊 ) S73 - S73 2023.10

米国留学中に経験した出産育児と共稼ぎから見えた外科医のワークライフバランスへの提言

金谷信彦, 黒田新士, 竹原裕子, 皆木仁志, 垣内慶彦, 近藤喜太, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S65 - S65 2023.10

Cadaver Surgical Trainingによる解剖を基本とした手術手技獲得の重要性

近藤喜太, 垣内慶彦, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 野間和広, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S95 - S95 2023.10

食道良性疾患に対する外科医の立ち位置を考える多診療科からなる食道疾患センターにおける食道外科医の役割

濱崎友洋, 野間和広, 安井雄一, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 寺石文則, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S206 - S206 2023.10

食道がんオリゴ転移・再発に対する治療戦略当院における食道癌オリゴ転移・再発に対する治療と成績

安井雄一, 野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S174 - S174 2023.10

Exosomes as a drug delivery tool for cancer therapy: a new era for existing drugs and oncolytic viruses. Reviewed International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Nobuhiko Kanaya, Shunsuke Kagawa, Hiroshi Tazawa, Toshiyoshi Fujiwara

Expert opinion on therapeutic targets 1 - 10 2023.9

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

INTRODUCTION: Exosomes are cell-derived nanovesicles involved in cell-to-cell communications. These nanovesicles are generally considered to contain important carriers of information such as DNA and RNA, and show specific tropism. AREAS COVERED: The combination of existing therapeutic agents with exosomes enhances therapeutic effects by increasing uptake into the tumor. Induction of immunogenic cell death (ICD) may also be triggered more strongly than with the drug alone. Oncolytic viruses (OVs) are even more effective as a drug in combination with exosomes. Although OVs are more likely to cause immune activity, combination with exosomes can exert synergistic effects. OVs have potent anti-tumor effects, but many limitations, such as being limited to local administration and vulnerability to attack by antibodies. Incorporation into exosomes can overcome these limitations and may allow effects against distant tumors. EXPERT OPINION: Novel therapies using exosomes are very attractive in terms of enhancing therapeutic efficacy and reducing side effects. This approach also contains elements overcoming disadvantages in OVs, which have not been used clinically until now, and may usher in a new era of cancer treatments.

DOI： 10.1080/14728222.2023.2259102

Stroke volume variation and dynamic arterial elastance predict fluid responsiveness even in thoracoscopic esophagectomy: a prospective observational study Reviewed

Yukiko Hikasa, Satoshi Suzuki, Shunsuke Tanabe, Kazuhiro Noma, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

Journal of Anesthesia 37 ( 6 ) 930 - 937 2023.9

PD-L1-expressing cancer-associated fibroblasts induce tumor immunosuppression and contribute to poor clinical outcome in esophageal cancer. Reviewed International journal

Kento Kawasaki, Kazuhiro Noma, Takuya Kato, Toshiaki Ohara, Shunsuke Tanabe, Yasushige Takeda, Hijiri Matsumoto, Seitaro Nishimura, Tomoyoshi Kunitomo, Masaaki Akai, Teruki Kobayashi, Noriyuki Nishiwaki, Hajime Kashima, Naoaki Maeda, Satoru Kikuchi, Hiroshi Tazawa, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 72 ( 11 ) 3787 - 3802 2023.9

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

The programmed cell death 1 protein (PD-1)/programmed cell death ligand 1 (PD-L1) axis plays a crucial role in tumor immunosuppression, while the cancer-associated fibroblasts (CAFs) have various tumor-promoting functions. To determine the advantage of immunotherapy, the relationship between the cancer cells and the CAFs was evaluated in terms of the PD-1/PD-L1 axis. Overall, 140 cases of esophageal cancer underwent an immunohistochemical analysis of the PD-L1 expression and its association with the expression of the α smooth muscle actin, fibroblast activation protein, CD8, and forkhead box P3 (FoxP3) positive cells. The relationship between the cancer cells and the CAFs was evaluated in vitro, and the effect of the anti-PD-L1 antibody was evaluated using a syngeneic mouse model. A survival analysis showed that the PD-L1+ CAF group had worse survival than the PD-L1- group. In vitro and in vivo, direct interaction between the cancer cells and the CAFs showed a mutually upregulated PD-L1 expression. In vivo, the anti-PD-L1 antibody increased the number of dead CAFs and cancer cells, resulting in increased CD8+ T cells and decreased FoxP3+ regulatory T cells. We demonstrated that the PD-L1-expressing CAFs lead to poor outcomes in patients with esophageal cancer. The cancer cells and the CAFs mutually enhanced the PD-L1 expression and induced tumor immunosuppression. Therefore, the PD-L1-expressing CAFs may be good targets for cancer therapy, inhibiting tumor progression and improving host tumor immunity.

DOI： 10.1007/s00262-023-03531-2

肝静脈狭窄によるOut-flow Block、十二指腸憩室穿孔による度重なる腹腔内出血と大量腹水に苦悩した生体肝移植の1例

安井和也, 佐藤真歩, 谷口厚樹, 木村次郎, 木村裕司, 高木弘誠, 藤智和, 楳田祐三, 藤原俊義

移植 58 ( 総会臨時 ) 265 - 265 2023.9

チーム医療効果的な周術期管理チーム介入を見据えた高齢大腸癌患者の術前機能評価の有用性

寺石文則, 庄司良平, 松三雄騎, 重安邦俊, 近藤喜太, 田村利枝, 松岡義和, 藤原俊義

日本大腸肛門病学会雑誌 76 ( 9 ) A100 - A100 2023.9

術前治療と手術アプローチから検討した直腸癌術後骨盤内局所再発の治療成績

庄司良平, 寺石文則, 近藤喜太, 松三雄騎, 重安邦俊, 藤原俊義

日本大腸肛門病学会雑誌 76 ( 9 ) A194 - A194 2023.9

鉄キレート効果を持つHIF-PH阻害薬は抗腫瘍免疫応答を向上させる(HIF-PH inhibitors with iron chelating ability enhance the tumor immune response)

大原利章, 陳悦華, 王宇沢, 濱田祐輔, 菊地覚次, 野間和広, 田澤大, 藤澤真義, 藤原俊義, 松川昭博

日本癌学会総会記事 82回 248 - 248 2023.9

CAFsを標的にした光免疫療法によるドラッグデリバリー改善効果(Drug delivery improvement of CAFs targeted photoimmunotherapy)

西村星多郎, 野間和広, 高橋達也, 竹田泰茂, 松本聖, 國友知義, 河崎健人, 赤井正明, 小林照貴, 賀島肇, 加藤卓也, 菊地覚次, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 82回 131 - 131 2023.9

骨髄由来免疫抑制細胞を標的とした光免疫療法は局所腫瘍免疫を活性化させ腫瘍増殖を抑制させる(Selective depletion of PMN-MDSCs in tumor be ds with near infrared photoimmunotherapy enhances host immune response)

加藤卓也, 野間和広, 古澤あき, 福島啓司, 高尾誠一郎, 田澤大, チョイキー・ピーター, 小林久隆, 藤原俊義

日本癌学会総会記事 82回 1758 - 1758 2023.9

共生細菌とがん免疫応答酪酸は腫瘍融解ウイルスの抗腫瘍効果を向上させる(Commensal bacteria and tumor immunity Butyrate enhances the antitumor efficacy of telomerase-specific oncolytic adenoviruses)

坂本真樹, 黒田新士, 垣内慶彦, 橋本将志, 八木千晶, 杉本龍馬, 濱田侑紀, 吉田有佑, 門脇大輔, 半澤俊哉, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 82回 1660 - 1660 2023.9

胃がん腹膜転移の生物学的解明を目的とした腹膜構造3Dモデルの開発(Development of the 3D model of peritoneum structure to explore the biology of gastric cancer peritoneal metastasis)

宇根悠太, 菊地覚次, 田澤大, 黒田新士, 大原利章, 野間和広, 香川俊輔, 藤原俊義

日本癌学会総会記事 82回 1858 - 1858 2023.9

CAFsを標的にした光免疫療法によるドラッグデリバリー改善効果(Drug delivery improvement of CAFs targeted photoimmunotherapy)

日本癌学会総会記事 82回 131 - 131 2023.9

鉄キレート効果を持つHIF-PH阻害薬は抗腫瘍免疫応答を向上させる(HIF-PH inhibitors with iron chelating ability enhance the tumor immune response)

大原利章, 陳悦華, 王宇沢, 濱田祐輔, 菊地覚次, 野間和広, 田澤大, 藤澤真義, 藤原俊義, 松川昭博

日本癌学会総会記事 82回 248 - 248 2023.9

宇根悠太, 菊地覚次, 田澤大, 黒田新士, 大原利章, 野間和広, 香川俊輔, 藤原俊義

日本癌学会総会記事 82回 1858 - 1858 2023.9

術前治療と手術アプローチから検討した直腸癌術後骨盤内局所再発の治療成績

庄司良平, 寺石文則, 近藤喜太, 松三雄騎, 重安邦俊, 藤原俊義

日本大腸肛門病学会雑誌 76 ( 9 ) A194 - A194 2023.9

チーム医療効果的な周術期管理チーム介入を見据えた高齢大腸癌患者の術前機能評価の有用性

寺石文則, 庄司良平, 松三雄騎, 重安邦俊, 近藤喜太, 田村利枝, 松岡義和, 藤原俊義

日本大腸肛門病学会雑誌 76 ( 9 ) A100 - A100 2023.9

膵・胆管合流異常に対する術後晩期合併症の検討

木村次郎, 藤智和, 廣野欣司, 佐藤真歩, 萱野真史, 山田元彦, 木村裕司, 高木弘誠, 安井和也, 楳田祐三, 藤原俊義

日本膵・胆管合流異常研究会プロシーディングス 46 43 - 43 2023.9

理想の男女共同参画を目指して外科医の男女共同参画の実現を目指して男性育児休業を取得した経験から

坂本真樹, 片岡正文, 仁熊健文, 黒田新士, 藤原俊義

日本外科学会雑誌 124 ( 5 ) 385 - 387 2023.9

Language：Japanese Publisher：(一社)日本外科学会

近年様々な社会で男女共同参画やワークライフバランスの重要性が指摘されているが,外科医の領域では進んでいるとは言い難い.今回,筆者は男性育児休業を取得した経験から,その問題点や解決策,今後の展望について考察したので報告する.(著者抄録)

肝移植後患者に発症したメトロニダゾール誘発性脳症の1例

Robotic Pancreaticoduodenectomy Using the Right Posterior Superior Mesenteric Artery Approach. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Tomokazu Fuji, Kazuya Yasui, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2023.8

實金悠, 安井和也, 楳田祐三, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 84 ( 8 ) 1301 - 1307 2023.8

Language：Japanese Publisher：日本臨床外科学会

患者は57歳,男性.Budd-Chiari症候群による非代償性肝硬変に対して46歳時に生体肝移植術後.慢性期に門脈狭窄に起因する門脈圧亢進症に伴う腸炎や肝性脳症を繰り返していたが,肝不全兆候はなく外来フォロー中であった.今回,間質性肺炎急性増悪に対しステロイド加療中にClostridium difficile腸炎を併発,メトロニダゾール内服にて軽快したが,腸炎症状は遷延していたためメトロニダゾール1g/日の内服を継続していた.約2ヵ月後に内服服薬管理困難,構音障害,手指振戦が出現し,症状発現から1週間後に意識障害の増悪を認め受診.頭部MRIで両側対称性に小脳歯状核の高信号域を確認,メトロニダゾール誘発性脳症と診断した.速やかにメトロニダゾールを中止したことで,徐々に意識レベルは改善した.メトロニダゾール誘発性脳症の発症は稀であり,肝移植・肝障害に関連した報告例は少なく,過去の文献的考察を加えて報告する.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J03156&link_issn=&doc_id=20230907150026&doc_link_id=10.3919%2Fjjsa.84.1301&url=https%3A%2F%2Fdoi.org%2F10.3919%2Fjjsa.84.1301&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

【まずはこれだけ消化器ナースがかかわる「ERAS」】

田邊俊介, 野間和広, 藤原俊義

消化器ナーシング 28 ( 8 ) 788 - 795 2023.8

Dual antiplatelet therapy inhibits neutrophil extracellular traps to reduce liver micrometastases of intrahepatic cholangiocarcinoma. Reviewed International journal

Masashi Yoshimoto, Shunsuke Kagawa, Hiroki Kajioka, Atsuki Taniguchi, Shinji Kuroda, Satoru Kikuchi, Yoshihiko Kakiuchi, Tomohiko Yagi, Shohei Nogi, Fuminori Teraishi, Kunitoshi Shigeyasu, Ryuichi Yoshida, Yuzo Umeda, Kazuhiro Noma, Hiroshi Tazawa, Toshiyoshi Fujiwara

Cancer letters 567 216260 - 216260 2023.7

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

The involvement of neutrophil extracellular traps (NETs) in cancer metastasis is being clarified, but the relationship between intrahepatic cholangiocarcinoma (iCCA) and NETs remains unclear. The presence of NETs was verified by multiple fluorescence staining in clinically resected specimens of iCCA. Human neutrophils were co-cultured with iCCA cells to observe NET induction and changes in cellular characteristics. Binding of platelets to iCCA cells and its mechanism were also examined, and their effects on NETs were analyzed in vitro and in in vivo mouse models. NETs were present in the tumor periphery of resected iCCAs. NETs promoted the motility and migration ability of iCCA cells in vitro. Although iCCA cells alone had a weak NET-inducing ability, the binding of platelets to iCCA cells via P-selectin promoted NET induction. Based on these results, antiplatelet drugs were applied to these cocultures in vitro and inhibited the binding of platelets to iCCA cells and the induction of NETs. Fluorescently labeled iCCA cells were injected into the spleen of mice, resulting in the formation of liver micrometastases coexisting with platelets and NETs. These mice were treated with dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor, which dramatically reduced micrometastases. These results suggest that potent antiplatelet therapy prevents micrometastases of iCCA cells by inhibiting platelet activation and NET production, and it may contribute to a novel therapeutic strategy.

DOI： 10.1016/j.canlet.2023.216260

Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 408 ( 1 ) 284 - 284 2023.7

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

PURPOSE: Biliary reconstruction remains a technically demanding and complicated procedure in minimally invasive hepatopancreatobiliary surgeries. No optimal hepaticojejunostomy (HJ) technique has been demonstrated to be superior for preventing biliary complications. This study aimed to investigate the feasibility of our unique technique of posterior double-layer interrupted sutures in robotic HJ. METHODS: We performed a retrospective analysis of a prospectively collected database. Forty-two patients who underwent robotic pancreatoduodenectomy using this technique between September 2020 and November 2022 at our center were reviewed. In the posterior double-layer interrupted technique, sutures were placed to bite the bile duct, posterior seromuscular layer of the jejunum, and full thickness of the jejunum. RESULTS: The median operative time was 410 (interquartile range [IQR], 388-478) min, and the median HJ time was 30 (IQR, 28-39) min. The median bile duct diameter was 7 (IQR, 6-10) mm. Of the 42 patients, one patient (2.4%) had grade B bile leakage. During the median follow-up of 12.6 months, one patient (2.4%) with bile leakage developed anastomotic stenosis. Perioperative mortality was not observed. A surgical video showing the posterior double-layer interrupted sutures in the robotic HJ is included. CONCLUSIONS: Posterior double-layer interrupted sutures in robotic HJ provided a simple and feasible method for biliary reconstruction with a low risk of biliary complications.

DOI： 10.1007/s00423-023-03020-1

Adenocarcinoma arising from widespread heterotopic gastric mucosa in the cervicothoracic esophagus: a case report. Reviewed International journal

Shohei Nogi, Kazuhiro Noma, Masashi Hashimoto, Takuya Kato, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Surgical case reports 9 ( 1 ) 132 - 132 2023.7

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

BACKGROUND: In Japan, about 6% of esophageal cancers are adenocarcinomas, although most of them arise from Barrett's epithelium. Adenocarcinoma arising from heterotopic gastric mucosa (HGM) is very rare. Due to its rarity, there is no unified view on its treatment strategy and prognosis. CASE PRESENTATION: A 57-year-old man presented with a protruding lesion in the cervicothoracic esophagus that was detected by an upper gastrointestinal series at a medical checkup. Esophagoscopy revealed a 30 mm Type 1 tumor circumferentially surrounded by widespread HGM. Computed tomography (CT) and fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed no metastasis or invasion of the surrounding organs. We diagnosed the lesion as cT2N0M0 cStageIIB [Union for International Cancer Control (UICC) 8th Ed] cancer and performed subtotal esophagectomy with three-field lymph node dissection. The tumor was determined to be a well-differentiated adenocarcinoma arising from HGM, with deep invasion of the submucosa. The patient underwent no adjuvant therapy and has currently survived without any evidence of recurrence for 15 months. CONCLUSIONS: Although the treatment for adenocarcinoma arising from HGM is basically the same as that for squamous cell carcinoma (SCC) of the esophagus, it is important to determine the treatment strategy based on the characteristics of the adenocarcinoma arising from HGM.

DOI： 10.1186/s40792-023-01707-7

【必携ロボット支援下消化器外科手術-基本手技とトラブルシューティング】肝胆膵領域ロボット支援下先天性胆道拡張症手術

高木弘誠, 楳田祐三, 藤智和, 安井和也, 藤原俊義, 八木孝仁

手術 77 ( 8 ) 1231 - 1238 2023.7

低侵襲時代の膵臓手術ロボット支援下膵切除術の定型化と普及にむけて

高木弘誠, 楳田祐三, 吉田龍一, 藤智和, 安井和也, 木村次郎, 八木孝仁, 藤原俊義

膵臓 38 ( 3 ) A179 - A179 2023.7

当院における化学放射線治療後ロボット支援下直腸手術の現状と課題

松三雄騎, 寺石文則, 半澤俊哉, 山田元彦, 賀島肇, 重安邦俊, 藤原俊義

日本消化器外科学会総会 78回 P019 - 6 2023.7

腹腔鏡下に十二指腸前壁を開放し切除を行った十二指腸Brunner腺過誤腫の一例

加藤貴光, 垣内慶彦, 庄司良平, 近藤喜太, 黒田新士, 野間和宏, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 P018 - 4 2023.7

当院の直腸癌に対する肛門温存手術アプローチの変遷と術後排便障害の発生状況

庄司良平, 寺石文則, 近藤喜太, 重安邦俊, 菊地覚次, 黒田新士, 田邊俊介, 野間和広, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 P244 - 8 2023.7

進行食道癌症例に対する微量元素に着目した術前から術後外来までのseamlessな多職種周術期管理

田邊俊介, 野間和広, 橋本将志, 加藤卓也, 前田直見, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 P032 - 5 2023.7

【総論】サルコペニア・フレイルに対する周術期・外来管理の工夫食道癌周術期の早期多職種チーム医療介入は術後合併症を軽減させる

河崎健人, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS4 - 2 2023.7

【上部】【Challenges beyond borders】高度進行胃癌に対するconversion surgeryの現状と新たな治療戦略 Stage IV因子と腫瘍マーカー変化率から見えたStage IV胃癌の予後を改善するための至適手術介入条件

垣内慶彦, 黒田新士, 菊地覚次, 重安邦俊, 賀島肇, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 PD3 - 6 2023.7

【肝胆膵】切除可能膵癌に対する術前化学療法の至適戦略血中循環腫瘍DNA内KRAS mutation profileとCA19-9値を組み合わせた膵癌予後の層別化戦略

安井和也, 吉田龍一, 宮本耕吉, 藤智和, 高木弘誠, 寺石文則, 黒田新士, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 78回 WS30 - 10 2023.7

【下部】切除不能な遠隔転移を有する局所進行大腸癌に対する集学的治療戦略大腸癌患者の長期生存を目指した遠隔転移臓器別の切除適応と化学療法レジメンの選択

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 WS20 - 9 2023.7

クローン病における肛門機能温存のための至適治療戦略

近藤喜太, 黒田新士, 田辺俊介, 菊地覚次, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 O13 - 8 2023.7

非大腸癌由来の少数肝転移症例の切除適応を見極める

岡田尚大, 藤智和, 楳田祐三, 吉田龍一, 高木弘誠, 安井和也, 黒田新士, 野間和広, 寺石文則, 藤原俊義

日本消化器外科学会総会 78回 O11 - 6 2023.7

周術期管理チーム介入後にみえてきたフレイル高齢者大腸癌治療の課題術前機能評価を用いた新たな取り組み

寺石文則, 山田元彦, 庄司良平, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 藤原俊義

日本消化器外科学会総会 78回 O33 - 5 2023.7

食道癌術後補助免疫療法中の早期再発リスクと免疫関連有害事象の検討

橋本将志, 野間和広, 加藤卓也, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O27 - 5 2023.7

過不足ない縦郭腹部リンパ郭清と機能温存術後再建の両立を目指して岡山大学病院の現状と展望

加藤卓也, 野間和広, 橋本将志, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O44 - 3 2023.7

Precision laparoscopic sentinel node navigation surgery for femoral skin cancer. Reviewed

Shunya Hanzawa, Fuminori Teraishi, Yuki Matsumi, Kota Tachibana, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 16 ( 3 ) 523 - 527 2023.7

Language：English

Navigation surgery using indocyanine green (ICG) fluorescence imaging has been used in thoracoabdominal surgery, and its usefulness has been reported in many cases. In this study, laparoscopic lateral lymph node dissection was performed using ICG fluorescence imaging in a patient with left femoral spinous cell carcinoma with inguinal and external iliac lymph node metastases. Spinous cell carcinoma is classified as a rare cancer in Japan, and there is a scarcity of evidence for pelvic lymph node dissection, as well as a lack of studies that mention the dissection area. We hypothesized that visualization of lymph nodes and lymph flow using intraoperative ICG fluorescence imaging would indicate the area of dissection and lead to more efficient dissection. In conclusion, intraoperative ICG fluorescence imaging may be useful in this area where there is limited evidence, although there are some limitations.

DOI： 10.1111/ases.13159

膵癌診療における検体固定の工夫と外科医と病理医間での相互フィードバックの実際

進行食道癌症例に対する微量元素に着目した術前から術後外来までのseamlessな多職種周術期管理

田邊俊介, 野間和広, 橋本将志, 加藤卓也, 前田直見, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 P032 - 5 2023.7

安井和也, 木村次郎, 高木弘誠, 藤智和, 楳田祐三, 藤原俊義

膵臓 38 ( 3 ) A461 - A461 2023.7

当院の直腸癌に対する肛門温存手術アプローチの変遷と術後排便障害の発生状況

庄司良平, 寺石文則, 近藤喜太, 重安邦俊, 菊地覚次, 黒田新士, 田邊俊介, 野間和広, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 P244 - 8 2023.7

Case of robot-assisted salvage surgery for esophageal cancer with a mediastinal fistula after definitive chemoradiotherapy. Reviewed

Daisuke Kadowaki, Kazuhiro Noma, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 16 ( 3 ) 505 - 509 2023.7

Language：English

Salvage surgery for esophageal cancer after definitive chemoradiotherapy (dCRT) is effective, but it is associated with a high rate of perioperative complications. The indications for robot-assisted minimally invasive esophagectomy (RAMIE) are expanding. However, there are few reports of salvage RAMIE. A 73-year-old man was referred to our hospital for residual esophageal cancer with a mediastinal fistula after dCRT. The perioperative diagnosis was T3N1M0-Stage III, and the salvage RAMIE was performed. Although the dissection was difficult due to fibrosis caused by dCRT and the esophageal mediastinal fistula, RAMIE was performed safely with no complications. Multiple features of RAMIE contributed to stable surgery. The monopolar dissection is effective for hard scar tissue caused by CRT and inflammation.

DOI： 10.1111/ases.13155

垣内慶彦, 黒田新士, 菊地覚次, 重安邦俊, 賀島肇, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 PD3 - 6 2023.7

【総論】サルコペニア・フレイルに対する周術期・外来管理の工夫食道癌周術期の早期多職種チーム医療介入は術後合併症を軽減させる

河崎健人, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS4 - 2 2023.7

【総論】大腸癌以外のoligometastasisに対する集学的治療の現状と課題食道がん術後再発のOligomatastasisにおける長期予後に関わる因子の解明

松本祐, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 菊地覚次, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS5 - 8 2023.7

【上部】進行食道胃接合部癌に対する集学的治療への取り組み進行食道胃接合部癌における術前化学療法,至適術式の検討

森分和也, 野間和広, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS11 - 6 2023.7

【肝胆膵】切除可能膵癌に対する術前化学療法の至適戦略血中循環腫瘍DNA内KRAS mutation profileとCA19-9値を組み合わせた膵癌予後の層別化戦略

安井和也, 吉田龍一, 宮本耕吉, 藤智和, 高木弘誠, 寺石文則, 黒田新士, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 78回 WS30 - 10 2023.7

切除不能食道癌に対する根治を目指した治療戦略

前田直見, 野間和広, 橋本将志, 加藤卓也, 菊地覚次, 黒田新士, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O8 - 5 2023.7

非大腸癌由来の少数肝転移症例の切除適応を見極める

岡田尚大, 藤智和, 楳田祐三, 吉田龍一, 高木弘誠, 安井和也, 黒田新士, 野間和広, 寺石文則, 藤原俊義

日本消化器外科学会総会 78回 O11 - 6 2023.7

クローン病における肛門機能温存のための至適治療戦略

近藤喜太, 黒田新士, 田辺俊介, 菊地覚次, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 O13 - 8 2023.7

体脂肪分布からみた減量代謝改善手術の効果

賀島肇, 菊地覚次, 香川俊輔, 黒田新士, 垣内慶彦, 松三雄騎, 山田元彦, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 78回 O18 - 2 2023.7

食道癌術後補助免疫療法中の早期再発リスクと免疫関連有害事象の検討

橋本将志, 野間和広, 加藤卓也, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O27 - 5 2023.7

過不足ない縦隔腹部リンパ郭清と機能温存術後再建の両立を目指して岡山大学病院の現状と展望

加藤卓也, 野間和広, 橋本将志, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O44 - 3 2023.7

Total upper GI surgeonによるJz癌へのsurgical approach

桂佑貴, 白川靖博, 石田道拡, 丁田泰宏, 井谷史嗣, 松川啓義, 塩崎滋弘, 田邊俊介, 野間和広, 藤原俊義

日本消化器外科学会総会 78回 O44 - 5 2023.7

地域基幹病院における一子相伝のロボット支援食道悪性腫瘍手術トレーニング

白川靖博, 桂佑貴, 石田道拡, 丁田泰宏, 井谷史嗣, 松川啓義, 塩崎滋弘, 田辺俊介, 野間和広, 藤原俊義

日本消化器外科学会総会 78回 P031 - 3 2023.7

当院における化学放射線治療後ロボット支援下直腸手術の現状と課題

松三雄騎, 寺石文則, 半澤俊哉, 山田元彦, 賀島肇, 重安邦俊, 藤原俊義

日本消化器外科学会総会 78回 P019 - 6 2023.7

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 WS20 - 9 2023.7

周術期管理チーム介入後にみえてきたフレイル高齢者大腸癌治療の課題術前機能評価を用いた新たな取り組み

寺石文則, 山田元彦, 庄司良平, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 藤原俊義

日本消化器外科学会総会 78回 O33 - 5 2023.7

膵頭部癌術前CT画像診断精度の実際病理診断からの振り返り

谷口厚樹, 安井和也, 藤原俊義

日本消化器外科学会総会 78回 S20 - 2 2023.7

Safe and curative modified two-stage operation for T4 esophageal cancer after definitive chemoradiotherapy: a case report. Reviewed International journal

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

Surgical case reports 9 ( 1 ) 119 - 119 2023.6

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

BACKGROUND: The prognosis of esophageal cancer (EC) with organ invasion is extremely poor. In these cases, definitive chemoradiotherapy (CRT) followed by salvage surgery can be planned; however, the issue of high morbidity and mortality rates persists. Herein, we report the long-term survival of a patient with EC and T4 invasion who underwent a modified two-stage operation after definitive CRT. CASE PRESENTATION: A 60-year-old male presented with type 2 upper thoracic EC with tracheal invasion. First, definitive CRT was performed, which resulted in tumor shrinkage and improvement in the tracheal invasion. However, an esophagotracheal fistula subsequently developed, and the patient was treated with fasting and antibiotics. Although the fistula recovered, severe esophageal stenoses made oral intake impossible. To improve quality of life and cure the EC, a modified two-stage operation was planned. In the first surgery, an esophageal bypass was performed using a gastric tube with cervical and abdominal lymph node dissections. After confirming improved nutritional status and absence of distant metastasis, the second surgery was performed with subtotal esophagectomy, mediastinal lymph node dissection, and tracheobronchial coverage of the fistula. The patient discharged without major complications after radical resection and has been recurrence-free for 5 years since the start of treatment. CONCLUSION: A standard curative strategy could be difficult for EC with T4 invasion due to differences in the invaded organs, presence of complications, and patient condition. Therefore, patient-tailored treatment plans are needed, including a modified two-stage operation.

DOI： 10.1186/s40792-023-01692-x

形成外科医による縦隔気管孔作成安全かつ低侵襲なTangentially sternal osteotomy

松本洋, 太田智之, 木股敬裕, 野間和広, 田辺俊介, 前田直見, 橋本将志, 加藤卓也, 藤原俊義, 白川靖博

日本食道学会学術集会プログラム・抄録集 77回 265 - 265 2023.6

ロボット支援下食道切除術のエビデンスわれわれのロボット支援食道切除術定型化の変遷

白川靖博, 桂佑貴, 井谷史嗣, 松川啓義, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 7 - 7 2023.6

ロボット支援下食道切除術のエビデンスロボット支援化食道切除180例の検討定型化とNIM導入の短期成績とその課題

野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 7 - 7 2023.6

cT4食道癌に対する根治を目指した治療戦略

前田直見, 野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 加藤卓也, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 134 - 134 2023.6

高齢者食道癌患者に対する根治的手術戦略

河崎健人, 野間和広, 國友知義, 橋本将志, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 169 - 169 2023.6

滑脱型食道裂孔ヘルニアを伴う胃噴門部粘膜下腫瘍に対してLECSが有用であった1例

賀島肇, 野間和広, 半澤俊哉, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 231 - 231 2023.6

食道がん術後患者のQOL向上に向けた多職種、施設間連携の強化と介入の仕組みづくり

山本有美, 野間和広, 青井美由紀, 川上雅弘, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 259 - 259 2023.6

形成外科医による縦隔気管孔作成安全かつ低侵襲なTangentially sternal osteotomy

松本洋, 太田智之, 木股敬裕, 野間和広, 田辺俊介, 前田直見, 橋本将志, 加藤卓也, 藤原俊義, 白川靖博

日本食道学会学術集会プログラム・抄録集 77回 265 - 265 2023.6

逆流防止機構を備えたDouble Flap Techniqueの挑戦

加藤卓也, 野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 327 - 327 2023.6

cStage II/IIIA食道癌:DCF NAC後の術後補助療法とその適応 pN2以上の再発リスクに対する術後補助免疫療法の短期成績

橋本将志, 野間和広, 河崎健人, 國友知義, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 45 - 45 2023.6

巨大食道裂孔ヘルニアに対する治療の工夫と成績巨大食道裂孔ヘルニアの腹腔鏡根治術における再発軽減のための手術手技の工夫と成績

田辺俊介, 野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 60 - 60 2023.6

当院におけるJz癌に対するoptimum surgical approach strategy

桂佑貴, 白川靖博, 石田道拡, 丁田泰宏, 井谷史嗣, 松川啓義, 塩崎滋弘, 田邊俊介, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 93 - 93 2023.6

食道癌根治切除時における再建経路がQOLに与える影響についての比較

國友知義, 野間和広, 川崎健人, 橋本将志, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 125 - 125 2023.6

Conventional Cancer Therapies Can Accelerate Malignant Potential of Cancer Cells by Activating Cancer-Associated Fibroblasts in Esophageal Cancer Models. Reviewed International journal

Satoshi Komoto, Kazuhiro Noma, Takuya Kato, Teruki Kobayashi, Noriyuki Nishiwaki, Toru Narusaka, Hiroaki Sato, Yuki Katsura, Hajime Kashima, Satoru Kikuchi, Toshiaki Ohara, Hiroshi Tazawa, Toshiyoshi Fujiwara

Cancers 15 ( 11 ) 2023.5

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

Esophageal cancer is one of the most aggressive tumors, and the outcome remains poor. One contributing factor is the presence of tumors that are less responsive or have increased malignancy when treated with conventional chemotherapy, radiotherapy, or a combination of these. Cancer-associated fibroblasts (CAFs) play an important role in the tumor microenvironment. Focusing on conventional cancer therapies, we investigated how CAFs acquire therapeutic resistance and how they affect tumor malignancy. In this study, low-dose chemotherapy or radiotherapy-induced normal fibroblasts showed enhanced activation of CAFs markers, fibroblast activation protein, and α-smooth muscle actin, indicating the acquisition of malignancy in fibroblasts. Furthermore, CAFs activated by radiotherapy induce phenotypic changes in cancer cells, increasing their proliferation, migration, and invasion abilities. In in vivo peritoneal dissemination models, the total number of tumor nodules in the abdominal cavity was significantly increased in the co-inoculation group of cancer cells and resistant fibroblasts compared to that in the co-inoculation group of cancer cells and normal fibroblasts. In conclusion, we demonstrated that conventional cancer therapy causes anti-therapeutic effects via the activation of fibroblasts, resulting in CAFs. It is important to select or combine modalities of esophageal cancer treatment, recognizing that inappropriate radiotherapy and chemotherapy can lead to resistance in CAF-rich tumors.

DOI： 10.3390/cancers15112971

Impact of sarcopenia on clinical outcomes for patients with resected hepatocellular carcinoma: A retrospective comparison of eastern and western cohorts. Reviewed International journal

Berend Robert Beumer, Kosei Takagi, Stefan Buettner, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Jeroen Laurens Ad van Vugt, Jan Nicolas Maria IJzermans

International journal of surgery (London, England) 109 ( 8 ) 2258 - 2266 2023.5

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

BACKGROUND: Patient fitness is important for guiding treatment. Muscle mass, as a reflection thereof, can be objectively measured. However, the role of east-west differences remains unclear. Therefore, we compared the impact of muscle mass on clinical outcomes after liver resection for HCC in a Dutch (NL) and Japanese (JP) setting and evaluated the predictive performance of different cut-off values for sarcopenia. METHOD: In this multicenter retrospective cohort study patients with hepatocellular carcinoma (HCC) undergoing liver resection were included. The skeletal muscle mass index (SMI) was determined on CT scans obtained within 3 months before surgery. The primary outcome measure was overall survival (OS). Secondary outcome measures were: 90-day mortality, severe complications, length of stay, and recurrence free survival. The predictive performance of several sarcopenia cut-off values was studied using the c-index and area under the curve. Interaction terms were used to study geographic effect modification of muscle mass. RESULTS: Demographics differed between NL and JP. Gender, age, and body mass index were associated with SMI. Significant effect modification between NL and JP was found for BMI. The predictive performance of sarcopenia for both short- and long-term outcomes was higher in JP compared to NL (max c-index: 0.58 vs 0.55, respectively). However, differences between cut-off values were small. For the association between sarcopenia and OS, a strong association was found in JP (Hazard ratio (HR) 2.00 95%CI[1.230 ; 3.08], P=0.002), where this was not found in NL (0.76 [0.42 ; 1.36], P=0.351). The interaction term confirmed that this difference was significant (HR 0.37 95%CI[0.19 ; 0.73], P=0.005). CONCLUSIONS: The impact of sarcopenia on survival differs between the east and west. Clinical trials and treatment guidelines using sarcopenia for risk stratification should be validated in race-dependent populations prior to clinical adoption.

DOI： 10.1097/JS9.0000000000000458

Clinical implications and optimal extent of lymphadenectomy for intrahepatic cholangiocarcinoma: A multicenter analysis of the therapeutic index. Reviewed

Yuzo Umeda, Kosei Takagi, Tatsuo Matsuda, Tomokazu Fuji, Toru Kojima, Daisuke Satoh, Masayoshi Hioki, Yoshikatsu Endo, Masaru Inagaki, Masahiro Oishi, Takahito Yagi, Toshiyoshi Fujiwara

Annals of gastroenterological surgery 7 ( 3 ) 512 - 522 2023.5

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

AIMS: Lymph node metastases (LNM) are associated with lethal prognosis in intrahepatic cholangiocarcinoma (ICC). Lymphadenectomy is crucial for accurate staging and hopes of possible oncological treatment. However, the therapeutic implications and optimal extent of lymphadenectomy remain contentious. METHODS: To clarify the prognostic value and optimal extent of lymphadenectomy, the therapeutic index (TI) for each lymph node was analyzed for 279 cases that had undergone lymphadenectomy in a multi-institutional database. Tumor localization was divided into hilar lesions (n = 130), right peripheral lesions (n = 60), and left peripheral lesions (n = 89). In addition, the lymph node station was classified as Level 1 (LV1: hepatoduodenal ligament node), Level 2 (LV2: postpancreatic or common hepatic artery nodes), or Level 3 (LV3: gastrocardiac, left gastric artery, or celiac artery nodes). RESULTS: Lymph node metastases were confirmed in 109 patients (39%). Five-y survival rates were 45.3% for N0 disease, 27.1% for LV1-LNM, 22.9% for LV2-LNM, and 7.3% for LV3-LNM (P < 0.001). LV3-LNM were the most frequent and earliest recurrence outcome, including multisite recurrence, followed by LV2, LV1, and N0 disease. The 5-year TI (5year-TI) for lymphadenectomy was 7.2 for LV1, 5.5 for LV2, and 1.9 for LV3. Regarding tumor location, hilar lesions showed 5-year TI >5.0 in LV1 and LV2, whereas bilateral peripheral lesions showed 5-year TI > 5.0 in LV1. CONCLUSION: The implications and extent of lymphadenectomy for ICC appear to rely on tumor location. In the peripheral type, the benefit of lymphadenectomy would be limited and dissection beyond LV1 should be avoided, while in the hilar type, lymphadenectomy up to LV2 could be recommended.

DOI： 10.1002/ags3.12642

【イラストで見る消化器癌手術アトラス】食道・胃ロボット支援下食道切除術における標準化と手技の工夫

野間和広, 田辺俊介, 前田直見, 藤原俊義

手術 77 ( 6 ) 757 - 762 2023.5

【消化器外科における各種デバイスの使い方とピットフォール】上部消化管食道・胃切除術における自動縫合器の使い方とピットフォール

田邊俊介, 垣内慶彦, 前田直見, 菊地覚次, 黒田新士, 野間和広, 藤原俊義

外科 85 ( 4 ) 345 - 350 2023.4

Language：Japanese Publisher：(株)南江堂

＜文献概要＞近年,自動縫合器を使用した臓器の切離,および再建が普及している.一方で,従来行われていた手縫い吻合と異なり,各臓器において使用の際のピットフォールが存在すると思われる.今回,当科で行っている食道および胃切除術時のサーキュラーステープラおよびリニアステープラの使い方およびそのピットフォールを説明する.

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00393&link_issn=&doc_id=20230414270006&doc_link_id=10.15106%2Fj_geka85_345&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka85_345&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

Locally Advanced Rectal Cancer Invading the Gluteus Maximus Muscle Completely Responded to Total Neoadjuvant Therapy. Reviewed

Masaki Sakamoto, Fuminori Teraishi, Kunitoshi Shigeyasu, Shunsuke Kagawa, Toshiyoshi Fujiwara

Acta medica Okayama 77 ( 2 ) 209 - 213 2023.4

Language：English

A 70-year-old male with anal pain and fever was diagnosed with rectal cancer perforation and abscess in the right gluteus maximus (GM) muscle. He underwent a transverse colon colostomy followed by preoperative capecitabine+oxaliplatin. Some local control was achieved but a residual abscess was observed in the right GM muscle. To secure circumferential resection margin by tumor reduction, he received chemoradiotherapy as total neoadjuvant therapy (TNT) and underwent laparoscopic abdominoperineal resection, D3 lymph node dissection, combined coccyx resection, and partial resection of the right GM muscle. The skin defect and pelvic dead space were filled with a right lateral vastus lateral great muscle flap. Histopathologically, the resected specimen showed no tumor cells in the primary tumor or lymph nodes, indicating a pathological complete response (pCR). This case suggests that TNT might improve the R0 resection and pCR rates and overall survival.

DOI： 10.18926/AMO/65152

【mRNAワクチンやゲノム編集で注目が集まる遺伝子治療】遺伝子治療技術を用いた疾患治療消化器がんに対する腫瘍融解ウイルス療法

食道癌術前化学療法時から介入する多職種チーム医療と微量元素に着目した栄養管理

田辺俊介, 野間和広, 橋本将志, 前田直見, 重安邦俊, 菊地覚次, 黒田新士, 近藤喜太, 吉田龍一, 櫻間教文, 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 123回 DP - 6 2023.4

食道良性疾患に対する手術の限界と挑戦高齢者に対する食道裂孔ヘルニアの腹腔鏡根治術における現状と手技の工夫

藤田脩斗, 野間和広, 橋本将志, 前田直見, 菊地覚次, 重安邦俊, 黒田新士, 近藤喜太, 田辺俊介, 吉田龍一, 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 123回 WS - 6 2023.4

ロボット手術と多科合同手術で食道癌に挑む

門脇大輔, 野間和広, 橋本将志, 前田直見, 重安邦俊, 菊地覚次, 近藤喜太, 黒田新士, 田辺俊介, 吉田龍一, 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 123回 DP - 5 2023.4

藤原俊義, 黒田新士, 田澤大

医学のあゆみ 285 ( 5 ) 446 - 452 2023.4

Language：Japanese Publisher：医歯薬出版(株)

がんは1981年以来,わが国の死亡原因の第1位であり,なかでも消化器がんは半数以上を占めており,消化器がん治療の進歩は国民衛生の向上に非常に重要である.遺伝子工学技術が進歩した今,遺伝子改変ウイルスをがん細胞のみを殺傷する治療用医薬品として用いることが可能となってきた.ウイルスはその生活環として本来,ヒトの細胞に感染・増殖し,その細胞をさまざまな機序により破壊する.この細胞傷害性をがん細胞に標的化することで安全性を担保できれば,臨床的にがん治療用ウイルスとしての使用が期待できる.また最近では,ウイルス製剤が宿主の免疫を活性化するという分子機構が明らかとなってきており,複合免疫療法としての開発も進んでいる.本稿では,筆者らが開発しているアデノウイルス製剤を中心に,消化器がんに対するがん治療用ウイルスの可能性を概説する.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00060&link_issn=&doc_id=20230502010024&doc_link_id=issn%3D0039-2359%26volume%3D285%26issue%3D5%26spage%3D446&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0039-2359%26volume%3D285%26issue%3D5%26spage%3D446&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

厳しい局所進行食道癌に対するロボット支援下手術の経験

白川靖博, 桂佑貴, 清水彰人, 實金悠, 森内俊行, 吉本匡志, 澤田紘幸, 石田道拡, 佐藤太祐, 丁田泰宏, 吉満政義, 中野敢友, 松川啓義, 井谷史嗣, 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 123回 DP - 2 2023.4

外科医療におけるサルコペニア・フレイル対策の最前線胃切除術後の認知行動療法を応用したサルコペニア予防策の効果

菊地覚次, 高田暢夫, 半澤俊哉, 賀島肇, 松三雄騎, 垣内慶彦, 黒田新士, 前田直見, 田辺俊介, 野間和広, 楳田祐三, 藤原俊義

日本外科学会定期学術集会抄録集 123回 SY - 1 2023.4

ロボット支援下肝胆膵高難度手術の導入と教育システムの確立

高木弘誠, 吉田龍一, 藤智和, 安井和也, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 123回 SF - 3 2023.4

Laparoscopic and Endoscopic Cooperative Surgery for Gastric Submucosal Tumor Near Esophagogastric Junction With Sliding Hiatal Hernia. Reviewed International journal

Hajime Kashima, Satoru Kikuchi, Shinji Kuroda, Toshiyoshi Fujiwara

Cureus 15 ( 4 ) e37902 2023.4

Language：English

The usefulness of laparoscopic and endoscopic cooperative surgery (LECS) for gastric submucosal tumors in the cardiac region has been reported in recent years. However, LECS for submucosal tumors at the esophagogastric junction with hiatal sliding esophageal hernia has not been reported, and its validity as a treatment method is unknown. The patient was a 51-year-old man with a growing submucosal tumor in the cardiac region. Surgical resection was indicated because a definitive diagnosis of the tumor was not determined. The lesion was a luminal protrusion tumor, located on the posterior wall of the stomach 20 mm from the esophagogastric junction, and had a maximum diameter of 16.3 mm on endoscopic ultrasound examination. Because of the hiatal hernia, the lesion could not be detected from the gastric side by endoscopy. Local resection was considered to be feasible because the resection line did not extend into the esophageal mucosa and the resection site could be less than half the circumference of the lumen. The submucosal tumor was resected completely and safely by LECS. The tumor was diagnosed as a gastric smooth muscle tumor finally. Nine months after surgery, a follow-up endoscopy showed reflux esophagitis. LECS was a useful technique for submucosal tumors of the cardiac region with hiatal hernia, but fundoplication might be considered for preventing backflow of gastric acid.

DOI： 10.7759/cureus.37902

Impact of educational video on performance in robotic simulation training (TAKUMI-1): a randomized controlled trial. Reviewed International journal

Kosei Takagi, Nanako Hata, Jiro Kimura, Satoru Kikuchi, Kazuhiro Noma, Kazuya Yasui, Tomokazu Fuji, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara

Journal of robotic surgery 17 ( 4 ) 1547 - 1553 2023.3

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

The use of virtual reality for simulations plays an important role in the initial training for robotic surgery. This randomized controlled trial aimed to investigate the impact of educational video on the performance of robotic simulation. Participants were randomized into the intervention (video) group that received an educational video and robotic simulation training or the control group that received only simulation training. The da Vinci® Skills Simulator was used for the basic course, including nine drills. The primary endpoint was the overall score of nine drills in cycles 1-10. Secondary endpoints included overall, efficiency, and penalty scores in each cycle, as well as the learning curves evaluated by the cumulative sum (CUSUM) analysis. Between September 2021 and May 2022, 20 participants were assigned to the video (n = 10) and control (n = 10) groups. The video group had significantly higher overall scores than the control group (90.8 vs. 72.4, P < 0.001). Significantly higher overall scores and lower penalty scores were confirmed, mainly in cycles 1-5. CUSUM analysis revealed a shorter learning curve in the video group. The present study demonstrated that educational video training can be effective in improving the performance of robotic simulation training and shortening the learning curve.

DOI： 10.1007/s11701-023-01556-4

Role of the Pfannenstiel Incision in Robotic Hepato-Pancreato-Biliary Surgery. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Jiro Kimura, Nanako Hata, Takahito Yagi, Toshiyoshi Fujiwara

Journal of clinical medicine 12 ( 5 ) 2023.3

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

Studies remain limited on the role of the Pfannenstiel incision in minimally invasive hepato-pancreato-biliary (HPB) surgery, especially robotic surgery. The role of various extraction sites in robotic HPB surgery should be understood. Herein, we describe the surgical techniques, outcomes, advantages, and disadvantages of the Pfannenstiel incision in robotic pancreatic surgery. Seventy patients underwent robotic pancreatectomy at our institution between September 2020 and October 2022. The Pfannenstiel incision was used for specimen retrieval in 55 patients. Advantages of the Pfannenstiel incision include less pain, cosmetic benefits, and a lower incidence of complications. Moreover, the specimen could be removed using the robotic system docked. However, all complex reconstructions should be performed intra-abdominally during robotic pancreatoduodenectomies. The incidence of mortality and postoperative pancreatic fistula (grade B) was 0% and 9.1%, respectively. During the median follow-up (11.2 months) after surgery, complications at the Pfannenstiel incision site included surgical site infection (n = 1, 1.8%) and incisional hernia (n = 1, 1.8%). The Pfannenstiel incision can be a useful option for specimen retrieval in minimally invasive HPB surgery, according to the surgeon's preferences and the patient's condition.

DOI： 10.3390/jcm12051971

【転移性肝癌を極める】大腸癌肝転移に対する肝切除

楳田祐三, 吉田龍一, 藤智和, 高木弘誠, 安井和也, 重安邦俊, 寺石文則, 八木孝仁, 藤原俊義

消化器外科 46 ( 3 ) 277 - 288 2023.3

Removing the Esophageal Stump During Reconstruction for Esophagojejunostomy in Total Gastrectomy for Gastric Cancer: the Modified Overlap Method. Reviewed International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Satoru Kikuchi, Hajime Kashima, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 27 ( 3 ) 643 - 645 2023.3

Robotic surgery for congenital biliary dilatation using the scope switch technique (with video). Reviewed International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Asian journal of surgery 2023.2

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

TECHNIQUE: Minimally invasive congenital biliary dilatation (CBD) surgery is technically demanding. However, few studies have reported surgical approaches of robotic surgery for CBD. This report presents robotic CBD surgery using a scope-switch technique. Our robotic surgery technique for CBD consisted of four steps: step 1, Kocher's maneuver; step 2, dissection of the hepatoduodenal ligament using the scope switch technique; step 3, preparation for the Roux-en-Y loop; and step 4, hepaticojejunostomy. RESULTS: The scope switch technique can provide different surgical approaches for dissecting the bile duct, including anterior approach by the standard position and right approach by the scope switch position. When approaching the ventral and left side of the bile duct, anterior approach with the standard position is suitable. In contrast, the lateral view by the scope switch position is preferable for approaching the bile duct laterally and dorsally. Using this technique, the dilated bile duct can be dissected circumferentially from four directions: anterior, medial, lateral, and posterior. Thereafter, complete resection of the choledochal cyst can be achieved. CONCLUSIONS: The scope switch technique in robotic surgery for CBD can be useful for dissecting around the bile duct with different surgical views, leading to the complete resection of the choledochal cyst.

DOI： 10.1016/j.asjsur.2023.02.021

Overcoming cancer-associated fibroblast-induced immunosuppression by anti-interleukin-6 receptor antibody. Reviewed International journal

Noriyuki Nishiwaki, Kazuhiro Noma, Toshiaki Ohara, Tomoyoshi Kunitomo, Kento Kawasaki, Masaaki Akai, Teruki Kobayashi, Toru Narusaka, Hajime Kashima, Hiroaki Sato, Satoshi Komoto, Takuya Kato, Naoaki Maeda, Satoru Kikuchi, Shunsuke Tanabe, Hiroshi Tazawa, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 2023.2

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

Cancer-associated fibroblasts (CAFs) are a critical component of the tumor microenvironment and play a central role in tumor progression. Previously, we reported that CAFs might induce tumor immunosuppression via interleukin-6 (IL-6) and promote tumor progression by blocking local IL-6 in the tumor microenvironment with neutralizing antibody. Here, we explore whether an anti-IL-6 receptor antibody could be used as systemic therapy to treat cancer, and further investigate the mechanisms by which IL-6 induces tumor immunosuppression. In clinical samples, IL-6 expression was significantly correlated with α-smooth muscle actin expression, and high IL-6 cases showed tumor immunosuppression. Multivariate analysis showed that IL-6 expression was an independent prognostic factor. In vitro, IL-6 contributed to cell proliferation and differentiation into CAFs. Moreover, IL-6 increased hypoxia-inducible factor 1α (HIF1α) expression and induced tumor immunosuppression by enhancing glucose uptake by cancer cells and competing for glucose with immune cells. MR16-1, a rodent analog of anti-IL-6 receptor antibody, overcame CAF-induced immunosuppression and suppressed tumor progression in immunocompetent murine cancer models by regulating HIF1α activation in vivo. The anti-IL-6 receptor antibody could be systemically employed to overcome tumor immunosuppression and improve patient survival with various cancers. Furthermore, the tumor immunosuppression was suggested to be induced by IL-6 via HIF1α activation.

DOI： 10.1007/s00262-023-03378-7

ADAR1 is a promising risk stratification biomarker of remnant liver recurrence after hepatic metastasectomy for colorectal cancer. Reviewed International journal

Nanako Hata, Kunitoshi Shigeyasu, Yuzo Umeda, Shuya Yano, Sho Takeda, Kazuhiro Yoshida, Tomokazu Fuji, Ryuichi Yoshida, Kazuya Yasui, Hibiki Umeda, Toshiaki Takahashi, Yoshitaka Kondo, Hiroyuki Kishimoto, Yoshiko Mori, Fuminori Teraishi, Hideki Yamamoto, Hiroyuki Michiue, Keiichiro Nakamura, Hiroshi Tazawa, Toshiyoshi Fujiwara

Scientific reports 13 ( 1 ) 2078 - 2078 2023.2

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

Adenosine-to-inosine RNA editing is a process mediated by adenosine deaminases that act on the RNA (ADAR) gene family. It has been discovered recently as an epigenetic modification dysregulated in human cancers. However, the clinical significance of RNA editing in patients with liver metastasis from colorectal cancer (CRC) remains unclear. The current study aimed to systematically and comprehensively investigate the significance of adenosine deaminase acting on RNA 1 (ADAR1) expression status in 83 liver metastatic tissue samples collected from 36 patients with CRC. The ADAR1 expression level was significantly elevated in liver metastatic tissue samples obtained from patients with right-sided, synchronous, or RAS mutant-type CRC. ADAR1-high liver metastasis was significantly correlated with remnant liver recurrence after hepatic metastasectomy. A high ADAR1 expression was a predictive factor of remnant liver recurrence (area under the curve = 0.72). Results showed that the ADAR1 expression level could be a clinically relevant predictive indicator of remnant liver recurrence. Patients with liver metastases who have a high ADAR1 expression requires adjuvant chemotherapy after hepatic metastasectomy.

DOI： 10.1038/s41598-023-29397-z

遺伝性出血性末梢血管拡張症(HHT;Hereditary hemorrhagic telangiectasia)による重症心不全患者に対する脳死肝移植の1例

安井和也, 吉田龍一, 楳田祐三, 杭瀬崇, 吉田一博, 藤智和, 藤原俊義, 八木孝仁

肝臓 64 ( 2 ) 103 - 104 2023.2

A Case Report of Non-typical Annular Pancreas Diagnosed during Laparoscopic Gastric Surgery. Reviewed

Toshiaki Takahashi, Yoshihiko Kakiuchi, Satoru Kikuch, Shinji Kuroda, Sho Takeda, Kunitoshi Shigeyasu, Yoshitaka Kondo, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Acta medica Okayama 77 ( 1 ) 91 - 95 2023.2

Language：English

An annular pancreas is a rare anomaly of the pancreas, defined as pancreatic tissue that totally or partly encircles the duodenum, usually the descending portion. A 76-year-old man who was diagnosed with gastric cancer cT3N0M0 Stage IIB underwent laparoscopic distal gastrectomy with D2 lymph node dissection. Intraoperatively, the dorsal half of the duodenal bulb was seen to be half surrounded by the pancreas, and a non-typical annular pancreas was diagnosed. Because of the risk to the pancreas, it was considered impossible to perform anastomosis by a linear stapler as in the usual laparoscopic procedure. Therefore, we performed laparoscopically assisted distal gastrectomy and Billroth-I reconstruction using a circular stapler, and the surgery was completed without difficulties. His postoperative course was good despite the development of a pancreatic fistula, which was an International Study Group for Pancreas Fistula biochemical leak. Some APs can be diagnosed preoperatively, but the rarer subtypes such as ours are more difficult to visualize on imaging. In gastrectomy, it is both oncologically important and technically challenging to perform lymph node dissection around the pancreas. In this case with an especially proximal pancreas, a circular stapler was considered better suited for gastroduodenal anastomosis and required a broader field than that afforded by laparoscopy. A case of non-typical annular pancreas diagnosed during laparoscopic gastric surgery is described.

DOI： 10.18926/AMO/64368

Fabry病患者におけるサイトメガロウイルス感染による小腸穿孔の1例

中村峻輔, 菊地覚次, 垣内慶彦, 黒田新士, 野間和広, 楳田祐三, 都地友紘, 藤原俊義

日本消化器外科学会雑誌 56 ( 2 ) 87 - 93 2023.2

Language：Japanese Publisher：(一社)日本消化器外科学会

症例は66歳の男性で,Fabry病による慢性腎不全に対して維持透析中であった.右肺癌に対して肺部分切除を施行後膿胸の増悪のため,ICUで全身管理中に小腸穿孔,汎発性腹膜炎を来し当科紹介となった.原因不明の小腸穿孔として緊急手術を施行した.術中所見では,Treitz靱帯より約200cmの部位での小腸穿孔,腸間膜側から腹腔内への穿破を認め,腹腔内汚染は著明であった.小腸を約20cm切除し,洗浄ドレナージ,回腸人工肛門造設を行った.切除標本では粘膜面に多発潰瘍を認め,その1ヶ所に穿孔を認めた.病理組織学的検査では,サイトメガロウイルス(cytomegalovirus;以下,CMVと略記)免疫染色検査で潰瘍部に一致して陽性細胞が検出され,CMV感染による小腸穿孔と診断した.CMV感染による消化管穿孔はまれであるが,免疫不全患者ではその存在を常に念頭に置く必要があり,早期診断・治療が重要である.(著者抄録)

Fabry病患者におけるサイトメガロウイルス感染による小腸穿孔の1例

中村峻輔, 菊地覚次, 垣内慶彦, 黒田新士, 野間和広, 楳田祐三, 都地友紘, 藤原俊義

日本消化器外科学会雑誌 56 ( 2 ) 87 - 93 2023.2

Language：Japanese Publisher：(一社)日本消化器外科学会

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01117&link_issn=&doc_id=20230308270006&doc_link_id=10.5833%2Fjjgs.2022.0036&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.2022.0036&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

【こだわりの体腔内縫合・吻合術】胃外科腹腔鏡下/ロボット支援下噴門側胃切除後の観音開き法による再建

黒田新士, 菊地覚次, 垣内慶彦, 香川俊輔, 藤原俊義

手術 77 ( 2 ) 189 - 195 2023.2

Oncologic Emergencyに対する二期的腹腔鏡下・ロボット支援下手術の実際閉塞・穿孔を伴う高度進行左側大腸癌に対する二期的低侵襲手術の治療成績

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

日本腹部救急医学会雑誌 43 ( 2 ) 329 - 329 2023.2

Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Jiro Kimura, Nanako Hata, Takahito Yagi, Toshiyoshi Fujiwara

Journal of clinical medicine 12 ( 2 ) 2023.1

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

BACKGROUND: Delayed gastric emptying (DGE) is a major complication of pancreatoduodenectomy (PD). Several efforts have been made to decrease the incidence of DGE. However, the optimal anastomotic method for gastro/duodenojejunostomy (GJ) remains debatable. Moreover, few studies have reported the impact of GJ surgical techniques on outcomes following robotic pancreatoduodenectomy (RPD). This study aimed to investigate the surgical outcomes of robot-sewn and stapled GJ anastomoses in RPD. METHODS: Forty patients who underwent RPD at the Okayama University Hospital between September 2020 and October 2022 were included. The outcomes between robot-sewn and stapled anastomoses were compared. RESULTS: The mean [standard deviation (SD)] operative and GJ time were 428 (63.5) and 34.0 (15.0) minutes, respectively. Postoperative outcomes included an overall incidence of DGE of 15.0%, and the mean postoperative hospital stays were 11.6 (5.3) days in length. The stapled group (n = 21) had significantly shorter GJ time than the robot-sewn group (n = 19) (22.7 min versus 46.5 min, p < 0.001). Moreover, stapled GJ cases were significantly associated with a lower incidence of DGE (0% versus 21%, p = 0.01). Although not significant, the stapled group tended to have shorter postoperative hospital stays (9.9 days versus 13.5 days, p = 0.08). CONCLUSIONS: Our findings suggest that stapled GJ anastomosis might decrease anastomotic GJ time and incidence of DGE after RPD. Surgeons should select a suitable method for GJ anastomosis based on their experiences with RPD.

DOI： 10.3390/jcm12020732

Role of Surgery for Pancreatic Ductal Adenocarcinoma in the Era of Multidisciplinary Treatment. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Journal of clinical medicine 12 ( 2 ) 2023.1

Survival Impact of Postoperative Skeletal Muscle Loss in Gastric Cancer Patients Who Underwent Gastrectomy. Reviewed International journal

Kazuya Kuwada, Satoru Kikuchi, Shinji Kuroda, Ryuichi Yoshida, Kosei Takagi, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Yuzo Umeda, Toshiyoshi Fujiwara

Anticancer research 43 ( 1 ) 223 - 230 2023.1

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

BACKGROUND/AIM: It has recently been recognized that preoperative sarcopenia contributes to postoperative complications and overall survival in gastric cancer (GC). However, few studies have investigated the relationship between postoperative skeletal muscle loss (SML) and survival in GC, despite the inevitability of body weight loss after gastrectomy in most GC patients. Herein, we studied the impact of postoperative SML on GC prognosis. PATIENTS AND METHODS: A total of 370 patients with GC who underwent curative gastrectomy were retrospectively evaluated in this study. Postoperative SML was assessed on computed tomography (CT) images taken before surgery and 1 year after surgery. The impact of postoperative SML on survival was evaluated. RESULTS: Postoperative severe SML was significantly associated with presence of comorbidities, higher tumor stage, higher postoperative complication rate and longer hospital stay. Univariate and multivariate analyses of prognostic factors for overall survival revealed that SML was an independent indicator of poor prognosis, along with age, tumor stage, preoperative sarcopenia, and operation time (hazard ratio, 2.65; 95% confidence interval, 1.68-4.20, p<0.0001). There was a strong association of severe postoperative SML with decreased overall survival in patients with preoperative sarcopenia. CONCLUSION: To improve the prognosis of GC patients after surgery, it is important to prevent postoperative SML as well as preoperative sarcopenia. Perioperative multimodal interventions including nutritional counseling, oral nutritional supplements, and exercise are required to prevent SML after gastrectomy.

DOI： 10.21873/anticanres.16153

Impact of cancer-associated fibroblasts on survival of patients with ampullary carcinoma. Reviewed International journal

Kosei Takagi, Kazuhiro Noma, Yasuo Nagai, Satoru Kikuchi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takehiro Tanaka, Hajime Kashima, Takahito Yagi, Toshiyoshi Fujiwara

Frontiers in oncology 13 1072106 - 1072106 2023

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

BACKGROUND: Cancer-associated fibroblasts (CAFs) reportedly enhance the progression of gastrointestinal surgery; however, the role of CAFs in ampullary carcinomas remains poorly examined. This study aimed to investigate the effect of CAFs on the survival of patients with ampullary carcinoma. MATERIALS AND METHODS: A retrospective analysis of 67 patients who underwent pancreatoduodenectomy between January 2000 and December 2021 was performed. CAFs were defined as spindle-shaped cells that expressed α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP). The impact of CAFs on survival, including recurrence-free (RFS) and disease-specific survival (DSS), as well as prognostic factors associated with survival, was analyzed. RESULTS: The high-α-SMA group had significantly worse 5-year RFS (47.6% vs. 82.2%, p = 0.003) and 5-year DSS (67.5% vs. 93.3%, p = 0.01) than the low-α-SMA group. RFS (p = 0.04) and DSS (p = 0.02) in the high-FAP group were significantly worse than those in the low-FAP group. Multivariable analyses found that high α-SMA expression was an independent predictor of RFS [hazard ratio (HR): 3.68; 95% confidence intervals (CI): 1.21-12.4; p = 0.02] and DSS (HR: 8.54; 95% CI: 1.21-170; p = 0.03). CONCLUSIONS: CAFs, particularly α-SMA, can be useful predictors of survival in patients undergoing radical resection for ampullary carcinomas.

DOI： 10.3389/fonc.2023.1072106

p53-armed oncolytic adenovirus induces autophagy and apoptosis in KRAS and BRAF-mutant colorectal cancer cells. Reviewed International journal

Shuta Tamura, Hiroshi Tazawa, Naoto Hori, Yuncheng Li, Motohiko Yamada, Satoru Kikuchi, Shinji Kuroda, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

PloS one 18 ( 11 ) e0294491 2023

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

Colorectal cancer (CRC) cells harboring KRAS or BRAF mutations show a more-malignant phenotype than cells with wild-type KRAS and BRAF. KRAS/BRAF-wild-type CRCs are sensitive to epidermal growth factor receptor (EGFR)-targeting agents, whereas KRAS/BRAF-mutant CRCs are resistant due to constitutive activation of the EGFR-downstream KRAS/BRAF signaling pathway. Novel therapeutic strategies to treat KRAS/BRAF mutant CRC cells are thus needed. We recently demonstrated that the telomerase-specific replication-competent oncolytic adenoviruses OBP-301 and p53-armed OBP-702 exhibit therapeutic potential against KRAS-mutant human pancreatic cancer cells. In this study, we evaluated the therapeutic potential of OBP-301 and OBP-702 against human CRC cells with differing KRAS/BRAF status. Human CRC cells with wild-type KRAS/BRAF (SW48, Colo320DM, CACO-2), mutant KRAS (DLD-1, SW620, HCT116), and mutant BRAF (RKO, HT29, COLO205) were used in this study. The antitumor effect of OBP-301 and OBP-702 against CRC cells was analyzed using the XTT assay. Virus-mediated modulation of apoptosis, autophagy, and the EGFR-MEK-ERK and AKT-mTOR signaling pathways was analyzed by Western blotting. Wild-type and KRAS-mutant CRC cells were sensitive to OBP-301 and OBP-702, whereas BRAF-mutant CRC cells were sensitive to OBP-702 but resistant to OBP-301. Western blot analysis demonstrated that OBP-301 induced autophagy and that OBP-702 induced autophagy and apoptosis in human CRC cells. In BRAF-mutant CRC cells, OBP-301 and OBP-702 suppressed the expression of EGFR, MEK, ERK, and AKT proteins, whereas mTOR expression was suppressed only by OBP-702. Our results suggest that p53-armed oncolytic virotherapy is a viable therapeutic option for treating KRAS/BRAF-mutant CRC cells via induction of autophagy and apoptosis.

DOI： 10.1371/journal.pone.0294491

チームでベッドサイドに寄り添う周術期栄養管理食道癌外科治療予後向上のための院内横断的周術期管理術前から術後までサポート

野間和広, 河崎健人, 國友知義, 橋本将志, 加藤卓也, 前田直見, 菊地覚次, 藤原俊義

外科と代謝・栄養 57 ( 3 ) 89 - 89 2023

RNA editing is a valuable biomarker for predicting carcinogenesis in ulcerative colitis. International journal

Kazutaka Takahashi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Kazuyoshi Gotoh, Shuya Yano, Yuzo Umeda, Toshihiro Inokuchi, Caiming Xu, Kazuhiro Yoshida, Hibiki Umeda, Toshiaki Takahashi, Sho Takeda, Ryuichi Yoshida, Fuminori Teraishi, Hiroyuki Kishimoto, Yoshiko Mori, Kazuhiro Noma, Yoshinaga Okugawa, Sakiko Hiraoka, Hiroyuki Michiue, Hiroshi Tazawa, Osamu Matsushita, Ajay Goel, Toshiyoshi Fujiwara

Journal of Crohn's & colitis 17 ( 5 ) 754 - 766 2022.12

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

BACKGROUND AND AIMS: Ulcerative colitis (UC) can develop colitis-associated colorectal neoplasm (CAN). Adenine-to-inosine RNA editing, which is regulated by adenosine deaminase acting on RNA (ADAR), induces the posttranscriptional modification of critical oncogenes, including antizyme inhibitor 1 (AZIN1), leading to colorectal carcinogenesis. Therefore, we hypothesized that ADAR1 might be involved in the development of CAN in UC. METHODS: We systematically analyzed a cohort of 139 UC cases (40 acute phase, 73 remission phase, 26 CAN). The degree of inflammation was evaluated using the Mayo endoscopic score (MES). RESULTS: The type 1 IFN-related inflammation pathway was upregulated in the rectum of active UC, rectum of UC-CAN, and tumor site of UC-CAN patients. ADAR1 expression was upregulated in the entire colon of CAN cases, while it was down-regulated in non-CAN MES0 cases. ADAR1 expression in the rectum predicted the development of CAN better than p53 or β-catenin, with an area under the curve of 0.93. The high expression of ADAR1 and high AZIN1 RNA editing in UC was triggered by type 1 IFN stimulation from UC-specific microbiomes, such as Fusobacterium in vitro analyses. The induction of AZIN1 RNA editing by ADAR1, whose expression is promoted by Fusobacterium, may induce carcinogenesis in UC. CONCLUSIONS: The risk of CAN can be evaluated by assessing ADAR1 expression in the rectum of MES0 UC patients, freeing UC patients from unnecessary colonoscopy and reducing their physical burden. RNA editing may be involved in UC carcinogenesis, and may be used to facilitate the prevention and treatment of CAN in UC.

DOI： 10.1093/ecco-jcc/jjac186

An oncolytic virus as a promising candidate for the treatment of radioresistant oral squamous cell carcinoma. International journal

Shunsuke Gohara, Kosuke Shinohara, Ryoji Yoshida, Ryusho Kariya, Hiroshi Tazawa, Masashi Hashimoto, Junki Inoue, Ryuta Kubo, Hikaru Nakashima, Hidetaka Arita, Sho Kawaguchi, Keisuke Yamana, Yuka Nagao, Asuka Iwamoto, Junki Sakata, Yuichiro Matsuoka, Hisashi Takeshita, Masatoshi Hirayama, Kenta Kawahara, Masashi Nagata, Akiyuki Hirosue, Yoshikazu Kuwahara, Manabu Fukumoto, Seiji Okada, Yasuo Urata, Toshiyoshi Fujiwara, Hideki Nakayama

Molecular therapy oncolytics 27 141 - 156 2022.12

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

We evaluated the usefulness of an oncolytic virus (Suratadenoturev; OBP-301) against radioresistant oral squamous cell carcinoma. We confirmed the expression of human telomerase reverse transcriptase and the coxsackievirus and adenovirus receptor in cell lines. Also, we examined the potential presence in a patient who has received existing therapy that is amenable to treatment with OBP-301. We evaluated: (1) the antitumor effects of OBP-301 alone and in combination with radiotherapy on radioresistant cell lines, (2) the molecular mechanism underlying the radiosensitizing effect and cell death increased by the combination therapy, and (3) the antitumor effect of the combination therapy in vivo using xenograft models (a radioresistant cell line-derived xenograft in mouse and a patient-derived xenograft). Human telomerase reverse transcriptase and the coxsackievirus and adenovirus receptor were expressed in all cell lines. OBP-301 decreased the proliferative activity of these cell lines in a concentration-dependent manner, and significantly enhanced the antitumor effect of irradiation. Phosphorylated STAT3 and its downstream molecules, which correlated with apoptosis and autophagy, showed significant changes in expression after treatment with OBP-301. The combination therapy exerted a significant antitumor effect versus radiotherapy alone in both xenograft models. Combination of OBP-301 with radiotherapy exerts a synergistic effect and may represent a promising treatment for radioresistant oral squamous cell carcinoma.

DOI： 10.1016/j.omto.2022.10.001

Oncolytic virus-mediated p53 overexpression promotes immunogenic cell death and efficacy of PD-1 blockade in pancreatic cancer. International journal

Hiroyuki Araki, Hiroshi Tazawa, Nobuhiko Kanaya, Yoshinori Kajiwara, Motohiko Yamada, Masashi Hashimoto, Satoru Kikuchi, Shinji Kuroda, Ryuichi Yoshida, Yuzo Umeda, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Molecular therapy oncolytics 27 3 - 13 2022.12

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

Immune checkpoint inhibitors, including anti-programmed cell death 1 (PD-1) antibody, provide improved clinical outcome in certain cancers. However, pancreatic ductal adenocarcinoma (PDAC) is refractory to PD-1 blockade therapy due to poor immune response. Oncolytic virotherapy is a novel approach for inducing immunogenic cell death (ICD). We demonstrated the therapeutic potential of p53-expressing telomerase-specific oncolytic adenovirus OBP-702 to induce ICD and anti-tumor immune responses in human PDAC cells with different p53 status (Capan-2, PK-59, PK-45H, Capan-1, MIA PaCa-2, BxPC-3) and murine PDAC cells (PAN02). OBP-702 significantly enhanced ICD with secretion of extracellular adenosine triphosphate and high-mobility group box protein B1 by inducing p53-mediated apoptosis and autophagy. OBP-702 significantly promoted the tumor infiltration of CD8+ T cells and the anti-tumor efficacy of PD-1 blockade in a subcutaneous PAN02 syngeneic tumor model. Our results suggest that oncolytic adenovirus-mediated p53 overexpression augments ICD and the efficacy of PD-1 blockade therapy against cold PDAC tumors. Further in vivo experiments would be warranted to evaluate the survival benefit of tumor-bearing mice in combination therapy with OBP-702 and PD-1 blockade.

DOI： 10.1016/j.omto.2022.09.003

切除可能膵癌における血中循環腫瘍DNA内Kras遺伝子変異とCA19-9値による予後層別化の試み

膵癌に対する低侵襲手術のエビデンス膵体尾部癌に対するSupracolic Anterior SMAアプローチを用いたロボット支援下RAMPSの定型化と短期成績

吉田龍一, 高木弘誠, 楳田祐三, 藤智和, 安井和也, 木村次郎, 畑七々子, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1282 - 1282 2022.12

小網アプローチによるロボット支援下脾温存膵体尾部切除

高木弘誠, 楳田祐三, 吉田龍一, 藤智和, 安井和也, 木村次郎, 畑七々子, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1708 - 1708 2022.12

症例数の限られた地方病院での安全かつ有効な新規代謝改善手術導入の課題

賀島肇, 菊地覚次, 香川俊輔, 黒田新士, 半澤俊哉, 庄司良平, 垣内慶彦, 松三雄騎, 野間和広, 楳田祐三, 寺石文則, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 298 - 298 2022.12

縦隔郭清を伴う食道胃接合部癌に対する岡山大学病院での取り組み

橋本将志, 野間和広, 前田直見, 菊地覚次, 重安邦俊, 近藤喜太, 田辺俊介, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 789 - 789 2022.12

術後再発困難症例に対する前方臓器温存のための集学的治療を併用したTaAPRの有用性

庄司良平, 近藤喜太, 垣内慶彦, 賀島肇, 松三雄騎, 寺石文則, 菊地覚次, 黒田新士, 田辺俊介, 野間和広, 吉田龍一, 楳田祐三, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 775 - 775 2022.12

神経モニタリングを用いたより低侵襲なロボット支援下食道手術

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1150 - 1150 2022.12

術前治療後の腹腔鏡下直腸癌手術の治療成績

寺石文則, 庄司良平, 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

日本内視鏡外科学会雑誌 27 ( 7 ) 1138 - 1138 2022.12

胸腔鏡下食道癌手術のコンセプトと成績、教育方法

前田直見, 野間和広, 橋本将志, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1722 - 1722 2022.12

内視鏡外科手術における遠隔医療の現状と課題内視鏡外科手術におけるカダバーサージカルトレーニング遠隔手術指導シミュレーションの実際

近藤喜太, 庄司良平, 垣内慶彦, 前田直見, 菊地覚次, 重安邦俊, 黒田新士, 田辺俊介, 野間和広, 吉田龍一, 寺石文則, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1268 - 1268 2022.12

胃癌に対する噴門側胃切除:手技の工夫と成績観音開き法(上川法)再建における吻合部狭窄ゼロを目指した手技の改変

黒田新士, 菊地覚次, 垣内慶彦, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 1848 - 1848 2022.12

食道良性疾患に対する胸腔鏡・腹腔鏡手術:手技の工夫と成績食道裂孔ヘルニアの腹腔鏡下根治手術における手技の工夫とQOL改善への貢献

田辺俊介, 野間和広, 橋本将志, 前田直見, 菊地覚次, 重安邦俊, 黒田新士, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 86 - 86 2022.12

低侵襲食道癌手術における専門医制度:食道外科専門医vs技術認定医食道外科医における技術認定制度、認定医とは?技術認定合格に必須なコンセプト

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 428 - 428 2022.12

宮本耕吉, 吉田龍一, 重安邦俊, 安井和也, 高木弘誠, 藤智和, 楳田祐三, 八木孝仁, 藤原俊義

日本分子腫瘍マーカー研究会誌 38 20 - 21 2022.12

ロボット支援膵頭十二指腸切除術:手技の工夫と成績当院におけるロボット支援下膵頭十二指腸切除術

高木弘誠, 楳田祐三, 吉田龍一, 藤智和, 安井和也, 木村次郎, 畑七々子, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 2595 - 2595 2022.12

十二指腸腫瘍の局在や特性に応じたLECSのアプローチ法や切除法の工夫と成績

菊地覚次, 西崎正彦, 黒田新士, 賀島肇, 松三雄騎, 半澤俊哉, 垣内慶彦, 田辺俊介, 野間和広, 香川俊輔, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 27 ( 7 ) 730 - 730 2022.12

チームで極める栄養管理-急性期から回復期まで- 食道癌周術期管理における早期包括的介入の有用性岡山大学病院におけるPERiOの取り組み

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

学会誌JSPEN 4 ( Suppl.2 ) 128 - 129 2022.12

Involvement in the tumor-infiltrating CD8+ T cell expression by the initial disease of remnant gastric cancer. International journal

Yoshihiko Kakiuchi, Satoru Kikuchi, Shinji Kuroda, Shunsuke Kagawa, Toshiyoshi Fujiwara

World journal of surgical oncology 20 ( 1 ) 374 - 374 2022.11

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

BACKGROUND: Remnant gastric cancer (RGC) has been increasing for various reasons such as a longer life span, medical progress, and others. It generally has a poor prognosis, and its mechanism of occurrence is unknown. The purpose of this study was to evaluate the clinicopathological features of and clarify the oncological features of RGC. METHODS: Between January 2002 and January 2017, 39 patients with RGC following distal gastrectomy underwent curative surgical resection at the Okayama University Hospital; their medical records and immunohistochemically stained extracted specimens were used for retrospective analysis. RESULTS: On univariate analysis, initial gastric disease, pathological lymph node metastasis, and pathological stage were the significant factors associated with poor overall survival (p=0.014, 0.0061, and 0.016, respectively). Multivariate analysis of these 3 factors showed that only initial gastric disease caused by malignant disease was an independent factor associated with a poor prognosis (p=0.014, hazard ratio: 4.2, 95% confidence interval: 1.3-13.0). In addition, tumor-infiltrating CD8+ T cells expression was higher in the benign disease group than in the malignant group (p=0.046). CONCLUSIONS: Initial gastrectomy caused by malignant disease was an independent poor prognostic factor of RGC, and as one of the causes, lower level of tumor-infiltrating CD8+ T cells in RGC may involve in.

DOI： 10.1186/s12957-022-02853-2

Surgical Strategies to Dissect around the Superior Mesenteric Artery in Robotic Pancreatoduodenectomy. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Jiro Kimura, Nanako Hata, Kento Mishima, Takahito Yagi, Toshiyoshi Fujiwara

Journal of clinical medicine 11 ( 23 ) 2022.11

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

The concept of the superior mesenteric artery (SMA)-first approach has been widely accepted in pancreatoduodenectomy. However, few studies have reported surgical approaches to the SMA in robotic pancreatoduodenectomy (RPD). Herein, we present our surgical strategies to dissect around the SMA in RPD. Among the various approaches, our standard protocol for RPD included the right approach to the SMA, which can result in complete tumor resection in most cases. In patients with malignant diseases requiring lymphadenectomy around the SMA, we developed a novel approach by combining the left and right approaches in RPD. Using this approach, circumferential dissection around the SMA can be achieved through both the left and right sides. This approach can also be helpful in patients with obesity or intra-abdominal adhesions. The present study summarizes the advantages and disadvantages of both the approaches during RPD. To perform RPD safely, surgeons should understand the different surgical approaches and select the best approach or a combination of different approaches, depending on demographic, anatomical, and oncological factors.

DOI： 10.3390/jcm11237112

Oncolytic virus-mediated reducing of myeloid-derived suppressor cells enhances the efficacy of PD-L1 blockade in gemcitabine-resistant pancreatic cancer. International journal

Yoshinori Kajiwara, Hiroshi Tazawa, Motohiko Yamada, Nobuhiko Kanaya, Takuro Fushimi, Satoru Kikuchi, Shinji Kuroda, Toshiaki Ohara, Kazuhiro Noma, Ryuichi Yoshida, Yuzo Umeda, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 72 ( 5 ) 1285 - 1300 2022.11

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

Pancreatic ductal adenocarcinoma (PDAC) is often refractory to treatment with gemcitabine (GEM) and immune checkpoint inhibitors including anti-programmed cell death ligand 1 (PD-L1) antibody. However, the precise relationship between GEM-resistant PDAC and development of an immunosuppressive tumor microenvironment (TME) remains unclear. In this study, we investigated the immunosuppressive TME in parental and GEM-resistant PDAC tumors and assessed the therapeutic potential of combination therapy with the telomerase-specific replication-competent oncolytic adenovirus OBP-702, which induces tumor suppressor p53 protein and PD-L1 blockade against GEM-resistant PDAC tumors. Mouse PDAC cells (PAN02) and human PDAC cells (MIA PaCa-2, BxPC-3) were used to establish GEM-resistant PDAC lines. PD-L1 expression and the immunosuppressive TME were analyzed using parental and GEM-resistant PDAC cells. A cytokine array was used to investigate the underlying mechanism of immunosuppressive TME induction by GEM-resistant PAN02 cells. The GEM-resistant PAN02 tumor model was used to evaluate the antitumor effect of combination therapy with OBP-702 and PD-L1 blockade. GEM-resistant PDAC cells exhibited higher PD-L1 expression and produced higher granulocyte-macrophage colony-stimulating factor (GM-CSF) levels compared with parental cells, inducing an immunosuppressive TME and the accumulation of myeloid-derived suppressor cells (MDSCs). OBP-702 significantly inhibited GEM-resistant PAN02 tumor growth by suppressing GM-CSF-mediated MDSC accumulation. Moreover, combination treatment with OBP-702 significantly enhanced the antitumor efficacy of PD-L1 blockade against GEM-resistant PAN02 tumors. The present results suggest that combination therapy involving OBP-702 and PD-L1 blockade is a promising antitumor strategy for treating GEM-resistant PDAC with GM-CSF-induced immunosuppressive TME formation.

DOI： 10.1007/s00262-022-03334-x

Dual-targeted near-infrared photoimmunotherapy for esophageal cancer and cancer-associated fibroblasts in the tumor microenvironment. International journal

Hiroaki Sato, Kazuhiro Noma, Toshiaki Ohara, Kento Kawasaki, Masaaki Akai, Teruki Kobayashi, Noriyuki Nishiwaki, Toru Narusaka, Satoshi Komoto, Hajime Kashima, Yuki Katsura, Takuya Kato, Satoru Kikuchi, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Hisataka Kobayashi, Toshiyoshi Fujiwara

Scientific reports 12 ( 1 ) 20152 - 20152 2022.11

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

Cancer-associated fibroblasts (CAFs) play a significant role in tumor progression within the tumor microenvironment. Previously, we used near-infrared photoimmunotherapy (NIR-PIT), a next-generation cancer cell-targeted phototherapy, to establish CAF-targeted NIR-PIT. In this study, we investigated whether dual-targeted NIR-PIT, targeting cancer cells and CAFs, could be a therapeutic strategy. A total of 132 cases of esophageal cancer were analyzed for epidermal growth factor receptor (EGFR), human epidermal growth factor 2 (HER2), and fibroblast activation protein (FAP) expression using immunohistochemistry. Human esophageal cancer cells and CAFs were co-cultured and treated with single- or dual-targeted NIR-PIT in vitro. These cells were co-inoculated into BALB/c-nu/nu mice and the tumors were treated with single-targeted NIR-PIT or dual-targeted NIR-PIT in vivo. Survival analysis showed FAP- or EGFR-high patients had worse survival than patients with low expression of FAP or EGFR (log-rank, P < 0.001 and P = 0.074, respectively), while no difference was observed in HER2 status. In vitro, dual (EGFR/FAP)-targeted NIR-PIT induced specific therapeutic effects in cancer cells and CAFs along with suppressing tumor growth in vivo, whereas single-targeted NIR-PIT did not show any significance. Moreover, these experiments demonstrated that dual-targeted NIR-PIT could treat cancer cells and CAFs simultaneously with a single NIR light irradiation. We demonstrated the relationship between EGFR/FAP expression and prognosis of patients with esophageal cancer and the stronger therapeutic effect of dual-targeted NIR-PIT than single-targeted NIR-PIT in experimental models. Thus, dual-targeted NIR-PIT might be a promising therapeutic strategy for cancer treatment.

DOI： 10.1038/s41598-022-24313-3

腹腔鏡下スリーブ状胃切除(LSG)の安全な導入と普及への課題

菊地覚次, 賀島肇, 香川俊輔, 江口潤, 中司敦子, 高橋絢子, 黒田新士, 半澤俊哉, 庄司良平, 垣内慶彦, 松三雄騎, 野間和広, 楳田祐三, 和田淳, 藤原俊義

肥満研究 28 ( Suppl. ) 354 - 354 2022.11

マジンドール(Mazindol:MZD)先行導入後に腹腔鏡下スリーブ胃切除術を行った高度肥満の2例

賀島肇, 菊地覚次, 香川俊輔, 江口潤, 中司敦子, 高橋絢子, 黒田新士, 半澤俊哉, 庄司良平, 垣内慶彦, 松三雄騎, 野間和広, 楳田祐三, 和田淳, 藤原俊義

肥満研究 28 ( Suppl. ) 352 - 352 2022.11

【ロボット支援下手術の現況と展望】ロボット支援下手術の現況と展望<膵臓>

高木弘誠, 八木孝仁, 楳田祐三, 吉田龍一, 藤智和, 安井和也, 藤原俊義

日本外科学会雑誌 123 ( 6 ) 538 - 545 2022.11

Language：Japanese Publisher：(一社)日本外科学会

ロボット支援下膵切除術は,欧米先進諸国において近年急速に普及し,その手術成績についても一定のエビデンスが得られてきている.一方,本邦では2020年の保険収載以降,大学病院や基幹病院を中心として徐々に普及しつつあるが,標準手術としての定着にはもう少し時間を要するのが現状である.高難度手術である膵頭十二指腸切除術や膵体尾部切除術に対するロボット支援下手術の安全な導入と普及には,術式の定型化とトレーニングシステムの確立が急務である.さらに,安全な手術の実践には,ロボット支援下手術の特性を理解し,外科医個人のみならずチームとして成熟していくことが重要である.今回,ロボット支援下膵切除術の欧米におけるコンセンサスを検討するとともに,当施設におけるロボット支援下膵切除術の定型化に向けた手術概要とトレーニングシステム,チームとしての取り組みを報告する.(著者抄録)

ASO Visual Abstract: Effect of Patient-Participation Continuous Nutritional Counseling in Gastric Cancer Patients Who Underwent Gastrectomy. International journal

Nobuo Takata, Satoru Kikuchi, Shinji Kuroda, Shunsuke Tanabe, Naoaki Maeda, Kazuhiro Noma, Ayako Takahashi, Yuzo Umeda, Kenichi Shikata, Kazuhide Ozaki, Toshiyoshi Fujiwara

Annals of surgical oncology 30 ( 2 ) 1119 - 1119 2022.10

Genomically stable gastric cancer characterized by hypomethylation in Wnt signal cascade. International journal

Hiroaki Tanioka, Yoshiko Mori, Takehiro Tanaka, Kazuya Yasui, Keisuke Kimura, Yuzo Umeda, Toshiyoshi Fujiwara, Akihiro Nyuya, Shuya Yano, Takeshi Nagasaka, Takeshi Nagasaka

Oncology 101 ( 2 ) 105 - 116 2022.10

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

Introduction Gastric cancer is divided into four subtypes by their molecular features linked with genetic alterations, e.g., Epstein-Barr virus (EBV), microsatellite instability-high (MSI-high), chromosomal instability (CIN), and genomically stable (GS), called as TCGA classification. In this study, we tried to clarify the epigenetic features of the four GC subtypes according to aberrant methylation status in 23 loci. Methods A total of 98 gastric cancers and their normal gastric mucosa samples were included in this study. We divided gastric cancers into TCGA subtypes which were determined in line with MSI-high, EBV, CIN, to GS by their molecular features. The 13 loci of polymorphic microsatellite sequences were used to determine loss of heterogeneity (LOH) for the detection of CIN. The MSI status was determined by three mononucleotide repeat markers. Infection of EBV was determined by recovering EBV BNRF1 sequence from genomic DNA collected from gastric cancers. Methylation status of 23 loci was investigated by the combined bisulfite restriction analysis (COBRA). Status of other findings, e.g., KRAS mutations, HER2 expression status and infection of helicobacter pylori were confirmed. Results Gastric cancers were divided into MSI (13%), EBV (7%), CIN (53%), and GS (27%). By histological classification, poorly differentiated adenocarcinoma (por) was more in tumors categorized in MSI-high, and GS and signet-ring cell carcinoma (sig) was more in GS. Among the 23 loci investigated their methylation status, 18 loci were significantly hypermethylated in caner tissues. A unsupervised clustering divided gastric cancers into two clusters, and revealed that most GS tumors clustered together in a cluster that exhibited lower methylation levels, distinct from the other subtypes. The inter-variable clustering revealed that a cluster contained the three loci (SFRP2-region 1/2 and APC) belonging to the Wnt signal cascade (Wnt-associated loci). The mean methylation score of Wnt-associated loci was the lowest in GS tumors (MSI-high: 2.7 [95% confidence interval (CI), 2.3-2.9]; EBV:2.1[1.2-3.1]; CIN: 2.4 [2.2-2.7]; GS: 1.3 [0.8-0.7]). In contrast, the mean methylation score of the other 15 loci was significantly higher in MSI-high, while that in GS was as same as that in EBV or CIN (MSI- high: 10.4 [8.3-12.4]; EBV:5.7 [1.7-9.7]; CIN: 4.4 [3.6-5.1]; GS: 3.4 [2.2-4.6]). Additionally, the lower methylation score of Wnt-associated loci was observed only in sig tumors. Conclusions GS subtype tumors have the potential to possess distinct signatures in DNA hypomethylation profiles in Wnt signaling pathway, especially in signet-ring cell carcinoma.

DOI： 10.1159/000527098

Prognostic risk factors for postoperative long-term outcomes in elderly stage IA gastric cancer patients. International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Satoru Kikuchi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Journal of gastrointestinal oncology 13 ( 5 ) 2178 - 2185 2022.10

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

BACKGROUND: The number of gastric cancer (GC) patients with other diseases is increasing due to the aging of the population. In particular, in stage IA GC patients who have multiple diseases, surgical indications should be considered after identifying prognostic factors. We therefore investigated prognostic factors for stage IA GC in the elderly. METHODS: Patient characteristics were collected and analyzed retrospectively for elderly patients with stage IA GC who underwent curative surgical treatment at Okayama University Hospital between 2010 and 2015, and an elderly group (EG; 75-79 years old) and very elderly group (VEG; ≥80 years old) were compared. RESULTS: Fifty-three patient in the EG and 31 patients in the VEG were compared. No factors associated with clinicopathological characteristics or surgical or postoperative short-term outcomes differed significantly between groups. Although no factors in the EG appeared significantly associated with poor overall survival (OS), severe comorbidity [Charlson Comorbidity Index (CCI) ≥2; P=0.019], open gastrectomy (P=0.012), high volume of blood loss (≥300 mL; P=0.013) and long postoperative hospital stay (≥14 days; P=0.041) were significantly associated with poor OS. Furthermore, only CCI ≥2 [hazard ratio (HR) =9.2; 95% confidence interval (CI): 1.2-68.9; P=0.032] was an independent prognostic factor associated with poor OS. Five-year OS was 88.9% for CCI 0/1 patients and 62.3% for CCI ≥2 patients, representing very impressive results. CONCLUSIONS: CCI ≥2 is an important prognostic factor in clinical decisions in stage IA GC patients ≥2, so careful determination of surgical indications is desirable.

DOI： 10.21037/jgo-22-527

高齢者に対する大腸がん治療の個別化を考える周術期管理チーム介入により高齢Frail大腸癌患者に対する手術の安全性は向上したか

寺石文則, 庄司良平, 賀島肇, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 松岡義和, 森松博史, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS9 - 3 2022.10

腸内細菌叢からがんを考える腸内細菌叢は潰瘍性大腸炎においてRNA編集を介し発癌を促進する

重安邦俊, 高橋一剛, 近藤喜太, 梅田響, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS17 - 4 2022.10

RNA編集は大腸癌の発癌や進展を促進するのみならず免疫療法のターゲットとなり得る

重安邦俊, 武田正, 高橋一剛, 小松泰浩, 畑七々子, 梅田響, 高橋利明, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 60回 P40 - 5 2022.10

Neoadjuvant chemotherapy for locally advanced esophageal cancer comparing cisplatin and 5-fluorouracil versus docetaxel plus cisplatin and 5-fluorouracil: a propensity score matching analysis.

Noriyuki Nishiwaki, Kazuhiro Noma, Tomoyoshi Kunitomo, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Esophagus : official journal of the Japan Esophageal Society 19 ( 4 ) 626 - 638 2022.10

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

BACKGROUND: The standard treatment for locally advanced esophageal cancer is preoperative chemotherapy with cisplatin and 5-fluorouracil (CF), followed by surgery. Although docetaxel plus cisplatin and 5-fluorouracil (DCF) has been reported to have favorable outcomes, no study has compared its therapeutic efficacy to that of standard treatment. This study aimed to compare the therapeutic effects of CF and DCF in the real world by matching patient background factors using propensity scores. METHODS: We retrospectively reviewed the data of 237 patients with esophageal squamous cell carcinoma who underwent esophagectomy between January 2008 and December 2018. Patients were divided into two groups based on the preoperative chemotherapy regimens of CF (79 patients) or DCF (158 patients), and 49 matched pairs were finally analyzed using propensity score matching. Short- and long-term outcomes were compared between groups. RESULTS: After matching, although no significant differences in survival were observed among the groups, patients receiving DCF showed a significantly high histological response (P < 0.001). Subgroup analyses demonstrated that DCF therapy had better overall survival (P = 0.046) and relapse-free survival (P = 0.010) among pathological T3 and T4 cases. Whereas, adverse effects of chemotherapy were more frequent in the DCF group. CONCLUSIONS: Patients receiving DCF had higher pathological response and better survival than those receiving CF, especially in pathological T3 and T4 cases matched using propensity scores. Thus, the DCF regimen might be an effective treatment for locally advanced esophageal cancer. However, the adverse side effects of chemotherapy remain high and should be handled appropriately.

DOI： 10.1007/s10388-022-00934-5

[Telomerase-Specific Oncolytic Adenovirus Expressing p53 Gene Stimulating CD8+ Memory T Cells in Pancreatic Cancer].

Masashi Hashimoto, Shinji Kuroda, Nobuhiko Kanaya, Yoshihiko Kakiuchi, Satoru Kikuchi, Hiroshi Tazawa, Shunsuke Kagawa, Yasuo Urata, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 49 ( 10 ) 1127 - 1129 2022.10

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

Pancreatic cancer has poor prognosis despite the various developed multimodal treatment strategies. Currently, neoadjuvant chemotherapy and immunotherapy have attracted substantial attention as effective treatment strategies. However, amplifying immune response with existing treatments is difficult. We developed telomerase-specific oncolytic adenoviruses (OAs), including OBP-301 that is currently tested in a clinical trial of combined anti-PD-1 antibody and p53-armed OBP- 301 variant(OBP-702). OAs have immune-modulation functions and induce CD8+ T cells into tumors by releasing immunogenic cell death markers, such as extracellular adenosine triphosphate. Here, we investigated the effectiveness of OBP- 702 in pancreatic cancer treatments, focusing on the influence on CD8+ memory T cells.

Surgical Resection for Local and Lateral Lymph Node Recurrence of MSI-high Cecal Cancer with the BRAF V600E Mutation.

Fuminori Teraishi, Atsushi Jikuhara, Ryunosuke Ogawa, Toshiyoshi Fujiwara

Acta medica Okayama 76 ( 5 ) 605 - 608 2022.10

Language：English

An 84-year-old female underwent open right hemicolectomy with D3 lymph node dissection for cecal cancer, pathologically identified as pT4aN2M0 Stage IIIc and BRAF mutation-positive. Due to early recurrence of abdominal wall and right lateral lymph nodes, the patient was treated with FOLFOXIRI+Bevacizumab. Imaging after 5 courses of chemotherapy found tumor shrinkage and no new metastases. The patient did not tolerate chemotherapy well, and tumor resection was performed. Microsatellite instability (MSI) testing using multiplex polymerase chain reaction (PCR) fragment analysis revealed MSI-high status. The patient is currently recurrence-free without chemotherapy at 1 year postoperatively. BRAF-mutated colorectal cancer has a poor prognosis, and may require resection of the metastatic or recurrent tumor after comprehensive evaluation.

DOI： 10.18926/AMO/64043

OBP-702を用いたウイルス治療による膵癌の長期抗腫瘍免疫賦活効果

橋本将志, 黒田新士, 金谷信彦, 垣内慶彦, 菊地覚次, 田澤大, 香川俊輔, 浦田泰生, 藤原俊義

癌と化学療法 49 ( 10 ) 1127 - 1129 2022.10

Language：Japanese Publisher：(株)癌と化学療法社

膵癌は予後不良な癌であり,近年話題の癌免疫療法に対しても免疫細胞の浸潤が乏しい腫瘍として知られている。また,近年術前化学療法の有効性が注目されている。我々は,腫瘍特異的に増殖する腫瘍融解アデノウイルス製剤(OBP-301)を開発し,食道癌において放射線療法+OBP-301治療の臨床試験が進行中である。臨床試験のなかで腫瘍浸潤リンパ球やPD-L1の発現増強を認め,免疫学的な治療効果も期待されている。次世代の薬剤としてOBP-301にp53遺伝子を搭載したOBP-702を開発し,膵癌に対して強力な治療効果を発揮することを確認した。今回,膵癌におけるOBP-702の有効性に関し,長期抗腫瘍免疫の指標としてCD8陽性メモリーT細胞に注目して検討した。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00296&link_issn=&doc_id=20221021370020&doc_link_id=issn%3D0385-0684%26volume%3D49%26issue%3D10%26spage%3D1127&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0385-0684%26volume%3D49%26issue%3D10%26spage%3D1127&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Current status and future perspectives of minimally invasive and open radical antegrade modular pancreatosplenectomy for pancreatic ductal adenocarcinoma: a review

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Laparoscopic Surgery 6 39 - 39 2022.10

OBP-702を用いたウイルス治療による膵癌の長期抗腫瘍免疫賦活効果

橋本将志, 黒田新士, 金谷信彦, 垣内慶彦, 菊地覚次, 田澤大, 香川俊輔, 浦田泰生, 藤原俊義

癌と化学療法 49 ( 10 ) 1127 - 1129 2022.10

Language：Japanese Publisher：(株)癌と化学療法社

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00296&link_issn=&doc_id=20221021370020&doc_link_id=%2Fab8gtkrc%2F2022%2F004910%2F021%2F1127-1129%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2022%2F004910%2F021%2F1127-1129%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

がんの微小環境を考える CAFsを標的にした光免疫療法による薬物動態改善効果の検証

西村星多郎, 野間和広, 竹田泰茂, 松本聖, 國友知義, 河崎健人, 赤井正明, 小林照貴, 前田直見, 菊地覚次, 田辺俊介, 大原利章, 田澤大, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS4 - 2 2022.10

食道癌患者における30秒椅子起立試験の運動耐容能指標としての妥当性多施設共同研究

池田朋大, 野間和広, 大倉和貴, 片山翔, 高橋裕介, 前田直見, 田邊俊介, 脇田晃行, 濱田全紀, 藤原俊義, 千田益生

日本癌治療学会学術集会抄録集 60回 MSA P32 - 4 2022.10

RNA編集は大腸癌の発癌や進展を促進するのみならず免疫療法のターゲットとなり得る

重安邦俊, 武田正, 高橋一剛, 小松泰浩, 畑七々子, 梅田響, 高橋利明, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 60回 P40 - 5 2022.10

呼吸筋サルコペニア・フレイル評価とリハビリは食道癌術後呼吸器合併症を減少させる

前田直見, 野間和広, 橋本将志, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OF - 2 2022.10

外科医不足に対してCadaver Surgical Trainingが果たす役割

近藤喜太, 庄司良平, 垣内慶彦, 黒田新士, 前田直見, 田辺俊介, 菊地覚次, 寺石文則, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S32 - S32 2022.10

当施設における大腸憩室炎に対する手術治療成績

寺石文則, 垣内慶彦, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 香川俊輔, 藤原俊義

日本消化器外科学会雑誌 55 ( Suppl.2 ) 255 - 255 2022.10

食道癌に対するロボット支援下手術の治療成績進行食道癌におけるロボット支援下食道手術の有用性

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S118 - S118 2022.10

食道癌手術における周術期チーム医療について呼吸筋機能評価と重点的呼吸筋リハビリは食道癌術後呼吸器合併症を低減する

前田直見, 野間和広, 橋本将志, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S116 - S116 2022.10

術前DCF療法を行った食道癌切除後の再発パターンと再発リスク因子

橋本将志, 野間和広, 前田直見, 菊地覚次, 重安邦俊, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S223 - S223 2022.10

根治性とQOL維持の両立を目指した食道胃接合部癌に対する至適術式の検討

田辺俊介, 野間和広, 橋本将志, 前田直見, 菊地覚次, 重安邦俊, 黒田新士, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S209 - S209 2022.10

高齢者に対する大腸がん治療の個別化を考える周術期管理チーム介入により高齢Frail大腸癌患者に対する手術の安全性は向上したか

寺石文則, 庄司良平, 賀島肇, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 松岡義和, 森松博史, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS9 - 3 2022.10

食道胃接合部がんの集学的治療のこれから食道胃接合部癌に対する集学的治療の後方視的解析と食道浸潤長から導かれる至適術式

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 櫻間教文, 寺石文則, 楳田祐三, 香川俊輔, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS16 - 2 2022.10

食道癌術後オリゴ転移に対する集学的治療

橋本将志, 野間和広, 前田直見, 田辺俊介, 菊地覚次, 近藤喜太, 黒田新士, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OF - 2 2022.10

腸内細菌叢からがんを考える腸内細菌叢は潰瘍性大腸炎においてRNA編集を介し発癌を促進する

重安邦俊, 高橋一剛, 近藤喜太, 梅田響, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS17 - 4 2022.10

がん治療におけるトランスレーショナルリサーチの新展開難治性膵臓癌に対するミトコンドリア阻害剤と腫瘍融解アデノウイルスの併用療法

庄司良平, 田澤大, 菊地覚次, 黒田新士, 吉田龍一, 浦田泰生, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS10 - 6 2022.10

がん治療におけるサルコペニアとフレイルの意義患者参加型継続的栄養指導による胃癌術後のサルコペニア予防効果

菊地覚次, 高田暢夫, 黒田新士, 田辺俊介, 前田直見, 賀島肇, 垣内慶彦, 野間和広, 香川俊輔, 高橋絢子, 楳田祐三, 四方賢一, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS19 - 2 2022.10

食道胃接合部癌に対する集学的治療食道浸潤長から導かれる食道胃接合部癌の至適術式と集学的治療の検討

田辺俊介, 野間和広, 藤原俊義

日本消化器外科学会雑誌 55 ( Suppl.2 ) 91 - 91 2022.10

消化管外科のSSI チームで取り組む食道外科手術における周術期感染症対策

田辺俊介, 野間和広, 橋本将志, 前田直見, 白川靖博, 藤原俊義

日本外科感染症学会雑誌 19 ( 1 ) 150 - 150 2022.10

食道がん集学的治療におけるチーム医療の実践とこれから食道癌周術期管理における多職種チーム医療の早期介入の有用性と今後の展望

田辺俊介, 野間和広, 橋本将志, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 櫻間教文, 吉田龍一, 寺石文明, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS8 - 2 2022.10

膵がんの治療成績は向上したか? 切除可能膵癌に対するNAC-GS療法は予後を改善したか? 非切除例を含む全コホート解析

安井和也, 吉田龍一, 楳田祐三, 藤智和, 高木弘誠, 宮本耕吉, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS15 - 5 2022.10

進行胸部食道癌に対するMIEの適応と工夫強力な導入DCF療法とロボット支援下手術を用いたcT3.5食道癌症例に対する治療戦略

田辺俊介, 野間和広, 橋本将志, 前田直見, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 75回 EVS1 - 5 2022.10

内視鏡外科手術時代における開胸手技の意義 Cadaverを用いた開胸手術トレーニング

前田直見, 野間和広, 橋本将志, 田辺俊介, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 75回 EPD1 - 4 2022.10

Developing the academic surgeons-キャリアパス形成-大学(院)での研究は必要か? 創造性を育む外科医の基礎研究

野間和広, 橋本将志, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 75回 CDPD2 - 6 2022.10

術後補助免疫療法に向けた術前DCF療法の再発リスク解析

橋本将志, 野間和広, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本胸部外科学会定期学術集会 75回 EOP2 - 3 2022.10

移植患者の外科感染症対策肝移植後の日和見感染症への対策と課題

安井和也, 吉田龍一, 畑七々子, 木村次郎, 高木弘誠, 藤智和, 楳田祐三, 八木孝仁, 藤原俊義

日本外科感染症学会雑誌 19 ( 1 ) 200 - 200 2022.10

肝胆膵がんに対する高難度腹腔鏡・ロボット支援手術の定型化と工夫当院におけるロボット支援下膵切除術の初期治療成績

高木弘誠, 楳田祐三, 吉田龍一, 藤智和, 安井和也, 木村次郎, 畑七々子, 八木孝仁, 藤原俊義

日本癌治療学会学術集会抄録集 60回 OWS29 - 8 2022.10

リキッドバイオプシーが変えるがん医療膵癌術前・術後血中循環腫瘍DNA内KRAS遺伝子変異の臨床的意義に関する検討

吉田龍一, 安井和也, 楳田祐三, 藤智和, 高木弘誠, 宮本耕吉, 黒田新士, 野間和宏, 八木孝仁, 藤原俊義

日本癌治療学会学術集会抄録集 60回 WS3 - 2 2022.10

切除可能膵癌に対する術前治療の現状と課題血中循環腫瘍DNA内Kras遺伝子変異情報とCA19-9値による切除可能膵癌層別化の試み

吉田龍一, 宮本耕吉, 楳田祐三, 藤智和, 安井和也, 高木弘誠, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 83 ( 増刊 ) S95 - S95 2022.10

Robotic Spleen-Preserving Distal Pancreatectomy with Preservation of Splenic Vessels Using the Gastrohepatic Ligament Approach: The Superior Window Approach in the Kimura Technique. International journal

Kosei Takagi, Ryuichi Yoshida, Yuzo Umeda, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Digestive surgery 39 ( 4 ) 137 - 140 2022.9

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

Minimally invasive spleen-preserving distal pancreatectomy (SPDP) is technically challenging, and only a few reports have described surgical approaches for minimally invasive SPDP. This report demonstrates our novel gastrohepatic ligament approach in robotic SPDP with preservation of the splenic vessels (the superior window approach in the Kimura technique). Our gastrohepatic ligament approach for robotic SPDP included four steps. First, the gastrohepatic ligament was divided extensively, and the pancreas was confirmed (step 1). In this step, we did not lift the stomach, nor did we divide the gastrocolic ligament. Next, the superior and inferior borders of the pancreas were dissected, and tunneling of the pancreas on the superior mesenteric vein was performed (step 2). Following the division of the pancreas (step 3), the pancreatic body and tail were dissected from the medial to the lateral side with preservation of the splenic vessels (step 4). Using this approach, the pancreas can be directly accessed via the gastrohepatic ligament route and dissected without division of the gastrocolic ligament or retraction of the stomach. The present approach for robotic SPDP preserves splenic vessels, facilitating easy access to the pancreas with minimal dissection, and may be optional in selected patients, including those with low body mass index.

DOI： 10.1159/000527249

Effect of Patient-Participation Continuous Nutritional Counseling in Gastric Cancer Patients who Underwent Gastrectomy. International journal

Nobuo Takata, Satoru Kikuchi, Shinji Kuroda, Shunsuke Tanabe, Naoaki Maeda, Kazuhiro Noma, Ayako Takahashi, Yuzo Umeda, Kenichi Shikata, Kazuhide Ozaki, Toshiyoshi Fujiwara

Annals of surgical oncology 30 ( 2 ) 1110 - 1118 2022.9

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

BACKGROUND: Body weight loss (BWL) and skeletal muscle loss (SML) are inevitable after gastrectomy for gastric cancer (GC) and can decrease patients' quality of life (QOL) and survival. OBJECTIVE: The aim of this retrospective study was to evaluate the effect of perioperative and post-discharge patient participation in continuous nutritional counseling (CNC) on post-gastrectomy BWL and SML. METHODS: Ninety-three patients with GC who underwent curative gastrectomy between March 2018 and July 2019 were analyzed. Patients received either pre-discharge nutritional counseling alone (control group, n = 49) or patient-participation CNC (CNC group, n = 44) after gastrectomy. Differences between percentage BWL (%BWL), percentage SML (%SML), and nutrition-related blood parameters between the preoperative values and those at 12 months after surgery were compared between the groups. RESULTS: Compared with the control group, %BWL was significantly lower in the CNC group at 1 month (-6.2 ± 2.5% vs. -7.9 ± 3.3%, p = 0.005), 6 months (-7.8 ± 6.6% vs. -12.3 ± 6.4%, p = 0.001) and 12 months (-7.9 ± 7.6% vs. -13.2 ± 8.2%, p = 0.002), and %SML was significantly lower in the CNC group at 12 months (-5.3 ± 10.3% vs. -12.8 ± 12%, p = 0.002). Regarding nutrition-related blood parameters, change in total cholesterol was significantly lower in the CNC group than the control group at 12 months after surgery (p = 0.02). Multivariate analysis identified no CNC as an independent risk factor for severe BWL (p = 0.001) and SML (p = 0.006) at 12 months after surgery. CONCLUSIONS: Following gastrectomy, patient-participation CNC prevented postoperative BWL and SML after surgery. These results support the induction of such a CNC program in these patients.

DOI： 10.1245/s10434-022-12572-3

Surgical Strategies to Approaching the Splenic Artery in Robotic Distal Pancreatectomy. International journal

Kosei Takagi, Kenjiro Kumano, Yuzo Umeda, Ryuichi Yoshida, Tomokazu Fuji, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Anticancer research 42 ( 9 ) 4471 - 4476 2022.9

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

BACKGROUND/AIM: Understanding different surgical approaches and anatomical landmarks adjacent to the splenic artery (SpA) is important for safe robotic distal pancreatectomy (RDP). Herein, we propose our standardized RDP techniques, focusing on these issues. PATIENTS AND METHODS: Between April 2021 and April 2022, 19 patients who underwent RDP at our Institution were reviewed. Anatomical patterns of the SpA were classified into three types: Type 1, no pancreatic parenchyma on the root of the SpA; type 2, any pancreatic parenchyma on the root of the SpA; and type 3, dorsal pancreatic artery around the bifurcation of the common hepatic artery and SpA. Next, the surgical strategy for approaching the SPA was determined according to the location of the pancreatic transection line: On the superior mesenteric vein (SMV) or on the left side of the root of the SpA. RESULTS: There were seven cases of type 1, nine cases of type 2, and three cases of type 3. When transecting the pancreas on the SMV, the SpA-first ligation technique was used for type 1 SpA anatomy, and the pancreas-first division technique was applied for types 2 and 3. In patients in whom the pancreas was transected at the left side of the root of the SpA, the SpA-first ligation technique was used. CONCLUSION: Our standardized surgical strategy based on anatomical landmarks and focusing on the approach to the SpA in RDP is demonstrated. Our strategy should help trainees approach the SpA and perform RDP safely.

DOI： 10.21873/anticanres.15947

骨・軟部腫瘍の基礎科学のトピックス転移性骨肉腫は臓器指向性サイトカインの分泌を介して微小環境を変化させ前転移ニッチを形成する

EMTバイオセンサーを用いたリアルタイムイメージングによる難治性膵臓癌の治療戦略(Real-time imaging of EMT biosensor provide a therapeutic strategy for refractory pancreatic cancer)

谷悠真, 田澤大, 重安邦俊, 藤原俊義

日本癌学会総会記事 81回 P - 3146 2022.9

直腸癌低位前方切除後の縫合不全に対する取り組みと課題

寺石文則, 半澤俊哉, 庄司良平, 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 75 ( 9 ) A163 - A163 2022.9

男女を問わず外科医が輝き続けるためにステレオタイプ・スレットという問題とニュースレターの果たす役割

竹原裕子, 溝尾妙子, 小林純子, 坂本美咲, 新田薫, 工藤由里絵, 安井和也, 菊池覚次, 黒田新士, 吉田龍一, 岡崎幹生, 枝園忠彦, 山根正修, 小谷恭弘, 豊岡伸一, 笠原真悟, 土井原博義, 藤原俊義

日本外科学会雑誌 123 ( 5 ) 501 - 502 2022.9

食道癌に対するウイルス治療、ワクチン治療の最前線食道癌に対する腫瘍融解ウイルス併用放射線療法の臨床研究の成果と展望

田辺俊介, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田澤大, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 59 - 59 2022.9

エクソソームを用いた食道扁平上皮癌のリンパ節転移メカニズムの解明(Elucidation for the mechanism of lymph node metastasis of esophageal squamous cell carcinoma by extracellular vesicles)

木谷嘉孝, 吉岡祐亮, 賀島肇, 野間和広, 田澤大, 藤原俊義, 永川裕一, 落谷孝広

日本癌学会総会記事 81回 P - 2122 2022.9

【ここまで進んだERAS】ERASにおけるチーム医療

野間和広, 田邊俊介, 藤原俊義

消化器外科 45 ( 9 ) 961 - 966 2022.9

食道癌単独肝転移、肺転移の治療戦略は? 食道癌根治切除術後の肝転移、肺転移切除についての検討

陶守貴人, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 57 - 57 2022.9

癌細胞と癌関連線維芽細胞は互いにPD-L1を増強させ予後に影響する(Cancer cell and cancer-associated fibroblast mutually enhance PD-L1 expression and affect survival in esophageal cancer)

河崎健人, 野間和広, 西村星多郎, 松本聖, 國友知義, 赤井正明, 小林照貴, 菊地覚次, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 81回 P - 2187 2022.9

転移性骨肉腫細胞はCCL2によるM2マクロファージの腫瘍内浸潤を誘導して肺転移を促進する(Metastatic osteosarcoma cells facilitate lung metastasis by inducing CCL2-mediated tumor infiltration of M2 macrophages)

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 国定俊之, 尾崎敏文, 藤原俊義

日本癌学会総会記事 81回 J - 2087 2022.9

血清エクソソームE1A-DNAはテロメラーゼ特異的腫瘍融解アデノウイルスの治療効果予測バイオマーカーとして有用である(Exosomal E1A-DNA in serum as a predictive biomarker of telomerase-specific oncolytic adenovirus)

八木千晶, 黒田新士, 吉田有佑, 坂本真樹, 濱田侑紀, 杉本龍馬, 橋本将志, 垣内慶彦, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 81回 E - 3068 2022.9

腫瘍免疫の改善に関わる、FAPを標的とした光免疫療法の可能性(Fibroblast Activation Protein targeted Near-Infrared Photoimmunotherapy improves tumor immunosuppression)

赤井正明, 野間和広, 大原利章, 松本聖, 西村星多郎, 國友知義, 河崎健人, 小林照貴, 賀島肇, 菊地覚次, 田澤大, 藤原俊義

日本癌学会総会記事 81回 J - 3010 2022.9

食道癌・接合部癌における免疫チェックポイント阻害剤の意義と課題術前DCF療法を施行した食道根治術術後再発に対するNivolumabの有効性

橋本将志, 野間和広, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 7 - 7 2022.9

p53搭載テロメラーゼ特異的腫瘍融解アデノウイルスの抗腫瘍効果予測スコアリングシステム(Scoring system to predict antitumor effects of p53-armed telomerase-specific oncolytic adenovirus)

杉本龍馬, 黒田新士, 吉田有佑, 坂本真樹, 濱田侑紀, 八木千晶, 橋本将志, 垣内慶彦, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 81回 P - 3347 2022.9

食道癌手術における安全で確実な胸部操作アプローチ法による特性を理解し、安全で確実な胸部操作を行う

前田直見, 野間和広, 橋本将志, 最所公平, 賀島肇, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 39 - 39 2022.9

ロボット手術における現状と課題ロボット支援下手術の導入により見えてきた一歩先の食道癌手術とその課題

野間和広, 白川靖博, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 9 - 9 2022.9

近藤宏也, 田澤大, 藤原智洋, 近藤彩奈, 片山晴喜, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1532 - S1532 2022.9

食道癌手術における腹腔鏡下腹部郭清の定型化とその有用性

菊地覚次, 野間和広, 田辺俊介, 前田直見, 橋本将志, 最所公平, 賀島肇, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 108 - 108 2022.9

胃管作製法と吻合法に着目した当科における食道切除後再建の変遷と工夫

國友知義, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊池覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 100 - 100 2022.9

当院における高齢者進行食道癌に対する治療戦略

竹田泰茂, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 300 - 300 2022.9

食道癌に対するサルベージロボット支援下胸腔鏡下食道亜全摘術5症例の検討

門脇大輔, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 186 - 186 2022.9

喉頭温存を目指した頸部進行食道癌の集学的治療戦略

田辺俊介, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 302 - 302 2022.9

食道癌に対するウイルス治療、ワクチン治療の最前線抗腫瘍免疫賦活を介した腫瘍融解アデノウイルス製剤による免疫チェックポイント阻害薬治療増強効果の検討

橋本将志, 黒田新士, 金谷信彦, 田辺俊介, 前田直見, 野間和広, 田澤大, 白川靖博, 浦田泰生, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 59 - 59 2022.9

谷悠真, 田澤大, 重安邦俊, 藤原俊義

日本癌学会総会記事 81回 P - 3146 2022.9

切除可能膵癌における血中循環腫瘍DNA内Kras遺伝子変異とCA19-9値による予後層別化の試み

宮本耕吉, 吉田龍一, 重安邦俊, 安井和也, 高木弘誠, 藤智和, 楳田祐三, 八木孝二, 藤原俊義

日本分子腫瘍マーカー研究会プログラム・講演抄録 42回 78 - 79 2022.9

男女を問わず外科医が輝き続けるためにステレオタイプ・スレットという問題とニュースレターの果たす役割

日本外科学会雑誌 123 ( 5 ) 501 - 502 2022.9

直腸癌低位前方切除後の縫合不全に対する取り組みと課題

寺石文則, 半澤俊哉, 庄司良平, 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 75 ( 9 ) A163 - A163 2022.9

切除可能膵癌における血中循環腫瘍DNA内Kras遺伝子変異とCA19-9値による予後層別化の試み

宮本耕吉, 吉田龍一, 重安邦俊, 安井和也, 高木弘誠, 藤智和, 楳田祐三, 八木孝二, 藤原俊義

日本分子腫瘍マーカー研究会プログラム・講演抄録 42回 78 - 79 2022.9

骨・軟部腫瘍の基礎科学のトピックス転移性骨肉腫は臓器指向性サイトカインの分泌を介して微小環境を変化させ前転移ニッチを形成する

近藤宏也, 田澤大, 藤原智洋, 近藤彩奈, 片山晴喜, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1532 - S1532 2022.9

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 国定俊之, 尾崎敏文, 藤原俊義

日本癌学会総会記事 81回 J - 2087 2022.9

八木千晶, 黒田新士, 吉田有佑, 坂本真樹, 濱田侑紀, 杉本龍馬, 橋本将志, 垣内慶彦, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 81回 E - 3068 2022.9

橋本将志, 黒田新士, 金谷信彦, 田辺俊介, 前田直見, 野間和広, 田澤大, 白川靖博, 浦田泰生, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 59 - 59 2022.9

杉本龍馬, 黒田新士, 吉田有佑, 坂本真樹, 濱田侑紀, 八木千晶, 橋本将志, 垣内慶彦, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 81回 P - 3347 2022.9

食道癌に対するウイルス治療、ワクチン治療の最前線食道癌に対する腫瘍融解ウイルス併用放射線療法の臨床研究の成果と展望

田辺俊介, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田澤大, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 59 - 59 2022.9

p53感作樹状細胞ワクチンは大腸癌に対するp53搭載腫瘍融解ウイルスの治療効果を増強する(Ad-p53-transduced dendritic cell vaccine enhances the efficacy of p53-armed oncolytic virotherapy in colorectal cancer)

山田元彦, 田澤大, 庄司良平, 永井康雄, 井上弘章, 菊地覚次, 黒田新士, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 81回 P - 2177 2022.9

喉頭温存を目指した頸部進行食道癌の集学的治療戦略

田辺俊介, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 302 - 302 2022.9

食道癌に対するサルベージロボット支援下胸腔鏡下食道亜全摘術5症例の検討

門脇大輔, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 186 - 186 2022.9

当院における高齢者進行食道癌に対する治療戦略

竹田泰茂, 野間和広, 橋本将志, 最所公平, 賀島肇, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 76回 300 - 300 2022.9

RNA editing facilitates the enhanced production of neoantigens during the simultaneous administration of oxaliplatin and radiotherapy in colorectal cancer. International journal

Yasuhiro Komatsu, Kunitoshi Shigeyasu, Shuya Yano, Sho Takeda, Kazutaka Takahashi, Nanako Hata, Hibiki Umeda, Kazuhiro Yoshida, Yoshiko Mori, Kazuya Yasui, Ryuichi Yoshida, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Yuzo Umeda, Shunsuke Kagawa, Hiroyuki Michiue, Hiroshi Tazawa, Ajay Goel, Toshiyoshi Fujiwara

Scientific reports 12 ( 1 ) 13540 - 13540 2022.8

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

Most cases of colorectal cancers (CRCs) are microsatellite stable (MSS), which frequently demonstrate lower response rates to immune checkpoint inhibitors (ICIs). RNA editing produces neoantigens by altering amino acid sequences. In this study, RNA editing was induced artificially by chemoradiation therapy (CRT) to generate neoantigens in MSS CRCs. Altogether, 543 CRC specimens were systematically analyzed, and the expression pattern of ADAR1 was investigated. In vitro and in vivo experiments were also performed. The RNA editing enzyme ADAR1 was upregulated in microsatellite instability-high CRCs, leading to their high affinity for ICIs. Although ADAR1 expression was low in MSS CRC, CRT including oxaliplatin (OX) treatment upregulated RNA editing levels by inducing ADAR1. Immunohistochemistry analyses showed the upregulation of ADAR1 in patients with CRC treated with CAPOX (capecitabine + OX) radiation therapy relative to ADAR1 expression in patients with CRC treated only by surgery (p < 0.001). Compared with other regimens, CRT with OX effectively induced RNA editing in MSS CRC cell lines (HT29 and Caco2, p < 0.001) via the induction of type 1 interferon-triggered ADAR1 expression. CRT with OX promoted the RNA editing of cyclin I, a neoantigen candidate. Neoantigens can be artificially induced by RNA editing via an OX-CRT regimen. CRT can promote proteomic diversity via RNA editing.

DOI： 10.1038/s41598-022-17773-0

Verrucous carcinoma of the esophagus with complete response after chemoradiotherapy. International journal

Masashi Hashimoto, Yasuhiro Shirakawa, Shunsuke Tanabe, Takehiro Tanaka, Naoaki Maeda, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Surgical case reports 8 ( 1 ) 128 - 128 2022.7

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

BACKGROUND: Verrucous carcinoma of the esophagus (VCE) is a rare tumor that is difficult to diagnose. In most cases, biopsies show nonspecific inflammatory and hyperkeratotic changes and do not show malignant findings. Most VCEs are slowly growing, locally advanced tumors with few metastases. Treatments for VCE are the same as for normal esophageal cancer, involving combined chemotherapy, surgical resection, and radiation therapy. However, it has been reported that VCE has a poor response to radiation or chemoradiotherapy (CRT). A case of VCE with complete response (CR) after CRT is presented. CASE PRESENTATION: A 70-year-old man was found to have white, irregular esophageal mucosa 4 years earlier. He had been followed up as an outpatient as having candidal esophagitis. However, his tumor grew gradually, and biopsy was performed by endoscopic mucosal resection (EMR). He was finally diagnosed with VCE. He had no metastases to distant organs, but some lymph node metastases were suspected. The tumor invaded his left bronchus. The esophagostomy and gastrostomy were constructed as emergent procedures. The patient then underwent definitive CRT. 4 weeks after the end of CRT, two-stage esophagectomy was performed. First, he underwent esophagectomy with thoracic lymph node dissection. A latissimus dorsi flap was patched to the bronchus after primary suture of the hole. 6 weeks later, reconstruction of the gastric tube was performed through the antethoracic route. The pathological findings showed CR to CRT, with no proliferative cancer cells in the specimen. The patient has had no recurrence for three and half years after the resection. CONCLUSIONS: We presented a locally advanced VCE that achieved CR to CRT. In cases that have some difficulty for local resection, CRT might be an appropriate treatment for VCE.

DOI： 10.1186/s40792-022-01486-7

【上部】噴門側胃切除の手術手技・再建噴門側胃切除術+観音開き法再建を施行した胃癌・食道胃接合部癌症例の長期予後因子に関する検討

垣内慶彦, 黒田新士, 丁田泰宏, 大塚眞哉, 上山聰, 田中則光, 村岡篤, 羽藤慎二, 上川康明, 藤原俊義

日本消化器外科学会総会 77回 WS10 - 4 2022.7

継続的な栄養指導と術後早期アミノ酸投与による胃切除術後の体重・筋肉量減少抑制効果

菊地覚次, 高田暢夫, 黒田新士, 垣内慶彦, 田辺俊介, 前田直見, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 77回 O4 - 3 2022.7

高度肥満症に対する減量・代謝改善手術の効果と安全性

香川俊輔, 菊地覚次, 黒田新士, 武田正, 垣内慶彦, 寺石文則, 近藤喜太, 重安邦俊, 楳田祐三, 藤原俊義

日本消化器外科学会総会 77回 P276 - 6 2022.7

Impact of Amino Acids Nutrition Following Gastrectomy in Gastric Cancer Patients. International journal

Satoru Kikuchi, Nobuo Takata, Shinji Kuroda, Hibiki Umeda, Shunsuke Tanabe, Naoaki Maeda, Kosei Takagi, Kazuhiro Noma, Yuko Hasegawa, Kumiko Nawachi, Shunsuke Kagawa, Yuzo Umeda, Kenichi Shikata, Toshiyoshi Fujiwara

Anticancer research 42 ( 7 ) 3637 - 3643 2022.7

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

BACKGROUND/AIM: Postoperative body weight loss (BWL) and skeletal muscle loss (SML) after gastrectomy are associated with a decline in quality of life and worse longterm prognosis in gastric cancer (GC) patients. This study aimed to evaluate the efficacy of amino acids nutrition on BWL and SML in the early period following gastrectomy. PATIENTS AND METHODS: The parameters of body composition were measured by bioelectrical impedance analysis in the patients undergoing radical gastrectomy for GC and analyzed retrospectively. Patients received either peripheral parenteral nutrition (PPN) of 4.3% glucose fluid with regular diet (control group, n=43) or PPN of 7.5% glucose fluid containing amino acids plus oral nutritional supplement (ONS) rich in protein with regular diet (amino acids group, n=40) following gastrectomy. The percentages of BWL and SML from preoperative values to those at 7 days and 1 month after surgery were compared between the two groups. RESULTS: The %BWL and %SML at 7 days after surgery were significantly lower in the amino acids group than those in the control group (%BWL, -2.4±1.7% vs. -4.2±1.8%; p<0.0001, %SML, -4.1±3.8 vs. -6.5±3.8; p=0.006). Moreover, the %BWL at 1 month after surgery was significantly lower in the amino acids group compared to that in the control group (- 4.6±2.9% vs. -6.1±2.6%; p=0.01); however, the %SML was similar between the two groups. The hematological nutritional parameters were similar between the two groups. CONCLUSION: Amino acids nutrition by PPN and ONS following gastrectomy prevented postoperative BWL and SML in the early period after surgery in GC patients.

DOI： 10.21873/anticanres.15852

狭窄を伴う食道癌患者における術前胃瘻造設と周術期管理チームの有用性

橋本将志, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P147 - 3 2022.7

高度局所進行食道癌に対する術前DCF療法plusロボット支援下手術

野間和広, 西脇紀之, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 O1 - 5 2022.7

難治性食道狭窄に対して食道亜全摘を施行した関節リウマチ合併Sjogren症候群の1例

柚木宏介, 野間和広, 藤原俊義

日本消化器外科学会総会 77回 S1 - 7 2022.7

術前化学療法を施行した膵癌患者における代謝栄養学的指標の意義に関する検討

佐藤博紀, 吉田龍一, 安井和也, 楳田祐三, 藤智和, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 77回 P224 - 3 2022.7

T4b食道癌に対する治療戦略についての検討 induction DCF vs.induction DCF-RTを中心に

最所公平, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P163 - 4 2022.7

【下部】IBDに対するMIS 炎症性腸疾患に対する経肛門的低侵襲手術は患者因子によらない安定した手術を可能にする

近藤喜太, 寺石文則, 菊地覚次, 田邊俊介, 黒田新士, 吉田龍一, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 77回 WS14 - 5 2022.7

食道癌術後肺転移に対して外科的切除を行った16例の検討

大亀正義, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P195 - 6 2022.7

食道狭窄、食道気道瘻に対する食道バイパス術の成績と新たな術式の構築

陶守貫人, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P195 - 3 2022.7

高度肥満症に対する減量・代謝改善手術の効果と安全性

香川俊輔, 菊地覚次, 黒田新士, 武田正, 垣内慶彦, 寺石文則, 近藤喜太, 重安邦俊, 楳田祐三, 藤原俊義

日本消化器外科学会総会 77回 P276 - 6 2022.7

根治的CRT後の食道縦隔瘻を伴う食道癌に対してロボット支援下胸腔鏡下食道切除術を施行した1例

門脇大輔, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P243 - 6 2022.7

【肝胆膵】大腸癌肝転移におけるBRとURの定義 BR大腸癌肝転移に対する肝切除アプローチ Vessel-Skeletonized Parenchyma-sparing Hepatectomyの有用性

楳田祐三, 藤智和, 高木弘誠, 安井和也, 黒田新士, 吉田龍一, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 77回 PD1 - 10 2022.7

術中神経刺激装置が有用であった右鎖骨下動脈起始異常を合併した胸部食道癌の一例

竹田泰茂, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P065 - 6 2022.7

高齢大腸癌患者の手術および長期予後についての検討

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

日本消化器外科学会総会 77回 P151 - 1 2022.7

狭窄を伴う食道癌患者における術前胃瘻造設と周術期管理チームの有用性

橋本将志, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 P147 - 3 2022.7

【総論】各臓器サブサブスペシャルティ外科医の育成法食道外科におけるサブサブスペシャリティ取得への取組み

前田直見, 野間和広, 菊地覚次, 田辺俊介, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 77回 WS15 - 9 2022.7

肝転移に焦点を置いた大腸癌多臓器転移症例の治療戦略

重安邦俊, 楳田祐三, 寺石文則, 武田正, 藤智和, 黒田新士, 近藤喜太, 香川俊輔, 藤原俊義

日本消化器外科学会総会 77回 P009 - 2 2022.7

80歳以上の高齢者に対する術前GS療法の忍容性はあるか?dose intensityの視点から

安井和也, 吉田龍一, 楳田祐三, 藤智和, 高木弘誠, 佐藤博紀, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 77回 RS5 - 3 2022.7

ベーラー大学における膵全摘自家膵島移植200例の検討

熊野健二郎, 藤智和, 高木弘誠, 安井和也, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義, バシュー・ナジルディン

日本消化器外科学会総会 77回 P130 - 7 2022.7

膵癌における術前血中KRAS遺伝子変異情報を用いた予後予測

吉田龍一, 安井和也, 宮本耕吉, 楳田祐三, 藤智和, 高木弘誠, 黒田新士, 野間和宏, 八木孝仁, 藤原俊義

日本消化器外科学会総会 77回 O3 - 4 2022.7

【総論】各臓器サブサブスペシャルティ外科医の育成法肝胆膵外科高度技能専門医の効率的な育成に向けて膵頭十二指腸切除のラーニングカーブ解析

藤智和, 楳田祐三, 高木弘誠, 安井和也, 熊野健二郎, 吉田龍一, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 77回 WS15 - 1 2022.7

Modulation of p53 expression in cancer-associated fibroblasts prevents peritoneal metastasis of gastric cancer. International journal

Toshihiro Ogawa, Satoru Kikuchi, Motoyasu Tabuchi, Ema Mitsui, Yuta Une, Hiroshi Tazawa, Shinji Kuroda, Kazuhiro Noma, Toshiaki Ohara, Shunsuke Kagawa, Yasuo Urata, Toshiyoshi Fujiwara

Molecular therapy oncolytics 25 249 - 261 2022.6

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

Cancer-associated fibroblasts (CAFs) in the tumor microenvironment are associated with the establishment and progression of peritoneal metastasis. This study investigated the efficacy of replicative oncolytic adenovirus-mediated p53 gene therapy (OBP-702) against CAFs and peritoneal metastasis of gastric cancer (GC). Higher CAF expression in the primary tumor was associated with poor prognosis of GC, and higher CAF expression was also observed with peritoneal metastasis in immunohistochemical analysis of clinical samples. And, we found transcriptional alteration of p53 in CAFs relative to normal gastric fibroblasts (NGFs). CAFs increased the secretion of cancer-promoting cytokines, including interleukin-6, and gained resistance to chemotherapy relative to NGFs. OBP-702 showed cytotoxicity to both GC cells and CAFs but not to NGFs. Overexpression of wild-type p53 by OBP-702 infection caused apoptosis and autophagy of CAFs and decreased the secretion of cancer-promoting cytokines by CAFs. Combination therapy using intraperitoneal administration of OBP-702 and paclitaxel synergistically inhibited the tumor growth of peritoneal metastases and decreased CAFs in peritoneal metastases. OBP-702, a replicative oncolytic adenovirus-mediated p53 gene therapy, offers a promising biological therapeutic strategy for peritoneal metastasis, modulating CAFs in addition to achieving tumor lysis.

DOI： 10.1016/j.omto.2022.04.009

Favorable control of hepatocellular carcinoma with peritoneal dissemination by surgical resection using indocyanine green fluorescence imaging: a case report and review of the literature. International journal

Yuma Tani, Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kosei Takagi, Masaaki Kagoura, Takahito Yagi, Toshiyoshi Fujiwara

Journal of medical case reports 16 ( 1 ) 222 - 222 2022.6

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

BACKGROUND: The optimal management for peritoneal dissemination in patients with hepatocellular carcinoma remains unclear. Although several reports have described the usefulness of surgical resection, the indications should be carefully considered. Herein, we report the case of a patient with hepatocellular carcinoma with peritoneal recurrence who underwent surgical resection using an indocyanine green fluorescence navigation system and achieved favorable disease control. CASE PRESENTATION: A 45-year-old Asian woman underwent left hemihepatectomy for a ruptured hepatocellular carcinoma. Seventeen months after the initial surgery, a single nodule near the cut surface of the liver was detected on computed tomography, along with elevation of tumor markers. The patient was diagnosed with peritoneal metastasis and underwent a surgical resection. Twelve months later, a single nodule on the dorsal side of the right hepatic lobe was detected on computed tomography, and we performed surgical resection. Indocyanine green (0.5 mg/kg) was intravenously administered 3 days before surgery, and the indocyanine green fluorescence imaging system revealed clear green fluorescence in the tumor, which helped us perform complete resection. Indocyanine green fluorescence enabled the detection of additional lesions that could not be identified by preoperative imaging, especially in the second metastasectomy. There was no further recurrence at 3 months postoperatively. CONCLUSION: When considering surgical intervention for peritoneal recurrence in patients with hepatocellular carcinoma, complete resection is mandatory. Given that disseminated nodules are sometimes too small to be detected by preoperative imaging studies, intraoperative indocyanine green fluorescence may be an essential tool for determining the indications for surgical resection.

DOI： 10.1186/s13256-022-03440-5

[The Chugoku-Shikoku GanPro Produces Advanced Cancer Specialists to Provide Whole Person Medical Care].

Shunsuke Kagawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 49 ( 6 ) 638 - 641 2022.6

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

The 3rd Chugoku-Shikoku GanPro has set a plan to train advanced cancer specialists to provide whole person medical care, and 11 partner universities have formed a consortium, and 18 working groups have been working to provide graduate school education. Through a unique e-learning system and an exercise to learn team medicine, we trained medical professionals who have advanced expertise and can provide cancer care through multidisciplinary team medicine. The project has produced a wide range of personnel including doctors, dentists, pharmacists, nurses, radiologists, medical physicists, and nutritionists. The graduates who have acquired various specialized cancer qualifications practice at regional cancer treatment centers, contributing to the enhancement and improvement of cancer treatment in the Chugoku and Shikoku regions.

Tumor-targeted fluorescence labeling systems for cancer diagnosis and treatment. International journal

Hiroshi Tazawa, Kunitoshi Shigeyasu, Kazuhiro Noma, Shunsuke Kagawa, Fuminori Sakurai, Hiroyuki Mizuguchi, Hisataka Kobayashi, Takeshi Imamura, Toshiyoshi Fujiwara

Cancer science 113 ( 6 ) 1919 - 1929 2022.6

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

Conventional imaging techniques are available for clinical identification of tumor sites. However, detecting metastatic tumor cells that are spreading from primary tumor sites using conventional imaging techniques remains difficult. In contrast, fluorescence-based labeling systems are useful tools for detecting tumor cells at the single-cell level in cancer research. The ability to detect fluorescent-labeled tumor cells enables investigations of the biodistribution of tumor cells for the diagnosis and treatment of cancer. For example, the presence of fluorescent tumor cells in the peripheral blood of cancer patients is a predictive biomarker for early diagnosis of distant metastasis. The elimination of fluorescent tumor cells without damaging normal tissues is ideal for minimally invasive treatment of cancer. To capture fluorescent tumor cells within normal tissues, however, tumor-specific activated target molecules are needed. This review focuses on recent advances in tumor-targeted fluorescence labeling systems, in which indirect reporter labeling using tumor-specific promoters is applied to fluorescence labeling of tumor cells for the diagnosis and treatment of cancer. Telomerase promoter-dependent fluorescence labeling using replication-competent viral vectors produces fluorescent proteins that can be used to detect and eliminate telomerase-positive tumor cells. Tissue-specific promoter-dependent fluorescence labeling enables identification of specific tumor cells. Vimentin promoter-dependent fluorescence labeling is a useful tool for identifying tumor cells that undergo epithelial-mesenchymal transition (EMT). The evaluation of tumor cells undergoing EMT is important for accurately assessing metastatic potential. Thus, tumor-targeted fluorescence labeling systems represent novel platforms that enable the capture of tumor cells for the diagnosis and treatment of cancer.

DOI： 10.1111/cas.15369

臓器指向性分泌サイトカイン/細胞外小胞を介したcell-cell communicationによる骨肉腫の新しい肺転移形成機構の同定

近藤宏也, 藤原智洋, 田澤大, 吉田晶, 片山晴喜, 近藤彩奈, 佐藤浩平, 畑利彰, たき平将太, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1424 - S1424 2022.6

Descending Colon Cancer Coincident with Schistosoma japonicum in an 89-year-old Male.

Fuminori Teraishi, Atsushi Jikuhara, Ryunosuke Ogawa, Toshiyoshi Fujiwara

Acta medica Okayama 76 ( 3 ) 355 - 358 2022.6

Language：English

An 89-year-old male came to the hospital with a complaint of abdominal distension. Abdominal computed tomography showed wall thickening in the descending colon and marked dilatation of the proximal colon, and lower gastrointestinal endoscopy demonstrated a stenosis in the descending colon. Although a biopsy from the stenotic lesion showed calcified eggs of Schistosoma japonicum with no malignant findings, we suspected malignant involvement, so we performed a descending colectomy with regional lymph node dissection. Pathological examination revealed a moderately differentiated adenocarcinoma. The colon cancer was diagnosed as pT4bN0M0, Stage IIc. The patient's history as a resident of one of the formerly endemic areas of Japan suggests that he may have carried S. japonicum for a long time, and that it may have contributed to carcinogenesis.

DOI： 10.18926/AMO/63748

H.pylori未感染胃粘膜を背景に発生したリンパ節転移を伴う低分化型進行胃癌の一例

倉岡紗樹子, 川野誠司, 小橋真由, 岡上昇太郎, 里見拓也, 稲生祥子, 濱田健太, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 岡田裕之, 垣内慶彦, 黒田新士, 藤原俊義, 田中健大, 池田宣聖

日本消化器病学会中国支部例会プログラム・抄録集 117回 75 - 75 2022.6

Adenomatoid mesothelioma arising from the diaphragm: a case report and review of the literature. International journal

Kenta Kawabe, Hiroki Sato, Akiko Kitano, Ryuichi Yoshida, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kosei Takagi, Masaaki Kagoura, Takahito Yagi, Toshiyoshi Fujiwara

Journal of medical case reports 16 ( 1 ) 228 - 228 2022.5

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

BACKGROUND: Adenomatoid mesothelioma is a rare subtype of malignant mesothelioma that can be confused with adenomatoid tumors, which are classified as benign. The clinical features and optimal management of adenomatoid mesothelioma have not been elucidated in the literature. In this report, we present an extremely rare case of adenomatoid mesothelioma that developed on the peritoneal surface of the diaphragm as well as a literature review of adenomatoid mesothelioma in the abdominal cavity. CASE PRESENTATION: The patient was a 61-year-old Japanese woman who had undergone resection of a malignant peripheral nerve sheath tumor of the hand 18 years prior. She was diagnosed with clinical stage I lung adenocarcinoma on follow-up chest radiography. Simultaneously, a 20-mm enhancing nodule with slow growth on the right diaphragm was detected on contrast-enhanced computed tomography. She presented no specific clinical symptoms. At this point, the lesion was suspected to be a hypervascular tumor of borderline malignancy, such as a solitary fibrous tumor. After a left upper lobectomy for lung adenocarcinoma, she was referred to our department, and laparoscopic tumor resection was performed. Adenomatoid tumors were also considered based on the histopathological and immunohistochemical analyses, but we made the final diagnosis of adenomatoid mesothelioma using the results of the genetic profile. The patient remains alive, with no recurrence noted 6 months after surgery. CONCLUSION: We encountered a valuable case of adenomatoid mesothelioma of peritoneal origin. There are some previously reported cases of adenomatoid mesothelioma and adenomatoid tumors that may need to be recategorized according to the current classification. It is important to accumulate and share new findings to clarify the clinicopathological characteristics and genetic status of adenomatoid mesothelioma.

DOI： 10.1186/s13256-022-03420-9

Optimal surveillance of intraductal papillary mucinous neoplasms of the pancreas focusing on remnant pancreas recurrence after surgical resection. International journal

Tomokazu Fuji, Yuzo Umeda, Kosei Takagi, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Kazuyuki Matsumoto, Hironari Kato, Takahito Yagi, Toshiyoshi Fujiwara

BMC cancer 22 ( 1 ) 588 - 588 2022.5

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

BACKGROUND: The international consensus guidelines for intraductal papillary mucinous neoplasm of the pancreas (IPMN) presented clinical features as indications for surgery. Whereas surveillance for recurrence, including de novo lesions, is essential, optimal surveillance protocols have not been established. AIM AND METHODS: This study aimed to assess the clinical features of recurrence at the remnant pancreas (Rem-Panc) and extra-pancreas (Ex-Panc) after surgery for IPMN. Ninety-one patients of IPMN that underwent detailed preoperative assessment and pancreatectomy were retrospectively analyzed, focusing especially on the type of recurrence. RESULTS: The IPMNs were finally diagnosed as low-grade dysplasia (LDA, n = 42), high-grade dysplasia (HAD, n = 19), and invasive carcinoma (IPMC, n = 30). Recurrence was observed in 26 patients (29%), of which recurrence was seen at Rem-Panc in 19 patients (21%) and Ex-Panc in 7 patients (8%). The frequency of Rem-Panc recurrence was 10% in LDA, 21% in HDA, and 37% in IPMC. On the other hand, Ex-Panc recurrence was observed only in IPMC (23%). Ex-Panc recurrence showed shorter median recurrence-free survival (RFS) and overall survival (OS) than Rem-Panc recurrence (median RFS 8 months vs. 35 months, p < 0.001; median OS 25 months vs. 72 months, p < 0.001). Regarding treatment for Rem-Panc recurrence, repeat pancreatectomy resulted in better OS than no repeat pancreatectomy (MST 36 months vs. 15.5 months, p = 0.033). On multivariate analysis, main duct stenosis or disruption as a preoperative feature (hazard ratio [HR] 10.6, p = 0.002) and positive surgical margin (HR 4.4, p = 0.018) were identified as risk factors for Rem-Panc recurrence. CONCLUSIONS: The risk factors for Rem-Panc and Ex-Panc recurrence differ. Therefore, optimal surveillance on these features is desirable to ensure that repeat pancreatectomy for Rem-Panc recurrence can be an appropriate surgical intervention.

DOI： 10.1186/s12885-022-09650-w

Feasibility of local therapy for recurrent pancreatic cancer. International journal

Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kosei Takagi, Takahito Yagi, Toshiyoshi Fujiwara

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 22 ( 6 ) 774 - 781 2022.5

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

BACKGROUND: Despite advances in perioperative management, recurrence after curative pancreatectomy is a critical issue in the treatment of pancreatic ductal adenocarcinoma (PDAC). The significance of local therapy for recurrent PDAC remains unclear. METHODS: We reviewed the medical records of patients with PDAC who underwent curative resection at our institution between January 2009 and December 2019. We examined the patterns of relapse and assessed the clinical outcomes of patients with recurrence who underwent local therapy, including surgical resection, radiotherapy, and radiofrequency ablation. RESULTS: A total of 246 patients with PDAC who underwent R0 or R1 resection were included in this study. The 3-year overall survival (OS) rate was 39.8%, and the 1-year recurrence-free survival rate was 51.2% for the entire population. Recurrence was observed in 172/246 (69.9%) patients, including multiple site recurrences in 50, liver metastasis in 41, locoregional recurrence in 34, and peritoneal dissemination in 27. Of the 172 patients, treatment was administered in 137 (79.7%), and 16 received local therapy, including surgical resection (n = 13), radiotherapy (n = 5), and RFA (n = 1). PS-matched analysis revealed that patients with recurrence who were treated with chemotherapy combined with local therapy showed better post-recurrence survival rates than those treated with chemotherapy alone (P = 0.016). Detailed clinical courses of these patients are presented in the main manuscript. CONCLUSIONS: Our results suggest that a multimodal approach may improve the clinical outcomes of patients with recurrent PDAC.

DOI： 10.1016/j.pan.2022.05.004

Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinoma. International journal

Daisuke Konishi, Yuzo Umeda, Kazuhiro Yoshida, Kunitoshi Shigeyasu, Shuya Yano, Tomohiro Toji, Sho Takeda, Ryuichi Yoshida, Kazuya Yasui, Tomokazu Fuji, Kazuyuki Matsumoto, Hiroyuki Kishimoto, Hiroyuki Michiue, Fuminori Teraishi, Hironari Kato, Hiroshi Tazawa, Hiroyuki Yanai, Takahito Yagi, Ajay Goel, Toshiyoshi Fujiwara

British journal of cancer 127 ( 4 ) 757 - 765 2022.5

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

BACKGROUND: Emerging evidence indicates that immunogenicity plays an important role in intrahepatic cholangiocarcinoma (ICC). Herein, we systematically evaluated the clinical relevance of immunogenicity in ICC. METHODS: Highly immunogenic ICCs identified in the public dataset and the Cancer Immunome Atlas (TCIA) were assessed to determine the prognostic impact of immunogenicity in ICC and key components after curative resection. We also investigated the clinical relevance of the immune milieu in ICC. RESULTS: Using the Gene Expression Omnibus dataset 89749 and TCIA, we identified CD8+/forkhead box P3 (FoxP3)+ tumour-infiltrating lymphocytes (TILs), T-cell immunoglobulin and mucin domain 3 (TIM-3) and human leukocyte antigen-A (HLA-A) in highly immunogenic ICCs. Immunohistochemical analysis of the in-house cohort showed that intratumoral FoxP3+ TILs correlated with CD8+ TILs (P = 0.045, Fisher's exact test) and that high FoxP3+/CD8+ ratio (FCR) was an important marker for poor survival (P < 0.001, log-rank test). Furthermore, the FCR was higher in tumour-free lymph nodes in ICCs with lymph node metastases than in those without lymph node metastases (P = 0.003, Mann-Whitney U test). CONCLUSIONS: FCR should be considered an important biomarker that represents the immune environment of ICC based on its potentially important role in tumour progression, especially lymph node metastasis.

DOI： 10.1038/s41416-022-01838-y

Prognostic Value of the Regional Lymph Node Station in Pancreatic Neuroendocrine Tumor. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Anticancer research 42 ( 5 ) 2797 - 2801 2022.5

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

BACKGROUND/AIM: Little is known regarding the impact of lymph node dissection on survival benefit after curative resection for pancreatic neuroendocrine tumor (PNET). This study aimed to evaluate the efficacy of lymph node dissection based on tumor location of PNET. PATIENTS AND METHODS: A retrospective study, including 50 patients with surgical resection for PNET between 2004 and 2020, was performed. The efficacy index (EI) was calculated by multiplication of the incidence of lymph node metastasis (LNM) at the station and the 5-year survival rate of patients with LNM at the station. RESULTS: In the pancreatic head tumors, the peri-pancreatic head and superior mesenteric artery lymph node stations had high EI of 13.3 and 25, respectively. In contrast, other stations, including stations 8 and 12, had zero EI. In the pancreatic body and tail tumors, only the splenic artery lymph node station had a survival benefit from lymph node dissection with an EI of 6.7. CONCLUSION: The extent of lymph node dissection for PNET should be decided based on the efficacy of lymph node dissection in accordance with tumor location. Our findings may be helpful in determining the extent of lymph node dissection required.

DOI： 10.21873/anticanres.15760

Anorectal leiomyoma with GLUT1 overexpression mimicking malignancy on FDG-PET/CT. International journal

Fuminori Teraishi, Kunitoshi Shigeyasu, Shunsuke Kagawa, Toshiyoshi Fujiwara

Journal of surgical case reports 2022 ( 5 ) rjac101 2022.5

Language：English

A 43-year-old female underwent pelvic magnetic resonance imaging for uterine myoma that incidentally revealed a 4.6 × 2.8 cm soft tissue mass in the anorectal region. Rectal endoscopy showed a submucosal tumor just above the anal canal. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) revealed an anorectal tumor with very high FDG uptake. Aspiration cytology and needle biopsy were inconclusive, and the patient underwent trans-perineal tumor resection. The excised tumor was a 4.6 × 3.5 × 2.7 cm gray-white bifurcated nodular tumor. Light microscopy revealed fenestrated growth of poorly dysmorphic short spindle-shaped cells with eosinophilic sporophytes. Immunohistochemical staining was positive for αSMA and desmin, negative for CD117 (KIT) and S100, and the patient was diagnosed with benign leiomyoma. Tumor cells were also positive for glucose transporter-1 (GLUT1) immunohistochemically. It is important to keep in mind that FDG-PET/CT may show false-positive results even in benign anal leiomyoma for various reasons, including GLUT1 overexpression.

DOI： 10.1093/jscr/rjac101

多職種チーム医療による周術期管理術前から術後まで幅広くサポートする多職種チーム医療による食道がん周術期管理

田辺俊介, 野間和広, 橋本将志, 前田直見, 櫻間教文, 白川靖博, 藤原俊義

日本外科系連合学会誌 47 ( 3 ) 361 - 361 2022.5

食道胃接合部癌に対する下縦隔郭清と再建食道胃接合部癌に対する腹臥位胸腔鏡下併用の下縦隔郭清および食道残胃吻合

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 香川俊輔, 白川靖博, 藤原俊義

日本外科系連合学会誌 47 ( 3 ) 414 - 414 2022.5

多職種チーム医療による周術期管理術前から術後まで幅広くサポートする多職種チーム医療による食道がん周術期管理

田辺俊介, 野間和広, 橋本将志, 前田直見, 櫻間教文, 白川靖博, 藤原俊義

日本外科系連合学会誌 47 ( 3 ) 361 - 361 2022.5

食道胃接合部癌に対する下縦隔郭清と再建食道胃接合部癌に対する腹臥位胸腔鏡下併用の下縦隔郭清および食道残胃吻合

野間和広, 橋本将志, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 香川俊輔, 白川靖博, 藤原俊義

日本外科系連合学会誌 47 ( 3 ) 414 - 414 2022.5

トランスレーショナル研究における外科医の役割外科医が思う「あったらいいな」をTranslational researchで解決する

垣内慶彦, 黒田新士, 橋本将志, 八木千晶, 杉本龍馬, 濱田侑紀, 坂本真樹, 吉田侑佑, 菊地覚次, 香川俊輔, 田澤大, 藤原俊義

日本外科学会定期学術集会抄録集 122回 DB - 4 2022.4

ステレオタイプ・スレットという問題とニュースレターの果たす役割

竹原裕子, 溝尾妙子, 小林純子, 坂本美咲, 新田薫, 工藤由里絵, 安井和也, 菊池覚次, 黒田新士, 吉田龍一, 岡崎幹生, 杉本誠一郎, 枝園忠彦, 小谷恭弘, 豊岡伸一, 笠原真悟, 藤原俊義, 土井原博義

日本外科学会定期学術集会抄録集 122回 SP - 6 2022.4

Overexpression of Adenovirus E1A Reverses Transforming Growth Factor-β-induced Epithelial-mesenchymal Transition in Human Esophageal Cancer Cells.

Tomoya Masuda, Hiroshi Tazawa, Yuuri Hashimoto, Takeshi Ieda, Satoru Kikuchi, Shinji Kuroda, Kazuhiro Noma, Yasuo Urata, Shunsuke Kagawa, Toshiyoshi Fujiwara

Acta medica Okayama 76 ( 2 ) 203 - 215 2022.4

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

The epithelial-mesenchymal transition (EMT), a normal biological process by which epithelial cells acquire a mesenchymal phenotype, is associated with migration, metastasis, and chemoresistance in cancer cells, and with poor prognosis in patients with esophageal cancer. However, therapeutic strategies to inhibit EMT in tumor environments remain elusive. Here, we show the therapeutic potential of telomerase-specific replication- competent oncolytic adenovirus OBP-301 in human esophageal cancer TE4 and TE6 cells with an EMT phenotype. Transforming growth factor-β (TGF-β) administration induced the EMT phenotype with spindleshaped morphology, upregulation of mesenchymal markers and EMT transcription factors, migration, and chemoresistance in TE4 and TE6 cells. OBP-301 significantly inhibited the EMT phenotype via E1 accumulation. EMT cancer cells were susceptible to OBP-301 via massive autophagy induction. OBP-301 suppressed tumor growth and lymph node metastasis of TE4 cells co-inoculated with TGF-β-secreting fibroblasts. Our results suggest that OBP-301 inhibits the TGF-β-induced EMT phenotype in human esophageal cancer cells. OBP-301-mediated E1A overexpression is a promising antitumor strategy to inhibit EMT-mediated esophageal cancer progression.

DOI： 10.18926/AMO/63425

食道癌に対するロボット支援手術の手技と成績【Video】2施設にわたるロボット支援下食道悪性腫瘍手術導入100例の経験

白川靖博, 桂佑貴, 石田道拡, 丁田泰宏, 矢野琢也, 佐藤太佑, 吉満政義, 中野敢友, 松川啓義, 井谷史嗣, 岡島正純, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義, 塩崎滋弘

日本外科学会定期学術集会抄録集 122回 SY - 5 2022.4

80歳以上の高齢者食道癌症例に対する安全性と根治性を担保した外科的治療戦略

松本聖, 野間和広, 前田直見, 菊地覚次, 田辺俊介, 黒田新士, 近藤喜太, 吉田龍一, 櫻間教文, 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 122回 DP - 6 2022.4

食道浸潤長から導かれる食道胃接合部癌の至適術式と集学的治療の後方視的解析

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 吉田龍一, 櫻間教文, 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 122回 SF - 1 2022.4

経口摂取不能上部消化管癌に対し外科医は何ができるのか? 食道バイパス術の有用性に関する検討

前田直見, 野間和広, 菊地覚次, 黒田新士, 近藤喜太, 田辺俊介, 吉田龍一, 櫻間教文, 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 122回 PD - 6 2022.4

肝胆膵領域における再生医療研究の最前線ベーラー大学における膵全摘自家膵島移植200例の検討

熊野健二郎, 藤智和, 金平典之, 佐藤博紀, 高木弘誠, 安井和也, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義, Bashoo Naziruddin

日本外科学会定期学術集会抄録集 122回 WS - 7 2022.4

The Gastrohepatic Ligament Approach in Robotic Spleen-Preserving Distal Pancreatectomy with Resection of the Splenic Vessels: The Superior Window Approach in the Warshaw Technique. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 26 ( 6 ) 1342 - 1344 2022.3

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

BACKGROUND: There have been few studies reporting on the surgical approaches of minimally invasive spleen-preserving distal pancreatectomy (SPDP). Herein, we present two cases who underwent robotic SPDP with resection of the splenic vessels using our novel gastrohepatic ligament approach (the superior window approach in the Warshaw technique). METHODS: Our gastrohepatic ligament approach in robotic SPDP consists of four steps: step 1, the gastrohepatic ligament transection; step 2, dissection around the pancreas; step 3, transection of the pancreas; and step 4, resection of the splenic vessels (the Warshaw technique). RESULTS: Starting with the gastrohepatic ligament transection, the pancreas was directly dissected with neither dissecting the gastrocolic ligament nor retracting the stomach. The mean operative time was 217 min with minimal estimated blood loss. Both of the patients had no postoperative morbidity. CONCLUSIONS: The gastrohepatic ligament approach may be helpful and optional in robotic SPDP with the Warshaw technique.

DOI： 10.1007/s11605-022-05286-0

Surgical resection of mixed neuroendocrine-non-neuroendocrine neoplasm in the biliary system: a report of two cases. International journal

Ayano Tamaki, Yuma Tani, Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Shigeru Horiguchi, Takashi Kuise, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kosei Takagi, Takahito Yagi, Toshiyoshi Fujiwara

Surgical case reports 8 ( 1 ) 38 - 38 2022.3

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

BACKGROUND: Mixed neuroendocrine-non-neuroendocrine neoplasm (MINEN) is a rare disease and there is scarce literature on its diagnosis, treatment, and prognosis. We encountered two unusual cases of MINEN in the biliary tract, one in the ampulla of Vater and the other in the distal bile duct. In this report, we describe the clinical course of these two cases in detail. CASE PRESENTATION: Case 1: A 69-year-old woman presented with a chief complaint of epigastric pain. When endoscopic sphincterotomy and retrograde biliary drainage were performed for gallstone pancreatitis, an ulcerated lesion was found in the ampulla of the Vater. Based on the biopsy results, the lesion was diagnosed as the ampulla of Vater carcinoma and subtotal stomach-preserving pancreatoduodenectomy (SSPPD) was performed. Postoperative histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, consistent with the diagnosis of MINEN. In addition, lymph node metastasis was found on the dorsal side of the pancreas and the metastatic component was adenocarcinoma. Adjuvant chemotherapy with etoposide and cisplatin was administered for 6 months, and presently the patient is alive without recurrence 64 months after surgery. Case 2: A 79-year-old man presented with a chief complaint of anorexia. Cholangiography showed severe stenosis of the distal bile duct. A biopsy was conducted from the stenotic lesion and it revealed the lesion to be adenocarcinoma. A diagnosis of distal bile duct carcinoma was made, and SSPPD was performed. Histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, and the tumor was confirmed as MINEN of the distal bile duct. No adjuvant chemotherapy was administered due to the poor performance status. 7 months later, the patient was found to have a liver metastasis. CONCLUSION: We experienced two valuable cases of biliary MINEN. To identify better treatments, it is important to consider the diversity of individual cases and to continue sharing a variety of cases with different presentations.

DOI： 10.1186/s40792-022-01386-w

高齢者胃癌症例(80歳以上)に対する周術期管理:合併症を予防するには高齢胃癌患者に対する周術期多職種介入の効果(The efficacy of the perioperative management for elderly gastric cancer patient by multiple experts)

垣内慶彦, 黒田新士, 菊地覚次, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 94回 195 - 195 2022.3

腹腔鏡下スリーブ状胃切除術導入から4年間での治療成績

香川俊輔, 菊地覚次, 黒田新士, 垣内慶彦, 武田正, 江口潤, 中司敦子, 山口哲志, 和田淳, 藤原俊義

肥満研究 27 ( Suppl. ) 358 - 358 2022.3

Surgical technique of suprapancreatic D2 lymphadenectomy focusing on the posterior hepatic plexus for advanced gastric cancer. International journal

Nobuhiko Kanaya, Shinji Kuroda, Yoshihiko Kakiuchi, Sho Takeda, Satoru Kikuchi, Kazuhiro Noma, Ryuichi Yoshida, Yuzo Umeda, Fuminori Teraishi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 407 ( 2 ) 871 - 877 2022.3

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

PURPOSE: Although D2 lymphadenectomy is currently considered a standard procedure for advanced gastric cancer (GC) worldwide, there is room for discussion about the appropriate range of suprapancreatic D2 lymphadenectomy. Focusing on the posterior hepatic plexus (PHP), which is not well recognized, we developed a surgical technique of suprapancreatic D2 lymphadenectomy, which we have called PHP-D2, and its short-term and long-term efficacies were evaluated in comparison with non-PHP-D2. METHODS: GC patients who underwent distal gastrectomy with D2 lymphadenectomy between July 2006 and May 2013 were enrolled, from which patients who had peritoneal metastasis and/or were peritoneal cytology-positive during surgery were excluded. Their medical records were retrospectively reviewed. RESULTS: Ninety-two patients (non-PHP-D2: 48, PHP-D2: 44) were enrolled. Shorter operation time (330 min vs 275 min, p < 0.0001) and less blood loss (290 mL vs 125 mL, p < 0.0001) were observed in PHP-D2, and no pancreatic fistulas were observed in PHP-D2. More lymph nodes of #11p (1 vs 1.5, p = 0.0328) and #12a lymph nodes (0 vs 1, p = 0.0034) were retrieved in PHP-D2, with no significant differences in #8a and #9 lymph nodes. Lymphatic recurrence was significantly less in PHP-D2 (p = 0.0166), and univariate and multivariate analyses showed that non-PHP-D2 was a significant risk factor for lymphatic recurrence (p = 0.0158), although there were no significant differences between non-PHP-D2 and PHP-D2 in 5-year overall survival and 5-year relapse-free survival. CONCLUSION: PHP-D2 was a safe and feasible procedure that had the potential to reduce lymphatic recurrence, and it can be a standard procedure of D2 lymphadenectomy for advanced GC.

DOI： 10.1007/s00423-022-02437-4

進行・再発胃癌患者に対するNivolumabの実臨床での治療成績の検討(Clinical outcomes of nivolumab in patients with advanced or recurrent gastric cancer)

香川俊輔, 黒田新士, 菊地覚次, 野間和広, 田辺俊介, 重安邦俊, 前田直見, 垣内慶彦, 武田正, 近藤喜太, 寺石文則, 藤原俊義

日本胃癌学会総会記事 94回 425 - 425 2022.3

腹腔鏡下スリーブ状胃切除術導入から4年間での治療成績

香川俊輔, 菊地覚次, 黒田新士, 垣内慶彦, 武田正, 江口潤, 中司敦子, 山口哲志, 和田淳, 藤原俊義

肥満研究 27 ( Suppl. ) 358 - 358 2022.3

進行・再発胃癌患者に対するNivolumabの実臨床での治療成績の検討(Clinical outcomes of nivolumab in patients with advanced or recurrent gastric cancer)

香川俊輔, 黒田新士, 菊地覚次, 野間和広, 田辺俊介, 重安邦俊, 前田直見, 垣内慶彦, 武田正, 近藤喜太, 寺石文則, 藤原俊義

日本胃癌学会総会記事 94回 425 - 425 2022.3

A Systematic Review of Minimally Invasive Versus Open Radical Antegrade Modular Pancreatosplenectomy for Pancreatic Cancer. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara

Anticancer research 42 ( 2 ) 653 - 660 2022.2

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

BACKGROUND/AIM: The aim of this study was to investigate surgical and oncological outcomes of minimally invasive (MI) and open radical antegrade modular pancreatosplenectomy (RAMPS) for the treatment of left-sided pancreatic cancer. MATERIALS AND METHODS: A systematic literature search and meta-analyses were performed focusing on short-term surgical oncology of MI- and open-RAMPS. RESULTS: A total of seven studies with 423 patients were included in this review. The equivalent short-term and long-term outcomes of the groups were confirmed. The results of meta-analyses found no significant difference in R0 resection rates (OR=1.78, 95%CI=0.76-4.15, p=0.18), although MI-RAMPS was associated with a smaller number of dissected lymph nodes (MD=-3.14, 95%CI=-4.75 - -1.53, p<0.001) and lymph node metastases (OR=0.55, 95%CI=0.31-0.97, p=0.04). CONCLUSION: MI-RAMPS could provide surgically and oncologically feasible outcomes for well-selected left-sided pancreatic cancer as compared to open-RAMPS. However, further high-level evidence should be needed to confirm survival benefits following MI-RAMPS.

DOI： 10.21873/anticanres.15523

【今知っておきたいゲノム医療と遺伝子治療-基礎から臨床まで】がんに対する腫瘍融解ウイルス療法

藤原俊義, 谷本光隆, 野田卓男, 田澤大

小児内科 54 ( 2 ) 361 - 364 2022.2

Language：Japanese Publisher：(株)東京医学社

＜Key Points＞(1)腫瘍融解ウイルスは低侵襲ながん治療プラットフォームとして注目されている。(2)神経芽腫など多くのヒト悪性腫瘍ではテロメラーゼ活性の上昇が認められる。(3)米国およびわが国で臨床開発が進むテロメラーゼ特異的腫瘍融解ウイルスTelomelysin(OBP-301)は、がん細胞を選択的に破壊して免疫学的活性化も誘導する。(4)p53遺伝子で武装化されたOBP-702は、N-mycを抑制して神経芽腫細胞を破壊する。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00648&link_issn=&doc_id=20220309070022&doc_link_id=10.24479%2Fpm.0000000073&url=https%3A%2F%2Fdoi.org%2F10.24479%2Fpm.0000000073&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

Effectiveness of early exercise on reducing skeletal muscle loss during preoperative neoadjuvant chemotherapy for esophageal cancer.

Tomohiro Ikeda, Kazuhiro Noma, Naoaki Maeda, Shunsuke Tanabe, Yoko Sakamoto, Yoshimi Katayama, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Masuo Senda

Surgery today 52 ( 8 ) 1143 - 1152 2022.1

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

PURPOSE: To investigate if early exercise can help prevent skeletal muscle loss and improve the clinical outcomes of esophageal cancer patients receiving preoperative neoadjuvant chemotherapy (NAC). METHODS: This was a single-center, retrospective observational cohort study of 110 patients with advanced esophageal cancer. We analyzed the effect of early exercise on the risk of skeletal muscle loss (defined as > 2.98%) during NAC and the subsequent clinical outcomes. Patients in the early exercise group (n = 71) started exercise therapy 8 days earlier than those the late exercise group (n = 39). RESULTS: The median age of the patients was 65.4 years, the mean BMI was 21.1 kg/m2, and 92 (84%) of the 110 patients were men. Skeletal muscle loss occurred in 34% and 67% of the early and late exercise groups, respectively (p < 0.001). There was a lower risk of surgical site infection in the early exercise group (1% vs 16%, p = 0.021). Multivariate analysis revealed that early exercise reduced the risk of skeletal muscle loss (OR = 0.25, 95% CI 0.09-0.65, p = 0.006). CONCLUSIONS: Our results suggest that early exercise reduces the risk of both skeletal muscle loss during NAC and subsequent surgical site infection in patients with esophageal cancer.

DOI： 10.1007/s00595-021-02449-5

【消化器外科ロボット支援手術の導入と手術教育】ロボット支援下膵切除術の導入と手術教育

高木弘誠, 楳田祐三, 吉田龍一, 藤原俊義, 八木孝仁

手術 76 ( 1 ) 69 - 77 2022.1

《外科学再興特別企画》癌に対する免疫治療New Era がん微小環境内のマクロファージ、好中球を癌の治療標的として解析する

香川俊輔, 吉本匡志, 伊藤雅典, 梶岡裕樹, 坂本修一, 桑田和也, 吉田龍一, 野間和広, 楳田祐三, 菊地覚次, 黒田新士, 矢野修也, 重安邦俊, 寺石文則, 田澤大, 藤原俊義

日本外科学会雑誌 123 ( 1 ) 80 - 82 2022.1

Acute acalculous cholecystitis caused by SARS-CoV-2 infection: A case report and literature review. International journal

Hana Futagami, Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

International journal of surgery case reports 90 106731 - 106731 2022.1

Language：English

BACKGROUND: Emerging data indicate that gastrointestinal disorders, in addition to pulmonary dysfunction, are also hallmarks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE PRESENTATION: A 42-year-old man with maintenance hemodialysis developed high fever and dyspnea. He was positive for SARS-CoV-2 and was diagnosed with pneumonia. After treatment for SARS-CoV-2, his respiratory condition improved. However, he developed right upper quadrant pain with elevated inflammatory markers (white blood cells, 21,160/μL; c-reactive protein, 163.9 mg/L) on the 13th day. Abdominal computed tomography revealed acute acalculous cholecystitis. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed together with antibiotic therapy, which resulted in improvement of symptoms. Laparoscopic cholecystectomy was performed 36 days after PTGBD. CONCLUSION: We report a rare case of acute acalculous cholecystitis (AAC) following pneumonia caused by SARS-CoV-2 infection. We also conducted a literature search to characterize SARS-CoV-2-related cholecystitis. Infection with SARS-CoV-2 is an important trigger for AAC, and appropriate therapeutic alternatives should be cautiously selected according to individual cases.

DOI： 10.1016/j.ijscr.2021.106731

大腸癌肝転移におけるRNA編集酵素ADAR1発現は肝転移切除後の残肝再発を予測するバイオマーカーになる

畑七々子, 重安邦俊, 高橋一剛, 梅田響, 武田正, 矢野修也, 楳田祐三, 田澤大, 藤原俊義

日本分子腫瘍マーカー研究会誌 37 23 - 24 2022

Association between Advanced T Stage and Thick Rectus Abdominis Muscle and Outlet Obstruction and High-Output Stoma after Ileostomy in Patients with Rectal Cancer

Yasuhiro Komatsu, Kunitoshi Shigeyasu, Sho Takeda, Yoshiko Mori, Kazutaka Takahashi, Nanako Hata, Kokichi Miyamoto, Hibiki Umeda, Yoshihiko Kakiuchi, Satoru Kikuchi, Shuya Yano, Shinji Kuroda, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

International Surgery 106 ( 3 ) 102 - 111 2022

Publishing type：Research paper (scientific journal)

Objective: This study aimed to identify factors associated with outlet obstruction and high-output stoma (HOS) after ileostomy creation. Summary of background data: Ileostomy creation is effective in preventing leakage among patients undergoing low anterior resection for rectal cancer. However, major complications such as outlet obstruction and HOS can occur after surgery. Moreover, these complications cannot be prevented. Methods: This retrospective study included 34 patients with rectal cancer who underwent low anterior resection and ileostomy creation at Okayama University Hospital from January 2015 to December 2018. Then, the risk factors associated with outlet obstruction and HOS were analyzed. Results: Of 34 patients, 7 (21%) experienced outlet obstruction. In a multivariate logistic regression analysis, advanced T stage (P ¼ 0.10), ileostomy with a short horizontal diameter (P ¼ 0.01), and thick rectus abdominis (RA) muscle (P ¼ 0.0005) were considered independent risk factors for outlet obstruction. There was a significant correlation between outlet obstruction and HOS (P ¼ 0.03). Meanwhile, the independent risk factors of HOS were advanced T stage (P ¼ 0.03) and thick RA muscle (P ¼ 0.04). Conclusions: Thick RA muscle and advanced T stage were the common risk factors of outlet obstruction and HOS. Therefore, in high-risk patients, these complications can be prevented by choosing an appropriate ileostomy location according to RA muscle thickness and by preventing tubing into the ileostomy.

DOI： 10.9738/INTSURG-D-21-00012.1

Prognostic Value of the Regional Lymph Node Station in Pancreatoduodenectomy for Ampullary Carcinoma. International journal

Kosei Takagi, Yasuo Nagai, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

In vivo (Athens, Greece) 36 ( 2 ) 973 - 978 2022

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

BACKGROUND/AIM: The optimal extent of lymph node dissection for ampullary carcinoma is controversial. The aim of this study was to investigate the efficacy of lymph node dissection for ampullary carcinoma. PATIENTS AND METHODS: Between 2000 and 2020, a total of 75 patients undergoing radical resection for ampullary carcinoma were included. The efficacy index (EI) was calculated by multiplication of the frequency of lymph node metastasis (LNM) at the station and the 5-year survival rate of patients with metastasis at the station. RESULTS: Out of 75 patients, 14 had LNM. The EI for the peri-pancreatic head (station 13 and 17) and superior mesenteric artery (station 14) lymph node were 4.4 and 3.5, respectively. Whereas the peri-gastric (station 5 and 6), common hepatic artery (station 8), and liver hilum (station 12) lymph node stations had zero EI. Although the number of patients with the station 16 dissected was small (9%), the para-aortic (station 16) lymph nodes had the highest EI of 14.3 despite being distant lymph nodes. CONCLUSION: We identified the distribution of LNM and survival benefit of lymph node dissection for ampullary carcinoma. Our results suggest that the optimal extent of lymph node dissection for ampullary carcinoma could be reconsidered.

DOI： 10.21873/invivo.12789

鏡視下での噴門側胃切除、胃全摘後の再建術腹腔鏡下噴門側胃切除後の観音開き法再建

西崎正彦, 黒田新士, 菊地覚次, 垣内慶彦, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) WS19 - 1 2021.12

腹腔鏡下幽門側胃切除において技術認定医取得は手術成績を改善する

菊地覚次, 香川哲也, 黒田新士, 西崎正彦, 垣内慶彦, 田辺俊介, 寺石文則, 野間和広, 香川俊輔, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO126 - 2 2021.12

術前診断が困難であった膵炎を伴った胃異所性膵に対して腹腔鏡下胃切除を行った1例

成田周平, 菊地覚次, 垣内慶彦, 黒田新士, 西崎正彦, 田辺俊介, 野間和広, 寺石文則, 香川俊輔, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO200 - 7 2021.12

Initial introduction of robot-assisted, minimally invasive esophagectomy using the microanatomy-based concept in the upper mediastinum. International journal

Yasuhiro Shirakawa, Kazuhiro Noma, Tomoyoshi Kunitomo, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara

Surgical endoscopy 35 ( 12 ) 6568 - 6576 2021.12

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

BACKGROUND: We have recently standardized upper mediastinal lymph node dissection (UMLND) using a microanatomy-based concept in thoracoscopic esophagectomy in the prone position (TEPP), and introduced robot-assisted minimally invasive esophagectomy (RAMIE) using the same concept as in TEPP while aiming at solo surgery. The purpose of this study was to investigate the outcomes of RAMIE using the microanatomy-based concept in the initial introduction phase. METHODS: We have performed more than 500 TEPP procedures as minimally invasive esophagectomy (MIE). After performing about 400 cases of MIE, we established a microanatomy-based standardization of UMLND. In October 2018, we introduced RAMIE, and have performed 75 procedures in 20 months. Two groups were analyzed: a group after microanatomy-based standardization in TEPP (100 cases after completing 400 cases of TEPP) and a RAMIE group (75 cases). Finally, 51 paired cases were matched using a propensity score. Furthermore, the change in postoperative short-term outcome for RAMIE in the initial introduction phase was analyzed. RESULTS: Although there were no significant differences between the two groups in the number of upper mediastinal lymph nodes dissected, there was a significant decrease (P = 0.036) in intraoperative blood loss volume with RAMIE, representing a definite benefit for patients. The thoracoscopic operative time for RAMIE decreased by almost 100 min following less than 50 cases of experience, reaching the same level as that for recent TEPP, but with only one-tenth the operator experience. There were no significant differences in the total postoperative morbidity rate including the recurrent laryngeal nerve palsy rate. CONCLUSION: RAMIE has been introduced safely and smoothly using the microanatomy-based concept established in TEPP.

DOI： 10.1007/s00464-020-08154-7

Paraesophageal hernia repair can decrease BNP levels. International journal

Shunsuke Tanabe, Yasuhiro Shirakawa, Naoaki Maeda, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Surgical endoscopy 35 ( 12 ) 6921 - 6929 2021.12

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

BACKGROUND: Although the main manifestation of giant paraesophageal hernia (PEH) is disordered meal passage due to gastric torsion, the contents of the hernia sometimes squeeze the heart and lungs and induce the symptoms of respiratory or heart failure. Furthermore, the quality of life (QOL) of patients with a heavy cardiac load deteriorates. In this study, changes in a heart failure marker and symptoms of cases with a giant PEH from before to after laparoscopic surgery were examined. METHODS: Levels of brain natriuretic peptide (BNP) as a heart failure marker were measured before and after radical laparoscopic surgery in cases of type III, IV type of giant PEH. Changes of the symptoms due to heart failure were also investigated. RESULTS: A total of 75 hiatal hernia surgeries were performed in 2012-2019. Of them, 50 had a giant PEH, and 20 (40.0%) had heart failure symptoms such as fatigue and exertional dyspnea. In the giant PEH cases, BNP could be measured before and after surgery to evaluate the presence of heart failure in 23 cases; postoperative BNP levels decreased from the preoperative values in 18 of them. Furthermore, in many cases, chest symptoms also improved. CONCLUSIONS: Radical laparoscopic surgery can reduce heart failure due to giant PEH. Therefore, in addition to conventional surgical indication criteria such as vomiting and food loss, increased cardiac load may be added to the new surgical indication criteria.

DOI： 10.1007/s00464-020-08202-2

Left Hemihepatectomy for Hepatocellular Carcinoma Following Esophagectomy with Retrosternal Gastric Tube Reconstruction for Esophageal Cancer.

Kosei Takagi, Takashi Kuise, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Yasuo Nagai, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Takahito Yagi, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 6 ) 755 - 758 2021.12

Language：English

Approximately 4% of patients with esophageal cancer develop a second primary malignancy in the upper gastrointestinal trunk. However, hepatectomy following esophagectomy for esophageal cancer has rarely been reported. We report the case of a 70-year-old man who underwent an esophagectomy for esophageal cancer with retrosternal gastric tube reconstruction. Nine years later, he developed hepatocellular carcinoma with tumor thrombus involving the left portal vein, and was successfully treated with left hemihepatectomy. Special attention should be paid to avoiding incidental injury of the gastric tube as well as the right gastroepiploic artery during the hepatectomy.

DOI： 10.18926/AMO/62818

Multiple Hepatolithiasis Following Hepaticojejunostomy Successfully Treated with Left Hemihepatectomy and Double Hepaticojejunostomy Reconstruction.

Yasuo Nagai, Kosei Takagi, Takashi Kuise, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 6 ) 735 - 739 2021.12

Language：English

Surgical intervention for hepatolithiasis following hepaticojejunostomy (HJ) has rarely been reported. Herein, we present a case of post-HJ multiple hepatolithiasis treated with left hemihepatectomy with double HJ reconstruction. A 72-year-old woman who had undergone HJ for iatrogenic bile duct injury developed repeated cholangitis due to complicated hepatolithiasis accompanied by an atrophied left hepatic lobe and HJ stricture. Since endoscopic intervention was unsuccessful, the patient underwent left hemihepatectomy with HJ re-anastomoses of the common hepatic duct and left hepatic duct (double HJ technique). The double HJ technique with hepatectomy can be a useful option for treating complicated hepatolithiasis following HJ.

DOI： 10.18926/AMO/62814

Concordance of acquired mutations between metastatic lesions and liquid biopsy in metastatic colorectal cancer. International journal

Fumitaka Taniguchi, Akihiro Nyuya, Toshiaki Toshima, Kazuya Yasui, Yoshiko Mori, Makoto Okawaki, Hiroyuki Kishimoto, Yuzo Umeda, Toshiyoshi Fujiwara, Hiroaki Tanioka, Yoshiyuki Yamaguchi, Ajay Goel, Takeshi Nagasaka

Future science OA 7 ( 10 ) FSO757 2021.12

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

Aim: To evaluate whether PCR-reverse sequence-specific oligonucleotide can examine the concordance between liquid biopsy and metastatic lesions with acquired resistance. Materials & methods: We examined acquired mutations in chemoresistant lesions and blood obtained from four patients with RAS wild-type metastatic colorectal cancer who underwent treatment with anti-epidermal growth factor receptor antibodies. Results: In one patient, metastatic lesions harbored diverse acquired mutations in KRAS in all seven metastases; the two acquired mutations were detectable in blood collected after the patient acquired resistance. None of the other patients exhibited liquid biopsy mutations, except one, with a BRAF mutation confirmed in primary tumor and peritoneal dissemination. Conclusion: Liquid biopsy based on PCR-reverse sequence-specific oligonucleotide is a successful procedure for capturing acquired mutations with precise information on the RAS mutational spectrum.

DOI： 10.2144/fsoa-2021-0059

Technique of vessel-skeletonized parenchyma-sparing hepatectomy for the oncological treatment of bilobar colorectal liver metastases

【conversion surgeryのすべて切除不能を切除可能に!】切除不能大腸癌肝転移に対するconversion surgery

楳田祐三, 高木弘誠, 藤智和, 吉田一博, 安井和也, 吉田龍一, 八木孝仁, 藤原俊義

消化器外科 44 ( 13 ) 1897 - 1913 2021.12

術中ドプラ超音波腹腔鏡により腹腔動脈の乱流と流速を評価した正中弓状靱帯圧迫症候群の1例

吉田有佑, 矢野修也, 菊地覚次, 高木弘誠, 高橋利明, 垣内慶彦, 武田正, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 寺石文則, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO073 - 7 2021.12

大腸癌術前Frail評価と腹腔鏡手術高Frail大腸癌患者に対する周術期管理チーム介入により腹腔鏡手術の安全性は向上したか

寺石文則, 成田周平, 武田正, 高橋利明, 吉田有佑, 重安邦俊, 矢野修也, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) WS24 - 7 2021.12

術前CAPOX+RTを施行した局所進行直腸癌に対する鏡視下手術成績の検討

武田正, 寺石文則, 高橋利明, 成田周平, 吉田有佑, 垣内慶彦, 重安邦俊, 菊地覚次, 矢野修也, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO206 - 3 2021.12

輪状膵を伴う進行胃癌において術式変更にて術中対応した腹腔鏡補助下幽門側胃切除を施行した1例

高橋利明, 垣内慶彦, 菊地覚次, 黒田新士, 武田正, 矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO123 - 9 2021.12

横行結腸・脾彎曲・下行結腸癌に対する郭清手技と治療成績脾彎曲結腸脾彎曲進行癌D3は下腸間膜静脈を軸にする腸間膜化を行うと郭清範囲が明確になる

矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 黒田新士, 菊地覚次, 吉田有佑, 垣内慶彦, 武田正, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD17 - 3 2021.12

食道胃接合部癌に対する鏡視下手術と再建術:胃外科vs食道外科の立場より食道食道浸潤が2cmを超える食道胃接合部進行癌に対する胸腔鏡下操作を先行した手術手技

白川靖博, 久保田哲史, 石田道拡, 丁田泰宏, 松川啓義, 井谷史嗣, 岡島正純, 塩崎滋弘, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) SY1 - 5 2021.12

定型的鏡視下食道癌根治術:術後合併症回避のための適切な剥離層を目指して左反回神経麻痺軽減のための適切な剥離層の確保

前田直見, 野間和広, 菊地覚次, 黒田新士, 田辺俊介, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD6 - 3 2021.12

右胸腔アプローチ困難例に対する縦隔鏡下食道切除術の治療成績

最所公平, 野間和広, 前田直見, 菊地覚次, 黒田新士, 田辺俊介, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO251 - 6 2021.12

胸腔鏡手術の利点を活かした食道癌サルベージ手術の治療成績

松本聖, 野間和広, 前田直見, 菊地覚次, 黒田新士, 田辺俊介, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) MO249 - 3 2021.12

ロボット支援食道切除術の工夫と周術期治療成績ロボット支援下手術による立体的微細解剖の理解を基礎とした安全で合理的な食道上縦隔郭清術

野間和広, 橋本将志, 最所公平, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) WS21 - 5 2021.12

食道裂孔ヘルニアに対する腹腔鏡下手術食道裂孔ヘルニアの腹腔鏡下根治手術による心負荷軽減への貢献

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) WS27 - 6 2021.12

地域基幹病院における高難度鏡視下手術の安全な実践と後進への教育について地域基幹病院での高難度鏡視下手術に対するCadaver Surgical Trainingの意義

近藤喜太, 前田直見, 矢野修也, 菊地覚次, 田辺俊介, 黒田新士, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) CSY11 - 6 2021.12

ロボット肝胆膵手術のコツとピットフォールロボット支援下膵切除術のコツとピットフォール

高木弘誠, 楳田祐三, 吉田龍一, 吉田一博, 藤智和, 熊野健二郎, 安井和也, 佐藤博紀, 八木孝仁, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD1 - 5 2021.12

腹腔鏡下右葉系系統的肝切除の定型化腹腔鏡下肝後区域切除の定型化

楳田祐三, 藤智和, 高木弘誠, 吉田一博, 安井和也, 野間和広, 黒田新士, 吉田龍一, 八木孝仁, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD2 - 3 2021.12

Yuzo Umeda, Takeshi Nagasaka, Kosei Takagi, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Tatsuo Matsuda, Kazuya Yasui, Kenjiro Kumano, Hiroki Sato, Takahito Yagi, Toshiyoshi Fujiwara

Langenbeck's Archives of Surgery 2021.11

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract
</title><sec>
<title>Background</title>
To aid in the oncological management of multiple bilobar colorectal liver metastases (CRLMs), we describe a new surgical procedure, VEssel-Skeletonized PArenchyma-sparing Hepatectomy (VESPAH).

</sec><sec>
<title>Study design</title>
Of 152 patients with CRLMs treated with hepatectomy, 33 patients had multiple bilobar liver metastases (≥8 liver metastases); their surgical procedures and clinical outcomes were retrospectively summarized and compared between those who underwent VESPAH and those who underwent major hepatectomy (Major Hx).

</sec><sec>
<title>Results</title>
Of the 33 patients, 20 patients were resected by VESPAH (the VESPAH group) and 13 patients by major hepatectomy (Major Hx group). The median number of CRLMs was 13 (range, 8–53) in the VESPAH group and 10 (range, 8–41) in the Major Hx group (<italic>P</italic>=0.511). No operative mortality nor severe morbidity was observed in either group. The VESPAH group showed earlier recovery of remnant liver function after surgery than the Major Hx group; the incidence of grade B/C post hepatectomy liver failure was 5% in the VESPAH group and 38% in the Major Hx group, <italic>P</italic>=0.048). Intrahepatic tumor recurrence was confirmed in 14 (70%) and 7 (54%) patients in the VESPAH and Major Hx groups, respectively (<italic>P</italic>=0.416). There was no significant difference in median overall survival (OS) after hepatectomy between the two groups; the median OS was 47 months in the VESPAH group and 33 months in the Major Hx group (<italic>P</italic>=0.481). The VESPAH group showed the higher induction rate of adjuvant chemotherapy within 2 months after surgery (<italic>P</italic>=0.002) and total number of repeat hepatectomy for intrahepatic recurrence (<italic>P</italic>=0.060) than the Major Hx group.

</sec><sec>
<title>Conclusions</title>
VESPAH enables us to clear surgical navigation by hepatic vessel skeletonization and may enhance patient tolerability of not only adjuvant chemotherapy but also repeat hepatectomies during the patients’ lifetimes.

</sec>

DOI： 10.1007/s00423-021-02373-9

胆嚢結石症術後に診断された胃癌の異時性胆嚢転移の1例

Other Link： https://link.springer.com/article/10.1007/s00423-021-02373-9/fulltext.html

杉本龍馬, 垣内慶彦, 黒田新士, 菊地覚次, 庄司良平, 西田賢司, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会雑誌 54 ( 11 ) 788 - 794 2021.11

Language：Japanese Publisher：(一社)日本消化器外科学会

症例は77歳の男性で,検診にて発見された胃癌に対してロボット支援下胃全摘術,D2郭清,Roux-en Y再建術を施行した.術後病理組織学的診断は,pT4a(SE)N3aM0 Stage IIIBであった.術後補助化学療法として,S-1を3コース施行した時点でCEAの上昇を認めたが,画像検査にて明らかな再発を認めなかったため治療を継続し,1年後の補助化学療法終了時には正常値まで低下した.術後26ヵ月経過時に急性胆管炎,胆嚢結石を認めたため,保存的加療後に待機的に腹腔鏡下胆嚢摘出術を行った.術前画像所見や術中所見で胆嚢に特記すべき所見は認めなかったが,術後病理組織学的診断にて,胃癌の胆嚢転移と診断された.極めてまれな胃癌の異時性胆嚢転移の1例を経験したため報告する.(著者抄録)

情熱・努力を継続できる外科教育外科生涯教育におけるCSTの果たす役割

近藤喜太, 前田直見, 黒田新士, 信岡大輔, 武田正, 重安邦俊, 菊地覚次, 矢野修也, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会雑誌 122 ( 6 ) 674 - 676 2021.11

80歳以上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外科治療戦略

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会雑誌 54 ( Suppl.2 ) 243 - 243 2021.11

情熱・努力を継続できる外科教育外科マネージメントセンターによる情熱のある外科医教育・育成システム

菊地覚次, 吉田龍一, 黒田新士, 野間和広, 安井和也, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会雑誌 122 ( 6 ) 680 - 682 2021.11

Application of convolutional neural networks for evaluating the depth of invasion of early gastric cancer based on endoscopic images. International journal

Kenta Hamada, Yoshiro Kawahara, Takayoshi Tanimoto, Akimitsu Ohto, Akira Toda, Toshiaki Aida, Yasushi Yamasaki, Tatsuhiro Gotoda, Taiji Ogawa, Makoto Abe, Shotaro Okanoue, Kensuke Takei, Satoru Kikuchi, Shinji Kuroda, Toshiyoshi Fujiwara, Hiroyuki Okada

Journal of gastroenterology and hepatology 2021.10

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

BACKGROUND AND AIM: Recently, artificial intelligence (AI) has been used in endoscopic examination and is expected to help in endoscopic diagnosis. We evaluated the feasibility of AI using convolutional neural network (CNN) systems for evaluating the depth of invasion of early gastric cancer (EGC), based on endoscopic images. METHODS: This study used a deep CNN model, ResNet152. From patients who underwent treatment for EGC at our hospital between January 2012 and December 2016, we selected 100 consecutive patients with mucosal (M) cancers and 100 consecutive patients with cancers invading the submucosa (SM cancers). A total of 3508 non-magnifying endoscopic images of EGCs, including white-light imaging, linked color imaging, blue laser imaging-bright, and indigo-carmine dye contrast imaging, were included in this study. A total of 2288 images from 132 patients served as the development dataset, and 1220 images from 68 patients served as the testing dataset. Invasion depth was evaluated for each image and lesion. The majority vote was applied to lesion-based evaluation. RESULTS: The sensitivity, specificity, and accuracy for diagnosing M cancer were 84.9% (95% confidence interval [CI] 82.3%-87.5%), 70.7% (95% CI 66.8%-74.6%), and 78.9% (95% CI 76.6%-81.2%), respectively, for image-based evaluation, and 85.3% (95% CI 73.4%-97.2%), 82.4% (95% CI 69.5%-95.2%), and 83.8% (95% CI 75.1%-92.6%), respectively, for lesion-based evaluation. CONCLUSIONS: The application of AI using CNN to evaluate the depth of invasion of EGCs based on endoscopic images is feasible, and it is worth investing more effort to put this new technology into practical use.

DOI： 10.1111/jgh.15725

Splenic and Peritoneal Metastases with Para-aortic and Virchow Lymph Node Metastases: Late Recurrence of Ovarian Cancer 30 Years after Initial Treatment.

Kosei Takagi, Takahito Yagi, Toshiyoshi Fujiwara

JMA journal 4 ( 4 ) 428 - 431 2021.10

Early intervention of the perioperative multidisciplinary team approach decreases the adverse events during neoadjuvant chemotherapy for esophageal cancer patients.

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Ayumi Sonoyama-Hanaoka, Aiko Yoshitomi, Reiko Kohno-Yamanaka, Yoshihiko Soga, Toshiyoshi Fujiwara

Esophagus : official journal of the Japan Esophageal Society 18 ( 4 ) 797 - 805 2021.10

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

BACKGROUND: Multidisciplinary team (MDT) approach has become a standard for perioperative patient care, including in esophageal cancer. In our institution, the Perioperative Management Center (PERiO) has been doing an MDT approach for patients undergoing esophageal cancer surgery since 2009. On the other hand, neoadjuvant therapy has also been becoming standard for many malignancies, including esophageal cancer. In Japan, neoadjuvant chemotherapy (NAC) for esophageal cancer is standard now. However, there have been no reports about when is the best time to start the MDT approach for patients with neoadjuvant therapy. In this study, the best start time for the MDT approach for esophageal cancer patients with NAC was examined from the perspective of adverse events during chemotherapy and perioperative period. METHODS: All cases underwent thoracoscopic esophagectomy in the prone position (TEPP) after NAC. The PERiO Intervention group that started before NAC (n = 100) was compared with the PERiO Intervention group that started after NAC (n = 77). Eventually, 54 paired cases were matched by propensity score matching. RESULTS: The adverse event rate during chemotherapy, especially oral complications, was significantly decreased in the PERiO Intervention started before the NAC group (P = 0.007). Furthermore, weight loss during the period from chemotherapy to surgery was significantly reduced in the group that started before NAC (P = 0.033). CONCLUSION: The MDT approach should be started before NAC in patients undergoing esophageal cancer surgery to prevent adverse events during chemotherapy and provide safe perioperative conditions.

DOI： 10.1007/s10388-021-00844-y

臓器移植におけるNew Normalを考える肝移植における免疫抑制のニューノーマルこれからの時代を見据えた免疫抑制の最適化

楳田祐三, 八木孝仁, 藤原俊義

Organ Biology 28 ( 3 ) 56 - 56 2021.10

ロボット支援下手術における私の工夫ロボット支援下手術の導入により見えてきた新たなアプローチ食道癌左上縦隔郭清術

野間和広, 最所公平, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 59回 WS9 - 3 2021.10

Charlson comorbidity indexは80歳高齢者stage IA胃癌の予後因子である

黒田新士, 垣内慶彦, 武田正, 菊地覚次, 重安邦俊, 矢野修也, 近藤喜太, 田辺俊介, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 59回 O48 - 6 2021.10

切除不能消化器癌に対するconversion surgeryの適応とタイミング骨盤内臓全摘術が高度進行大腸癌へのコンバージョン手術となるかはRAS statusで決まる

矢野修也, 重安邦俊, 垣内慶彦, 武田正, 菊地覚次, 近藤喜太, 黒田新士, 田辺俊介, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 59回 WS18 - 4 2021.10

周術期管理における多職種チーム医療管理栄養士による患者教育プロトコールの胃癌術後体重減少、サルコペニア抑制効果

今井祥子, 菊地覚次, 高田暢夫, 黒田新士, 田辺俊介, 前田直見, 西崎正彦, 野間和広, 香川俊輔, 楳田祐三, 縄稚久美子, 高橋絢子, 長谷川祐子, 四方賢一, 藤原俊義

日本癌治療学会学術集会抄録集 59回 WS7 - 6 2021.10

胃切除後食道癌再建のベストプラクティス結腸vs.空腸胃を使用できない症例に対する安全で生理的な再建を目指した有茎空腸を用いた食道再建術

白川靖博, 桂佑貴, 石田道拡, 丁田泰宏, 矢野琢也, 佐藤大祐, 義満政義, 中野敢友, 松川啓義, 井谷史嗣, 岡島正純, 塩崎滋弘, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本胸部外科学会定期学術集会 74回 EDB1 - 3 2021.10

岡山大学外科広域外科専門研修プログラム関連病院における専攻医の産前産後休暇・育児休業/休暇・介護休業/休暇、その他支援についての実態調査

竹原裕子, 溝尾妙子, 小林純子, 菊地覚次, 池田宏国, 岡崎幹生, 吉田龍一, 黒田新士, 枝園忠彦, 小谷恭弘, 山根正修, 豊岡伸一, 笠原真悟, 土井原博義, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S24 - S24 2021.10

術前から術後まで幅広くサポートする多職種による食道がん周術期管理

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S550 - S550 2021.10

食道癌に対する内視鏡下手術の技術取得と向上胸腔鏡下食道癌手術の技術習得と向上への取り組み

前田直見, 野間和広, 菊地覚次, 黒田新士, 田辺俊介, 近藤喜太, 吉田龍一, 櫻間教文, 寺石文則, 白川靖博, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S480 - S480 2021.10

食道癌術後乳糜胸に対する治療マネージメント

永久成一, 野間和広, 前田直見, 菊地覚次, 黒田新士, 田邊俊介, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S603 - S603 2021.10

食道癌に対するロボット支援下手術ロボット支援手術の特性を生かした上縦隔郭清手技

野間和広, 前田直見, 菊地覚次, 田辺俊介, 近藤喜太, 黒田新士, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S318 - S318 2021.10

高齢者癌に対する外科治療 80歳以上高齢者食道癌症例に対する外科治療戦略

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 59回 WS13 - 1 2021.10

ロボット支援下手術における私の工夫ロボット支援下手術の導入により見えてきた新たなアプローチ食道癌左上縦隔郭清術

野間和広, 最所公平, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 櫻間教文, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 59回 WS9 - 3 2021.10

局所進行食道がんに対する治療戦略局所進行食道がんに対するDCF併用放射線療法を用いた治療戦略

白川靖博, 橋本将志, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本癌治療学会学術集会抄録集 59回 SY6 - 3 2021.10

食道胃接合部癌に対する治療戦略食道胃接合部癌に対する至適術式と術前療法の有用性に関する検討

田辺俊介, 野間和広, 前田直見, 菊地覚次, 黒田新士, 近藤喜太, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S111 - S111 2021.10

胃切除後食道癌再建のベストプラクティス結腸vs.空腸胃を使用できない症例に対する安全で生理的な再建を目指した有茎空腸を用いた食道再建術

日本胸部外科学会定期学術集会 74回 EDB1 - 3 2021.10

頭頸部・消化器疾患の治療における栄養管理の工夫(外科・内科) 頭頸部癌集学的治療に対する胃瘻を有効に活用した栄養管理確立への道のり

田辺俊介, 今井祥子, 開原裕子, 長谷川祐子, 岡野寛子, 大木晴美, 三浦太郎, 金聖暎, 前田直見, 菊地覚次, 野間和広, 白川靖博, 四方賢一, 藤原俊義

学会誌JSPEN 3 ( Suppl.1 ) 233 - 233 2021.10

がん免疫療法の新展開-がん免疫療法の今後の展望- テロメラーゼ特異的腫瘍融解ウイルス製剤の創薬研究がん免疫療法との協働

藤原俊義, 黒田新士, 田辺俊介, 浦田泰生, 田澤大

日本癌治療学会学術集会抄録集 59回 SSY9 - 2 2021.10

肝内胆管癌におけるNeutrophil Extracellular Traps産生のための血小板の役割

吉本匡志, 香川俊介, 梶原義典, 藤智和, 菊池覚次, 黒田新士, 吉田龍一, 楳田祐三, 田澤大, 藤原俊義

日本癌治療学会学術集会抄録集 59回 O5 - 1 2021.10

胃癌腹膜播種に対する癌関連線維芽細胞を標的としたp53遺伝子治療

菊地覚次, 小川俊博, 田渕幹康, 光井恵麻, 宇根悠太, 田澤大, 黒田新士, 野間和広, 香川俊輔, 浦田泰生, 藤原俊義

日本癌治療学会学術集会抄録集 59回 O51 - 3 2021.10

生体肝移植ドナー肝切除成熟段階となった開腹手技

楳田祐三, 高木弘誠, 藤智和, 吉田一博, 安井和也, 熊野健二郎, 佐藤博紀, 吉田龍一, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S586 - S586 2021.10

Impact of lymph node dissection on clinical outcomes of intrahepatic cholangiocarcinoma: inverse probability of treatment weighting with survival analysis.

Yuzo Umeda, Toshiharu Mitsuhashi, Toru Kojima, Daisuke Satoh, Kenta Sui, Yoshikatsu Endo, Masaru Inagaki, Masahiro Oishi, Takahito Yagi, Toshiyoshi Fujiwara

Journal of hepato-biliary-pancreatic sciences 2021.9

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

BACKGROUND: Lymph node metastasis (LNM) has been established as a critical risk factor for prognosis in intrahepatic cholangiocarcinoma (ICC). The clinical implications of lymph-node dissection (LND) have been debated. This study aimed to clarify the prognostic impact of LND by multicenter-retrospective analysis. METHODS: A total of 310 ICC patients who had undergone curative resection between 2000 and 2016 were retrospectively analyzed. The prognostic impact of LND was estimated under an inverse probability of treatment weighting (IPTW) approach using propensity scores. RESULTS: LND was performed for 224 patients (72%), with LNM pathologically confirmed in 90 patients (40%). Prognosis was poorer for patients with LNM (median survival, 16.9 months) than for those without (57.2 months; p<0.0001). One-, 3-, and 5-year overall survival rates (OS) were comparable among the LND+ (81.6%, 48.0%, and 37.5%, respectively) and the LND- groups (81.6%, 55.4%, and 44.6%, respectively). However, advanced tumor, as characterized by larger tumor, multinodular lesions, and serosal invasion, was significantly more frequent in the LND+ group than in the LND- group. After IPTW adjusting for imbalances, 1-, 3-, and 5-year OS were better in the LND+ group (83.5%, 52.2%, and 42.8%, respectively) than in the LND- group (71.9%, 32.4%, and 23.4%, respectively; p=0.046). LND thus showed significant prognostic impact (hazard ratio = 0.58, 95%CI = |0.39|-|0.84|, p=0.005). Especially in hilar ICC, LND showed significant prognostic impact. However, peripheral ICC displayed no therapeutic benefit from LND. CONCLUSIONS: LND could have significant role to improve oncologic outcomes. Therapeutic LND should be implemented on the basis of tumor location and tumor advancement.

DOI： 10.1002/jhbp.1038

腫瘍融解アデノウイルスによる治療機序の次なる一手細胞外小胞を介して全身免疫賦活と局所細胞毒性を誘発するウイルス療法

垣内慶彦, 黒田新士, 金谷信彦, 公文剣斗, 津村朋子, 橋本将志, 八木千晶, 杉本龍馬, 濱田侑紀, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 80回 [IS1 - 6] 2021.9

Oncolytic virotherapy reverses chemoresistance in osteosarcoma by suppressing MDR1 expression. International journal

Kazuhisa Sugiu, Hiroshi Tazawa, Joe Hasei, Yasuaki Yamakawa, Toshinori Omori, Tadashi Komatsubara, Yusuke Mochizuki, Hiroya Kondo, Shuhei Osaki, Tomohiro Fujiwara, Aki Yoshida, Toshiyuki Kunisada, Koji Ueda, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancer chemotherapy and pharmacology 88 ( 3 ) 513 - 524 2021.9

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

BACKGROUND: Osteosarcoma (OS) is a malignant bone tumor primarily affecting children and adolescents. The prognosis of chemotherapy-refractory OS patients is poor. We developed a tumor suppressor p53-expressing oncolytic adenovirus (OBP-702) that exhibits antitumor effects against human OS cells. Here, we demonstrate the chemosensitizing effect of OBP-702 in human OS cells. MATERIALS AND METHODS: The in vitro and in vivo antitumor activities of doxorubicin (DOX) and OBP-702 were assessed using parental and DOX-resistant OS cells (U2OS, MNNG/HOS) and a DOX-resistant MNNG/HOS xenograft tumor model. RESULTS: DOX-resistant OS cells exhibited high multidrug resistant 1 (MDR1) expression, which was suppressed by OBP-702 or MDR1 siRNA, resulting in enhanced DOX-induced apoptosis. Compared to monotherapy, OBP-702 and DOX combination therapy significantly suppressed tumor growth in the DOX-resistant MNNG/HOS xenograft tumor model. CONCLUSION: Our results suggest that MDR1 is an attractive therapeutic target for chemoresistant OS. Tumor-specific virotherapy is thus a promising strategy for reversing chemoresistance in OS patients via suppression of MDR1 expression.

DOI： 10.1007/s00280-021-04310-5

Drug repositioningによる新規がん治療の開発に向けてがん関連線維芽細胞由来IL-6の作用と制御

國友知義, 野間和広, 西脇紀之, 河崎健人, 小林照貴, 菊地覚次, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 80回 [J13 - 3] 2021.9

これからのハイパーサーミアに向けた研究のトピックス同所性ヌードマウスモデルにおける腹膜播種に対する磁性体ナノ粒子を用いた温熱療法

松三雄騎, 香川哲也, 矢野修也, 田澤大, 重安邦俊, 武田正, 大原利章, 青野宏通, Hoffman Robert M., 藤原俊義, 岸本浩行

Thermal Medicine 37 ( Suppl. ) S7 - 2 2021.9

テロメラーゼ特異的腫瘍融解アデノウイルス製剤の免疫賦活剤としての有用性と抗PD-1抗体との相乗効果

橋本将志, 黒田新士, 金谷信彦, 津村朋子, 垣内慶彦, 菊地覚次, 田澤大, 香川俊輔, 浦田泰生, 藤原俊義

日本癌学会総会記事 80回 [IS10 - 6] 2021.9

大腸癌肝転移におけるRNA編集酵素ADAR1発現は肝転移切除後の残肝再発を予測するバイオマーカーになる

畑七々子, 重安邦俊, 高橋一剛, 梅田響, 武田正, 矢野修也, 楳田祐三, 田澤大, 藤原俊義

日本分子腫瘍マーカー研究会プログラム・講演抄録 41回 58 - 59 2021.9

高齢者大腸癌患者に対する周術期管理と術後化学療法の現況

寺石文則, 武田正, 矢野修也, 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 74 ( 9 ) A166 - A166 2021.9

80歳以上の高齢者食道癌症例に対する安全性と根治性を担保した外科治療戦略

松本聖, 野間和広, 前田直見, 田辺俊介, 櫻間教文, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 75回 124 - 124 2021.9

食道癌手術後再建方法の工夫下咽頭喉頭食道全摘における遊離空腸間置胃管再建の検討

松本洋, 太田智之, 野間和広, 田邊俊介, 前田直見, 白川靖博, 藤原俊義, 木股敬裕

日本食道学会学術集会プログラム・抄録集 75回 42 - 42 2021.9

食道癌術後再建胃管切除の諸問題と対策

白川靖博, 久保田哲史, 石田道拡, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 井谷史嗣, 藤原俊義

日本食道学会学術集会プログラム・抄録集 75回 230 - 230 2021.9

食道外科専門医取得のための各施設の取り組み食道外科専門医育成に向けた当院の取り組み

前田直見, 野間和広, 田辺俊介, 櫻間教文, 白川靖博, 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 75回 33 - 33 2021.9

食道良性疾患に対する外科的治療の創意工夫高齢者食道裂孔ヘルニアの安全でQOL改善に貢献する至適な腹腔鏡下根治術

田辺俊介, 野間和広, 前田直見, 櫻間教文, 西崎正彦, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 75回 27 - 27 2021.9

食道癌手術における合理的なリンパ節郭清食道切除における合理的な上縦隔郭清da Vinci導入により見えてきた新たなアプローチ

野間和広, 前田直見, 田辺俊介, 櫻間教文, 西崎正彦, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 75回 23 - 23 2021.9

食道胃接合部癌に対する外科治療食道胃接合部癌に対する至適術式と集学的治療に関する後方視的解析

田辺俊介, 野間和広, 前田直見, 櫻間教文, 西崎正彦, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 75回 5 - 5 2021.9

大腸癌肝転移におけるRNA編集酵素ADAR1発現は肝転移切除後の残肝再発を予測するバイオマーカーになる

畑七々子, 重安邦俊, 高橋一剛, 梅田響, 武田正, 矢野修也, 楳田祐三, 田澤大, 藤原俊義

日本分子腫瘍マーカー研究会プログラム・講演抄録 41回 58 - 59 2021.9

腸内細菌が誘導するRNA編集は炎症関連発癌におけるfield cancerizationを促進する

高橋一剛, 重安邦俊, 奥川喜永, 畑七々子, 梅田響, 武田正, 矢野修也, 香川俊輔, 藤原俊義

日本癌学会総会記事 80回 [IS6 - 6] 2021.9

これからのハイパーサーミアに向けた研究のトピックス同所性ヌードマウスモデルにおける腹膜播種に対する磁性体ナノ粒子を用いた温熱療法

松三雄騎, 香川哲也, 矢野修也, 田澤大, 重安邦俊, 武田正, 大原利章, 青野宏通, Hoffman Robert M., 藤原俊義, 岸本浩行

Thermal Medicine 37 ( Suppl. ) S7 - 2 2021.9

高齢者大腸癌患者に対する周術期管理と術後化学療法の現況

寺石文則, 武田正, 矢野修也, 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 74 ( 9 ) A166 - A166 2021.9

テロメラーゼ特異的腫瘍融解アデノウイルス製剤の免疫賦活剤としての有用性と抗PD-1抗体との相乗効果

橋本将志, 黒田新士, 金谷信彦, 津村朋子, 垣内慶彦, 菊地覚次, 田澤大, 香川俊輔, 浦田泰生, 藤原俊義

日本癌学会総会記事 80回 [IS10 - 6] 2021.9

肺転移能を有する骨肉腫細胞はM2様マクロファージへの分化を強力に誘導する

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 国定俊之, 尾崎敏文, 藤原俊義

日本癌学会総会記事 80回 [J14 - 4] 2021.9

膵臓癌の代謝サブタイプが腫瘍融解アデノウイルスに対する感受性を運命づける

庄司良平, 田澤大, 梶原義典, 李云成, 山田元彦, 井上弘章, 永井康雄, 菊地覚次, 黒田新士, 吉田龍一, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 80回 [P14 - 6] 2021.9

Drug repositioningによる新規がん治療の開発に向けてがん関連線維芽細胞由来IL-6の作用と制御

國友知義, 野間和広, 西脇紀之, 河崎健人, 小林照貴, 菊地覚次, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 80回 [J13 - 3] 2021.9

腫瘍溶解性ウイルスを介したp53遺伝子治療は胃癌腹膜播種に対する抗腫瘍効果を増強する

光井恵麻, 菊地覚次, 小川俊博, 田渕幹康, 宇根悠太, 田澤大, 黒田新士, 野間和広, 香川俊輔, 大塚旬子, 大木理恵子, 浦田泰生, 藤原俊義

日本癌学会総会記事 80回 [E14 - 1] 2021.9

Adult Bochdalek hernia following living donor left hepatectomy repaired by thoracoscopy-assisted surgery: A case report.

Kosei Takagi, Takashi Kuise, Kazuhiro Yoshida, Ryuichi Yoshida, Yuzo Umeda, Toshiyoshi Fujiwara, Takahito Yagi

Asian journal of endoscopic surgery 15 ( 1 ) 220 - 224 2021.8

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

Bochdalek hernia is a congenital diaphragmatic hernia (DH). Herein, we report a case of adult Bochdalek hernia following living donor hepatectomy repaired by thoracoscopy-assisted surgery. A 36-year-old man underwent living donor left hepatectomy. Four months later, the patient presented with acute epigastric pain. Computed tomography found the left-sided DH in which the stomach was incarcerated into the pleural cavity without ischemic changes. As endoscopic intervention was unsuccessful, the herniated stomach was repositioned by thoracoscopy-assisted surgery. The 3-cm hernia orifice was found to have a smooth edge with no hernia sac, suggesting Bochdalek hernia, and the defect was primarily closed. The patient was followed up for 20 months without hernia recurrence. This is the first presentation of a case of Bochdalek hernia following donor hepatectomy. In cases of early detected DH, primary repair via a transthoracic approach with thoracoscopy-assisted surgery is safe and feasible.

DOI： 10.1111/ases.12981

Robotic Radical Antegrade Modular Pancreatosplenectomy Using the Supracolic Anterior Superior Mesenteric Artery Approach. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 25 ( 11 ) 3015 - 3018 2021.8

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

BACKGROUND: Radical antegrade modular pancreatosplenectomy (RAMPS) is the standardized approach in open pancreatic resection for pancreatic body and tail cancer. However, few studies have described regarding robotic RAMPS for pancreatic cancer. We herein present our techniques of robotic RAMPS using the supracolic anterior superior mesenteric artery (SMA) approach with the ventral view. METHODS: The patient was a 75-year-old female with a diagnosis of pancreatic body cancer. Following neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel, robotic RAMPS was performed. Our techniques of robotic RAMPS include four steps: (1) gastrocolic ligament division, (2) dissection of superior and inferior border of the pancreas, (3) division of the pancreas, and (4) retroperitoneal dissection. RESULTS: The operative time was 251 min with an estimated blood loss of 10 mL. The uneventful postoperative course was observed. The final pathology confirmed R0 surgical resection. CONCLUSIONS: Robotic RAMPS using the supracolic anterior SMA approach is safe and feasible for pancreatic body and tail cancer. Standardization and precise anatomical knowledge are key elements of performing robotic RAMPS.

DOI： 10.1007/s11605-021-05112-z

膵・胆管合流異常に対する術後中長期的な経過観察の検討

熊野健二郎, 藤智和, 金平典之, 佐藤博紀, 高木弘誠, 安井和也, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義

日本膵・胆管合流異常研究会プロシーディングス 44 36 - 36 2021.8

先天性胆道拡張症術後46年目に発生し根治切除が可能であった肝門部胆管癌の1例

吉田龍一, 野田卓男, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 藤智和, 熊野健二郎, 高木弘誠, 金平典之, 納所洋, 谷本光隆, 八木孝仁, 藤原俊義

日本膵・胆管合流異常研究会プロシーディングス 44 42 - 43 2021.8

CSF1/CSF1R Signaling Inhibitor Pexidartinib (PLX3397) Reprograms Tumor-Associated Macrophages and Stimulates T-cell Infiltration in the Sarcoma Microenvironment. International journal

Tomohiro Fujiwara, Mohamed A Yakoub, Andrew Chandler, Alexander B Christ, Guangli Yang, Ouathek Ouerfelli, Vinagolu K Rajasekhar, Aki Yoshida, Hiroya Kondo, Toshiaki Hata, Hiroshi Tazawa, Yildirim Dogan, Malcolm A S Moore, Toshiyoshi Fujiwara, Toshifumi Ozaki, Ed Purdue, John H Healey

Molecular cancer therapeutics 20 ( 8 ) 1388 - 1399 2021.8

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

Colony-stimulating factor 1 (CSF1) is a primary regulator of the survival, proliferation, and differentiation of monocyte/macrophage that sustains the protumorigenic functions of tumor-associated macrophages (TAMs). Considering current advances in understanding the role of the inflammatory tumor microenvironment, targeting the components of the sarcoma microenvironment, such as TAMs, is a viable strategy. Here, we investigated the effect of PLX3397 (pexidartinib) as a potent inhibitor of the CSF1 receptor (CSF1R). PLX3397 was recently approved by the Food and Drug Administration (FDA) to treat tenosynovial giant cell tumor and reprogram TAMs whose infiltration correlates with unfavorable prognosis of sarcomas. First, we confirmed by cytokine arrays of tumor-conditioned media (TCM) that cytokines including CSF1 are secreted from LM8 osteosarcoma cells and NFSa fibrosarcoma cells. The TCM, like CSF1, stimulated ERK1/2 phosphorylation in bone marrow-derived macrophages (BMDMs), polarized BMDMs toward an M2 (TAM-like) phenotype, and strikingly promoted BMDM chemotaxis. In vitro administration of PLX3397 suppressed pERK1/2 stimulation by CSF1 or TCM, and reduced M2 polarization, survival, and chemotaxis in BMDMs. Systemic administration of PLX3397 to the osteosarcoma orthotopic xenograft model significantly suppressed the primary tumor growth and lung metastasis, and thus improved metastasis-free survival. PLX3397 treatment concurrently depleted TAMs and FOXP3+ regulatory T cells and, surprisingly, enhanced infiltration of CD8+ T cells into the microenvironments of both primary and metastatic osteosarcoma sites. Our preclinical results show that PLX3397 has strong macrophage- and T-cell-modulating effects that may translate into cancer immunotherapy for bone and soft-tissue sarcomas.

DOI： 10.1158/1535-7163.MCT-20-0591

Phase I dose-escalation study of endoscopic intratumoral injection of OBP-301 (Telomelysin) with radiotherapy in oesophageal cancer patients unfit for standard treatments. International journal

Yasuhiro Shirakawa, Hiroshi Tazawa, Shunsuke Tanabe, Nobuhiko Kanaya, Kazuhiro Noma, Takeshi Koujima, Hajime Kashima, Takuya Kato, Shinji Kuroda, Satoru Kikuchi, Shunsuke Kagawa, Kuniaki Katsui, Susumu Kanazawa, Yasuo Urata, Toshiyoshi Fujiwara

European journal of cancer (Oxford, England : 1990) 153 98 - 108 2021.8

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

PURPOSE: OBP-301 (Telomelysin) is an attenuated type-5 adenovirus that contains the human telomerase reverse transcriptase promoter to regulate viral replication. OBP-301 sensitises human cancer cells to ionising radiation by inhibiting DNA repair, and radiation enhances coxsackievirus and adenovirus receptor-mediated OBP-301 infection on the contrary. We assessed OBP-301 with radiotherapy in oesophageal cancer patients unfit for standard chemoradiation treatments. METHODS: A phase I dose-escalation study of OBP-301 with radiotherapy was conducted in 13 histologically confirmed oesophageal cancer patients deemed unfit to undergo surgery or chemotherapy. Study treatment consisted of OBP-301 administration by intratumoural needle injection using a flexible endoscope on days 1, 18 and 32. Radiotherapy was administered concurrently over 6 weeks, beginning on day 4, to a total of 60 Gy. RESULTS: Of the 13 patients, 7, 3 and 3 patients were treated with 1010, 1011 and 1012 virus particles, respectively. Study group comprised 10 males and 3 females, with a median age of 82 years (range, 53-91 years). All patients developed a transient, self-limited lymphopenia. Distribution studies revealed transient virus shedding in the plasma. Eight patients had local complete response (CR); all of them exhibited no pathologically viable malignant cells in biopsy specimens, and 3 patients had a partial response. The objective response rate was 91.7%. The clinical CR rate was 83.3% in stage I and 60.0% in stage II/III. Histopathological examination revealed massive infiltration of CD8+ cells and increased PD-L1 expression. CONCLUSION: Multiple courses of endoscopic intratumoural OBP-301 injection with radiotherapy are feasible and provide clinical benefits in patients with oesophageal cancer unfit for standard treatments.

DOI： 10.1016/j.ejca.2021.04.043

【分子標的治療の最前線】ウイルスによるがん治療食道がんに対するウイルス療法の現状と今後の展望

藤原俊義, 田澤大, 田辺俊介, 白川靖博

腫瘍内科 28 ( 2 ) 179 - 184 2021.8

Usefulness of Middle Colic Artery Transposition Technique for Hepatic Arterial Reconstruction in Conversion Surgery for an Initially Unresectable, Locally Advanced Pancreatic Cancer.

Ryuichi Yoshida, Takahito Yagi, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kosei Takagi, Kenjiro Kumano, Masashi Yoshimoto, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 4 ) 543 - 548 2021.8

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

The outcomes of pancreatectomy with resection and reconstruction of the involved arteries for locally advanced pancreatic cancer following chemotherapy have improved in recent years. In pancreatic head cancers in which there is contact with the common and proper hepatic arteries, margin-negative resection requires pancreati-coduodenectomy, with the resection of these arteries and the restoration of hepatic arterial flow. Here, we describe a middle colic artery transposition technique in hepatic arterial reconstruction during pancreatoduo-denectomy for an initially unresectable locally advanced pancreatic cancer. This technique was effective and may provide a new option for hepatic artery reconstruction in such cases.

DOI： 10.18926/AMO/62410

骨肉腫における腫瘍関連マクロファージの役割とin vitro実験による検証

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1556 - S1556 2021.8

Prediction of Early Recurrence After Surgery for Liver Tumor (ERASL): An International Validation of the ERASL Risk Models. International journal

Berend R Beumer, Kosei Takagi, Bastiaan Vervoort, Stefan Buettner, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Ewout W Steyerberg, Jan N M IJzermans

Annals of surgical oncology 28 ( 13 ) 8211 - 8220 2021.7

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

BACKGROUND: This study aimed to assess the performance of the pre- and postoperative early recurrence after surgery for liver tumor (ERASL) models at external validation. Prediction of early hepatocellular carcinoma (HCC) recurrence after resection is important for individualized surgical management. Recently, the preoperative (ERASL-pre) and postoperative (ERASL-post) risk models were proposed based on patients from Hong Kong. These models showed good performance although they have not been validated to date by an independent research group. METHODS: This international cohort study included 279 patients from the Netherlands and 392 patients from Japan. The patients underwent first-time resection and showed a diagnosis of HCC on pathology. Performance was assessed according to discrimination (concordance [C] statistic) and calibration (correspondence between observed and predicted risk) with recalibration in a Weibull model. RESULTS: The discriminatory power of both models was lower in the Netherlands than in Japan (C statistic, 0.57 [95% confidence interval {CI} 0.52-0.62] vs 0.69 [95% CI 0.65-0.73] for the ERASL-pre model and 0.62 [95% CI 0.57-0.67] vs 0.70 [95% CI 0.66-0.74] for the ERASL-post model), whereas their prognostic profiles were similar. The predictions of the ERASL models were systematically too optimistic for both cohorts. Recalibrated ERASL models improved local applicability for both cohorts. CONCLUSIONS: The discrimination of ERASL models was poorer for the Western patients than for the Japanese patients, who showed good performance. Recalibration of the models was performed, which improved the accuracy of predictions. However, in general, a model that explains the East-West difference or one tailored to Western patients still needs to be developed.

DOI： 10.1245/s10434-021-10235-3

Heterogeneous distribution of Fusobacterium nucleatum in the progression of colorectal cancer. International journal

Shumpei Yamamoto, Hideaki Kinugasa, Mami Hirai, Hiroyuki Terasawa, Eriko Yasutomi, Shohei Oka, Masayasu Ohmori, Yasushi Yamasaki, Toshihiro Inokuchi, Keita Harada, Sakiko Hiraoka, Kazuhiro Nouso, Takehiro Tanaka, Fuminori Teraishi, Toshiyoshi Fujiwara, Hiroyuki Okada

Journal of gastroenterology and hepatology 36 ( 7 ) 1869 - 1876 2021.7

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

BACKGROUND AND AIM: Fusobacterium nucleatum (Fn) is involved in colorectal cancer (CRC) growth and is a biomarker for patient prognosis and management. However, the ecology of Fn in CRC and the distribution of intratumoral Fn are unknown. METHODS: We evaluated Fn and the status of KRAS and BRAF in 200 colorectal neoplasms (118 adenomas and 82 cancers) and 149 matched adjacent normal mucosas. The differentiation status between "surface" and "deep" areas of cancer tissue and matched normal mucosa were analyzed in 46 surgical samples; the Ki-67 index was also evaluated in these samples. RESULTS: Fusobacterium nucleatum presence in the tumor increased according to pathological stage (5.9% [adenoma] to 81.8% [stage III/IV]), while Fn presence in normal mucosa also increased (7.6% [adenoma] to 40.9% [stage III/IV]). The detection rates of Fn on the tumor surface and in deep areas were 45.7% and 32.6%, while that of normal mucosa were 26.1% and 23.9%, respectively. Stage III/IV tumors showed high Fn surface area expression (66.7%). Fn intratumoral heterogeneity (34.8%) was higher than that of KRAS (4.3%; P < 0.001) and BRAF (2.2%; P < 0.001). The Ki-67 index in Fn-positive cases was higher than that in negative cases (93.9% vs 89.0%; P = 0.01). CONCLUSIONS: Fusobacterium nucleatum was strongly present in CRC superficial areas at stage III/IV. The presence of Fn in the deep areas of adjacent normal mucosa also increased. The intratumoral heterogeneity of Fn is important in the use of Fn as a biomarker, as Fn is associated with CRC proliferative capacity.

DOI： 10.1111/jgh.15361

肥満症に対する腹腔鏡下スリーブ状胃切除術の治療成績

香川俊輔, 黒田新士, 菊地覚次, 垣内慶彦, 寺石文則, 矢野修也, 吉田龍一, 楳田祐三, 野間和広, 藤原俊義

日本消化器外科学会総会 76回 P270 - 3 2021.7

高齢者胃癌に対する治療の工夫高齢者Stage IA胃癌の治療適応を考える

垣内慶彦, 菊地覚次, 黒田新士, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 WS10 - 6 2021.7

ロボット支援下観音開き法再建の手技上の有用性と注意点

黒田新士, 菊地覚次, 垣内慶彦, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P174 - 7 2021.7

Intracorporeal semi-hand-sewn Billroth I reconstruction in total laparoscopic distal gastrectomy.

Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Kazuya Kuwada, Nobuo Takata, Yoshihiko Kakiuchi, Shuya Yano, Kazuhiro Noma, Shunsuke Kagawa, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 14 ( 3 ) 640 - 643 2021.7

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

INTRODUCTION: Intracorporeal Billroth I (B-I) reconstruction using an endoscopic linear stapler (ELS) is widely performed in total laparoscopic distal gastrectomy. However, conventional procedures require many ELSs for anastomosis. Here, we introduce the novel intracorporeal semi-hand-sewn (SHS) B-I reconstruction. MATERIALS AND SURGICAL TECHNIQUE: After the transection of stomach and duodenum using ELS following adequate lymph node dissection, small entry holes were made on the anterior wall in the greater curvature of the stomach and the duodenal stump. The posterior walls of both the remnant stomach and the duodenum were attached with the ELS and fired to create the posterior wall of the B-I anastomosis. All the transection line of the duodenum and one-third of the transection line of the stomach were dissected; finally the anterior wall suturing at the anastomotic site was performed by the laparoscopic hand-sewn technique. DISCUSSION: SHS procedure was performed for 17 gastric cancer patients. There were no intraoperative complications or conversions to open surgery. One intra-abdominal abscess was observed although there was no anastomotic leakage. The median reconstruction time was 48 minutes (32-63). The SHS procedure was safe, feasible, and economical, although it requires sufficient laparoscopic suturing and ligation skill.

DOI： 10.1111/ases.12887

高度なHCCの治療を目的とする粒子線治療を先行させた肝移植

八木孝仁, 吉田龍一, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 杭瀬崇, 高木弘誠, 藤原俊義

日本消化器外科学会総会 76回 P143 - 6 2021.7

肥満症に対する腹腔鏡下スリーブ状胃切除術の治療成績

香川俊輔, 黒田新士, 菊地覚次, 垣内慶彦, 寺石文則, 矢野修也, 吉田龍一, 楳田祐三, 野間和広, 藤原俊義

日本消化器外科学会総会 76回 P270 - 3 2021.7

IBD治療における外科医の役割 Colitis-associated neoplasiaに対する早期治療介入を目指した診療科横断的連携の重要性

高橋一剛, 近藤喜太, 重安邦俊, 菊地覚次, 矢野修也, 黒田新士, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 O33 - 5 2021.7

スキルス胃癌の制圧に向けての進歩癌および癌関連線維芽細胞を標的とした胃癌腹膜播種の新規治療戦略

菊地覚次, 小川俊博, 田渕幹康, 光井恵麻, 黒田新士, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 WS8 - 1 2021.7

Frailな高齢者大腸癌患者に対する周術期管理チーム介入後のアウトカムの検証と最近の取り組み

寺石文則, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P233 - 7 2021.7

術前診断に苦慮した、稀な形態を呈した胃粘膜下腫瘍の治療経験

猿渡和也, 野間和広, 前田直見, 菊地覚次, 田邊俊介, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 P230 - 1 2021.7

Cadaverトレーニングの現状と課題岡山大学における過去8年のCSTの傾向から見たCSTプログラム作成における要点

近藤喜太, 前田直見, 黒田新士, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 PD1 - 1 2021.7

家庭運営と消化器外科医を両立するリーダーを育てる男性消化器外科医のワークライフバランス実現に向けて男性育休を取得した経験から

坂本真樹, 黒田新士, 菊地覚次, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 仁熊健文, 片岡正文, 藤原俊義

日本消化器外科学会総会 76回 WS1 - 5 2021.7

切除後再発時期・生存期間に着目した膵癌治療成績の検討今後の治療方向性を探る

安井和也, 吉田龍一, 佐藤博紀, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 4 2021.7

膵癌術後再発巣に対する局所療法の有用性の検討

佐藤博紀, 吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 3 2021.7

切除可能大腸癌肝転移に対する治療戦略大腸癌肝転移における術前化学療法の適応選別 RAS/RAF変異による肝外進展リスク

岡林弘樹, 楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 RS24 - 1 2021.7

胆管空腸吻合術後の難治性肝内結石症に対する治療経験

永井康雄, 杭瀬崇, 高木弘誠, 楳田祐三, 吉田龍一, 黒田新士, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P184 - 5 2021.7

ロボット支援下観音開き法再建の手技上の有用性と注意点

黒田新士, 菊地覚次, 垣内慶彦, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P174 - 7 2021.7

進行膵癌集学的治療における術前血中KRAS遺伝子変異の新規バイオマーカーとしての有用性に関する検討

吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 佐藤博紀, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P167 - 3 2021.7

T4食道癌への最適な治療Strategyの模索 cT4食道癌に対する導入療法後手術症例の検討

宇根悠太, 野間和広, 前田直見, 田邊俊介, 菊地覚次, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 RS17 - 4 2021.7

高齢者食道癌患者に対する治療戦略高齢者食道癌に対する包括的治療戦略

前田直見, 野間和広, 田辺俊介, 菊地覚次, 黒田新士, 櫻間教文, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 O21 - 3 2021.7

肝細胞癌治療における肝移植の役割肝癌肝移植の長期予後に向けて肝移植適応の選別と再発時治療

楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 WS20 - 6 2021.7

Pittsburgh styleによるロボット支援下膵頭十二指腸切除術術式の定型化と手技の工夫

高木弘誠, 楳田祐三, 吉田龍一, 吉田一博, 安井和也, 黒田新士, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P147 - 4 2021.7

高齢者胃癌に対する治療の工夫高齢者Stage IA胃癌の治療適応を考える

垣内慶彦, 菊地覚次, 黒田新士, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 WS10 - 6 2021.7

食道裂孔ヘルニア、逆流性食道炎に対する外科的治療法 80歳以上の高齢者に対する食道裂孔ヘルニア手術の安全性と有効性の検討

井上弘章, 野間和広, 前田直見, 菊池覚次, 田辺俊介, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 RS2 - 1 2021.7

局所進行直腸癌における術前FOLFOXIRIおよびCAPOX+RT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, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P010 - 2 2021.7

予後を左右する進行大腸癌再発形式の抽出と治療戦略の検討

重安邦俊, 矢野修也, 武田正, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P296 - 1 2021.7

高齢者に対する肝臓外科治療高齢者に対する肝切除術前評価における5-Item Modified Frailty Indexの有用性

吉田一博, 楳田祐三, 吉田龍一, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 PD5 - 3 2021.7

横行結腸癌手術におけるアプローチ法と至適郭清範囲横行結腸癌D3郭清範囲の明確化に発生由来の理解が、術式の定型化には大腸、胃、膵臓外科の融合が重要である

矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 黒田新士, 菊地覚次, 岸本浩行, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 76回 WS13 - 5 2021.7

【上部消化管・こんなときどうする?高難度手術手技をマスターしよう】食道残胃吻合(観音開き法)

黒田新士, 西崎正彦, 菊地覚次, 野間和広, 香川俊輔, 藤原俊義

消化器外科 44 ( 8 ) 1343 - 1351 2021.7

The treatment strategies for esophagogastric junction cancer Retrospective study of induction chemotherapy and surgery for esophagogastric junction cancer(和訳中)

Tanabe Shunsuke, Noma Kazuhiro, Maeda Naoaki, Kikuchi Satoru, Kuroda Shinji, Sakurama Kazufumi, Umeda Yuzo, Teraishi Fuminori, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本消化器外科学会総会 76回 SY4 - 4 2021.7

The progress of minimally invasive surgery for esophageal cancer Standardization of robotic-assisted thoracoscopic esophagectomy(和訳中)

Noma Kazuhiro, Maeda Naoaki, Kikuchi Satoru, Tanabe Shunsuke, Kuroda Shinji, Sakurama Kazufumi, Teraishi Fuminori, Umeda Yuzo, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本消化器外科学会総会 76回 SY3 - 6 2021.7

術後アミノ酸輸液投与による胃切除後体重・筋肉量減少抑制効果

梅田響, 菊地覚次, 藤原俊義

日本消化器外科学会総会 76回 S4 - 4 2021.7

【上部消化管・こんなときどうする?高難度手術手技をマスターしよう】食道残胃吻合(観音開き法)

黒田新士, 西崎正彦, 菊地覚次, 野間和広, 香川俊輔, 藤原俊義

消化器外科 44 ( 8 ) 1343 - 1351 2021.7

切除後再発時期・生存期間に着目した膵癌治療成績の検討今後の治療方向性を探る

安井和也, 吉田龍一, 佐藤博紀, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 4 2021.7

膵癌術後再発巣に対する局所療法の有用性の検討

佐藤博紀, 吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 3 2021.7

切除可能大腸癌肝転移に対する治療戦略大腸癌肝転移における術前化学療法の適応選別 RAS/RAF変異による肝外進展リスク

岡林弘樹, 楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 RS24 - 1 2021.7

進行膵癌集学的治療における術前血中KRAS遺伝子変異の新規バイオマーカーとしての有用性に関する検討

吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 佐藤博紀, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P167 - 3 2021.7

肝細胞癌治療における肝移植の役割肝癌肝移植の長期予後に向けて肝移植適応の選別と再発時治療

楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 WS20 - 6 2021.7

Pittsburgh styleによるロボット支援下膵頭十二指腸切除術術式の定型化と手技の工夫

高木弘誠, 楳田祐三, 吉田龍一, 吉田一博, 安井和也, 黒田新士, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P147 - 4 2021.7

高度なHCCの治療を目的とする粒子線治療を先行させた肝移植

八木孝仁, 吉田龍一, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 杭瀬崇, 高木弘誠, 藤原俊義

日本消化器外科学会総会 76回 P143 - 6 2021.7

高齢者に対する肝臓外科治療高齢者に対する肝切除術前評価における5-Item Modified Frailty Indexの有用性

吉田一博, 楳田祐三, 吉田龍一, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 PD5 - 3 2021.7

予後を左右する進行大腸癌再発形式の抽出と治療戦略の検討

重安邦俊, 矢野修也, 武田正, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P296 - 1 2021.7

局所進行直腸癌における術前FOLFOXIRIおよびCAPOX+RT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, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P010 - 2 2021.7

矢野修也, 重安邦俊, 近藤喜太, 寺石文則, 黒田新士, 菊地覚次, 岸本浩行, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 76回 WS13 - 5 2021.7

IBD治療における外科医の役割 Colitis-associated neoplasiaに対する早期治療介入を目指した診療科横断的連携の重要性

高橋一剛, 近藤喜太, 重安邦俊, 菊地覚次, 矢野修也, 黒田新士, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 O33 - 5 2021.7

Frailな高齢者大腸癌患者に対する周術期管理チーム介入後のアウトカムの検証と最近の取り組み

寺石文則, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P233 - 7 2021.7

家庭運営と消化器外科医を両立するリーダーを育てる男性消化器外科医のワークライフバランス実現に向けて男性育休を取得した経験から

坂本真樹, 黒田新士, 菊地覚次, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 仁熊健文, 片岡正文, 藤原俊義

日本消化器外科学会総会 76回 WS1 - 5 2021.7

Cadaverトレーニングの現状と課題岡山大学における過去8年のCSTの傾向から見たCSTプログラム作成における要点

近藤喜太, 前田直見, 黒田新士, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 PD1 - 1 2021.7

術前診断に苦慮した、稀な形態を呈した胃粘膜下腫瘍の治療経験

猿渡和也, 野間和広, 前田直見, 菊地覚次, 田邊俊介, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 P230 - 1 2021.7

高齢者食道癌患者に対する治療戦略高齢者食道癌に対する包括的治療戦略

前田直見, 野間和広, 田辺俊介, 菊地覚次, 黒田新士, 櫻間教文, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 O21 - 3 2021.7

食道裂孔ヘルニア、逆流性食道炎に対する外科的治療法 80歳以上の高齢者に対する食道裂孔ヘルニア手術の安全性と有効性の検討

井上弘章, 野間和広, 前田直見, 菊池覚次, 田辺俊介, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 RS2 - 1 2021.7

胆管空腸吻合術後の難治性肝内結石症に対する治療経験

永井康雄, 杭瀬崇, 高木弘誠, 楳田祐三, 吉田龍一, 黒田新士, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P184 - 5 2021.7

T4食道癌への最適な治療Strategyの模索 cT4食道癌に対する導入療法後手術症例の検討

宇根悠太, 野間和広, 前田直見, 田邊俊介, 菊地覚次, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 RS17 - 4 2021.7

Gastroenteropancreatic neuroendocrine tumor of the accessory papilla of the duodenum: a case report. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Hiroki Sato, Takahito Yagi, Toshiyoshi Fujiwara

Surgical case reports 7 ( 1 ) 156 - 156 2021.6

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

BACKGROUND: Contrary to the increasing incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), GEP-NETs of the accessory papilla of the duodenum are extremely rare. Furthermore, there have been no recommendations regarding the treatment strategy for GEP-NETs of the accessory papilla of the duodenum. We present a case of GEP-NET of the accessory papilla of the duodenum successfully treated with robotic pancreatoduodenectomy. CASE PRESENTATION: A case of a 70-year-old complaining of no symptoms was diagnosed with GEP-NET of the accessory papilla of the duodenum. A 8-mm tumor was located at the submucosal layer with a biopsy demonstrating a neuroendocrine tumor grade 1. The patient underwent robotic pancreatoduodenectomy as curative resection for the tumor. The total operative time was 406 min with an estimated blood loss of 150 mL. The histological examination revealed a well-differentiated neuroendocrine tumor with low Ki-67 index (< 1%). In the posterior areas of the pancreas, the lymph node metastases were detected. The patient was followed up for 6 months with no recurrence postoperatively. CONCLUSIONS: Considering the potential risks of the lymph node metastases, the standard treatment strategy for GEP-NETs of the accessory papilla of the duodenum should be radical resection with pancreatoduodenectomy. Minimally invasive approach can be the alternative to the conventional open surgery.

DOI： 10.1186/s40792-021-01241-4

ASO Visual Abstract: Prediction of Early Hepatocellular Carcinoma Recurrence After Resection-An International Validation of the ERASL Risk Models. International journal

Berend R Beumer, Kosei Takagi, Bastiaan Vervoort, Stefan Buettner, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Ewout W Steyerberg, Jan N M IJzermans

Annals of surgical oncology 28 ( Suppl 3 ) 505 - 506 2021.6

Immuno-hyperthermia effected by antibody-conjugated nanoparticles selectively targets and eradicates individual cancer cells. International journal

Tetsuya Kagawa, Yuki Matsumi, Hiromichi Aono, Toshiaki Ohara, Hiroshi Tazawa, Kunitoshi Shigeyasu, Shuya Yano, Sho Takeda, Yasuhiro Komatsu, Robert M Hoffman, Toshiyoshi Fujiwara, Hiroyuki Kishimoto

Cell cycle (Georgetown, Tex.) 20 ( 13 ) 1 - 11 2021.6

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

Hyperthermia has been used for cancer therapy for along period of time, but has shown limited clinical efficacy. Induction-heating hyperthermia using the combination of magnetic nanoparticles (MNPs) and an alternating magnetic field (AMF), termed magnetic hyperthermia (MHT), has previously shown efficacy in an orthotopic mouse model of disseminated gastric cancer. In the present study, superparamagnetic iron oxide nanoparticles (SPIONs), atype of MNP, were conjugated with an anti-HER2 antibody, trastuzumab and termed anti-HER2-antibody-linked SPION nanoparticles (anti-HER2 SPIONs). Anti-HER2 SPIONs selectively targeted HER2-expressing cancer cells co-cultured along with normal fibroblasts and HER2-negative cancer cells and caused apoptosis only in the HER2-expressing individual cancer cells. The results of the present study show proof-of-concept of anovel hyperthermia technology, immuno-MHT for selective cancer therapy, that targets individual cancer cells.AbbreviationsAMF:alternating magnetic fieldDDW:double distilled waterDMEM:Dulbecco's Modified Eagle's Mediumf:frequencyFBS:fetal bovine serumFITC:Fluorescein isothiocyanateGFP:green fluorescent proteinH:amplitudeHsp:heat shock proteinMHT:magnetic hyperthermiaMNPs:magnetic nanoparticlesPI:propidium iodideRFP:red fluorescent proteinSPION:superparamagnetic iron oxide (Fe3O4) nanoparticle.

DOI： 10.1080/15384101.2021.1915604

Preoperative prognostic nutritional index predicts postoperative infectious complications and oncological outcomes after hepatectomy in intrahepatic cholangiocarcinoma. International journal

Tatsuo Matsuda, Yuzo Umeda, Tadakazu Matsuda, Yoshikatsu Endo, Daisuke Sato, Toru Kojima, Kenta Sui, Masaru Inagaki, Tetsuya Ota, Masayoshi Hioki, Masahiro Oishi, Masashi Kimura, Toshihiro Murata, Nobuhiro Ishido, Takahito Yagi, Toshiyoshi Fujiwara

BMC cancer 21 ( 1 ) 708 - 708 2021.6

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

BACKGROUND: In the surgical treatment of intrahepatic cholangiocarcinoma (ICC), postoperative complications may be predictive of long-term survival. This study aimed to identify an immune-nutritional index (INI) that can be used for preoperative prediction of complications. PATIENTS AND METHODS: Multi-institutional data from 316 patients with ICC who had undergone surgical resection were retrospectively analysed, with a focus on various preoperative INIs. RESULTS: Severe complications (Clavien-Dindo grade III-V) were identified in 66 patients (20.8%), including Grade V complications in 7 patients (2.2%). Comparison of areas under the receiver operating characteristic curve (AUCs) among various INIs identified the prognostic nutritional index (PNI) as offering the highest predictive value for severe complications (AUC = 0.609, cut-off = 50, P = 0.008). Multivariate analysis revealed PNI < 50 (odds ratio [OR] = 2.22, P = 0.013), hilar lesion (OR = 2.46, P = 0.026), and long operation time (OR = 1.003, P = 0.029) as independent risk factors for severe complications. In comparing a high-PNI group (PNI ≥ 50, n = 142) and a low-PNI group (PNI < 50, n = 174), the low-PNI group showed higher rates of both major complications (27% vs. 13.4%; P = 0.003) and infectious complications (14.9% vs. 3.5%; P = 0.0021). Furthermore, median survival time and 1- and 5-year overall survival rates were 34.2 months and 77.4 and 33.8% in the low-PNI group, respectively, and 52.4 months and 89.3 and 47.5% in the high-PNI group, respectively (P = 0.0017). CONCLUSION: Preoperative PNI appears useful as an INI correlating with postoperative severe complications and as a prognostic indicator for ICC.

DOI： 10.1186/s12885-021-08424-0

Hyperthermia generated by magnetic nanoparticles for effective treatment of disseminated peritoneal cancer in an orthotopic nude-mouse model. International journal

Yuki Matsumi, Tetsuya Kagawa, Shuya Yano, Hiroshi Tazawa, Kunitoshi Shigeyasu, Sho Takeda, Toshiaki Ohara, Hiromichi Aono, Robert M Hoffman, Toshiyoshi Fujiwara, Hiroyuki Kishimoto

Cell cycle (Georgetown, Tex.) 20 ( 12 ) 1 - 12 2021.6

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

Magnetic hyperthermia (MHT), which combines magnetic nanoparticles (MNPs) with an alternating magnetic field (AMF), holds promise as a cancer therapy. There have been many studies about hyperthermia, most of which have been performed by direct injection of MNPs into tumor tissues. However, there have been no reports of treating peritoneal disseminated disease with MHT to date. In the present study, we treated peritoneal metastasis of gastric cancer with MHT using superparamagnetic iron oxide (Fe3O4) nanoparticle (SPION) coated with carboxydextran as an MNP, in an orthotopic mouse model mimicking early peritoneal disseminated disease of gastric cancer. SPIONs of an optimal size were intraperitoneally administered, and an AMF (390 kHz, 28 kAm-1) was applied for 10 minutes, four times every three days. Three weeks after the first MHT treatment, the peritoneal metastases were significantly inhibited compared with the AMF-alone group or the untreated-control group. The results of the present study show that MHT can be applied as a new treatment option for disseminated peritoneal gastric cancer.Abbreviations: AMF: alternating magnetic field; Cy1: cytology-positive; DMEM: Dulbecco's Modified Eagle's Medium; FBS: fetal bovine serum; H&E: hematoxylin and eosin; HIPEC: hyperthermic intraperitoneal chemotherapy; MEM: Minimum Essential Medium; MHT: magnetic hyperthermia; MNPs: magnetic nanoparticles; P0: macroscopic peritoneal dissemination; RFP: red fluorescent protein; SPION: superparamagnetic iron oxide (Fe3O4) nanoparticle.

DOI： 10.1080/15384101.2021.1919441

細胞外小胞がもたらす腫瘍融解アデノウイルス療法の全身性免疫賦活と局所細胞毒性

垣内慶彦, 黒田新士, 津村朋子, 橋本将志, 八木千晶, 杉本龍馬, 菊地覚次, 香川俊輔, 田澤大, 藤原俊義

日本DDS学会学術集会プログラム予稿集 37回 96 - 96 2021.6

消化管腫瘍に対する内視鏡治療、現況と展望食道癌に対する腫瘍融解ウイルス併用放射線療法の臨床研究高リスク症例の治療成績向上を目指して

田辺俊介, 野間和広, 田澤大, 白川靖博, 藤原俊義

日本消化器内視鏡学会中国支部例会 126回 32 - 32 2021.6

Accreditation as a qualified surgeon improves surgical outcomes in laparoscopic distal gastrectomy.

Satoru Kikuchi, Tetsuya Kagawa, Shinji Kuroda, Masahiko Nishizaki, Nobuo Takata, Kazuya Kuwada, Ryohei Shoji, Yoshihiko Kakiuchi, Toshiharu Mitsuhashi, Yuzo Umeda, Kazuhiro Noma, Shunsuke Kagawa, Toshiyoshi Fujiwara

Surgery today 51 ( 12 ) 1978 - 1984 2021.5

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

PURPOSE: The Endoscopic Surgical Skill Quantification System for qualified surgeons (QSs) was introduced in Japan to improve surgical outcomes. This study reviewed the surgical outcomes after initial experience performing laparoscopic distal gastrectomy (LDG) and evaluated the improvement in surgical outcomes following accreditation as a QS. METHODS: Eighty-seven consecutive patients who underwent LDG for gastric cancer by a single surgeon were enrolled in this study. The cumulative sum method was used to analyze the learning curve for LDG. The surgical outcomes were evaluated according to the two phases of the learning curve (learning period vs. mastery period) and accreditation (non-QS period vs. QS period). RESULTS: The learning period for LDG was 48 cases. Accreditation was approved at the 67th case. The operation time and estimated blood loss were significantly reduced in the QS period compared to the non-QS period (230 vs. 270 min, p < 0.001; 20.5 vs. 59.8 ml, p = 0.024, respectively). Furthermore, the major complication rate was significantly lower in the QS period than in the non-QS period (0 vs. 10.6%, p = 0.044). CONCLUSIONS: Experience performing approximately 50 cases is required to reach proficiency in LDG. After receiving accreditation as a QS, the surgical outcomes, including the complication rate, were improved.

DOI： 10.1007/s00595-021-02309-2

Clinical and epigenetic features of colorectal cancer patients with somatic POLE proofreading mutations. International journal

Takashi Kawai, Akihiro Nyuya, Yoshiko Mori, Takehiro Tanaka, Hiroaki Tanioka, Kazuya Yasui, Toshiaki Toshima, Fumitaka Taniguchi, Kunitoshi Shigeyasu, Yuzo Umeda, Toshiyoshi Fujiwara, Makoto Okawaki, Yoshiyuki Yamaguchi, Ajay Goel, Takeshi Nagasaka

Clinical epigenetics 13 ( 1 ) 117 - 117 2021.5

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

BACKGROUND: Mutations in the POLE gene result in an ultra-hypermutated phenotype in colorectal cancer (CRC); however, the molecular characterisation of epigenetic alterations remains unclear. We examined the genetic and epigenetic profiles of POLE-mutant CRC to elucidate the clinicopathological features of the associated genetic and epigenetic alterations. RESULTS: Tumour tissues (1,013) obtained from a cohort of patients with CRC were analysed to determine associations between the proofreading domain mutations of POLE with various clinicopathological variables, microsatellite instability (MSI) status, BRAF and KRAS mutations, and the methylation status of key regions of MLH1, MGMT, and SFRP2 promoters by calculating the methylation scores (range 0-6). Only four cases (0.4%) exhibited pathogenic POLE hotspot mutations (two p.P286R [c.857C > G], one p.V411L [c.1231G > C], and p.S459F [c.1376C > T] each), which were mutually exclusive to BRAF and KRAS mutations and MSI. CRC patients were divided into four subgroups: patients with POLE mutations (POLE, 0.4%, n = 4), patients with both MSI and extensive methylation in MLH1 (MSI-M, 2.9%, n = 29), patients with MSI but no extensive methylation in MLH1 (MSI-U, 3.6%, n = 36), and patients without MSI (non-MSI, 93.2%, n = 944). The POLE group was younger at diagnosis (median 52 years, P < 0.0001), with frequent right-sided tumour localisation (frequency of tumours located in the right colon was 100%, 93.1%, 36.1%, and 29.9% in POLE, MSI-M, MSI-U, and non-MSI, respectively; P < 0.0001), and was diagnosed at an earlier stage (frequency of stages I-II was 100%, 72.4%, 77.8%, and 46.6% in POLE, MSI-M, MSI-U, and non-MSI, respectively, P < 0.0001). The mean methylation score in POLE was not different from that in MSI-U and non-MSI, but the methylation signature was distinct from that of the other subgroups. Additionally, although the examined number of POLE-mutant tumours was small, the number of CD8-positive cells increased in tumours with partial methylation in the MLH1 gene. CONCLUSIONS: CRC patients with POLE proofreading mutations are rare. Such mutations are observed in younger individuals, and tumours are primarily located in the right colon. Diagnosis occurs at an earlier stage, and distinct epigenetic alterations may be associated with CD8 cell infiltration.

DOI： 10.1186/s13148-021-01104-7

Local oncolytic adenovirotherapy produces an abscopal effect via tumor-derived extracellular vesicles. International journal

Yoshihiko Kakiuchi, Shinji Kuroda, Nobuhiko Kanaya, Kento Kumon, Tomoko Tsumura, Masashi Hashimoto, Chiaki Yagi, Ryoma Sugimoto, Yuki Hamada, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Hiroshi Tazawa, Yasuo Urata, Toshiyoshi Fujiwara

Molecular therapy : the journal of the American Society of Gene Therapy 29 ( 10 ) 2920 - 2930 2021.5

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

Extracellular vesicles (EVs) play important roles in various intercellular communication processes. The abscopal effect is an interesting phenomenon in cancer treatment, in which immune activation is generally considered a main factor. We previously developed a telomerase-specific oncolytic adenovirus, Telomelysin (OBP-301), and occasionally observed therapeutic effects on distal tumors after local treatment in immunodeficient mice. Here, we hypothesized that EVs may be involved in the abscopal effect of OBP-301. EVs isolated from the supernatant of HCT116 human colon carcinoma cells treated with OBP-301 were confirmed to contain OBP-301, and showed cytotoxic activity (apoptosis and autophagy) similar to OBP-301. In bilateral subcutaneous HCT116 and CT26 tumor models, intratumoral administration of OBP-301 produced potent antitumor effects on tumors that were not directly treated with OBP-301, involving direct mediation by tumor-derived EVs containing OBP-301. This indicates that immune activation is not the main factor in this abscopal effect. Moreover, tumor-derived EVs exhibited high tumor tropism in orthotopic HCT116 rectal tumors, in which adenovirus E1A and adenovirus type 5 proteins were observed in metastatic liver tumors after localized rectal tumor treatment. In conclusion, local treatment with OBP-301 has the potential to produce abscopal effects via tumor-derived EVs.

DOI： 10.1016/j.ymthe.2021.05.015

SMAD4 Germline Pathogenic Variant-Related Gastric Juvenile Polyposis with Adenocarcinoma Treated with Laparoscopic Total Gastrectomy: A Case Report

Yuya Sakurai, Satoru Kikuchi, Kunitoshi Shigeyasu, Yoshihiko Kakiuchi, Takehiro Tanaka, Hibiki Umeda, Masaki Sakamoto, Sho Takeda, Shuya Yano, Mashu Futagawa, Fumino Kato, Reimi Sogawa, Hideki Yamamoto, Shinji Kuroda, Yoshitaka Kondo, Fuminori Teraishi, Hiroyuki Kishimoto, Masahiko Nishizaki, Shunsuke Kagawa, Akira Hirasawa, Toshiyoshi Fujiwara

American Journal of Case Reports 22 2021.5

Long-term survival without recurrence after surgery for gastric yolk sac tumor-like carcinoma: a case report. International journal

Hibiki Umeda, Satoru Kikuchi, Shinji Kuroda, Shuya Yano, Takehiro Tanaka, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Yuzo Umeda, Toshiyoshi Fujiwara

Surgical case reports 7 ( 1 ) 111 - 111 2021.5

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

BACKGROUND: Gastric yolk sac tumor (YST)-like carcinoma is extremely rare, and its prognosis is poor, because most patients have widespread metastases at the time of diagnosis. We report a case of gastric YST-like carcinoma with an adenocarcinoma component without metastases in which curative resection was performed. CASE PRESENTATION: A 77-year-old man complaining of melena and dizziness due to anemia was diagnosed with poorly differentiated adenocarcinoma in the gastric cardia, with a benign ulcer in the gastric body. He underwent total gastrectomy with D2 lymph node dissection for the tumor. Histological examination of the resected specimens revealed a mixture of reticular and glandular neoplastic components morphologically. In the reticular area, an endodermal sinus pattern and some Schiller-Duval bodies were confirmed. Gastric YST-like carcinoma with adenocarcinoma components, T2N0M0 Stage IB, was diagnosed. Immunohistochemical analysis showed that the YST was positive for carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and p53. In contrast, the adenocarcinoma was positive for p53 and negative for CEA and AFP. The patient remained healthy as of 7 years postoperatively, with no recurrence. CONCLUSIONS: Routine medical examinations or endoscopic examinations for accidental symptom may be helpful for early diagnosis and good prognosis for gastric YST-like carcinoma, although the prognosis is generally poor.

DOI： 10.1186/s40792-021-01199-3

Telomerase-specific oncolytic immunotherapy for promoting efficacy of PD-1 blockade in osteosarcoma. International journal

Yusuke Mochizuki, Hiroshi Tazawa, Koji Demiya, Miho Kure, Hiroya Kondo, Tadashi Komatsubara, Kazuhisa Sugiu, Joe Hasei, Aki Yoshida, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 70 ( 5 ) 1405 - 1417 2021.5

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

Immune checkpoint inhibitors including anti-programmed cell death 1 (PD-1) antibody have recently improved clinical outcome in certain cancer patients; however, osteosarcoma (OS) patients are refractory to PD-1 blockade. Oncolytic virotherapy has emerged as novel immunogenic therapy to augment antitumor immune response. We developed a telomerase-specific replication-competent oncolytic adenovirus OBP-502 that induces lytic cell death via binding to integrins. In this study, we assessed the combined effect of PD-1 blockade and OBP-502 in OS cells. The expression of coxsackie and adenovirus receptor (CAR), integrins αvβ3 and αvβ5, and programmed cell death ligand 1 (PD-L1) was analyzed in two murine OS cells (K7M2, NHOS). The cytopathic activity of OBP-502 in both cells was analyzed using the XTT assay. OBP-502-induced immunogenic cell death was assessed by analyzing the level of extracellular ATP and high-mobility group box protein B1 (HMGB1). Subcutaneous tumor models for K7M2 and NHOS cells were used to evaluate the antitumor effect and number of tumor-infiltrating CD8+ cells in combination therapy. K7M2 and NHOS cells showed high expression of integrins αvβ3 and αvβ5, but not CAR. OBP-502 significantly suppressed the viability of both cells, in which PD-L1 expression and the release of ATP and HMGB1 were significantly increased. Intratumoral injection of OBP-502 significantly augmented the efficacy of PD-1 blockade on subcutaneous K2M2 and NHOS tumor models via enhancement of tumor-infiltrating CD8+ T cells. Our results suggest that telomerase-specific oncolytic virotherapy is a promising antitumor strategy to promote the efficacy of PD-1 blockade in OS.

DOI： 10.1007/s00262-020-02774-7

Efficacy and safety of short-term (3 days) enoxaparin in preventing venous thromboembolism after gastric cancer surgery: A single-center, prospective cohort study. International journal

Shinji Kuroda, Satoru Kikuchi, Yoshihiko Kakiuchi, Megumi Watanabe, Kazuya Kuwada, Tomoko Tsumura, Masahiko Nishizaki, Shunsuke Kagawa, Shiro Hinotsu, Toshiyoshi Fujiwara

International journal of surgery (London, England) 89 105946 - 105946 2021.5

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

BACKGROUND: Pharmacologic prophylaxis such as enoxaparin for venous thromboembolism (VTE) is rarely used in Japan, even following abdominal cancer surgery, for which it is recommended in relevant guidelines (at least 7 days of use) along with mechanical prophylaxis with intermittent pneumatic compression. Reasons for enoxaparin's unpopularity include concerns over postoperative bleeding and its inconvenience in clinical practice. Here, we conducted a prospective clinical study of short-term (3 days) use of enoxaparin, which is considered to minimally impact postoperative management without increasing bleeding risk. METHODS: Gastric cancer patients who underwent gastrectomy received enoxaparin for 3 days from postoperative day (POD) 1-4. The primary endpoint was the incidence of deep vein thrombosis (DVT), which was examined primarily via Doppler ultrasonography of the lower limbs between POD 8 and 14. The planned sample size was 70, which was calculated based on an estimated incidence rate of 9% and an upper limit of incidence rate of 20%, with alpha of 0.05 and beta of 0.2. RESULTS: A total of 70 gastric cancer patients were enrolled, and ultimately, 68 patients received the protocol intervention and DVT evaluation. Sixty-seven patients completed 6 enoxaparin injections, but 1 patient did not complete the course due to abdominal bleeding after initiation. The incidence of DVT was 4.4% (3/68), and the 95% upper confidence interval was 12.2%, lower than the 20% threshold we set as the upper limit of DVT incidence. DVT was detected only in the peripheral veins of the lower extremities in all 3 affected patients. The incidence of bleeding-related complications, which were not severe, was 1.5% (1/68). CONCLUSIONS: Short-term (3 days) use of enoxaparin was shown to be effective and safe for VTE prophylaxis, comparable to regular use (at least 7 days), in postoperative management of gastric cancer surgery.

DOI： 10.1016/j.ijsu.2021.105946

【消化器癌;診断と治療のすべて】消化器癌の診断・病期分類・治療・成績食道癌外科治療と成績

野間和広, 田辺俊介, 藤原俊義

消化器外科 44 ( 6 ) 659 - 666 2021.5

肺癌と直腸癌の同時性重複癌にpembrolizumabが著効した1例

寺石文則, 岡凌也, 武田正, 高田暢夫, 重安邦俊, 菊地覚次, 矢野修也, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本大腸肛門病学会雑誌 74 ( 5 ) 346 - 346 2021.5

Dramatic Response to Carboplatin Plus Paclitaxel in Pancreatic Mucinous Cystadenocarcinoma with Liver Metastasis.

Naohiro Oda, Masahiro Tabata, Masatoshi Uno, Yuzo Umeda, Hironari Kato, Toshio Kubo, Satoru Senoo, Takahito Yagi, Toshiyoshi Fujiwara, Yoshinobu Maeda, Katsuyuki Kiura

Internal medicine (Tokyo, Japan) 60 ( 18 ) 2967 - 2971 2021.4

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

Mucinous cystic neoplasm (MCN) of the pancreas is a rare cystic tumor occurring in the pancreatic body and tail in young to middle-aged women that is pathologically characterized by an ovarian-like stroma. Chemotherapy for recurrent/advanced pancreatic MCN has been based on chemotherapy regimens for pancreatic ductal adenocarcinoma, but the prognosis is poor. We herein report a 37-year-old woman with pancreatic mucinous cystadenocarcinoma with liver metastasis that responded dramatically to carboplatin plus paclitaxel therapy (CBDCA + PTX). CBDCA + PTX may be a treatment option for recurrent/advanced pancreatic MCN with an ovarian-like stroma.

DOI： 10.2169/internalmedicine.6730-20

Long-term Survival with a Rare Advanced Primary Gastrointestinal Malignant Melanoma Treated with Laparoscopic Surgery/Immune Checkpoint Inhibitor.

Motochika Endo, Shuya Yano, Hiroaki Asano, Sho Takeda, Yuki Hamada, Yoshitaka Kondo, Shinji Kuroda, Kunitoshi Shigeyasu, Satoru Kikuchi, Takehiro Tanaka, Fuminori Teraishi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 2 ) 231 - 238 2021.4

Language：English

Targeted therapies for malignant melanoma have improved patients' prognoses. A primary gastrointestinal malignant melanoma is very rare, with no standard treatment strategy. We treated a 78-year-old Japanese female with advanced primary gastrointestinal melanoma of the descending colon and gallbladder. We administered a multidisciplinary treatment: surgical resection of the descending colon and gallbladder tumors, resection of the metastatic lymph nodes behind the pancreas head, and immune checkpoint antibody-blockade therapy (nivolumab) for ~4 years. PET/CT demonstrated no recurrent lesion for > 3 years. Multidisciplinary therapies (e.g., surgery, chemotherapy, radiotherapy, target therapy, and immune checkpoint antibody-blockade therapy) can successfully treat primary gastrointestinal malignant melanoma.

DOI： 10.18926/AMO/61906

Laparoscopic Hepatectomy for the Patient with Hemophilia A with High Titer Factor VIII Inhibitor.

Tatsuo Matsuda, Yuzo Umeda, Kazuhiro Yoshida, Tadakazu Matsuda, Masatoshi Uno, Masaya Abe, Noboru Asada, Yoshinobu Maeda, Takahito Yagi, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 2 ) 199 - 204 2021.4

Language：English

We present the first case of laparoscopic left lateral segmentectomy for hepatocellular carcinoma (HCC) in a patient with hemophilia A, acquired hepatitis C, and high-titer factor VIII inhibitor, which was confirmed by preoperative diagnosis. He underwent laparoscopic left lateral segmentectomy with the administration of recombinant activated factor VII. Surgery could be performed with reduced intraoperative hemorrhage. He experienced postoperative intra-abdominal wall hemorrhage, which was successfully managed with red cell concentrates transfusion and administration of recombinant activated factor VII. Laparoscopic hepatectomy can be applied for hemophilia patients with high titer inhibitors.

DOI： 10.18926/AMO/61901

食道癌におけるこだわりの手術手技従来の胸腔鏡下手術における上縦隔微細解剖コンセプトを応用したロボット支援下食道悪性腫瘍手術

白川靖博, 大下航, 久保田哲史, 矢野琢也, 石田道拡, 佐藤太佑, 丁田泰宏, 吉満政義, 中野敢友, 松川哲義, 井谷史嗣, 塩崎滋弘, 岡島正純, 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 121回 PD - 3 2021.4

pT3 or pN1以上の局所進行直腸癌に対する術前化学療法の有効性

武田正, 寺石文則, 遠藤福力, 濱田侑紀, 畑七々子, 高橋一剛, 小松泰浩, 三村直毅, 垣内慶彦, 重安邦俊, 菊地覚次, 矢野修也, 近藤喜太, 黒田新士, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 PS - 7 2021.4

再発直腸癌に対するICG蛍光ナビゲーション腹腔鏡下骨盤内臓全摘術

矢野修也, 近藤喜太, 重安邦俊, 寺石文則, 菊地覚次, 黒田新士, 濱田侑紀, 遠藤福力, 武田正, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 4 2021.4

転移に関わる上皮間葉移行を制御する薬剤スクリーニングシステムの開発と転移予防効果の検討

岡林弘樹, 田澤大, 家田偉史, 矢野修也, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 今村健志, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 3 2021.4

岡山大学外科GRAPESの活動とこれから

竹原裕子, 吉田龍一, 溝尾妙子, 剱持礼子, 小林純子, 新田薫, 工藤由里絵, 元木崇之, 片岡正文, 池田宏国, 菊池覚次, 黒田新士, 枝園忠彦, 山根正修, 小谷恭弘, 大澤晋, 土井原博義, 豊岡伸一, 笠原慎悟, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 5 2021.4

腫瘍組織浸潤T細胞は残胃癌の予後予測因子となりえる

垣内慶彦, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 4 2021.4

外科周術期管理におけるサルコペニア対策患者教育と栄養・運動強化プロトコールが胃癌術後体重減少に与える影響

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

日本外科学会定期学術集会抄録集 121回 PD - 5 2021.4

食道胃接合部癌に対する至適な手術術式 Siewert type I/II食道胃接合部癌に対する至適手術郭清から再建まで

野間和広, 赤井正明, 國友知義, 西脇紀之, 前田直見, 田邊俊介, 黒田新士, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SY - 3 2021.4

外科における多施設臨床試験の意義と方向性消化器外科における多施設共同研究の意義地方からのevidence発信を目指して

楳田祐三, 黒田新士, 香川俊輔, 吉田龍一, 菊池覚次, 杭瀬崇, 吉田一博, 高木弘誠, 安井和也, 西崎正彦, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 121回 NES - 4 2021.4

がん微小環境内のマクロファージ、好中球を癌の治療標的として解析する

香川俊輔, 吉本匡志, 伊藤雅典, 坂本修一, 桑田和也, 吉田龍一, 野間和広, 楳田祐三, 菊地覚次, 黒田新士, 矢野修也, 重安邦俊, 寺石文則, 田澤大, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SP - 1 2021.4

外科マネージメントセンターによる情熱のある外科医教育・育成システム

菊地覚次, 吉田龍一, 黒田新士, 野間和広, 安井和也, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SP - 6 2021.4

外科生涯教育におけるCSTの果たす役割

日本外科学会定期学術集会抄録集 121回 SP - 4 2021.4

外科マネージメントセンターによる情熱のある外科医教育・育成システム

菊地覚次, 吉田龍一, 黒田新士, 野間和広, 安井和也, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SP - 6 2021.4

A case of esophageal cancer with an aberrant right subclavian artery treated with mediastinoscopic esophagectomy.

Masashi Hashimoto, Yasuhiro Shirakawa, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 14 ( 2 ) 293 - 296 2021.4

Language：English

An aberrant right subclavian artery (ARSA) is one of the famous anatomical abnormalities with a prevalence of 0.16-4.4%. In esophagectomy, anatomical abnormalities of the ARSA could cause complications with some surgical procedures. An 85-year old man was referred to our department for esophageal adenocarcinoma that was at a slightly high position for esophagectomy with the abdominal approach. However, he had a significant past medical history. This risk factor made it difficult to perform thoracoscopic esophagectomy. He underwent mediastinoscopic esophagectomy (ME) with the left cervical and laparoscopic approach. The ARSA presented no difficulties with the ME surgical technique including the dissection of the left recurrent laryngeal nerve lymph node. Although this patient had a respiratory dysfunction and some difficulties in a prone position, ME enabled a safe esophagectomy with lymph node dissection.

DOI： 10.1111/ases.12859

pT3 or pN1以上の局所進行直腸癌に対する術前化学療法の有効性

日本外科学会定期学術集会抄録集 121回 PS - 7 2021.4

再発直腸癌に対するICG蛍光ナビゲーション腹腔鏡下骨盤内臓全摘術

矢野修也, 近藤喜太, 重安邦俊, 寺石文則, 菊地覚次, 黒田新士, 濱田侑紀, 遠藤福力, 武田正, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 4 2021.4

転移に関わる上皮間葉移行を制御する薬剤スクリーニングシステムの開発と転移予防効果の検討

岡林弘樹, 田澤大, 家田偉史, 矢野修也, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 今村健志, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 3 2021.4

腫瘍組織浸潤T細胞は残胃癌の予後予測因子となりえる

垣内慶彦, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 4 2021.4

食道癌手術周術期における心合併症の発生とリスク因子の解析

山田元彦, 野間和広, 西脇紀之, 前田直見, 田辺俊介, 菊地覚次, 櫻間教文, 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 121回 SF - 3 2021.4

外科周術期管理におけるサルコペニア対策患者教育と栄養・運動強化プロトコールが胃癌術後体重減少に与える影響

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

日本外科学会定期学術集会抄録集 121回 PD - 5 2021.4

がん微小環境内のマクロファージ、好中球を癌の治療標的として解析する

日本外科学会定期学術集会抄録集 121回 SP - 1 2021.4

外科生涯教育におけるCSTの果たす役割

日本外科学会定期学術集会抄録集 121回 SP - 4 2021.4

ハイリスク症例への大腸手術-いかに安全に行うか- ハイリスク高齢者大腸癌への周術期管理チーム介入による術後アウトカムの変化

寺石文則, 垣内慶彦, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 121回 WS - 8 2021.4

食道胃接合部癌に対する至適な手術術式 Siewert type I/II食道胃接合部癌に対する至適手術郭清から再建まで

野間和広, 赤井正明, 國友知義, 西脇紀之, 前田直見, 田邊俊介, 黒田新士, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SY - 3 2021.4

外科における多施設臨床試験の意義と方向性消化器外科における多施設共同研究の意義地方からのevidence発信を目指して

楳田祐三, 黒田新士, 香川俊輔, 吉田龍一, 菊池覚次, 杭瀬崇, 吉田一博, 高木弘誠, 安井和也, 西崎正彦, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 121回 NES - 4 2021.4

切除不能局所進行食道癌に対するDCFを軸にした集学的治療による根治への挑戦

田辺俊介, 野間和広, 國友知義, 前田直見, 櫻間教文, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 8 2021.4

ハイリスク食道癌手術症例に対する包括的治療戦略

前田直見, 野間和広, 國友知義, 田辺俊介, 櫻間教文, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 8 2021.4

T1/T2膵癌の術前治療適応に関する検討多施設共同後方視的研究

吉田龍一, 日置勝義, 須井健太, 佐藤太佑, 児島亨, 國府島健, 安井和也, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SF - 2 2021.4

Nanog is a promising chemo-resistant stemness marker and therapeutic target by iron chelators for esophageal cancer. International journal

Toru Narusaka, Toshiaki Ohara, Kazuhiro Noma, Noriyuki Nishiwaki, Yuki Katsura, Takuya Kato, Hiroaki Sato, Yasuko Tomono, Satoru Kikuchi, Hiroshi Tazawa, Yasuhiro Shirakawa, Akihiro Matsukawa, Toshiyoshi Fujiwara

International journal of cancer 149 ( 2 ) 347 - 357 2021.3

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

Esophageal cancer is a disease showing poor prognosis. Although combination chemotherapy using cisplatin and 5-fluorouracil is standard for unresectable esophageal cancer, the response rate is 35%. Cancer stem cells (CSCs) and inflammation are reportedly responsible for the poor prognosis of esophageal cancer. However, comprehensive analyses have not been conducted and proposals for progress remain lacking. Iron is known to be a key factor in the stemness of CSCs. This study focused on the therapeutic potential of iron control using iron chelators for CSCs in esophageal cancer. Among 134 immunohistochemically analyzed cases, Nanog expression was high in 98 cases and low in 36 cases. High Nanog expression correlated with low overall and disease-free survivals. The iron chelators deferasirox (DFX) and SP10 suppressed the proliferation and expression of stemness markers in TE8 and OE33 cells. DFX and SP10 did not induce compensatory interleukin (IL)-6 secretion, although cisplatin did result in high induction. Moreover, BBI608 and SSZ, as other CSC-targeting drugs, could not suppress the expression of stemness markers. Together, Nanog expression appears related to poor prognosis in esophageal cancer patients, and inhibition of stemness and compensatory IL-6 secretion by iron chelators may offer a novel therapeutic strategy for esophageal cancer.

DOI： 10.1002/ijc.33544

Role of Tumor-Associated Macrophages in Sarcomas. International journal

Tomohiro Fujiwara, John Healey, Koichi Ogura, Aki Yoshida, Hiroya Kondo, Toshiaki Hata, Miho Kure, Hiroshi Tazawa, Eiji Nakata, Toshiyuki Kunisada, Toshiyoshi Fujiwara, Toshifumi Ozaki

Cancers 13 ( 5 ) 2021.3

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

Sarcomas are complex tissues in which sarcoma cells maintain intricate interactions with their tumor microenvironment. Tumor-associated macrophages (TAMs) are a major component of tumor-infiltrating immune cells in the tumor microenvironment and have a dominant role as orchestrators of tumor-related inflammation. TAMs promote tumor growth and metastasis, stimulate angiogenesis, mediate immune suppression, and limit the antitumor activity of conventional chemotherapy and radiotherapy. Evidence suggests that the increased infiltration of TAMs and elevated expression of macrophage-related genes are associated with poor prognoses in most solid tumors, whereas evidence of this in sarcomas is limited. Based on these findings, TAM-targeted therapeutic strategies, such as inhibition of CSF-1/CSF-1R, CCL2/CCR2, and CD47/SIRPα, have been developed and are currently being evaluated in clinical trials. While most of the therapeutic challenges that target sarcoma cells have been unsuccessful and the prognosis of sarcomas has plateaued since the 1990s, several clinical trials of these strategies have yielded promising results and warrant further investigation to determine their translational benefit in sarcoma patients. This review summarizes the roles of TAMs in sarcomas and provides a rationale and update of TAM-targeted therapy as a novel treatment approach for sarcomas.

DOI： 10.3390/cancers13051086

【胆膵領域のロボット支援下手術:ベストプラックティスを求めて】海外におけるロボット支援下膵頭十二指腸切除の現状

胃癌治療における栄養治療戦略患者教育プログラムが胃癌術後の体および骨格筋量の変化に及ぼす影響(Effect of patient education protocol on body weight and skeletal muscle reduction after gastrectomy)

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

日本胃癌学会総会記事 93回 216 - 216 2021.3

観音開き法再建の技術的進化更なる患者QOLの向上を目指して(Technical evolution of the double-flap reconstruction for further improvement of patient's QOL)

黒田新士, 西崎正彦, 菊地寛次, 垣内慶彦, 武田正, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 93回 300 - 300 2021.3

高木弘誠, 楳田祐三, 吉田龍一, 八木孝仁, 藤原俊義

胆と膵 42 ( 3 ) 217 - 221 2021.3

Language：Japanese Publisher：医学図書出版(株)

近年、内視鏡手術は肝胆膵外科領域で急速に普及しつつあり、高難度手術の膵頭十二指腸切除術においても腹腔鏡手術が定着し今後はロボット支援下手術への展開が期待されている。一方、欧米では、世界に先駆けてロボット支援下膵切除が導入され、とくに膵頭部領域の良性・悪性疾患に対するロボット支援下膵頭十二指腸切除(robotic pancreatoduodenectomy:RPD)は、その安全性と有効性の報告とともに、近年は腹腔鏡手術を凌駕して増加傾向にある。本邦においてもロボット支援下膵切除術が保険収載されたが、RPDの安全な導入には、肝胆膵外科手術の豊富な経験に加え、ロボット支援下手術の特性に精通する必要があるため、術前の系統的トレーニングが重要である。海外におけるわれわれの経験を基に、RPDの現状、トレーニングシステム、手術成績に関して報告する。(著者抄録)

【「課題解決型医療人養成プログラム「国内初の、肝移植を担う医療人養成-6大学連携プログラム-」の成果」】SNUC-LT Program外科履修生の成果と課題、キャリアパス形成

高木弘誠, 杭瀬崇, 楳田祐三, 藤原俊義, 八木孝仁

移植 55 ( 4 ) 361 - 369 2021.3

食道疾患に対する低侵襲手術(Current status and perspective of minimally invasive surgery for esophageal cancer)

Shirakawa Yasuhiro, Noma Kazuhiro, Tanabe Shunsuke, Maeda Naoaki, Kawasaki Kento, Kunitomo Tomoyoshi, Nishie Naoki, Yamada Motohiko, Kikuchi Satoru, Kuroda Shinji, Nishizaki Masahiko, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本内視鏡外科学会雑誌 25 ( 7 ) SY6 - 5 2021.3

術前療法が直腸癌鏡視下手術に与える短期、長期治療成績の検討

武田正, 畑七々子, 高橋一剛, 小松泰浩, 三村直毅, 垣内慶彦, 重安邦俊, 菊地覚次, 矢野修也, 近藤喜太, 黒田新士, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) DP77 - 3 2021.3

腹腔鏡下胃全摘術および噴門側胃切除術における再建法腹腔鏡下噴門側胃切除術における観音開き法食道残胃吻合

西崎正彦, 黒田新士, 菊地覚次, 垣内慶彦, 香川俊輔, 前田直見, 田邊俊介, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) SY12 - 3 2021.3

カダバーサージカルトレーニングにおける遠隔手術指導の実際

近藤喜太, 前田直見, 菊地覚次, 矢野修也, 黒田新士, 野間和弘, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) BSP4 - 4 2021.3

岡山大学における消化器外科領域鏡視下カダバートレーニングの現状と未来

近藤喜太, 前田直見, 黒田新士, 楳田祐三, 矢野修也, 菊地覚次, 田辺俊介, 野間和広, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) SP9 - 1 2021.3

観音開き法再建の技術的進化更なる患者QOLの向上を目指して(Technical evolution of the double-flap reconstruction for further improvement of patient's QOL)

黒田新士, 西崎正彦, 菊地寛次, 垣内慶彦, 武田正, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 93回 300 - 300 2021.3

進行・再発胃癌に対するNivolumabの実臨床での治療成績(Clinical Outcome of Nivolumab for Advanced or Recurrent Gastric Cancer)

香川俊輔, 黒田新士, 菊地覚次, 西崎正彦, 野間和広, 田辺俊介, 重安邦俊, 前田直見, 垣内慶彦, 武田正, 近藤喜太, 矢野修也, 寺石文則, 藤原俊義

日本胃癌学会総会記事 93回 284 - 284 2021.3

癌細胞および癌関連線維芽細胞を標的とした腹腔内ウイルス療法(Intraperitoneal oncolytic virotherapy targeting cancer cells and cancer-associated fibroblasts)

菊地覚次, 小川俊博, 田渕幹康, 黒田新士, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 93回 246 - 246 2021.3

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

日本胃癌学会総会記事 93回 216 - 216 2021.3

Minimally invasive approach for gastric SMT depending on the characteristics of tumor(和訳中)

Kikuchi Satoru, Nishizaki Masahiko, Kuroda Shinji, Takata Nobuhiko, Takeda Sho, Kakiuchi Yoshihiko, Sugimoto Ryoma, Kagawa Shunsuke, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本内視鏡外科学会雑誌 25 ( 7 ) OS55 - 6 2021.3

胃癌に対する内視鏡外科手術手技の工夫(Present position and future possibility of the double-flap reconstruction after proximal gastrectomy)

Kuroda Shinji, Nishizaki Masahiko, Choda Yasuhiro, Ishida Michihiro, Muraoka Atsushi, Tanaka Norimitsu, Hato Shinji, Kikuchi Satoru, Takata Nobuo, Kakiuchi Yoshihiko, Tanabe Shunsuke, Noma Kazuhiro, Kagawa Shunsuke, Shirakawa Yasuhiro, Kamikawa Yasuaki, Fujiwara Toshiyoshi

日本内視鏡外科学会雑誌 25 ( 7 ) WS33 - 7 2021.3

進行・再発胃癌に対するNivolumabの実臨床での治療成績(Clinical Outcome of Nivolumab for Advanced or Recurrent Gastric Cancer)

香川俊輔, 黒田新士, 菊地覚次, 西崎正彦, 野間和広, 田辺俊介, 重安邦俊, 前田直見, 垣内慶彦, 武田正, 近藤喜太, 矢野修也, 寺石文則, 藤原俊義

日本胃癌学会総会記事 93回 284 - 284 2021.3

術前療法が直腸癌鏡視下手術に与える短期、長期治療成績の検討

日本内視鏡外科学会雑誌 25 ( 7 ) DP77 - 3 2021.3

カダバーサージカルトレーニングにおける遠隔手術指導の実際

近藤喜太, 前田直見, 菊地覚次, 矢野修也, 黒田新士, 野間和弘, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) BSP4 - 4 2021.3

岡山大学における消化器外科領域鏡視下カダバートレーニングの現状と未来

近藤喜太, 前田直見, 黒田新士, 楳田祐三, 矢野修也, 菊地覚次, 田辺俊介, 野間和広, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 25 ( 7 ) SP9 - 1 2021.3

Surgical training model and safe implementation of robotic pancreatoduodenectomy in Japan: a technical note. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara, Amer H Zureikat, Melissa E Hogg, Bas Groot Koerkamp

World journal of surgical oncology 19 ( 1 ) 55 - 55 2021.2

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

BACKGROUND: Growing evidence for the advantages of robotic pancreatoduodenectomy (RPD) has been demonstrated internationally. However, there has been no structured training program for RPD in Japan. Herein, we present the surgical training model of RPD and a standardized protocol for surgical technique. METHODS: The surgical training model and surgical technique were standardized in order to implement RPD safely, based on the Dutch training system collaborated with the University of Pittsburgh Medical Center. RESULTS: The surgical training model included various trainings such as basic robotic training, simulation training, biotissue training, and a surgical video review. Furthermore, a standardized protocol on the surgical technique was established to understand the tips, tricks, and pitfalls of RPD. CONCLUSIONS: Safe implementation of RPD can be achieved through the completion of a structured training program and learning surgical technique. A nationwide structured training system should be developed to implement the program safely in Japan.

DOI： 10.1186/s12957-021-02167-9

Targeting neutrophil extracellular traps with thrombomodulin prevents pancreatic cancer metastasis. International journal

Hiroki Kajioka, Shunsuke Kagawa, Atene Ito, Masashi Yoshimoto, Shuichi Sakamoto, Satoru Kikuchi, Shinji Kuroda, Ryuichi Yoshida, Yuzo Umeda, Kazuhiro Noma, Hiroshi Tazawa, Toshiyoshi Fujiwara

Cancer letters 497 1 - 13 2021.1

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

Surgery is the only curative treatment option for pancreatic cancer, but patients often develop postoperative recurrence. Surgical invasiveness might be involved in the mechanism of recurrence. The associations among inflammation caused by surgery, neutrophils, and cancer metastasis were investigated. At first, neutrophil extracellular traps (NETs) were examined in clinical specimens, and NETs were observed around metastatic tumors. To explore how NETs were induced, neutrophils were cultured with pancreatic cancer or in cancer-conditioned medium. Neutrophils formed NETs when they were cultured with pancreatic cancer or even its conditioned medium. The effects of NETs on cancer cells were further investigated in vitro and in vivo. NETs induced the epithelial to mesenchymal transition in cancer cells and thereby promoted their migration and invasion. HMGB1 derived from NETs appeared to potentiate the malignancy of cancer cells. In a mouse model of liver metastasis with inflammation, NETs participated in the metastatic process by enhancing extravasation. Interestingly, thrombomodulin degraded HMGB1 and consequently inhibited the induction of NETs, thereby preventing pancreatic cancer metastasis to the liver. In conclusion, NETs interact reciprocally with pancreatic cancer cells, which play a pivotal role in inflammation-associated metastasis. Targeting NETs with thrombomodulin can be a novel strategy to improve the surgical outcome of pancreatic cancer patients.

DOI： 10.1016/j.canlet.2020.10.015

Extracellular vesicles shed from gastric cancer mediate protumor macrophage differentiation. International journal

Atene Ito, Shunsuke Kagawa, Shuichi Sakamoto, Kazuya Kuwada, Hiroki Kajioka, Masashi Yoshimoto, Satoru Kikuchi, Shinji Kuroda, Ryuichi Yoshida, Hiroshi Tazawa, Toshiyoshi Fujiwara

BMC cancer 21 ( 1 ) 102 - 102 2021.1

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

BACKGROUND: Peritoneal dissemination often develops in gastric cancer. Tumor-associated macrophages (TAMs) are present in the peritoneal cavity of gastric cancer patients with peritoneal dissemination, facilitating tumor progression. However, the mechanism by which macrophages differentiate into tumor-associated macrophages in the peritoneal cavity is not well understood. In this study, the interplay between gastric cancer-derived extracellular vesicles (EVs) and macrophages was investigated. METHODS: The association between macrophages and EVs in peritoneal ascitic fluid of gastric cancer patients, or from gastric cancer cell lines was examined, and their roles in differentiation of macrophages and potentiation of the malignancy of gastric cancer were further explored. RESULTS: Immunofluorescent assays of the ascitic fluid showed that M2 macrophages were predominant along with the cancer cells in the peritoneal cavity. EVs purified from gastric cancer cells, as well as malignant ascitic fluid, differentiated peripheral blood mononuclear cell-derived macrophages into the M2-like phenotype, which was demonstrated by their morphology and expression of CD163/206. The macrophages differentiated by gastric cancer-derived EVs promoted the migration ability of gastric cancer cells, and the EVs carried STAT3 protein. CONCLUSION: EVs derived from gastric cancer play a role by affecting macrophage phenotypes, suggesting that this may be a part of the underlying mechanism that forms the intraperitoneal cancer microenvironment.

DOI： 10.1186/s12885-021-07816-6

Fibroblast activation protein targeted near infrared photoimmunotherapy (NIR PIT) overcomes therapeutic resistance in human esophageal cancer. International journal

Ryoichi Katsube, Kazuhiro Noma, Toshiaki Ohara, Noriyuki Nishiwaki, Teruki Kobayashi, Satoshi Komoto, Hiroaki Sato, Hajime Kashima, Takuya Kato, Satoru Kikuchi, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Hisataka Kobayashi, Toshiyoshi Fujiwara

Scientific reports 11 ( 1 ) 1693 - 1693 2021.1

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

Cancer-associated fibroblasts (CAFs) have an important role in the tumor microenvironment. CAFs have the multifunctionality which strongly support cancer progression and the acquisition of therapeutic resistance by cancer cells. Near-infrared photoimmunotherapy (NIR-PIT) is a novel cancer treatment that uses a highly selective monoclonal antibody (mAb)-photosensitizer conjugate. We developed fibroblast activation protein (FAP)-targeted NIR-PIT, in which IR700 was conjugated to a FAP-specific antibody to target CAFs (CAFs-targeted NIR-PIT: CAFs-PIT). Thus, we hypothesized that the control of CAFs could overcome the resistance to conventional chemotherapy in esophageal cancer (EC). In this study, we evaluated whether EC cell acquisition of stronger malignant characteristics and refractoriness to chemoradiotherapy are mediated by CAFs. Next, we assessed whether the resistance could be rescued by eliminating CAF stimulation by CAFs-PIT in vitro and in vivo. Cancer cells acquired chemoradiotherapy resistance via CAF stimulation in vitro and 5-fluorouracil (FU) resistance in CAF-coinoculated tumor models in vivo. CAF stimulation promoted the migration/invasion of cancer cells and a stem-like phenotype in vitro, which were rescued by elimination of CAF stimulation. CAFs-PIT had a highly selective effect on CAFs in vitro. Finally, CAF elimination by CAFs-PIT in vivo demonstrated that the combination of 5-FU and NIR-PIT succeeded in producing 70.9% tumor reduction, while 5-FU alone achieved only 13.3% reduction, suggesting the recovery of 5-FU sensitivity in CAF-rich tumors. In conclusion, CAFs-PIT could overcome therapeutic resistance via CAF elimination. The combined use of novel targeted CAFs-PIT with conventional anticancer treatments can be expected to provide a more effective and sensible treatment strategy.

DOI： 10.1038/s41598-021-81465-4

Real-Time Fluorescence Image-Guided Oncolytic Virotherapy for Precise Cancer Treatment. International journal

Shuya Yano, Hiroshi Tazawa, Hiroyuki Kishimoto, Shunsuke Kagawa, Toshiyoshi Fujiwara, Robert M Hoffman

International journal of molecular sciences 22 ( 2 ) 2021.1

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

Oncolytic virotherapy is one of the most promising, emerging cancer therapeutics. We generated three types of telomerase-specific replication-competent oncolytic adenovirus: OBP-301; a green fluorescent protein (GFP)-expressing adenovirus, OBP-401; and Killer-Red-armed OBP-301. These oncolytic adenoviruses are driven by the human telomerase reverse transcriptase (hTERT) promoter; therefore, they conditionally replicate preferentially in cancer cells. Fluorescence imaging enables visualization of invasion and metastasis in vivo at the subcellular level; including molecular dynamics of cancer cells, resulting in greater precision therapy. In the present review, we focused on fluorescence imaging applications to develop precision targeting for oncolytic virotherapy. Cell-cycle imaging with the fluorescence ubiquitination cell cycle indicator (FUCCI) demonstrated that combination therapy of an oncolytic adenovirus and a cytotoxic agent could precisely target quiescent, chemoresistant cancer stem cells (CSCs) based on decoying the cancer cells to cycle to S-phase by viral treatment, thereby rendering them chemosensitive. Non-invasive fluorescence imaging demonstrated that complete tumor resection with a precise margin, preservation of function, and prevention of distant metastasis, was achieved with fluorescence-guided surgery (FGS) with a GFP-reporter adenovirus. A combination of fluorescence imaging and laser ablation using a KillerRed-protein reporter adenovirus resulted in effective photodynamic cancer therapy (PDT). Thus, imaging technology and the designer oncolytic adenoviruses may have clinical potential for precise cancer targeting by indicating the optimal time for administering therapeutic agents; accurate surgical guidance for complete resection of tumors; and precise targeted cancer-specific photosensitization.

DOI： 10.3390/ijms22020879

Prognostic Utility of the Glasgow Prognostic Score for the Long-Term Outcomes After Liver Resection for Intrahepatic Cholangiocarcinoma: A Multi-institutional Study. International journal

Kenta Sui, Takehiro Okabayashi, Yuzo Umeda, Masahiro Oishi, Toru Kojima, Daisuke Sato, Yoshikatsu Endo, Tetsuya Ota, Katsuyoshi Hioki, Masaru Inagaki, Tadakazu Matsuda, Ryuji Hirai, Masashi Kimura, Takahito Yagi, Toshiyoshi Fujiwara

World journal of surgery 45 ( 1 ) 279 - 290 2021.1

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

OBJECTIVE: The usefulness of the modified Glasgow prognostic score (GPS) as a prognostic tool remains unclear for patients undergoing curative surgery for intrahepatic cholangiocarcinoma (ICC). Therefore, this study investigated the prognostic usefulness of the GPS for patients who underwent ICC surgery. METHOD: All ICC patients who had a curative-intent hepatectomy at 17 institutions between 2000 and 2016 were included. The correlation was assessed between the preoperative GPS and the baseline characteristics of the patients, histopathological parameters, surgical parameters, and the postresection overall survival (OS). RESULT: There were 273 patients who met the eligibility criteria between the years 2000 and 2016. The postoperative OS rates at 1, 3, and 5 years were 83.8%, 56.3%, and 41.5%, respectively (median OS, 47.7 months). A multivariate analysis revealed the factors that were associated with a worse OS, which included an increased GPS (hazard ratio = 1.62; 95% confidence interval [CI]: 1.01-2.53; P = 0.03), an elevated carcinoembryonic antigen level (hazard ratio = 1.60; 95% CI: 1.06-2.41; P = 0.02), an elevated carbohydrate antigen 19-9 level (hazard ratio = 1.55; 95% CI: 1.05-2.30; P = 0.03), undifferentiated carcinoma (hazard ratio = 2.41; 95% CI: 1.56-3.67; P < 0.01), and positive metastasis to the lymph nodes (hazard ratio = 2.54; 95% CI: 1.76-3.67; P < 0.01). In ICC patients after a hepatectomy, an elevated GPS was associated with poorer OS, even if the tumour factors that affected GPS were eliminated by propensity-score matching. CONCLUSION: Preoperative GPS can be useful to predict the postoperative outcomes of ICC patients. Therefore, this relatively simple and inexpensive scoring system can be utilized to further refine patient stratification as well as to predict survival.

DOI： 10.1007/s00268-020-05797-4

【消化器・一般外科領域の手術教育を考える】総論手術教育における手術記録の活用法

楳田祐三, 杭瀬崇, 吉田龍一, 吉田一博, 藤原俊義, 八木孝仁

手術 75 ( 1 ) 43 - 53 2021.1

【徹底解説術後後遺症をいかに防ぐか-コツとポイント】胃癌ダンピング症候群その病態と機能温存手術による予防のポイント

菊地覚次, 黒田新士, 藤原俊義

臨床外科 76 ( 1 ) 38 - 42 2021.1

Language：Japanese Publisher：(株)医学書院

＜文献概要＞ポイント ◆胃切除後障害の代表的な一つであるダンピング症候群予防は,胃切除後のQOL向上において重要である.◆ダンピング症候群を予防する機能温存手術の適応や手術手技のコツを正しく理解する.◆管理栄養士などの医療スタッフと連携したチーム医療体制の構築と患者教育が重要である.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01539&link_issn=&doc_id=20210108600008&doc_link_id=10.11477%2Fmf.1407213236&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1407213236&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Microanatomy-based standardization of left upper mediastinal lymph node dissection in thoracoscopic esophagectomy in the prone position. International journal

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara

Surgical endoscopy 35 ( 1 ) 349 - 357 2021.1

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

BACKGROUND: Although thoracoscopic esophagectomy in the prone position (TEPP) has become a standard procedure for esophageal cancer surgery, upper mediastinal lymph node dissection (UMLND) on the left side remains an issue. We have recently developed a new standardized approach to left UMLND in TEPP based on the microanatomy of the membranes and layers with the aim of achieving quick and safe surgery. The purpose of this study was to establish and evaluate our new standardized procedure in left UMLND. PATIENTS AND METHODS: Patients were divided into 2 groups: a pre-standardization group (n = 100) and a post-standardization group (n = 100). Eventually, 83 paired cases were matched using propensity score matching. In our new standardized procedure, left UMLND was performed while focusing on the visceral sheath, vascular sheath, and the fusion layer between them using a magnified view. RESULTS: The thoracoscopic operative time was significantly shorter (P < 0.001) in the post-standardization group [n = 83; 209.0 (176.0-235.0) min] than in the pre-standardization group [n = 83; 235.5 (202.8-264.5) min]. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the two groups. There was a tendency for the total postoperative morbidity to decrease in the post-standardization group. Furthermore, the left recurrent laryngeal nerve palsy rate was significantly lower in the post-standardization group (18.1% to 8.7%, P = 0.015). CONCLUSION: Microanatomy-based standardization contributes to safe and efficient left UMLND.

DOI： 10.1007/s00464-020-07407-9

外科系新専門医制度のあるべきグランドデザイン地域枠医師に対する外科専門研修のあり方充実した地域医療の実現を目指して

黒田新士, 吉田龍一, 池田宏国, 岡崎幹生, 大澤晋, 小谷恭弘, 山根正修, 杉本誠一郎, 菊地覚次, 安井和也, 野田卓男, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会雑誌 122 ( 1 ) 83 - 85 2021.1

外科系新専門医制度のあるべきグランドデザイン地域枠医師に対する外科専門研修のあり方充実した地域医療の実現を目指して Reviewed

日本外科学会雑誌 122 ( 1 ) 83 - 85 2021.1

がん関連線維芽細胞由来IL-6制御による免疫応答の効率化バイオマーカーとしてのIL-6の可能性

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

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

Oncolytic virotherapy promotes radiosensitivity in soft tissue sarcoma by suppressing anti-apoptotic MCL1 expression. International journal

Toshinori Omori, Hiroshi Tazawa, Yasuaki Yamakawa, Shuhei Osaki, Joe Hasei, Kazuhisa Sugiu, Tadashi Komatsubara, Tomohiro Fujiwara, Aki Yoshida, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

PloS one 16 ( 4 ) e0250643 2021

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

Soft tissue sarcoma (STS) is a rare cancer that develops from soft tissues in any part of the body. Despite major advances in the treatment of STS, patients are often refractory to conventional radiotherapy, leading to poor prognosis. Enhancement of sensitivity to radiotherapy would therefore improve the clinical outcome of STS patients. We previously revealed that the tumor-specific, replication-competent oncolytic adenovirus OBP-301 kills human sarcoma cells. In this study, we investigated the radiosensitizing effect of OBP-301 in human STS cells. The in vitro antitumor effect of OBP-301 and ionizing radiation in monotherapy or combination therapy was assessed using highly radiosensitive (RD-ES and SK-ES-1) and moderately radiosensitive (HT1080 and NMS-2) STS cell lines. The expression of markers for apoptosis and DNA damage were evaluated in STS cells after treatment. The therapeutic potential of combination therapy was further analyzed using SK-ES-1 and HT1080 cells in subcutaneous xenograft tumor models. The combination of OBP-301 and ionizing radiation showed a synergistic antitumor effect in all human STS cell lines tested, including those that show different radiosensitivity. OBP-301 was found to enhance irradiation-induced apoptosis and DNA damage via suppression of anti-apoptotic myeloid cell leukemia 1 (MCL1), which was expressed at higher levels in moderately radiosensitive cell lines. The combination of OBP-301 and ionizing radiation showed a more profound antitumor effect compared to monotherapy in SK-ES-1 (highly radiosensitive) and HT1080 (moderately radiosensitive) subcutaneous xenograft tumors. OBP-301 is a promising antitumor reagent to improve the therapeutic potential of radiotherapy by increasing radiation-induced apoptosis in STS.

DOI： 10.1371/journal.pone.0250643

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

Language：Japanese Publisher：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。

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

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

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

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 2020.12

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 2020.12

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 2020.12

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 2020.12

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 2020.12

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 2020.12

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

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 2020.12

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

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

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 2020.12

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 2020.12

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 2020.12

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 2020.12

[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 2020.12

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 2020.12

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

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 2020.12

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

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

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 2020.12

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 2020.12

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 2020.12

有茎広背筋弁移植による胸部食道癌術後気管瘻の予防

太田智之, 松本洋, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義, 木股敬裕

日本食道学会学術集会プログラム・抄録集 74回 326 - 326 2020.12

重度呼吸機能障害のある食道がん患者の意思決定支援を振りかえる

廣川万里子, 板垣栞, 田村利枝, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 74回 228 - 228 2020.12

より安全で生理的な経路を追求した有茎空腸を用いた食道再建術における工夫

國友知義, 白川靖博, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 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 158 - 158 2020.12

新規技術の開発とカダバートレーニングの実際食道癌手術におけるCadaver Surgical Trainingの現状と課題

前田直見, 白川靖博, 橋本将志, 田辺俊介, 野間和広, 櫻間教文, 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 75 - 75 2020.12

MM、SM1食道癌の治療手術か化学放射線療法か(領域横断的セッション) 食道ESD後追加手術例と再発後手術例から考える食道ESD後の適切な追加治療

田辺俊介, 白川靖博, 國友知義, 前田直見, 櫻間教文, 野間和広, 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 54 - 54 2020.12

食道癌周術期チーム医療の現況と将来展望

白川靖博, 國友知義, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 74回 12 - 12 2020.12

局所進行食道癌に対するDCF-RT後の食道切除術の有用性と安全性の検討

山田元彦, 白川靖博, 河崎健人, 橋本将志, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 75回 O1 - 5 2020.12

術前化学療法後に手術を行った食道胃接合部癌症例の検討

赤井正明, 野間和広, 西江尚貴, 前田直見, 田辺俊介, 櫻間教文, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 75回 P010 - 2 2020.12

食道がん症例におけるチームによる周術期管理の介入開始の至適時期の検討

河崎健人, 白川靖博, 西江尚貴, 山田元彦, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 75回 RS5 - 6 2020.12

腹臥位胸腔鏡下食道切除における微細解剖に基づいた上縦隔リンパ節郭清手技の定形化

前田直見, 白川靖博, 河崎健人, 西江尚貴, 山田元彦, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 75回 O2 - 4 2020.12

局所進行切除不能膵癌における予後規定因子の検討非切除例を含めたall cohort解析

安井和也, 吉田龍一, 楳田祐三, 杭瀬崇, 吉田一博, 高木弘誠, 松田達雄, 荒木宏之, 八木孝仁, 藤原俊義

日本消化器外科学会総会 75回 O16 - 2 2020.12

再手術症例から学ぶ形成外科的手技を用いた合併症回避のための術式の工夫

松本洋, 太田智之, 川本幸司, 木股敬裕, 白川靖博, 野間和広, 田邊俊介, 前田直見, 藤原俊義

日本食道学会学術集会プログラム・抄録集 74回 327 - 327 2020.12

切除可能/切除可能境界膵癌における術前後血中KRAS遺伝子変異検出とその意義に関する検討

吉田龍一, 安井和也, 楳田祐三, 杭瀬崇, 吉田一博, 松田達雄, 高木弘誠, 荒木宏之, 八木孝仁, 藤原俊義

日本消化器外科学会総会 75回 P276 - 4 2020.12

切除可能膵癌における術後早期再発予測因子の解析多施設共同後方視的研究

須井健太, 吉田龍一, 日置勝義, 佐藤太祐, 児島亨, 國府島健, 久保孝文, 安井和也, 八木孝仁, 藤原俊義

日本消化器外科学会総会 75回 RS19 - 1 2020.12

膵頭十二指腸切除術における周術期栄養療法のエビデンス

高木弘誠, 楳田祐三, 吉田龍一, 杭瀬崇, 吉田一博, 安井和也, 松田達雄, 荒木宏之, 八木孝仁, 藤原俊義

日本消化器外科学会総会 75回 O17 - 6 2020.12

The PVT1 lncRNA is a novel epigenetic enhancer of MYC, and a promising risk-stratification biomarker in colorectal cancer. International journal

Kunitoshi Shigeyasu, Shusuke Toden, Tsuyoshi Ozawa, Takatoshi Matsuyama, Takeshi Nagasaka, Toshiaki Ishikawa, Debashis Sahoo, Pradipta Ghosh, Hiroyuki Uetake, Toshiyoshi Fujiwara, Ajay Goel

Molecular cancer 19 ( 1 ) 155 - 155 2020.11

Language：English

Accumulating evidence suggests that dysregulation of transcriptional enhancers plays a significant role in cancer pathogenesis. Herein, we performed a genome-wide discovery of enhancer elements in colorectal cancer (CRC). We identified PVT1 locus as a previously unrecognized transcriptional regulator in CRC with a significantly high enhancer activity, which ultimately was responsible for regulating the expression of MYC oncogene. High expression of the PVT1 long-non-coding RNA (lncRNA) transcribed from the PVT1 locus was associated with poor survival among patients with stage II and III CRCs (p < 0.05). Aberrant methylation of the PVT1 locus inversely correlated with the reduced expression of the corresponding the PVT1 lncRNA, as well as MYC gene expression. Bioinformatic analyses of CRC-transcriptomes revealed that the PVT1 locus may also broadly impact the expression and function of other key genes within two key CRC-associated signaling pathways - the TGFβ/SMAD and Wnt/β-Catenin pathways. We conclude that the PVT1 is a novel oncogenic enhancer of MYC and its activity is controlled through epigenetic regulation mediated through aberrant methylation in CRC. Our findings also suggest that the PVT1 lncRNA expression is a promising prognostic biomarker and a potential therapeutic target in CRC.

DOI： 10.1186/s12943-020-01277-4

夢を実現するためのキャリアパス・教育システム進化する外科マネージメントセンターそれぞれの夢を実現するためのキャリアパス支援システム

超高齢者食道癌症例のサルコペニアと術後合併症の関連の検討

田辺俊介, 白川靖博, 前田直見, 野間和広, 藤原俊義

学会誌JSPEN 2 ( Suppl.1 ) 819 - 819 2020.11

胃周術期管理・合併症

高田暢夫, 菊地覚次, 武田正, 垣内慶彦, 黒田新士, 田辺俊介, 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雑誌 53 ( Suppl.2 ) 280 - 280 2020.11

菊地覚次, 黒田新士, 吉田龍一, 香川俊輔, 山根正修, 小谷恭弘, 笠原真悟, 豊岡伸一, 藤原俊義

日本外科学会雑誌 121 ( 6 ) 669 - 671 2020.11

腫瘍融解ウイルスによるp53の発現増強は骨肉腫に対する全身性の抗腫瘍免疫反応を増強する

近藤宏也, 田澤大, 出宮光二, 久禮美穂, 望月雄介, 長谷井嬢, 國定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 79回 OE14 - 2 2020.10

癌関連線維芽細胞由来IL-6制御による免疫応答の効率化 "Drug repositioning"による癌治療の可能性

西脇紀之, 野間和広, 大原利章, 小林照貴, 菊地覚次, 田澤大, 藤原俊義

日本癌学会総会記事 79回 OE12 - 7 2020.10

癌関連線維芽細胞を標的とした光免疫療法の新たな開発

小林照貴, 野間和広, 河崎健人, 赤井正明, 西脇紀之, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 79回 OJ12 - 3 2020.10

胃癌サブタイプと癌関連線維芽細胞の相互作用

李云成, 田澤大, 野間和広, 大原利章, 黒田新士, 菊地覚次, 香川俊輔, 藤原俊義

日本癌学会総会記事 79回 OE14 - 7 2020.10

腫瘍融解ウイルスによるp53の発現増強は膵癌微小環境における腫瘍間質ネットワークを遮断する

西山岳芳, 田澤大, 梶原義典, 庄司良平, 菊地覚次, 黒田新士, 野間和広, 吉田龍一, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 79回 OE14 - 4 2020.10

腫瘍溶解ウイルスを介したp53遺伝子治療による腹腔内免疫環境改善を利用した胃癌腹膜播種治療

田渕幹康, 菊地覚次, 小川俊博, 田澤大, 黒田新士, 野間和広, 西崎正彦, 香川俊輔, 大塚旬子, 大木理恵子, 浦田泰生, 藤原俊義

日本癌学会総会記事 79回 OE14 - 8 2020.10

テロメラーゼ特異的腫瘍融解アデノウイルス製剤の併用による抗PD-1抗体治療効果の増強

橋本将志, 黒田新士, 金谷信彦, 八木千晶, 津村朋子, 公文剣斗, 垣内慶彦, 菊地覚次, 田澤大, 香川俊輔, 水口裕之, 浦田泰生, 藤原俊義

日本癌学会総会記事 79回 OE12 - 10 2020.10

腫瘍融解アデノウイルスで治療した腫瘍から得られる細胞外小胞は樹状細胞を活性化する能力を有する

津村朋子, 黒田新士, 金谷信彦, 垣内慶彦, 公文剣斗, 橋本将志, 八木千晶, 杉本龍馬, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 79回 OJ11 - 2 2020.10

好中球と血小板の相互作用が胆管癌の悪性形質転換を促進する

吉本匡志, 香川俊輔, 梶原義典, 西山岳芳, 李云成, 岡林弘樹, 菊地覚次, 黒田新士, 田澤大, 藤原俊義

日本癌学会総会記事 79回 OJ10 - 2 2020.10

食道癌の治療戦略食道胃接合部癌に対する術前化学療法治療効果予測因子の解析

野間和広, 赤井正明, 前田直見, 菊地覚次, 田邊俊介, 黒田新士, 楳田祐三, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 58回 WS24 - 5 2020.10

【早わかり縫合・吻合のすべて】(4章)術式別の縫合・吻合法胃噴門側胃切除術食道-残胃吻合観音開き法

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

臨床外科 75 ( 11 ) 142 - 144 2020.10

【食道胃接合部癌update】治療噴門側胃切除後再建法食道残胃吻合の手技と成績

黒田新士, 西崎正彦, 菊地覚次, 野間和広, 香川俊輔, 藤原俊義

外科 82 ( 11 ) 1144 - 1148 2020.10

Language：Japanese Publisher：(株)南江堂

＜文献概要＞観音開き法再建は,1998年に上川らにより報告された逆流防止機構を付加した食道残胃吻合である.漿膜筋層フラップ下に埋没した食道が胃内圧の上昇に伴い押しつぶされることで,逆流防止弁としての機能を発揮することを特徴としている.多施設共同後ろ向き臨床試験において,逆流性食道炎発生予防の観点から良好な成績が報告されており,また縫合不全の発生頻度も非常に低率であることから,食道胃接合部癌などの縦隔内再建を要する症例に対しても非常に有用な再建法と考えられる.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00393&link_issn=&doc_id=20201001100010&doc_link_id=10.15106%2Fj_geka82_1144&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka82_1144&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

食道癌術後肺転移に対する外科的切除の意義

田辺俊介, 白川靖博, 野間和広, 前田直見, 國友知義, 藤原俊義

日本癌治療学会学術集会抄録集 58回 O56 - 3 2020.10

転移性肺腫瘍の外科治療up to date 食道癌術後肺転移再発に対する外科的切除の役割

國友知義, 白川靖博, 西村星多郎, 管野令子, 光井恵麻, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 81 ( 増刊 ) 283 - 283 2020.10

高度進行食道癌、再発食道癌に対する治療戦略-薬物療法と手術との融合- T4進行食道癌に対するDCF併用放射線療法を用いた治療戦略

白川靖博, 國友知義, 橋本将志, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 81 ( 増刊 ) 269 - 269 2020.10

食道切除後の消化管再建胃管作成不能例に対する有茎空腸を用いた食道再建術の工夫と成績

田辺俊介, 白川靖博, 西村星多郎, 菅野令子, 光井恵麻, 國友知義, 前田直見, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 81 ( 増刊 ) 241 - 241 2020.10

エクソソームを用いた革新的治療法腫瘍融解アデノウイルス局所療法後に産生されるエクソソームはアブスコパル効果を起こす

垣内慶彦, 黒田新士, 金谷信彦, 公文剣斗, 津村朋子, 橋本将志, 八木千晶, 杉本龍馬, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 79回 IS5 - 7 2020.10

ゲムシタビン耐性膵癌細胞は免疫抑制性の微小環境を増強する

梶原義典, 田澤大, 西山岳芳, 庄司良平, 伏見卓郎, 菊地覚次, 黒田新士, 野間和広, 吉田龍一, 西崎正彦, 香川俊輔, 藤原俊義

日本癌学会総会記事 79回 OJ17 - 6 2020.10

術前臨床情報を用いた切除可能膵癌の層別化多施設共同後方視的研究

佐藤太佑, 吉田龍一, 日置勝義, 須井健太, 児島亨, 國府島健, 久保孝文, 安井和也, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 81 ( 増刊 ) 331 - 331 2020.10

肝癌に対する肝移植の長期成績と再発予防肝癌肝移植の長期予後に向けて肝移植適応の選別と再発時治療

楳田祐三, 吉田龍一, 杭瀬崇, 吉田一博, 高木弘誠, 安井和也, 荒木宏之, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 81 ( 増刊 ) 246 - 246 2020.10

Boosting Replication and Penetration of Oncolytic Adenovirus by Paclitaxel Eradicate Peritoneal Metastasis of Gastric Cancer. International journal

Wataru Ishikawa, Satoru Kikuchi, Toshihiro Ogawa, Motoyasu Tabuchi, Hiroshi Tazawa, Shinji Kuroda, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Yasuo Urata, Toshiyoshi Fujiwara

Molecular therapy oncolytics 18 262 - 271 2020.9

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

Peritoneal metastasis is the most frequent form of distant metastasis and recurrence in gastric cancer, and the prognosis is extremely poor due to the resistance of systemic chemotherapy. Here, we demonstrate that intraperitoneal (i.p.) administration of a green fluorescence protein (GFP)-expressing attenuated adenovirus with oncolytic potency (OBP-401) synergistically suppressed the peritoneal metastasis of gastric cancer in combination with paclitaxel (PTX). OBP-401 synergistically suppressed the viability of human gastric cancer cells in combination with PTX. PTX enhanced the antitumor effect of OBP-401 due to enhanced viral replication in cancer cells. The combination therapy increased induction of mitotic catastrophe, resulting in accelerated autophagy and apoptosis. Peritoneally disseminated nodules were selectively visualized as GFP-positive spots by i.p. administration of OBP-401 in an orthotopic human gastric cancer peritoneal dissemination model. PTX enhanced the deep penetration of OBP-401 into the disseminated nodules. Moreover, a non-invasive in vivo imaging system demonstrated that the combination therapy of i.p. OBP-401 administration with PTX significantly inhibited growth of peritoneal metastatic tumors and the amount of malignant ascites. i.p. virotherapy with PTX may be a promising treatment strategy for the peritoneal metastasis of gastric cancer.

DOI： 10.1016/j.omto.2020.06.021

Elimination of MYCN-Amplified Neuroblastoma Cells by Telomerase-Targeted Oncolytic Virus via MYCN Suppression. International journal

Terutaka Tanimoto, Hiroshi Tazawa, Takeshi Ieda, Hiroshi Nouso, Morimichi Tani, Takanori Oyama, Yasuo Urata, Shunsuke Kagawa, Takuo Noda, Toshiyoshi Fujiwara

Molecular therapy oncolytics 18 14 - 23 2020.9

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

Neuroblastoma (NB) is a primary malignant tumor of the peripheral sympathetic nervous system. High-risk NB is characterized by MYCN amplification and human telomerase reverse transcriptase (hTERT) rearrangement, contributing to hTERT activation and a poor outcome. For targeting hTERT-activated tumors, we developed two oncolytic adenoviruses, OBP-301 and tumor suppressor p53-armed OBP-702, in which the hTERT promoter drives expression of the viral E1 gene for tumor-specific virus replication. In this study, we demonstrate the therapeutic potential of the hTERT-driven oncolytic adenoviruses OBP-301 and OBP-702 using four human MYCN-amplified NB cell lines (IMR-32, CHP-134, NB-1, LA-N-5) exhibiting high hTERT expression. OBP-301 and OBP-702 exhibited a strong antitumor effect in association with autophagy in NB cells. Virus-mediated activation of E2F1 protein suppressed MYCN expression. OBP-301 and OBP-702 significantly suppressed the growth of subcutaneous CHP-134 tumors. Thus, these hTERT-driven oncolytic adenoviruses are promising antitumor agents for eliminating MYCN-amplified NB cells via E2F1-mediated suppression of MYCN protein.

DOI： 10.1016/j.omto.2020.05.015

FUCCI Real-Time Cell-Cycle Imaging as a Guide for Designing Improved Cancer Therapy: A Review of Innovative Strategies to Target Quiescent Chemo-Resistant Cancer Cells. International journal

Shuya Yano, Hiroshi Tazawa, Shunsuke Kagawa, Toshiyoshi Fujiwara, Robert M Hoffman

Cancers 12 ( 9 ) 2020.9

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

Progress in chemotherapy of solid cancer has been tragically slow due, in large part, to the chemoresistance of quiescent cancer cells in tumors. The fluorescence ubiquitination cell-cycle indicator (FUCCI) was developed in 2008 by Miyawaki et al., which color-codes the phases of the cell cycle in real-time. FUCCI utilizes genes linked to different color fluorescent reporters that are only expressed in specific phases of the cell cycle and can, thereby, image the phases of the cell cycle in real-time. Intravital real-time FUCCI imaging within tumors has demonstrated that an established tumor comprises a majority of quiescent cancer cells and a minor population of cycling cancer cells located at the tumor surface or in proximity to tumor blood vessels. In contrast to most cycling cancer cells, quiescent cancer cells are resistant to cytotoxic chemotherapy, most of which target cells in S/G2/M phases. The quiescent cancer cells can re-enter the cell cycle after surviving treatment, which suggests the reason why most cytotoxic chemotherapy is often ineffective for solid cancers. Thus, quiescent cancer cells are a major impediment to effective cancer therapy. FUCCI imaging can be used to effectively target quiescent cancer cells within tumors. For example, we review how FUCCI imaging can help to identify cell-cycle-specific therapeutics that comprise decoy of quiescent cancer cells from G1 phase to cycling phases, trapping the cancer cells in S/G2 phase where cancer cells are mostly sensitive to cytotoxic chemotherapy and eradicating the cancer cells with cytotoxic chemotherapy most active against S/G2 phase cells. FUCCI can readily image cell-cycle dynamics at the single cell level in real-time in vitro and in vivo. Therefore, visualizing cell cycle dynamics within tumors with FUCCI can provide a guide for many strategies to improve cell-cycle targeting therapy for solid cancers.

DOI： 10.3390/cancers12092655

骨肉腫に対するp53誘導性腫瘍融解ウイルスを用いたアブスコパル効果・ワクチン効果の誘導

出宮光二, 田澤大, 近藤宏也, 久禮美穂, 長谷井嬢, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 94 ( 8 ) S1855 - S1855 2020.9

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プログラム・講演抄録 40回 56 - 58 2020.9

がん関連線維芽細胞由来IL-6制御による免疫応答の効率化バイオマーカーとしてのIL-6の可能性

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プログラム・講演抄録 40回 72 - 73 2020.9

【肝胆膵外科におけるConversion Surgery】大腸癌肝転移に対するConversion Surgery

楳田祐三, 吉田龍一, 杭瀬崇, 吉田一博, 藤原俊義, 八木孝仁

手術 74 ( 10 ) 1427 - 1434 2020.9

High incidence of tracheobronchial diverticulum in esophageal cancer patients: a retrospective survey alerting pitfall during thoracoscopic esophagectomy.

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

General thoracic and cardiovascular surgery 68 ( 9 ) 1018 - 1023 2020.9

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

OBJECTIVES: Although tracheobronchial diverticulum (DV) rarely cause problems, attention should be paid during esophagectomy, which requires careful dissection around the trachea and bronchi. Here, we retrospectively review cases of tracheobronchial DVs among esophageal cancer patients and report two cases of bronchial DV injury during thoracoscopic esophagectomy that were successfully repaired. METHODS: The thin-section CT images of esophageal cancer patients who underwent thoracoscopic esophagectomy from January 2013 to December 2015 were retrospectively reviewed. The localization, number, and size (largest axial diameter) of all detected DVs were recorded. RESULTS: A total of 180 patients were enrolled in this study. The incidence of tracheal DV was 5.0%, and that of bronchial DV was 40.0%. The median diameter of the tracheal diverticula was 2.45 [interquartile range (IQR) 2.00-8.17] mm and that of the bronchial diverticula was 1.90 (IQR 1.51-2.46) mm. All tracheal diverticula presented at the right tracheal wall 4.5-6.0 cm below the vocal cords; bronchial diverticula presented at the subcarinal lesions. We experienced two cases with bronchial diverticulum injuries during thoracoscopic esophagectomy, which were repaired by primary closure and confirmed that there was no air leak. No postoperative complications associated with bronchial injury occurred in either patient. CONCLUSION: Since tracheobronchial DVs are not as rare as previously thought, careful evaluation of thin-slice CT scans is necessary before thoracoscopic esophagectomy. If a tracheobronchial DV is injured during surgery, it is important to carefully repair it and confirm that there is no air leak to avoid complications.

DOI： 10.1007/s11748-020-01421-3

Fibroblast activation protein-α(FAP)を標的とした癌関連線維芽細胞(CAFs)に対する光免疫療法 Sunrise of targeting tumor microenvironment therapy

小林照貴, 野間和広, 赤井正明, 西脇紀之, 鳴坂徹, 河本慧, 前田直見, 大原利章, 田辺俊介, 田澤大, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 8 2020.8

発生学・拡大視局所微細解剖に基づく最新の手術手技【Video】進行横行結腸癌に対する複雑な幅広いD3郭清手技を結腸の成り立ちから理解することにより単純化し定型手術として言語化する

矢野修也, 近藤喜太, 寺石文則, 黒田新士, 重安邦俊, 母里淑子, 菊池覚次, 藤本卓也, 岸本浩行, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 WS - 5 2020.8

噴門側胃切除術後再建法-食道残胃吻合 vs 食道空腸吻合-【食道残胃】噴門側胃切除術後標準再建法としての観音開き法再建の可能性

黒田新士, 西崎正彦, 丁田泰宏, 石田道拡, 村岡篤, 田中則光, 羽藤慎二, 菊地覚次, 高田暢夫, 庄司良平, 重安邦俊, 矢野修也, 近藤喜太, 田辺俊介, 野間和広, 寺石文則, 香川俊輔, 白川靖博, 上川康明, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DB - 2 2020.8

局所進行直腸癌に対する術前治療における放射線治療の意義放射線療法を併用しない術前化学療法との治療成績の比較

寺石文則, 藤本卓也, 重安邦俊, 矢野修也, 近藤喜太, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 7 2020.8

肝内胆管癌における免疫微小環境と治療予後の関連性

小西大輔, 吉田一博, 楳田祐三, 重安邦俊, 矢野修也, 武田正, 吉田龍一, 杭瀬崇, 藤智和, 安井和也, 松田達雄, 田澤大, 白川靖博, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 3 2020.8

直腸癌に対するtaTMEの意義-あり vs なし-【なし】解剖学的知識と内視鏡技術に卓越しなければtaTMEの意義はない

近藤喜太, 重安邦俊, 矢野修也, 寺石文則, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DB - 3 2020.8

腹腔内アプローチ困難と予想される症例に対する、taTMEの役割と安全性

藤本卓也, 近藤喜太, 矢野修也, 重安邦俊, 母里淑子, 寺石文則, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DP - 2 2020.8

病的肥満症に対する腹腔鏡下スリーブ状胃切除術導入と初期10例の治療成績

香川俊輔, 黒田新士, 菊地覚次, 高田暢夫, 庄司良平, 西崎正彦, 寺石文則, 近藤喜太, 矢野修也, 重安邦俊, 野間和広, 田辺俊介, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DP - 5 2020.8

癌微小環境が引き起こす腫瘍免疫抑制の解明 "Drug repositioning"による免疫応答賦活化の可能性

西脇紀之, 野間和広, 赤井正明, 小林照貴, 鳴坂徹, 河本慧, 加藤卓也, 前田直見, 田辺俊介, 大原利章, 田澤大, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 4 2020.8

Systematic review on immunonutrition in partial pancreatoduodenectomy. International journal

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 405 ( 5 ) 585 - 593 2020.8

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

BACKGROUND: The effect of immunonutrition (IM) on postoperative outcomes has been investigated in gastrointestinal cancer surgery; however, strong evidence regarding IM in partial pancreatoduodenectomy (PD) is lacking. This study evaluated the effect of IM on short-term outcomes in patients undergoing PD. METHODS: A systematic literature review of randomized controlled trials was conducted to identify the studies investigating the IM effect on outcomes in PD. Random-effects meta-analyses were conducted to calculate the pooled risk ratio (RR). Studies were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Five studies were included in the meta-analysis. IM was associated with a lower incidence of overall complications (RR 0.74; 95% confidence interval (CI) 0.58, 0.94; P = 0.01; I2 = 0%) and infectious complications (RR 0.60; 95% CI 0.42, 0.84; P = 0.003; I2 = 0%). However, no significant association was noted in the incidence of major complications (RR 0.68; 95% CI 0.41, 1.12; P = 0.13), mortality (RR 0.79; 95% CI 0.16, 3.99; P = 0.78), postoperative pancreatic fistula (RR 0.92, 95% CI 0.59, 1.46; P = 0.74), and delayed gastric emptying (RR 1.09; 95% CI 0.55, 2.15; P = 0.81). CONCLUSIONS: IM administration in PD can prevent the incidence of overall and infectious complications postoperatively (GRADE recommendation: moderate). However, IM has no impact on major complications, mortality, and PD-specific complications (GRADE recommendation: low).

DOI： 10.1007/s00423-020-01916-w

食道胃接合部癌の手術-アプローチ法・郭清範囲・再建術式のdecision making- Siewert I型およびII型食道胃接合部癌の縦隔リンパ節転移に関するリスク因子(Risk factor for mediastinal lymph node metastasis of siewert type I and II esophagogastric junction tumors)

野間和広, 白川靖博, 赤井正明, 西江尚貴, 前田直見, 田辺俊介, 櫻間教文, 藤原俊義

日本外科学会定期学術集会抄録集 120回 PD - 2 2020.8

胃粘膜下腫瘍に対するClosed-LECSの成績と早期胃癌、十二指腸病変への応用

菊地覚次, 西崎正彦, 黒田新士, 高田暢夫, 庄司良平, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 7 2020.8

化学療法反応性の症例に対するR0切除はstage IV胃癌の予後を改善する

庄司良平, 香川俊輔, 高田暢夫, 菊地覚次, 黒田新士, 西崎正彦, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 8 2020.8

解熱剤のアスピリン投与によるEMT阻害作用を介した大腸がん腹膜播種の抑制効果

岡林弘樹, 田澤大, 家田偉史, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 今村健志, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 8 2020.8

臨床医学の教育と研究における献体使用の現状と将来 Cadaver surgical trainingが果たすべき役割と未来

近藤喜太, 黒田新士, 前田直見, 楳田祐三, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 CST - 3 2020.8

Immuno-Oncologyが変えるがん集学的治療【International】テロメラーゼ特異的腫瘍融解アデノウイルス製剤と抗PD-1抗体を併用した集学的免疫療法(Multidisciplinary immunotherapy with telomerase-specific oncolytic adenovirus and anti-PD-1 antibody)

黒田新士, 金谷信彦, 垣内慶彦, 公文剣斗, 津村朋子, 橋本将志, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SY - 5 2020.8

外科の輝ける「未来」のために、我々が「今」できること

竹原裕子, 吉田龍一, 溝尾妙子, 剱持礼子, 光井恵麻, 佃和寧, 土井原博義, 豊岡伸一, 笠原真悟, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SSF - 2 2020.8

大腸癌以外の肝転移の切除成績切除適応を見極める

畑七々子, 藤智和, 楳田祐三, 吉田龍一, 杭瀬崇, 吉田一博, 安井和也, 白川靖博, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DP - 6 2020.8

肝動脈浸潤を伴う局所進行切除不能膵頭部癌に対する膵頭十二指腸切除術結腸動脈を用いた肝動脈再建の適応と手術手技

安井和也, 吉田龍一, 楳田祐三, 杭瀬崇, 吉田一博, 藤智和, 松田達雄, 畑七々子, 八木千晶, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 120回 DP - 5 2020.8

脳死肝移植マージナルドナーの移植予後の解明と活用への提言

吉田一博, 楳田祐三, 吉田龍一, 杭瀬崇, 藤智和, 安井和也, 松田達雄, 畑七々子, 八木千晶, 八木孝仁, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 4 2020.8

局所進行膵癌治療中のliquid biopsyによるKRAS遺伝子変異検出とCA19-9値推移の意義に関する検討

吉田龍一, 安井和也, 楳田祐三, 杭瀬崇, 吉田一博, 藤智和, 松田達雄, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 4 2020.8

我が国の肝移植医療の実力と未来【International】生体肝移植における有望な外科的イノベーション技術と周術期管理(Promising surgical innovation and perioperative management in living donor liver transplantation)

楳田祐三, 八木孝仁, 吉田龍一, 杭瀬崇, 吉田一博, 藤智和, 安井和也, 松田達雄, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SY - 3 2020.8

一人前の肝胆膵外科医をめざして中堅肝胆膵外科医からみる岡山大学育成システムの回顧と展望

杭瀬崇, 楳田祐三, 吉田龍一, 吉田一博, 藤智和, 安井和也, 松田達雄, 畑七々子, 八木千晶, 白川靖博, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SSF - 2 2020.8

術前化学療法開始前から始めるチームによる食道がん周術期管理の有用性についての検討

田辺俊介, 白川靖博, 赤井正明, 西江尚貴, 前田直見, 櫻間教文, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 120回 SF - 5 2020.8

発生学・拡大視局所微細解剖に基づく最新の手術手技【Video】腹臥位胸腔鏡下食道癌手術における微細解剖に基づいた上縦隔リンパ節郭清定型化の工夫

白川靖博, 赤井正明, 西江尚貴, 橋本将志, 前田直見, 田辺俊介, 楳田祐三, 香川俊輔, 野間和広, 藤原俊義

日本外科学会定期学術集会抄録集 120回 WS - 2 2020.8

局所進行食道癌・胃癌に対する内視鏡外科の手術手技【Video】気管前リンパ節転移、心膜T4症例に対する胸腔鏡下食道切除術

前田直見, 白川靖博, 赤井正明, 西江尚貴, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 120回 WS - 8 2020.8

局所進行下部直腸癌に対する術前化学療法の治療成績

寺石文則, 高橋一剛, 重安邦俊, 矢野修也, 母里淑子, 近藤喜太, 岸本浩行, 香川俊輔, 藤原俊義

日本大腸肛門病学会雑誌 73 ( 7 ) 341 - 341 2020.7

有茎広背筋弁移植による胸部食道癌術後気管瘻の予防

太田智之, 松本洋, 前田直見, 田邊俊介, 野間和広, 白川靖博, 藤原俊義, 木股敬裕

頭頸部癌 46 ( 2 ) 180 - 180 2020.7

Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor. International journal

Naoaki Maeda, Yasuhiro Shirakawa, Shunsuke Tanabe, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

World journal of surgical oncology 18 ( 1 ) 143 - 143 2020.6

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

BACKGROUND: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery. METHODS: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and February 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and 3 days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model. RESULTS: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The 3-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group. CONCLUSION: Skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.

DOI： 10.1186/s12957-020-01908-6

整形トピックス骨肉腫に対する抗PD-1抗体の効果増強をめざした腫瘍融解ウイルス併用複合免疫療法の開発

肺癌と直腸癌の同時性重複癌にpembrolizumabが著効した1例

岡凌也, 寺石文則, 杉本龍馬, 武田正, 垣内慶彦, 高田暢夫, 重安邦俊, 菊地覚次, 矢野修也, 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 81 ( 6 ) 1202 - 1203 2020.6

望月雄介, 田澤大, 出宮光二, 久禮美穂, 長谷井嬢, 中田英二, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

整形外科 71 ( 7 ) 786 - 786 2020.6

横隔膜上食道憩室に対して胸腔鏡下憩室切除術を施行した1例

久松加寿也, 白川靖博, 赤井正明, 西江尚貴, 前田直見, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 81 ( 6 ) 1202 - 1202 2020.6

女性外科医の生活の現状と展望

八木千晶, 吉田龍一, 黒田新士, 藤原俊義

日本臨床外科学会雑誌 81 ( 6 ) 1204 - 1204 2020.6

腹腔鏡下胃全摘術における食道空腸吻合の手技と治療成績

高田暢夫, 黒田新士, 庄司良平, 菊地覚次, 西崎正彦, 香川俊輔, 白川博靖, 藤原俊義

日本臨床外科学会雑誌 81 ( 6 ) 1202 - 1202 2020.6

Intraoperative fluid therapy and postoperative complications during minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study.

Yukiko Hikasa, Satoshi Suzuki, Yuko Mihara, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

Journal of anesthesia 34 ( 3 ) 404 - 412 2020.6

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

PURPOSE: Compared with open thoracotomy, minimally invasive esophagectomy (MIE) methods, such as transhiatal or thoracoscopic esophagectomy, likely have lower morbidity. However, the relationship between intraoperative fluid management and postoperative complications after MIE remains unclear. Thus, we investigated the association of cumulative intraoperative fluid balance and postoperative complications in patients undergoing MIE. METHODS: This single-center retrospective cohort study examined patients undergoing thoracoscopic esophagectomy for esophageal cancer in the prone position. Postoperative complications included pneumonia, arrhythmia, thrombotic events and acute kidney injury (AKI). We compared patients with higher and lower intraoperative fluid balance (higher and lower than the median). Multivariable logistic regression analyses were performed to estimate the odds ratio of intraoperative fluid balance status on the incidence of postoperative complications. RESULTS: In total, 135 patients were included in the study. Postoperative complications occurred in 43 (32%), including cardiac arrhythmia (n = 12, 9%), thrombosis (n = 20, 15%), pneumonia (n = 13, 10%), and AKI required hemodialysis (n = 1, 1%). Patients with a higher fluid balance had higher incidence of complications than those with a lower fluid balance (46% vs. 18%, p < 0.001). After adjusting for age, ASA-PS ≥ III, blood loss, and the use of radical surgery, the higher intraoperative fluid balance group was significantly and independently associated with postoperative complications (adjusted OR 5.31, 95% CI 2.26-13.6, p < 0.0001). CONCLUSIONS: In patients undergoing thoracoscopic esophagectomy in the prone position, a greater intraoperative positive fluid balance was independently associated with a higher incidence of complications.

DOI： 10.1007/s00540-020-02766-y

希少脾腫瘍の2例 SANT(sclerosing angiomatoid nodular transformation)とIPT(inflammatory pseudotumor)

村田光隆, 杭瀬崇, 畑七々子, 八木千晶, 松田達雄, 安井和也, 藤智和, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 81 ( 6 ) 1203 - 1203 2020.6

Upregulation of microRNA-31 is associated with poor prognosis in patients with advanced colorectal cancer. International journal

Nobuhito Kubota, Fumitaka Taniguchi, Akihiro Nyuya, Yuzo Umeda, Yoshiko Mori, Toshiyoshi Fujiwara, Hiroaki Tanioka, Atsushi Tsuruta, Yoshiyuki Yamaguchi, Takeshi Nagasaka

Oncology letters 19 ( 4 ) 2685 - 2694 2020.4

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

Colorectal cancer (CRC) manifests after the accumulation of genetic and epigenetic alterations along with tumor microenvironments. MicroRNA (miRNA/miR) molecules have been revealed to serve in critical roles in the progression various types of cancer, and their expression level is often an important diagnostic, predictive or prognostic biomarker. The aim of the present study was to evaluate the potential of miRNAs as prognostic biomarkers for patients with advanced CRC. miRNA arrays were performed on CRC specimens obtained from tumors with various molecular statuses [e.g. KRAS proto-oncogene, GTPase (KRAS)/B-Raf proto-oncogene, serine/threonine kinase (BRAF)/microsatellite instability (MSI)], and their paired normal mucosal specimens. The miRNA array revealed that miR-31-5p (miR-31) was specifically upregulated in CRCs with the BRAF V600E mutation, the results of which were supported by subsequent analysis of a dataset retrieved from The Cancer Genome Atlas (TCGA) database, which contained information regarding 170 patients with CRC including 51 BRAF-mutant CRCs. Of our cohort of 67 patients with stage IV CRC, 15 (22%) and 4 (6%) showed KRAS and BRAF V600E mutations, respectively. Since the median miR-31 expression was 3.45 (range, 0.004-6330.531), the cut-off value was chosen as 3.5, and all tumors were categorized into two groups accordingly (high-/low-miR-31 expression). The high miR-31 expression group (n=33) was significantly associated with a poorer mortality (univariate hazard ratio=2.12; 95% confidence interval, 0.23-0.95; P=0.03) and exhibited a shorter median survival time (MST; 20.1 months) compared with the low miR-31 expression group (n=34) (MST, 38.3 months; P=0.03), indicating that miR-31 is a promising prognostic biomarker for patients with advanced CRC. Thus, performing a functional analysis of miR-31 expression may lead to the development of new targeted therapies for the various genetic subtypes of CRC.

DOI： 10.3892/ol.2020.11365

Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer.

Masashi Hashimoto, Yasuhiro Shirakawa, Naoaki Maeda, Shunsuke Tanabe, Kazuhiro Noma, Kazufumi Sakurama, Kuniaki Katsui, Masahiko Nishizaki, Toshiyoshi Fujiwara

Esophagus : official journal of the Japan Esophageal Society 17 ( 2 ) 127 - 134 2020.4

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

BACKGROUND: Locally advanced esophageal cancer (EC) invading surrounding organs (T4b) is difficult to treat. In general, definitive chemoradiotherapy (d-CRT) has been chosen as treatment for such cases. However, the outcome has not been good. Recently, the effectiveness of d-CRT with docetaxel, cisplatin, and 5-fluorouracil (DCF-RT) has been reported. Furthermore, surgery after d-CRT has a better prognosis than d-CRT alone in some reports, although it has a high risk of surgical complications. This study investigated the effectiveness and safety of induction DCF-RT. METHODS: The subjects were EC patients who underwent induction DCF-RT in Okayama University Hospital between January 2011 and December 2017. Their background characteristics, treatment details, histopathological factors, adverse events during CRT, postoperative complications, and overall survival (OS) were assessed. RESULTS: A total of 16 cases were performed induction DCF-RT. In 10 cases, death occurred, with 9 cancer-related deaths, and 1 death due to other disease. For all cases, OS was 37.5% at 3 years. 12 cases underwent esophagectomy after DCF-RT. Their OS was 50% at 3 years. 13 patients (81.3%) had Grade 3 febrile neutropenia. In 7 cases (62.5%), fasting for the treatment of diarrhea was needed. Three patients (25%) developed anastomotic leakage. Some recurrent laryngeal nerve paralysis was observed in 6 cases (50%). CONCLUSION: Although the rates of adverse events and surgical complications were slightly higher than in past reports, they were acceptable. It is useful to perform induction DCF-RT for T4b EC.

DOI： 10.1007/s10388-019-00709-5

【消化器外科手術の論点2020 誌上ディベートと手術手技】胃外科噴門側胃切除後の再建法観音開き法の立場から

術前SOX療法を施行した進行胃癌症例の治療成績(Outcomes of preoperative S-1 plus oxaliplatin(SOX) therapy for advanced gastric cancer)

香川俊輔, 黒田新士, 菊地覚次, 高田暢夫, 垣内慶彦, 武田正, 野間和広, 田辺俊介, 寺石文則, 近藤喜太, 矢野修也, 重安邦俊, 西崎正彦, 白川靖博, 藤原俊義

日本胃癌学会総会記事 92回 288 - 288 2020.3

術前SOX療法を施行した進行胃癌症例の治療成績(Outcomes of preoperative S-1 plus oxaliplatin(SOX) therapy for advanced gastric cancer)

日本胃癌学会総会記事 92回 288 - 288 2020.3

食道癌患者に対する腫瘍融解ウイルスの内視鏡的投与の実際病棟実施にむけた他部署連携

矢野朋美, 采女典子, 森隆弘, 笠原由美子, 石川貴子, 田辺俊介, 黒田新士, 野間和広, 田澤大, 香川俊輔, 白川靖博, 藤原俊義

日本消化器内視鏡技師会会報 ( 64 ) 111 - 112 2020.3

高齢者胃癌の治療成績と栄養状態向上を目指した治療戦略(Strategy to improve the outcome and nutritional status for elderly gastric cancer patients)

高田暢夫, 伊藤雅典, 庄司良平, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 92回 252 - 252 2020.3

黒田新士, 西崎正彦, 菊地覚次, 高田暢夫, 香川俊輔, 藤原俊義

手術 74 ( 4 ) 477 - 483 2020.3

Bone and Soft-Tissue Sarcoma: A New Target for Telomerase-Specific Oncolytic Virotherapy. Reviewed International journal

Hiroshi Tazawa, Joe Hasei, Shuya Yano, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancers 12 ( 2 ) 2020.2

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

Adenovirus serotype 5 (Ad5) is widely and frequently used as a virus vector in cancer gene therapy and oncolytic virotherapy. Oncolytic virotherapy is a novel antitumor treatment for inducing lytic cell death in tumor cells without affecting normal cells. Based on the Ad5 genome, we have generated three types of telomerase-specific replication-competent oncolytic adenoviruses: OBP-301 (Telomelysin), green fluorescent protein (GFP)-expressing OBP-401 (TelomeScan), and tumor suppressor p53-armed OBP-702. These viruses drive the expression of the adenoviral E1A and E1B genes under the control of the hTERT (human telomerase reverse transcriptase-encoding gene) promoter, providing tumor-specific virus replication. This review focuses on the therapeutic potential of three hTERT promoter-driven oncolytic adenoviruses against bone and soft-tissue sarcoma cells with telomerase activity. OBP-301 induces the antitumor effect in monotherapy or combination therapy with chemotherapeutic drugs via induction of autophagy and apoptosis. OBP-401 enables visualization of sarcoma cells within normal tissues by serving as a tumor-specific labeling reagent for fluorescence-guided surgery via induction of GFP expression. OBP-702 exhibits a profound antitumor effect in OBP-301-resistant sarcoma cells via activation of the p53 signaling pathway. Taken together, telomerase-specific oncolytic adenoviruses are promising antitumor reagents that are expected to provide novel therapeutic options for the treatment of bone and soft-tissue sarcomas.

DOI： 10.3390/cancers12020478

Immune Modulation by Telomerase-Specific Oncolytic Adenovirus Synergistically Enhances Antitumor Efficacy with Anti-PD1 Antibody. Reviewed International journal

Nobuhiko Kanaya, Shinji Kuroda, Yoshihiko Kakiuchi, Kento Kumon, Tomoko Tsumura, Masashi Hashimoto, Toshiaki Morihiro, Tetsushi Kubota, Katsuyuki Aoyama, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Hiroshi Tazawa, Hiroyuki Mizuguchi, Yasuo Urata, Toshiyoshi Fujiwara

Molecular therapy : the journal of the American Society of Gene Therapy 28 ( 3 ) 794 - 804 2020.1

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

The clinical benefit of monotherapy involving immune checkpoint inhibitors (ICIs) such as anti-programmed death-1 antibody (PD-1 Ab) is limited to small populations. We previously developed a telomerase-specific oncolytic adenovirus, Telomelysin (OBP-301), the safety of which was confirmed in a phase I clinical study. Here, we examined the potential of OBP-502, an OBP-301 variant, as an agent for inducing immunogenic cell death (ICD) and synergistically enhancing the efficacy of OBP-502 with PD-1 Ab using CT26 murine colon cancer and PAN02 murine pancreatic cancer cell lines. OBP-502 induced the release of ICD molecules such as adenosine triphosphate (ATP) and high-mobility group box protein 1 (HMGB1) from CT26 and PAN02 cells, leading to recruitment of CD8-positive lymphocytes and inhibition of Foxp3-positive lymphocyte infiltration into tumors. Combination therapy involving OBP-502 intratumoral administration and PD-1 Ab systemic administration significantly suppressed the growth of not only OBP-502-treated tumors but also tumors not treated with OBP-502 (so-called abscopal effect) in CT26 and PAN02 bilateral subcutaneous tumor models, in which active recruitment of CD8-positve lymphocytes was observed even in tumors not treated with OBP-502. This combined efficacy was similar to that observed in a CT26 rectal orthotopic tumor model involving liver metastases. In conclusion, telomerase-specific oncolytic adenoviruses are promising candidates for combined therapies with ICIs.

DOI： 10.1016/j.ymthe.2020.01.003

Development of a Novel Oncolytic Adenovirus Expressing a Short-hairpin RNA Against Cullin 4A. International journal

Keisaku Wakabayashi, Fuminori Sakurai, Ryosuke Ono, Toshiyoshi Fujiwara, Hiroyuki Mizuguchi

Anticancer research 40 ( 1 ) 161 - 168 2020.1

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

BACKGROUND: Arming of an oncolytic adenovirus (OAd) by inserting expression cassettes of therapeutic transgenes into the OAd genome is a promising approach to enhance the therapeutic effects of an OAd. Ideally, this approach would simultaneously promote the replication of an OAd in tumor cells and transgene product-mediated antitumor effects by expressing therapeutic transgenes. We previously demonstrated that knockdown of cullin 4A (CUL4A), which is an E3 ubiquitin ligase, significantly promoted adenovirus replication by increasing the c-JUN protein level. In addition, previous studies reported that CUL4A was highly expressed in various types of tumor, and was involved in tumor growth and metastasis. MATERIALS AND METHODS: In this study, we developed a novel OAd expressing a short-hairpin RNA (shRNA) against CUL4A (OAd-shCUL4A). RESULTS: OAd-shCUL4 mediated higher levels of cytotoxic effects on various types of human tumor cell than a conventional OAd. Higher levels of OAd genome copy numbers were found in the tumor cells for OAd-shCUL4A, compared with a conventional OAd. CONCLUSION: OAd-shCUL4A showed efficient antitumor effects by both enhancing OAd replication and inhibiting tumor cell growth.

DOI： 10.21873/anticanres.13937

"伝わる"肝胆膵外科手術記録 iPadを用いた効率的で効果的なイラスト作成法

楳田祐三, 藤原俊義

日本消化器外科学会雑誌 53 ( 1 ) 105 - 115 2020.1

Language：Japanese Publisher：(一社)日本消化器外科学会

手術記録は,診療情報にとどまらず,外科修練における研鑽,医療チーム内での手術情報の共有,そして紹介医へのfeed-backと,その意義は大きい.今回,iPadを用いた効率的で効果的なイラスト作成を中心に,我々が実践している"伝わる"肝胆膵外科手術記録の作成法を紹介する.従来の手描き法と異なり,iPad/Apple pencil/描画アプリを用いることで,自由な描き直し,レイヤー機能や多岐にわたる着色ツール,拡大・縮小機能による微細描画や着色時間の短縮,イラストパーツの貼付など,効率的で効果的なイラストの作成が可能となる.外科修練において,繰り返し手術イラストの作成に取り組むことは,観察力を養い,解剖構造の理解を深め,手術の本質を理解し修得するのに有用である.症例からの学びと反省,患者さん,そして紹介医の患者さんへの思い入れに報いるためにも,手術のみならず,外科医の想いが"伝わる"手術記録の作成に,外科医は一例入魂の精神で臨むことが望まれる.(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01117&link_issn=&doc_id=20200131210016&doc_link_id=10.5833%2Fjjgs.2020.sr005&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.2020.sr005&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Molecular radiosensitization of soft tissue sarcoma by oncolytic virus-mediated MCL1 ablation

Omori T, Tazawa H, Yamakawa Y, Osaki S, Hasei J, Sugiu K, Komatsubara T, Fujiwara T, Yoshida A, Kunisada T, Urata Y, Kagawa S, Ozaki T, Fujiwara T

2020.1

Short-term and long-term comparisons of laparoscopy-assisted proximal gastrectomy with esophagogastrostomy by the double-flap technique and laparoscopy-assisted total gastrectomy for proximal gastric cancer. International journal

Tomoko Tsumura, Shinji Kuroda, Masahiko Nishizaki, Satoru Kikuchi, Yoshihiko Kakiuchi, Nobuo Takata, Atene Ito, Megumi Watanabe, Kazuya Kuwada, Shunsuke Kagawa, Toshiyoshi Fujiwara

PloS one 15 ( 11 ) e0242223 2020

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

BACKGROUND: Although proximal gastrectomy (PG) is a recognized surgical procedure for early proximal gastric cancer, total gastrectomy (TG) is sometimes selected due to concern about severe gastroesophageal reflux. Esophagogastrostomy by the double-flap technique (DFT) is an anti-reflux reconstruction after PG, and its short-term effectiveness has been reported. However, little is known about the long-term effects on nutritional status and quality of life (QOL). METHODS: Gastric cancer patients who underwent laparoscopy-assisted PG (LAPG) with DFT or laparoscopy-assisted TG (LATG) between April 2011 and March 2014 were retrospectively analyzed. Body weight (BW), body mass index (BMI), and prognostic nutritional index (PNI) were reviewed to assess nutritional status, and the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 was used to assess QOL. RESULTS: A total of 36 patients (LATG: 17, LAPG: 19) were enrolled. Four of 17 LATG patients (24%) were diagnosed with Stage ≥II after surgery, and half received S-1 adjuvant chemotherapy. BW and PNI were better maintained in LAPG than in LATG patients until 1-year follow-up. Seven of 16 LATG patients (44%) were categorized as "underweight (BMI<18.5 kg/m2)" at 1-year follow-up, compared to three of 18 LAPG patients (17%; p = 0.0836). The PGSAS-45 showed no significant difference in all QOL categories except for decreased BW (p = 0.0132). Multivariate analysis showed that LATG was the only potential risk factor for severe BW loss (odds ratio: 3.03, p = 0.0722). CONCLUSIONS: LAPG with DFT was superior to LATG in postoperative nutritional maintenance, and can be the first option for early proximal gastric cancer.

DOI： 10.1371/journal.pone.0242223

Efficacy of surgical management for recurrent intrahepatic cholangiocarcinoma: A multi-institutional study by the Okayama Study Group of HBP surgery. International journal

Toru Kojima, Yuzo Umeda, Tomokazu Fuji, Takefumi Niguma, Daisuke Sato, Yoshikatsu Endo, Kenta Sui, Masaru Inagaki, Masahiro Oishi, Tetsuya Ota, Katsuyoshi Hioki, Tadakazu Matsuda, Hideki Aoki, Ryuji Hirai, Masashi Kimura, Takahito Yagi, Toshiyoshi Fujiwara

PloS one 15 ( 9 ) e0238392 2020

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

BACKGROUND: The prognosis of intrahepatic cholangiocarcinoma (ICC) has been poor, because of the high recurrence rate even after curative surgery. This study aimed to evaluate the prognostic impact of surgical resection of recurrent ICC. PATIENTS AND METHODS: A total of 345 cases of ICC who underwent hepatectomy with curative intent in 17 institutions were retrospectively analyzed, focusing on recurrence patterns and treatment modalities for recurrent ICC. RESULTS: Median survival time and overall 5-year recurrence-free survival rate were 17.8 months and 28.5%, respectively. Recurrences (n = 223) were classified as early (recurrence at ≤1 year, n = 131) or late (recurrence at >1 year, n = 92). Median survival time was poorer for early recurrence (16.3 months) than for late recurrence (47.7 months, p<0.0001). Treatment modalities for recurrence comprised surgical resection (n = 28), non-surgical treatment (n = 134), and best supportive care (BSC) (n = 61). Median and overall 1-/5-year survival rates after recurrence were 39.5 months and 84.6%/36.3% for surgical resection, 14.3 months and 62.5%/2.9% for non-surgical treatment, and 3 months and 4.8%/0% for BSC, respectively (p<0.0001). Multivariate analysis identified early recurrence, simultaneous intra- and extrahepatic recurrence, and surgical resection of recurrence as significant prognostic factors. In subgroup analyses, surgical resection may have positive prognostic impacts on intra- and extrahepatic recurrences, and even on early recurrence. However, simultaneous intra- and extrahepatic recurrence may not see any survival benefit from surgical management. CONCLUSION: Surgical resection of recurrent ICC could improve survival after recurrence, especially for patients with intra- or extrahepatic recurrence as resectable oligo-metastases.

DOI： 10.1371/journal.pone.0238392

Laparoscopic liver resection of segment seven: A case report and review of surgical techniques. International journal

Kosei Takagi, Takashi Kuise, Yuzo Umeda, Ryuichi Yoshida, Fuminori Teraishi, Takahito Yagi, Toshiyoshi Fujiwara

International journal of surgery case reports 73 168 - 171 2020

Language：English

INTRODUCTION: Laparoscopic liver resection of segment seven (LLR-S7) is a technically challenging procedure due to its anatomical location and difficult accessibility. Herein, we present our experience with LLR-S7, and demonstrate a literature review regarding surgical techniques. PRESENTATION OF CASE: A 28-year-old female was diagnosed with rectosigmoid cancer and synchronous liver metastases at the segment three (S3) and S7, which were treated with laparoscopic procedure. After the completely mobilization of the right lobe, the Glissonean pedicle of S7 (G7) was intrahepatically transected. The right hepatic vein was exposed to identify the venous branch of S7 (V7). Finally the liver parenchyma between RHV and dissection line was divided. DISCUSSION: Various laparoscopic approaches for S7 have been reported including the Glissonian approach from the hilum, the intrahepatic Glissonean approach, the caudate lobe first approach, and the lateral approach from intercostal ports. To perform LLR-S7 safely, it is important to understand the advantage of each technique including the trocar placement and approaches to S7 by laparoscopy. CONCLUSION: We present our experience of LLR-S7 for the tumor located at the top of S7, successfully performed with the intrahepatic Glissonean approach. LLR-S7 can be performed safely with advanced laparoscopic techniques and sufficient knowledge on various approaches for S7.

DOI： 10.1016/j.ijscr.2020.06.107

A novel modified hanging maneuver in laparoscopic left hemihepatectomy. International journal

Kosei Takagi, Yuzo Umeda, Takashi Kuise, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Yuma Tani, Takahito Yagi, Toshiyoshi Fujiwara

International journal of surgery case reports 76 251 - 253 2020

Language：English

INTRODUCTION: The liver hanging maneuver is an essential technique for controlling bleeding in hepatectomy, however it is often difficult in laparoscopic major hepatectomy. The present study describes a novel modified hanging maneuver in laparoscopic left hemihepatectomy. PRESENTATION OF CASE: A 29-year-old female underwent laparoscopic left hemihepatectomy for mucinous cystic neoplasm. After mobilizing the left lobe, the liver parenchyma was dissected along the demarcation line. For the hanging technique, the upper edge of the hanging tape was placed on the lateral side of the left hepatic vein, and fixed with the Falciform ligament. The lower edge of the tape was extracted outside the abdomen. Accordingly the hanging tape can be controlled extraperitoneally during the liver parenchyma dissection. DISCUSSION: This technique includes several advantages including no need of assistance using forceps, easy control of the hanging tape extraperitoneally, outflow control, better exposure of surgical field, and helpful guide of the liver dissection line toward the root of the left hepatic vein. CONCLUSION: Our novel modified hanging maneuver is easy and reproducible to use in laparoscopic left hemihepatectomy. Moreover, this technique can be applied to other laparoscopic hepatectomy.

DOI： 10.1016/j.ijscr.2020.10.002

How to transmit surgeons' spirit in surgery records: Ipad could be a promising illustrator tool for creating attractive illustrations

Yuzo Umeda, Toshiyoshi Fujiwara

Japanese Journal of Gastroenterological Surgery 53 ( 1 ) 105 - 115 2020

直腸癌腹腔鏡手術における縫合不全と回腸人工肛門合併症の因果関係についての検討 Reviewed

重安邦俊, 母里淑子, 矢野修也, 近藤喜太, 寺石文則, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) SF055 - 6 2019.12

3D画像構築を元に検討した胸腔鏡下食道癌手術において留意すべき解剖学的亜型

前田直見, 白川靖博, 赤井正明, 西江尚貴, 田辺俊介, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) PT2 - 2 2019.12

LTGにおける食道空腸吻合の手技と治療成績

高田暢夫, 黒田新士, 庄司良平, 菊地覚次, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) MO246 - 1 2019.12

残胃癌に対する腹腔鏡下残胃全摘術の検討

庄司良平, 高田暢夫, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) SF041 - 1 2019.12

腹腔鏡下観音開き法(上川法)再建の治療成績と吻合部狭窄予防のための取り組み

黒田新士, 西崎正彦, 菊地覚次, 高田暢夫, 庄司良平, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) SF016 - 4 2019.12

食道癌に対するロボット支援手術ロボット支援下食道癌手術導入におけるわれわれの工夫と今後の展望

白川靖博, 野間和広, 赤井正明, 西江尚貴, 前田直見, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) WS11 - 5 2019.12

腹腔鏡内視鏡合同手術(LECS)の新展開 Closed-LECSの新展開早期胃癌、十二指腸病変への応用

菊地覚次, 西崎正彦, 黒田新士, 高田暢夫, 庄司良平, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) PD18 - 3 2019.12

右鎖骨下動脈起始異常を合併した食道癌症例に対する縦隔鏡下食道亜全摘術の経験

赤井正明, 白川靖博, 西江尚貴, 前田直見, 田辺俊介, 野間和広, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) MO252 - 3 2019.12

食道裂孔ヘルニア根治術による心負荷改善への貢献

田辺俊介, 白川靖博, 赤井正明, 西江尚貴, 前田直見, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) SF072 - 1 2019.12

食道胃接合部癌に対するcTLA(combined thoracoscopic laparoscopic approach)の検討

西江尚貴, 野間和広, 赤井正明, 前田直見, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) SF071 - 4 2019.12

反回神経周囲リンパ節郭清手技と麻痺軽減の工夫胸腔鏡下手術における反回神経周囲微細解剖に留意した定型化手技

野間和広, 白川靖博, 赤井正明, 西江尚貴, 前田直見, 田辺俊介, 藤原俊義

日本内視鏡外科学会雑誌 24 ( 7 ) PD16 - 2 2019.12

Visualization of epithelial-mesenchymal transition in an inflammatory microenvironment-colorectal cancer network. Reviewed International journal

Ieda T, Tazawa H, Okabayashi H, Yano S, Shigeyasu K, Kuroda S, Ohara T, Noma K, Kishimoto H, Nishizaki M, Kagawa S, Shirakawa Y, Saitou T, Imamura T, Fujiwara T

Scientific reports 9 ( 1 ) 16378 - 16378 2019.11

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

Epithelial-mesenchymal transition (EMT) is a biological process by which epithelial cells acquire mesenchymal characteristics. In malignant tumors, EMT is crucial for acquisition of a mesenchymal phenotype with invasive and metastatic properties, leading to tumor progression. An inflammatory microenvironment is thought to be responsible for the development and progression of colorectal cancer (CRC); however, the precise role of inflammatory microenvironments in EMT-related CRC progression remains unclear. Here, we show the spatiotemporal visualization of CRC cells undergoing EMT using a fluorescence-guided EMT imaging system in which the mesenchymal vimentin promoter drives red fluorescent protein (RFP) expression. An inflammatory microenvironment including TNF-α, IL-1β, and cytokine-secreting inflammatory macrophages induced RFP expression in association with the EMT phenotype in CRC cells. In vivo experiments further demonstrated the distribution of RFP-positive CRC cells in rectal and metastatic tumors. Our data suggest that the EMT imaging system described here is a powerful tool for monitoring EMT in inflammatory microenvironment-CRC networks.

DOI： 10.1038/s41598-019-52816-z

トランスレーショナルリサーチとしての外科治療を補完する新たな集学的治療の開発研究

周術期管理チーム介入によるリスク評価が高齢者大腸癌患者の術後アウトカムに与える影響

寺石文則, 重安邦俊, 矢野修也, 母里淑子, 近藤喜太, 藤原俊義

日本消化器外科学会雑誌 52 ( Suppl.2 ) 253 - 253 2019.11

田澤大, 田辺俊介, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会雑誌 120 ( 6 ) 735 - 737 2019.11

低侵襲内視鏡治療の今後の展開上部消化管腫瘍に対するClosed LECSの開発と応用

西崎正彦, 菊地覚次, 藤原俊義

日本消化器病学会雑誌 116 ( 臨増大会 ) A503 - A503 2019.11

Comparison of the Effects of Epidural Analgesia and Patient-controlled Intravenous Analgesia on Postoperative Pain Relief and Recovery After Laparoscopic Gastrectomy for Gastric Cancer. International journal

Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Takashi Matsusaki, Kazuya Kuwada, Yoshikazu Kimura, Shunsuke Kagawa, Hiroshi Morimatsu, Toshiyoshi Fujiwara

Surgical laparoscopy, endoscopy & percutaneous techniques 29 ( 5 ) 405 - 408 2019.10

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

PURPOSE: Epidural analgesia (EDA) is an imperative modality for postoperative pain relief after major open abdominal surgery. However, whether EDA has benefits in laparoscopic surgery has not been clear. In this study, the effects of EDA and patient-controlled intravenous analgesia (PCIA) after laparoscopic distal gastrectomy (LDG) were compared. METHODS: This was a retrospective study that included 82 patients undergoing LDG for gastric cancer. Patients received either EDA (n=67) or PCIA (n=15) for postoperative pain relief. Postoperative outcomes and analgesia-related adverse events were compared between the two modalities. RESULTS: EDA and PCIA patients showed no differences in the incidence of complications [9 (13%) vs. 2 (13%); P=0.99] and the length of postoperative hospital stay (9.6±4.5 d vs. 9.7±4.0 d; P=0.90), although the PCIA included poorer preoperative physical status (PS) patients. The number of additional doses of analgesics was higher in the EDA than in the PCIA (1.8±2.4 vs. 0.9±1.0; P=0.01), although postoperative pain scores were similar in the 2 groups. Though the time to first passage of flatus was shorter in the EDA (P<0.05), more EDA patients developed postoperative hypotension as an adverse event (P<0.01). The full mobilization day and the day of oral intake tolerance were not significantly different between the 2 groups after surgery. CONCLUSIONS: After LDG, EDA may not be indispensable, while PCIA may be the optimal modality for providing safe and effective postoperative analgesia and recovery.

DOI： 10.1097/SLE.0000000000000605

【消化器腫瘍に対する腹腔鏡・内視鏡合同手術(LECS)up date】各種LECS手技 Closed LECS

ロボット支援下手術の現状と今後の展開1 胸腔鏡下食道切除に対する合併症ゼロへの挑戦胸腔鏡下食道切除に対する合併症ゼロへの挑戦鏡視下からロボット支援手術導入

野間和広, 白川靖博, 西江尚貴, 赤井正明, 前田直見, 田辺俊介, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 80 ( 増刊 ) 365 - 365 2019.10

進行・再発胃癌に対するNivolumab投与例の検討

香川俊輔, 黒田新士, 菊地覚次, 高田暢夫, 庄司良平, 西崎正彦, 藤原俊義

日本癌治療学会学術集会抄録集 57回 P134 - 2 2019.10

西崎正彦, 菊地覚次, 黒田新士, 藤原俊義

外科 81 ( 11 ) 1125 - 1129 2019.10

Language：Japanese Publisher：(株)南江堂

＜文献概要＞管内発育型や壁内発育型消化管間質腫瘍(gastrointestinal stromal tumor:GIST)を主体とした5cm以下の胃粘膜下腫瘍の手術療法は,内視鏡・腹腔鏡合同手術(laparoscopic and endoscopic cooperative surgery:LECS)の登場により必要最小限の胃部分切除を低侵襲手術として行うことが可能となった.しかし,LECS原法(classical LECS)では腫瘍切除の過程で胃内腔と腹腔が交通し,腫瘍も腹腔内に露出するため,潰瘍のあるGISTや早期胃癌は適応外と考えてきた.それらに対応するために胃壁を開放しない,あるいは胃内容物を撒布しない方法として,すでにいくつかの手技が臨床応用されているが,筆者らはclassical LECSを発展させたclosed LECSを考案したので,手術手技について概説する.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00393&link_issn=&doc_id=20191003060005&doc_link_id=issn%3D0016-593X%26volume%3D81%26issue%3D11%26spage%3D1125&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0016-593X%26volume%3D81%26issue%3D11%26spage%3D1125&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

鏡視下手術時代の外科感染対策はどうなる食道癌に対する鏡視下手術導入による周術期管理の変遷と多職種介入による外科感染対策の現況

田辺俊介, 白川靖博, 前田直見, 野間和広, 藤原俊義

日本外科感染症学会雑誌 16 ( 5 ) 479 - 479 2019.10

DCF療法不応の進行食道癌に対する集学的治療の検討

西江尚貴, 白川靖博, 赤井正明, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 80 ( 増刊 ) 564 - 564 2019.10

当院における若年発症の食道癌症例の検討

赤井正明, 白川靖博, 西江尚貴, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 80 ( 増刊 ) 563 - 563 2019.10

他科との合同手術形成外科とのコラボレーションによる食道癌手術

田辺俊介, 白川靖博, 西江尚貴, 赤井正明, 前田直見, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 80 ( 増刊 ) 436 - 436 2019.10

食道切除術における再建の工夫有茎空腸を用いた食道再建術における工夫

前田直見, 白川靖博, 赤井正明, 西江尚貴, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 80 ( 増刊 ) 427 - 427 2019.10

消化器外科手術におけるNPWTの最前線クローン病に対する治療的および予防的NPWT、当院IBDセンターにおける10年の変遷

近藤喜太, 藤原俊義

日本外科感染症学会雑誌 16 ( 5 ) 502 - 502 2019.10

がん関連線維芽細胞(CAFs)による腫瘍免疫抑制のメカニズムについて(Exploring the mechanism of cancer-associated fibroblasts(CAFs) induced immunosuppression in tumor microenvironment) Reviewed

西脇紀之, 野間和広, 小林照貴, 鳴坂徹, 河本慧, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 78回 P - 3083 2019.9

鉄キレート剤による幹細胞性制御による新規食道癌治療法(Stemness control by iron chelator is a novel therapeutic strategy for esophageal cancer treatment) Reviewed

鳴坂徹, 大原利章, 桂佑貴, 野間和広, 西脇紀之, 河本慧, 田澤大, 香川俊輔, 藤原俊義

日本癌学会総会記事 78回 P - 1077 2019.9

骨肉腫に対する抗PD-1抗体と腫瘍融解アデノウイルスの複合免疫療法

望月雄介, 田澤大, 出宮光二, 久禮美穂, 長谷井嬢, 中田英二, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1672 - S1672 2019.9

骨肉腫に対するp53誘導性腫瘍融解ウイルス療法のアブスコパル効果

出宮光二, 田澤大, 久禮美穂, 望月雄介, 長谷井嬢, 中田英二, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1673 - S1673 2019.9

骨肉腫に対するテロメラーゼ特異的腫瘍融解ウイルスを用いた複合免疫療法(Combination immunotherapy with telomerase-specific oncolytic adenovirus for osteosarcoma)

出宮光二, 田澤大, 望月雄介, 久禮美穂, 近藤宏也, 長谷井嬢, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 78回 J - 1001 2019.9

【肝内胆管癌のすべて】リンパ節郭清の意義

稲垣優, 楳田祐三, 八木孝仁, 藤原俊義

消化器外科 42 ( 10 ) 1417 - 1426 2019.9

化学放射線療法は線維芽細胞の活性化を介して食道癌細胞の悪性度を向上させる(Chemoradiotherapy promotes malignancy of cancer cells via activating fibroblasts in esophageal squamous cell carcinomas) Reviewed

河本慧, 野間和広, 小林照貴, 西脇紀之, 鳴坂徹, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 78回 E - 1038 2019.9

Cureを得るためにはヒト悪性腫瘍に対する集学的腫瘍融解ウイルス療法現状と次世代の展望(Aiming to cure cancer Multidisciplinary oncolytic virotherapy for human cancer: current status and next-generation perspective)

藤原俊義, 田澤大, 田辺俊介, 浦田泰生, 白川靖博

日本癌学会総会記事 78回 S8 - 6 2019.9

消化器外科領域に応用可能な分子レベルの技術開発標準治療が困難な食道がん患者に対する低侵襲なテロメラーゼ標的型分子治療法の開発(Molecular Technology Development for Gastroenterological Diseases Minimally invasive telomerase-targeted molecular therapy in esophageal cancer patients unfit for standard treatments)

田澤大, 田辺俊介, 野間和広, 黒田新士, 香川俊輔, 浦田泰生, 白川靖博, 藤原俊義

日本癌学会総会記事 78回 SST6 - 7 2019.9

腫瘍融解ウイルス療法にて認められるアブスコパル効果と細胞外小胞の関連性についてのリバーストランスレーショナルリサーチ(Reverse translational research with extracellular vesicles for the abscopal effect of oncolytic adenovirotherapy)

垣内慶彦, 黒田新士, 金谷信彦, 公文剣斗, 津村朋子, 橋本将志, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 78回 E - 3056 2019.9

テロメラーゼ依存性腫瘍融解ウイルスは化学療法抵抗性の膵臓がん細胞を破壊する(Telomerase-specific oncolytic virus eliminates chemoresistant pancreatic ductal adenocarcinoma cells)

伏見卓郎, 田澤大, 荒木宏之, 西山岳芳, 菊地覚次, 黒田新士, 野間和広, 吉田龍一, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 78回 E - 3003 2019.9

解熱剤のアスピリンはEMT阻害作用を介して大腸がんの腹膜播種を抑制する(Antipyretic aspirin inhibits peritoneal dissemination of colon cancer cells via suppression of EMT)

岡林弘樹, 田澤大, 家田偉史, 矢野修也, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 今村健志, 藤原俊義

日本癌学会総会記事 78回 J - 2032 2019.9

癌微小環境での胃癌に対するp53武装化腫瘍溶解アデノウイルスの影響(The impact of p53-arming multi-potent oncolytic adenovirus on gastric cancer cells in tumor microenvironment)

小川俊博, 菊地覚次, 石川亘, 田澤大, 田渕幹康, 黒田新士, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本癌学会総会記事 78回 J - 2029 2019.9

膵癌に対する免疫チェックポイント阻害剤を併用したテロメラーゼ特異的腫瘍融解免疫療法(Telomerase-specific oncolytic immunotherapy combined with immune checkpoint inhibitor against pancreatic cancer)

荒木宏之, 田澤大, 金谷信彦, 伏見卓郎, 西山岳芳, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 78回 E - 2110 2019.9

Cureを得るためには好中球細胞外トラップによるEMTを介した消化器癌肝転移促進メカニズムの解明(Aiming to cure cancer Neutrophil extracellular traps promote liver metastasis of gastrointestinal cancer through the induction of EMT)

梶岡裕紀, 香川俊輔, 田澤大, 伊藤雅典, 桑田和也, 菊池覚次, 黒田新士, 藤原俊義

日本癌学会総会記事 78回 S8 - 5 2019.9

食道裂孔ヘルニアの腹腔鏡下逆流防止手術後に発症した食道胃接合部癌に対し,腹腔鏡下にredo surgeryを施行した1例

田辺俊介, 白川靖博, 黒田新士, 野間和広, 西崎正彦, 藤原俊義

手術 73 ( 10 ) 1503 - 1507 2019.9

Language：Japanese Publisher：金原出版(株)

70代女。腹腔鏡下逆流防止手術(LARS)の5年後に食道胃接合部癌を認め、腹腔鏡下に噴門側胃切除術と観音開き法による再建を行った。本例では逆流防止手術としてLARSと観音開き法再建という2種類の術式を施行し、いずれも有効であった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00620&link_issn=&doc_id=20190906120017&doc_link_id=10.18888%2Fop.0000001395&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fop.0000001395&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

神経芽腫に対するp53発現性腫瘍融解アデノウイルスによる免疫原性細胞死の誘導効果(Induction of immunogenic cell death by p53-armed telomerase-specific oncolytic adenovirus in neuroblastoma)

谷守通, 田澤大, 谷本光隆, 納所洋, 浦田泰生, 香川俊輔, 野田卓男, 藤原俊義

日本癌学会総会記事 78回 P - 1178 2019.9

本音で話そう、それぞれの手術室プロフェッショナルの思い-安全で低侵襲な手術医療にコミットする手術室多職種チーム- 高難度手術におけるCadaver Surgical Trainingによるチームシミュレーション教育

近藤喜太, 藤原俊義

日本手術看護学会誌 15 ( 2 ) 97 - 97 2019.9

【微細解剖に基づいた正確な上部消化管リンパ節郭清術】胃癌に対するNo.8a、9膵上縁リンパ節郭清術

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

消化器外科 42 ( 9 ) 1351 - 1358 2019.8

【外科におけるカテーテル管理のコツ】消化管内留置カテーテルイレウス管の留置適応と管理法

近藤喜太, 藤原俊義

外科 81 ( 9 ) 917 - 922 2019.8

Language：Japanese Publisher：(株)南江堂

＜文献概要＞イレウス管の適応決定に造影CTは必須の検査であり,虚血あるいは可逆性の閉塞を示唆する所見があれば,外科的治療を積極的に考慮する.挿入後は吸引器あるいは用手的に,間欠吸引あるいは低圧持続吸引を行い,開存を確認する必要がある.抜去の可否決定には造影検査が有用である.イレウス管は迅速な減圧が可能となる強力な治療であるが,患者にかなりの苦痛を強いる治療であることを医療者は意識する必要がある.

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00393&link_issn=&doc_id=20190729080003&doc_link_id=issn%3D0016-593X%26volume%3D81%26issue%3D9%26spage%3D917&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0016-593X%26volume%3D81%26issue%3D9%26spage%3D917&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Endoscopic Ultrasound-Guided Transgastric Drainage of an IntraAbdominal Abscess following Gastrectomy. International journal

Satoru Kikuchi, Tetsushi Kubota, Shinji Kuroda, Masahiko Nishizaki, Shunsuke Kagawa, Hironari Kato, Hiroyuki Okada, Toshiyoshi Fujiwara

Clinical endoscopy 52 ( 4 ) 373 - 376 2019.7

Language：English

Endoscopic ultrasound (EUS)-guided transgastric drainage has been performed as a less invasive procedure for pancreatic fistulas and intra-abdominal abscesses occurring after surgery in recent years. However, there are no reports of EUS-guided transgastric drainage of intra-abdominal abscesses following gastrectomy. This case report describes 2 patients who developed an intra-abdominal abscess following gastrectomy and underwent EUS-guided transgastric drainage. Both patients underwent laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction for gastric cancer. The intra-abdominal abscesses were caused by postoperative pancreatic fistula that developed following gastrectomy. One patient underwent naso-cystic drainage and the other underwent only a needle puncture of the abscess cavity. EUS-guided drainage was performed safely and effectively, although 1 patient developed gastroduodenal anastomotic leakage related to this procedure. In summary, EUS-guided transgastric drainage is safe and technically feasible even in post-gastrectomy patients. However, it is necessary to be careful if this procedure is performed in the early period following gastrectomy.

DOI： 10.5946/ce.2018.134

【徹底解説! 噴門側胃切除術】私の手技再建逆流性食道炎が生じにくい観音開き法再建の手技と特徴

【大腸】ストーマ造設法と閉鎖法の工夫回腸双孔式人工肛門の2大合併症である閉塞とhigh output stomaのリスク因子同定と回避のための工夫 Reviewed

重安邦俊, 矢野修也, 母里淑子, 近藤喜太, 岸本浩行, 寺石文則, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 74回 WS10 - 6 2019.7

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

臨床外科 74 ( 7 ) 832 - 835 2019.7

Language：Japanese Publisher：(株)医学書院

＜文献概要＞ポイント ◆噴門側胃切除後の消化管再建で最も注意すべき点は術後の逆流性食道炎の予防である.◆観音開き法再建(上川法,英語表記double-flap technique)は食道を胃壁に埋め込むことで逆流防止に効果的な一方弁を形成する.◆逆流防止には埋め込む食道の長さを十分にとること,狭窄予防には吻合操作やフラップ縫着時にきつく締めすぎないことが重要である.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01539&link_issn=&doc_id=20190628360012&doc_link_id=10.11477%2Fmf.1407212532&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1407212532&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

腹腔鏡手術は開腹手術と比較して術後の筋肉量減少を予防できる可能性がある

桑田和也, 金谷信彦, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 74回 P46 - 2 2019.7

ERAS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, 桑田和也, 金谷信彦, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 74回 O30 - 4 2019.7

胃癌腹膜播種に対する新たな治療戦略としての腹腔内ウイルス療法

石川亘, 菊地覚次, 田澤大, 桑田和也, 黒田新士, 野間和広, 西崎正彦, 白川靖博, 香川俊輔, 藤原俊義

日本消化器外科学会総会 74回 RS20 - 1 2019.7

上腹部開腹歴を有する胃癌症例への腹腔鏡手術ポート挿入までの定型化と短期治療成績

黒田新士, 津村朋子, 桑田和也, 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 74回 O14 - 2 2019.7

神経解剖・層構造より解き明かす腹腔鏡下胃癌リンパ節郭清のポイント

西崎正彦, 渡邉めぐみ, 黒田新士, 菊地覚次, 桑田和也, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 74回 RS6 - 5 2019.7

誌上ディベート(第15回) 噴門側胃切除後の再建方法 double tract vs. 観音開き法観音開き法の立場から

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

消化器外科 42 ( 8 ) 1250 - 1253 2019.7

切除不能食道癌に対し化学放射線療法(CRT)を行いConversion Surgeryを行った11例の検討

小林照貴, 白川靖博, 梅田将志, 橋本将志, 前田直見, 田辺俊介, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 74回 P18 - 2 2019.7

【肝胆膵】肝移植と合併症対策生体肝移植後における脾動脈盗血症候群に対する治療介入の意義

松田達雄, 楳田祐三, 吉田一博, 安井和也, 藤智和, 杭瀬崇, 吉田龍一, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 WS12 - 7 2019.7

【肝胆膵】大腸癌原発でない転移性肝癌に対する肝切除の適応と治療成績非大腸癌・非内分泌腫瘍由来肝転移の切除成績切除適応となる癌腫を見極める

梶原義典, 藤智和, 楳田祐三, 吉田龍一, 杭瀬崇, 吉田一博, 安井和也, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 WS29 - 2 2019.7

【肝】肝移植ハイリスク患者への挑戦生体肝移植におけるハイリスク症例 MELDは移植予後を反映するか

楳田祐三, 八木孝仁, 吉田龍一, 杭瀬崇, 吉田一博, 藤智和, 松田達雄, 安井和也, 白川靖博, 藤原俊義

日本消化器外科学会総会 74回 PD4 - 4 2019.7

切除可能膵頭部癌における早期再発予測因子と転移形式の解析

安井和也, 吉田龍一, 楳田祐三, 杭瀬崇, 吉田一博, 藤智和, 松田達雄, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 P246 - 5 2019.7

医原性胆道損傷に対する修復術 Immediate repairと手技の要点

杭瀬崇, 楳田祐三, 松田達雄, 安井和也, 藤智和, 吉田一博, 吉田龍一, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 P214 - 5 2019.7

膵IPMN術後残膵再発累積リスクに着目した術後至適surveillance法の検討

藤智和, 楳田祐三, 安井和也, 吉田一博, 杭瀬崇, 吉田龍一, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 P237 - 2 2019.7

再肝切除における根治性確保と合併症軽減に向けた工夫

吉田一博, 楳田祐三, 吉田龍一, 杭瀬崇, 藤智和, 松田達雄, 安井和也, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 74回 O10 - 7 2019.7

【食道】食道癌手術における再建のbest practice 有茎空腸を用いた食道再建術

前田直見, 白川靖博, 梅田将志, 橋本将志, 小林照貴, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 74回 PD1 - 8 2019.7

根治をめざした食道癌の再発に対する集学的治療〜外科・内科・放射線科の立場から〜食道癌術後再発に対する手術療法の意義の検討

前田直見, 白川靖博, 橋本将志, 小林照貴, 田辺俊介, 櫻間教文, 野間和広, 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 73回 24 - 24 2019.6

食道癌周術期管理におけるエビデンス創出に向けたPERiOの現況と課題

白川靖博, 橋本将志, 小林照貴, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 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 73回 11 - 11 2019.6

超高齢者食道癌症例のサルコペニアの有無は術後合併症の予測因子となり得るか?

田辺俊介, 白川靖博, 橋本将志, 小林照貴, 前田直見, 櫻間教文, 野間和広, 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 73回 10 - 10 2019.6

トラスツズマブ耐性胃癌に対するHER2標的金ナノ粒子製剤の開発

公文剣斗, 黒田新士, 久保田哲史, 津村朋子, 垣内慶彦, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 藤原俊義

日本DDS学会学術集会プログラム予稿集 35回 152 - 152 2019.6

腫瘍融解ウイルス療法によるエクソソームを介したアブスコパル効果の可能性

垣内慶彦, 黒田新士, 金谷信彦, 公文剣斗, 津村朋子, 菊地覚次, 香川俊輔, 田澤大, 浦田泰生, 藤原俊義

日本DDS学会学術集会プログラム予稿集 35回 140 - 140 2019.6

乳児劇症肝炎に対して生体肝移植術を施行した1例

高木弘誠, 八木孝仁, 吉田龍一, 藤智和, 杭瀬崇, 渡辺信之, 信岡大輔, 楳田祐三, 篠浦先, 藤原俊義

肝臓 60 ( 6 ) 216 - 216 2019.6

食道癌術後における抑うつ傾向の頻度と臨床病期についての検討

櫻間教文, 平松聡, 江原啓太, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 73回 381 - 381 2019.6

高度局所進行食道癌に対するサルベージ手術の治療成績

橋本将志, 白川靖博, 小林照貴, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 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 73回 292 - 292 2019.6

混合型食道裂孔ヘルニアに対する心負荷軽減に着目した新たな手術適応

田辺俊介, 白川靖博, 橋本将志, 小林照貴, 前田直見, 櫻間教文, 野間和広, 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 73回 69 - 69 2019.6

再建臓器の評価とそれにもとづく再建法の工夫食道切除における血流評価を元に行う安全な胃管・空腸再建法

野間和広, 橋本将志, 小林照貴, 前田直見, 田辺俊介, 櫻間教文, 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 73回 54 - 54 2019.6

Clinical Impact of Sarcopenia on Gastric Cancer. International journal

Kazuya Kuwada, Shinji Kuroda, Satoru Kikuchi, Ryuichi Yoshida, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Anticancer research 39 ( 5 ) 2241 - 2249 2019.5

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

Sarcopenia is a complex syndrome defined by progressive and generalized loss of skeletal muscle mass and strength. Although sarcopenia is mainly associated with aging, cancer is also one of its causes. Sarcopenia is now drawing attention as a poor prognostic factor in cancer. In patients with gastric cancer associated with eating disorders that often leads to loss of weight and muscle, sarcopenia is particularly important. Its definition and method of assessment, however, vary between studies, thus these need to be standardized. Nevertheless, emerging evidence suggests that sarcopenia contributes independently to postoperative complications and overall survival in gastric cancer. Interventions preventing sarcopenia with targeted nutrition and exercise are currently explored. This review aims to provide an understanding of sarcopenia, emphasizing its importance in the management of gastric cancer.

DOI： 10.21873/anticanres.13340

【消化器疾患に対する機能温存・再建手術】上部消化管領域噴門側胃切除における観音開き法再建

岡山大学病院における大腸癌エキスパートパネル診療

母里淑子, 矢野修也, 遠西大輔, 田端雅弘, 柳井広之, 豊岡伸一, 平沢晃, 藤原俊義

日本外科学会定期学術集会抄録集 119回 PS - 1 2019.4

肥満症に対する腹腔鏡下スリーブ状胃切除術の導入とその効果

香川俊輔, 黒田新士, 菊地覚次, 桑田和也, 津村朋子, 西崎正彦, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 119回 PS - 1 2019.4

テロメラーゼ標的蛍光発現ウイルスを用いた腹腔内腫瘍関連マクロファージの機能解析

桑田和也, 香川俊輔, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SF - 5 2019.4

遺伝子改変ウイルスを用いた胃癌腹膜播種に対する腹腔内治療の可能性

菊地覚次, 石川亘, 小川俊博, 田澤大, 黒田新士, 桑田和也, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SF - 6 2019.4

胃切除後の機能評価噴門側胃切除術後の逆流防止機能を付加した観音開き法(上川法)食道残胃吻合の有効性と安全性を評価する多施設共同後向き研究(rD-FLAP Study)

丁田泰宏, 黒田新士, 石田道拡, 久保田哲史, 大塚眞哉, 上山聡, 田中則光, 村岡篤, 羽藤慎二, 木村臣一, 田中屋宏爾, 上川康明, 藤原俊義

日本外科学会定期学術集会抄録集 119回 WS - 10 2019.4

西崎正彦, 黒田新士, 藤原俊義

外科 81 ( 5 ) 417 - 421 2019.4

MELD scoreによる生体肝移植の術後解析生体肝移植におけるMELD/重症度に応じたDonor/Graft選択の重要性

楳田祐三, 八木孝仁, 吉田龍一, 杭瀬崇, 吉田一博, 藤智和, 安井和也, 松田達雄, 白川靖博, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 119回 PD - 3 2019.4

80歳以上の超高齢者食道癌に対する包括的治療戦略

前田直見, 白川靖博, 西脇紀之, 松田達雄, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本外科学会定期学術集会抄録集 119回 PS - 1 2019.4

肝移植患者の移植後二次発癌

松田達雄, 楳田祐三, 吉田一博, 吉田龍一, 野間和広, 信岡大輔, 田辺俊介, 杭瀬崇, 前田直見, 安井和也, 白川靖博, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 119回 PS - 2 2019.4

食道外科・頭頸部外科・形成外科の三科合同で行う頸胸部食道癌の拡大切除と消化管・気道再建術におけるチームワークの重要性

橋本将志, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SF - 4 2019.4

切除不能T4食道癌に対するDCFを用いた化学放射線療法による集学的治療と最適な救済手術のタイミングの検討

田辺俊介, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 櫻間教文, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SF - 3 2019.4

食道胃接合部癌の外科治療(郭清・再建) 食道胃接合部癌168例の治療経験から導かれる最適な集学的治療

野間和広, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SY - 4 2019.4

トランスレーショナルリサーチとしての外科治療を補完する新たな集学的治療の開発研究

田澤大, 田辺俊介, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SP - 5 2019.4

血中遊離メチル化DNA測定による早期診断、術後再発予測、病勢予測

戸嶋俊明, 永坂岳司, 入谷光洋, 安井和也, 吉田一博, 稲田涼, 楳田祐三, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SF - 2 2019.4

外科治療成績の向上を目指した感染症対策 IBDセンターにおける外科感染症対策10年の推移、感染率低下のbreakthrough

近藤喜太, 藤原俊義

日本外科学会定期学術集会抄録集 119回 SY - 3 2019.4

PD-L1 expression combined with microsatellite instability/CD8+ tumor infiltrating lymphocytes as a useful prognostic biomarker in gastric cancer. Reviewed International journal

Toshiaki Morihiro, Shinji Kuroda, Nobuhiko Kanaya, Yoshihiko Kakiuchi, Tetsushi Kubota, Katsuyuki Aoyama, Takehiro Tanaka, Satoru Kikuchi, Takeshi Nagasaka, Masahiko Nishizaki, Shunsuke Kagawa, Hiroshi Tazawa, Toshiyoshi Fujiwara

Scientific reports 9 ( 1 ) 4633 - 4633 2019.3

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

While the importance of programmed death-ligand 1 (PD-L1), mutation burden caused by microsatellite instability (MSI), and CD8+ tumor infiltrating lymphocytes (TILs) has become evident, the significance of PD-L1 expression on prognosis still remains controversial. We evaluated the usefulness of combined markers of PD-L1 and MSI or CD8+ TILs as a prognostic biomarker in gastric cancer. A total of 283 patients with gastric cancer were reviewed retrospectively. PD-L1 expression on >5% tumor cells was defined as PD-L1-positive. PD-L1-positive rate was 15.5% (44/283). PD-L1 positivity was significantly correlated with invasive and advanced cancer and also significantly correlated with MSI, whereas no significance was observed with CD8+ TILs. Kaplan-Meier analysis showed that PD-L1 positivity significantly correlated with a poor prognosis (p = 0.0025). Multivariate analysis revealed that PD-L1 positivity was an independent poor prognostic factor (hazard ratio [HR]: 1.97, p = 0.0106) along with diffuse histological type and lymph node metastases. Combinations of PD-L1 and MSI (HR: 2.18) or CD8+ TILs (HR: 2.57) were stronger predictive factors for prognosis than PD-L1 alone. In conclusion, combined markers of PD-L1 and MSI or CD8+ TILs may be more useful prognostic biomarkers in gastric cancer, and better clarify the immune status of gastric cancer patients.

DOI： 10.1038/s41598-019-41177-2

Activation of AZIN1 RNA editing is a novel mechanism that promotes invasive potential of cancer-associated fibroblasts in colorectal cancer. Reviewed

Takeda S, Shigeyasu K, Okugawa Y, Yoshida K, Mori Y, Yano S, Noma K, Umeda Y, Kondo Y, Kishimoto H, Teraishi F, Nagasaka T, Tazawa H, Kagawa S, Fujiwara T, Goel A

Cancer letters 444 127 - 135 2019.3

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER IRELAND LTD

Adenosine-to-inosine (A-to-I) RNA editing is a recently described epigenetic modification, which is believed to constitute a key oncogenic mechanism in human cancers. However, its functional role in cancer-associated fibroblasts (CAFs) within the tumor microenvironment (TME) and its clinical significance remains unclear. Herein, we systematically analyzed a large cohort of 627 colorectal cancer (CRC) specimens, and investigated the expression pattern of ADAR1 and its biological significance on the antizyme inhIbitor 1 (AZIN1) RNA editing levels. Both ADAR1 expression and AZIN1 RNA editing levels were significantly elevated in CRC tissues vs. normal mucosa, and these findings correlated with the increased expression of mesenchymal markers, Vimentin (p = 0.44) and Fibroblast activation protein (p = 0.38). Intriguingly, ADAR1 expression was specifically upregulated in both cancer cells and fibroblasts from cancerous lesions. Conditioned medium from cancer cells led to induction of ADAR1 expression and activation of AZIN1 RNA editing in fibroblasts (p < 0.05). Additionally, edited AZIN1 enhanced the invasive potential of fibroblasts. In conclusion, we provide novel evidence that hyper-editing of AZIN1 enhances the invasive potential of CAFs within the TME in colon and is an important predictor of tumor invasiveness in CRC.

DOI： 10.1016/j.canlet.2018.12.009

多発筋炎/皮膚筋炎でみつかった直腸癌の一例 Reviewed

重安邦俊, 母里淑子, 三村直毅, 小松泰浩, 戸嶋俊明, 矢野修也, 近藤喜太, 岸本浩行, 寺石文則, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 80 ( 3 ) 607 - 607 2019.3

腹腔鏡下胃切除術後出血の1例

菊地覚次, 津村朋子, 桑田和也, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 80 ( 3 ) 606 - 606 2019.3

サルベージ手術としての腹臥位胸腔鏡下食道切除術拡大視効果を最大限に活かして

松田達雄, 西脇紀之, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 80 ( 3 ) 605 - 605 2019.3

下大静脈腫瘍栓を有する巨大肝細胞癌に対し積極的な肝切除を施行した2例

岡凌也, 信岡大輔, 小西大輔, 西山岳芳, 田渕幹康, 安井和也, 吉田一博, 杭瀬崇, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 80 ( 3 ) 606 - 606 2019.3

A Novel Combination Cancer Therapy with Iron Chelator Targeting Cancer Stem Cells via Suppressing Stemness. Reviewed International journal

Yuki Katsura, Toshiaki Ohara, Kazuhiro Noma, Takayuki Ninomiya, Hajime Kashima, Takuya Kato, Hiroaki Sato, Satoshi Komoto, Toru Narusaka, Yasuko Tomono, Boyi Xing, Yuehua Chen, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Tomonari Kasai, Masaharu Seno, Akihiro Matsukawa, Toshiyoshi Fujiwara

Cancers 11 ( 2 ) 2019.2

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

Excess iron causes cancer and is thought to be related to carcinogenesis and cancer progression including stemness, but the details remain unclear. Here, we hypothesized that stemness in cancer is related to iron metabolism and that regulating iron metabolism in cancer stem cells (CSCs) may be a novel therapy. In this study, we used murine induced pluripotent stem cells that expressed specific stem cell genes such as Nanog, Oct3/4, Sox2, Klf4, and c-Myc, and two human cancer cell lines with similar stem cell gene expression. Deferasirox, an orally available iron chelator, suppressed expression of stemness markers and spherogenesis of cells with high stemness status in vitro. Combination therapy had a marked antitumor effect compared with deferasirox or cisplatin alone. Iron metabolism appears important for maintenance of stemness in CSCs. An iron chelator combined with chemotherapy may be a novel approach via suppressing stemness for CSC targeted therapy.

DOI： 10.3390/cancers11020177

【食道癌集学的治療の最前線】食道癌周術期チーム医療の最前線

胃癌手術患者における術前・術後サルコペニアの予後に与える影響

桑田和也, 金谷信彦, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 91回 249 - 249 2019.2

進行胃癌に対するネオアジュバント化学療法の治療成績(Outcomes of neoadjuvant chemotherapy for advanced gastric cancer)

Kagawa Shunsuke, Kuroda Shinji, Kikuchi Satoru, Kuwada Kazuya, Tsumura Tomoko, Nishizaki Masahiko, Fujiwara Toshiyoshi

日本胃癌学会総会記事 91回 464 - 464 2019.2

胃癌の腹膜転移に対する新規の腹腔内ウイルス療法(Novel intraperitoneal virotherapy for the peritoneal metastasis of gastric cancer)

Kikuchi Satoru, Ishikawa Wataru, Ogawa Toshihiro, Kuroda Shinji, Kuwada Kazuya, Nishizaki Masahiko, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本胃癌学会総会記事 91回 337 - 337 2019.2

観音開き法による食道残胃吻合を行ったLAPGとLATGとの中期および長期成績比較(Mid- and long-term comparison of LAPG with double-flap esophagogastrostomy and LATG)

Kuroda Shinji, Nishizaki Masahiko, Kikuchi Satoru, Tsumura Tomoko, Kuwada Kazuya, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本胃癌学会総会記事 91回 302 - 302 2019.2

近位胃切除術後のEGJCに対するDFTを使用した弁形成食道胃吻合術(Valvutoplastic esophagogastrostomy using DFT for EGJC after proximal gastrectomy)

Nishizaki Masahiko, Kuroda Shinji, Noma Kazuhiro, Kikuchi Satoru, Kuwada Kazuya, Tanabe Shunsuke, Kagawa Shunsuke, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本胃癌学会総会記事 91回 273 - 273 2019.2

白川靖博, 田辺俊介, 藤原俊義

日本消化器病学会雑誌 116 ( 2 ) 138 - 144 2019.2

Language：Japanese Publisher：(一財)日本消化器病学会

Enhanced recovery after surgery(ERAS)プロトコールの本質は、エビデンスの検証が行われかつ推奨されている「周術期に特化して作成されたクリニカルパスのアウトライン」である。ERASプロトコールを実践するためには、チーム医療を行うことが必要不可欠である。当院では、ERASプロトコールの多くを取り入れた周術期管理センター(Perioperative management center;PERiO)が周術期チーム医療を行っている。多職種のスタッフが組織横断的に情報を共有しながら業務を行うことにより、より一層安全・安心な周術期管理の環境を提供することを実現している。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01118&link_issn=&doc_id=20190218280005&doc_link_id=130007595859&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007595859&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Multicenter retrospective study to evaluate the efficacy and safety of the double-flap technique as antireflux esophagogastrostomy after proximal gastrectomy (rD-FLAP Study).

Shinji Kuroda, Yasuhiro Choda, Shinya Otsuka, Satoshi Ueyama, Norimitsu Tanaka, Atsushi Muraoka, Shinji Hato, Toshikazu Kimura, Kohji Tanakaya, Satoru Kikuchi, Shunsuke Tanabe, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Yasuhiro Shirakawa, Yasuaki Kamikawa, Toshiyoshi Fujiwara

Annals of gastroenterological surgery 3 ( 1 ) 96 - 103 2019.1

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

Aim: As a result of the difficulty in effective prevention of gastroesophageal reflux, no standard reconstruction procedure after proximal gastrectomy (PG) has yet been established. The double-flap technique (DFT), or Kamikawa procedure, is an antireflux reconstruction procedure in esophagogastrostomy. The efficacy of DFT has recently been reported in several studies. However, these were all single-center studies with a limited number of cases. Methods: We conducted a multicenter retrospective study in which patients who underwent DFT, irrespective of disease type and reconstruction approach, at each participating institution between 1996 and 2015 were registered. Primary endpoint was incidence of reflux esophagitis at 1-year after surgery, and secondary endpoint was incidence of anastomosis-related complications. Results: Of 546 patients who were eligible for this study, 464 patients who had endoscopic examination at 1-year follow up were evaluated for reflux esophagitis. Incidence of reflux esophagitis of all grades was 10.6% and that of grade B or higher was 6.0%. Male gender and anastomosis located in the mediastinum/intra-thorax were independent risk factors for grade B or higher reflux esophagitis (odds ratio [OR]: 4.21, 95% confidence interval [CI]: 1.44-10.9, P = 0.0109). Total incidence of anastomosis-related complications was 7.2%, including leakage in 1.5%, strictures in 5.5% and bleeding in 0.6% of cases. Laparoscopic reconstruction was the only independent risk factor for anastomosis-related complications (OR: 3.93, 95% CI: 1.93-7.80, P = 0.0003). Conclusion: Double-flap technique might be a feasible option after PG for effective prevention of reflux, although anastomotic stricture is a complication that must be well-prepared for.

DOI： 10.1002/ags3.12216

外科医のトレーニング技術の継承とはカダバートレーニングにおける技術の継承

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 西崎正彦, 白川靖博, 藤原俊義

日本外科学会雑誌 120 ( 1 ) 105 - 107 2019.1

【腹腔鏡下胃切除後体腔内再建のKnack & Pitfalls】腹腔鏡下噴門側胃切除術観音開き法(上川法)による再建

西崎正彦, 黒田新士, 野間和広, 菊地覚次, 白川靖博, 藤原俊義

手術 73 ( 1 ) 55 - 59 2019.1

Photoimmunotherapy for cancer-associated fibroblasts targeting fibroblast activation protein in human esophageal squamous cell carcinoma. Reviewed International journal

Shinichiro Watanabe, Kazuhiro Noma, Toshiaki Ohara, Hajime Kashima, Hiroaki Sato, Takuya Kato, Shinichi Urano, Ryoichi Katsube, Yuuri Hashimoto, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Hisataka Kobayashi, Toshiyoshi Fujiwara

Cancer biology & therapy 20 ( 9 ) 1234 - 1248 2019

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

Cancer-associated fibroblasts (CAFs) are strongly implicated in tumor progression, including in the processes of tumorigenesis, invasion, and metastasis. The targeting of CAFs using various therapeutic approaches is a novel treatment strategy; however, the efficacy of such therapies remains limited. Recently, near-infrared photoimmunotherapy (NIR-PIT), which is a novel targeted therapy employing a cell-specific mAb conjugated to a photosensitizer, has been introduced as a new type of phototherapy. In this study, we have developed a novel NIR-PIT technique to target CAFs, by focusing on fibroblast activation protein (FAP), and we evaluate the treatment efficacy in vitro and in vivo. Esophageal carcinoma cells exhibited enhanced activation of fibroblasts, with FAP over-expressed in the cytoplasm and on the cell surface. FAP-IR700-mediated PIT showed induced rapid cell death specifically for those cells in vitro and in vivo, without adverse effects. This novel therapy for CAFs, designed as local control phototherapy, was safe and showed a promising inhibitory effect on FAP+ CAFs. PIT targeting CAFs via the specific marker FAP may be a therapeutic option for CAFs in the tumor microenvironment in the future.

DOI： 10.1080/15384047.2019.1617566

Intraperitoneal cancer-immune microenvironment promotes peritoneal dissemination of gastric cancer. Reviewed International journal

Shuichi Sakamoto, Shunsuke Kagawa, Kazuya Kuwada, Atene Ito, Hiroki Kajioka, Yoshihiko Kakiuchi, Megumi Watanabe, Tetsuya Kagawa, Ryuichi Yoshida, Satoru Kikuchi, Shinji Kuroda, Hiroshi Tazawa, Toshiyoshi Fujiwara

Oncoimmunology 8 ( 12 ) e1671760 2019

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

A solid tumor consists of cancer and stromal cells, which comprise the tumor microenvironment (TME). Tumor-associated macrophages (TAMs) are usually abundant in the TME, contributing to tumor progression. In cases of peritoneal dissemination of gastric cancer (GC), the contribution of intraperitoneal TAMs remains unclear. Macrophages from peritoneal washings of GC patients were analyzed, and the link between intraperitoneal TAMs and GC cells was investigated to clarify the interaction between them in peritoneal dissemination. Macrophages were predominant among leukocytes constituting the microenvironment of the peritoneal cavity. The proportion of CD163-positive TAMs was significantly higher in stage IV than in stage I GC. Co-culture with TAMs potentiated migration and invasion of GC. IL-6 was the most increased in the medium of in vitro co-culture of macrophages and GC, and IL-6 elevation was also observed in the peritoneal washes with peritoneal dissemination. An elevated concentration of intraperitoneal IL-6 was correlated with a poor prognosis in clinical cases. In conclusion, intraperitoneal TAMs are involved in promoting peritoneal dissemination of GC via secreted IL-6. TAM-derived IL-6 could be a potential therapeutic target for peritoneal dissemination of GC.

DOI： 10.1080/2162402X.2019.1671760

Forefront of perioperative team medicine for esophageal cancer surgery

Yasuhiro Shirakawa, Shunsuke Tanabe, Toshiyoshi Fujiwara

Journal of Japanese Society of Gastroenterology 116 ( 2 ) 138 - 144 2019

The epithelial-to-mesenchymal transition induced by tumor-associated macrophages confers chemoresistance in peritoneally disseminated pancreatic cancer. Reviewed International journal

Kuwada K, Kagawa S, Yoshida R, Sakamoto S, Ito A, Watanabe M, Ieda T, Kuroda S, Kikuchi S, Tazawa H, Fujiwara T

Journal of experimental & clinical cancer research : CR 37 ( 1 ) 307 - 307 2018.12

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

BACKGROUND: The peritoneum is one of the most frequent metastatic sites in pancreatic cancer patients, and peritoneal dissemination makes this disease refractory due to aggressive progression and chemoresistance. Although the role of the tumor microenvironment in cancer development is recognized, the correlation between the peritoneal environment and refractoriness of peritoneal dissemination remains unclear. The intraperitoneal tumor-microenvironment and its potential role in the progression of peritoneal dissemination and chemo-refractoriness, focusing especially on macrophages, were investigated. MATERIALS AND METHODS: Peritoneal washes were obtained from pancreatic cancer patients, and cellular components were subjected to immunofluorescence assays. The effects of macrophages induced from monocytic THP-1 cells on pancreatic cancer cells were examined in co-culture conditions. The in vivo effects of macrophages on tumor growth and chemo-sensitivity were investigated by subcutaneously or intraperitoneally co-injecting cancer cells with macrophages into mice. RESULTS: CD204-positive macrophages were present along with cancer cells in the peritoneal washes. In in vitro co-culture, tumor-associated macrophages affected pancreatic cancer cells, induced the epithelial-to-mesenchymal transition (EMT), and made them more resistant to chemotherapeutic agents. M2 macrophages promoted growth of both subcutaneous tumors and peritoneal dissemination in mice. Furthermore, co-inoculation of M2 macrophages conferred chemoresistance in the peritoneal dissemination mouse model, which significantly shortened their survival. CONCLUSION: Intraperitoneal tumor-associated macrophages potentially play an important role in promotion of peritoneal dissemination and chemoresistance of pancreatic cancer via EMT induction.

DOI： 10.1186/s13046-018-0981-2

taTMEを安全に導入、普及させるためのcadaver surgical trainingの役割

戸嶋俊明, 近藤喜太, 信岡大輔, 黒田新士, 前田直見, 寺石文則, 白川靖博, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS78 - 7 2018.12

Closed-LECS手技の確立と今後の可能性早期胃癌、十二指腸病変への応用

菊地覚次, 西崎正彦, 黒田新士, 桑田和也, 津村朋子, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS23 - 2 2018.12

上部胃癌に対する再建法を考える腹腔鏡下噴門側胃切除術における観音開き法再建の中長期成績

西崎正彦, 黒田新士, 菊地覚次, 桑田和也, 津村朋子, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) WS12 - 7 2018.12

内視鏡外科におけるCadaver教育が果たすべき役割と未来

近藤喜太, 前田直見, 黒田新士, 信岡大輔, 西崎正彦, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) EDS - 2 2018.12

Prognostic Factors for Pediatric Living Donor Liver Transplantation: Impact of Zero-mortality Transplant for Cholestatic Diseases.

Takahito Yagi, Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Toshiyoshi Fujiwara

Acta medica Okayama 72 ( 6 ) 567 - 576 2018.12

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

Living donor liver transplantation (LDLT) is the final therapeutic arm for pediatric end-stage liver diseases. Toward the goal of achieving further improvement in LDLT survival, we investigated factors affecting recipient survival. We evaluated the prognostic factors of 60 pediatric recipients (< 16 years old) who underwent LDLT between 1997 and 2015. In a univariate analysis, non-cholestatic (NCS) disease, graft/recipient body weight ratio, cold and warm ischemic times, and intraoperative blood loss were significant factors impacting survival. In a multivariate analysis, NCS disease was the only significant factor worsening survival (p=0.0021). One-and 5-year survival rates for the cholestatic disease (CS, n=43) and NCS (n=17) groups were 100% vs. 70.6% and 97.4% vs. 58.8% (p=0.004, log-rank). Intergroup comparisons revealed that CS was significantly associated with operation time, cold ischemia, hepatomegaly of the native liver, and portal plasty. These data suggest that a cirrhotic, swollen, artery-dominant liver did not increase graft size-related risks despite the surgical complexity of preceding operations. The NCS group's poorer survival originated from recurrence of the primary disease and liver manifestation of systemic disease untreatable by transplantation. Improving the survival of pediatric recipients requires intensive efforts to prevent primary disease relapse and more rapid diagnoses to exclude contraindications from NCS disease.

DOI： 10.18926/AMO/56374

手術既往を有する炎症性腸疾患に対する腹腔鏡手術完遂のための工夫

小松泰浩, 近藤喜太, 三村直毅, 戸嶋俊明, 寺石文則, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS53 - 1 2018.12

鏡視下食道癌手術のヒヤリハットとトラブルシューティング

西脇紀之, 野間和広, 松田達雄, 前田直見, 田辺俊介, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS233 - 4 2018.12

サルベージ手術としての腹臥位胸腔鏡下食道切除術拡大視効果を最大限に活かして

松田達雄, 田辺俊介, 西脇紀之, 前田直見, 野間和広, 楳田祐三, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS230 - 3 2018.12

右肺癌に対する開胸術後に発症した食道癌に対する腹臥位胸腔鏡下食道亜全摘の経験

前田直見, 白川靖博, 西脇紀之, 松田達雄, 田辺俊介, 野間和広, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS229 - 7 2018.12

膜と層を意識した胸腔鏡下食道切除術胸腔鏡下食道癌手術における交感神経を指標とした上縦隔リンパ節郭清

白川靖博, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) PD8 - 1 2018.12

食道胃接合部癌に対する治療戦略食道胃接合部癌に対する胸腔鏡腹腔鏡を併用した切除再建術式の有用性

野間和広, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) SY8 - 2 2018.12

チーム医療における人材育成のためのカダバーサージカルトレーニング

近藤喜太, 前田直見, 黒田新士, 信岡大輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS223 - 1 2018.12

巨大食道裂孔ヘルニアの噴門形成術後に発症した胃噴門部癌に対するRedo surgery

田辺俊介, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 桑田和也, 菊地覚次, 黒田新士, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS148 - 1 2018.12

上腹部開腹歴を有する腹腔鏡下胃切除術における安全性の検討

津村朋子, 黒田新士, 桑田和也, 菊池覚次, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 23 ( 7 ) OS115 - 5 2018.12

陰圧閉鎖療法を極める-NPWTの至適使用法(チーム医療、効果的使用法、使用部位、等)- 消化器外科領域における陰圧閉鎖療法の意義と使用時期に関する検討

近藤喜太, 藤原俊義

日本創傷治癒学会プログラム・抄録集 48回 119 - 119 2018.11

Cancer-Associated Fibroblasts Affect Intratumoral CD8(+) and FoxP3(+) T Cells Via IL6 in the Tumor Microenvironment Reviewed International journal

Kato Takuya, Noma Kazuhiro, Ohara Toshiaki, Kashima Hajime, Katsura Yuki, Sato Hiroaki, Komoto Satoshi, Katsube Ryoichi, Ninomiya Takayuki, Tazawa Hiroshi, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

CLINICAL CANCER RESEARCH 24 ( 19 ) 4820 - 4833 2018.10

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

Purpose: Cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) play a central role in tumor progression. We investigated whether CAFs can regulate tumor-infiltrating lymphocytes (TILs) and their role in tumor immunosuppression.Experimental Design: A total of 140 cases of esophageal cancer were analyzed for CAFs and CD8+ or forkhead box protein 3 (FoxP3+) TILs by IHC. We analyzed cytokines using murine or human fibroblasts and cancer cells. Murine-derived fibroblasts and cancer cells were also inoculated into BALB/c or BALB/c-nu/nu mice and the tumors treated with recombinant IL6 or anti-IL6 antibody.Results: CD8+ TILs and CAFs were negatively correlated in intratumoral tissues (P < 0.001), whereas FoxP3+ TILs were positively correlated (P < 0.001) in esophageal cancers. Cocultured Colon26 cancer cells and fibroblasts resulted in accelerated tumor growth in BALB/c mice, along with decreased CD8+ and increased FoxP3+ TILs, compared with cancer cells alone. In vitro, IL6 was highly secreted in both murine and human cancer cell/fibroblast cocultures. IL6 significantly increased Colon26 tumor growth in immune-competent BALB/c (P < 0.001) with fewer CD8+ TILs than untreated tumors (P < 0.001), whereas no difference in BALB/c-nu/nu mice. In contrast, FoxP3+ TILs increased in IL6-treated tumors (P < 0.001). IL6 antibody blockade of tumors cocultured with fibroblasts resulted not only in regression of tumor growth but also in the accumulation of CD8+ TILs in intratumoral tissues.Conclusions: CAFs regulate immunosuppressive TIL populations in the TME via IL6. IL6 blockade, or targeting CAFs, may improve preexisting tumor immunity and enhance the efficacy of conventional immunotherapies. Clin Cancer Res; 24(19); 4820-33. ©2018 AACR.

DOI： 10.1158/1078-0432.CCR-18-0205

Cancer-associated fibroblasts (CAFs) promote the lymph node metastasis of esophageal squamous cell carcinoma. Reviewed International journal

Kashima H, Noma K, Ohara T, Kato T, Katsura Y, Komoto S, Sato H, Katsube R, Ninomiya T, Tazawa H, Shirakawa Y, Fujiwara T

International journal of cancer 144 ( 4 ) 828 - 840 2018.10

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

Lymph node metastasis is a pathognomonic feature of spreading tumors, and overcoming metastasis is a challenge in attaining more favorable clinical outcomes. Esophageal cancer is an aggressive tumor for which lymph node metastasis is a strong poor prognostic factor, and the tumor microenvironment (TME), and cancer-associated fibroblasts (CAFs) in particular, has been implicated in esophageal cancer progression. CAFs play a central role in the TME and have been reported to provide suitable conditions for the progression of esophageal cancer, similar to their role in other malignancies. However, little is known concerning the relevance of CAFs to the lymph node metastasis of esophageal cancer. Here, we used clinical samples of esophageal cancer to reveal that CAFs promote lymph node metastasis and subsequently verified the intercellular relationships in vitro and in vivo using an orthotopic metastatic mouse model. In the analysis of clinical samples, FAP+ CAFs were strongly associated with lymph node metastasis rather than with other prognostic factors. Furthermore, CAFs affected the ability of esophageal cancer cells to acquire metastatic phenotypes in vitro; this finding was confirmed by data from an in vivo orthotopic metastatic mouse model showing that the number of lymph node metastases increased upon injection of cocultured cancer cells and CAFs. In summary, we verified in vitro and in vivo that the accumulation of CAFs enhances the lymph node metastasis of ESCC. Our data suggest that CAF targeted therapy can reduce lymph node metastasis and improve the prognosis of patients with esophageal cancer in the future.

DOI： 10.1002/ijc.31953

【消化器外科ロボット支援手術の実際】ロボット支援腹腔鏡下噴門側胃切除術

Integrated fluorescent cytology with nano-biologics in peritoneally disseminated gastric cancer. Reviewed

Watanabe M, Kagawa S, Kuwada K, Hashimoto Y, Shigeyasu K, Ishida M, Sakamoto S, Ito A, Kikuchi S, Kuroda S, Kishimoto H, Tomida S, Yoshida R, Tazawa H, Urata Y, Fujiwara T

Cancer science 109 ( 10 ) 3263 - 3271 2018.10

食道癌鏡視下手術における拡大視野での新しい外科解剖胸腔鏡下食道癌手術における高精細画像がもたらす微細解剖

白川靖博, 橋本将志, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 野間和広, 楳田祐三, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 409 - 409 2018.10

胃癌・低侵襲手術-ロボット手術と鏡視下手術- ロボット支援下幽門側胃切除術の導入と噴門側胃切除術・胃全摘術への応用

西崎正彦, 黒田新士, 菊地覚次, 桑田和也, 津村朋子, 香川俊輔, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 394 - 394 2018.10

西崎正彦, 黒田新士, 菊地覚次, 野間和広, 白川靖博, 藤原俊義

手術 72 ( 11 ) 1589 - 1594 2018.10

高齢者に対する食道裂孔ヘルニア手術によるQOL改善への貢献

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本老年医学会雑誌 55 ( 4 ) 719 - 719 2018.10

重複癌の治療戦略〜食道癌〜食道癌手術症例の同時性異時性重複癌の検討

田辺俊介, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 野間和広, 楳田祐三, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 335 - 335 2018.10

食道癌の鏡視下手術のトラブルシューティング腹臥位鏡視下食道癌手術のヒヤリハットとトラブルシューティング

野間和広, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 田辺俊介, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 308 - 308 2018.10

【食道癌(第2版)-基礎・臨床研究の進歩-】食道癌の治療外科治療食道胃接合部癌に対する手術経裂孔的食道切除術腹腔鏡手術

白川靖博, 前田直見, 田辺俊介, 野間和広, 藤原俊義

日本臨床 76 ( 増刊8 食道癌 ) 305 - 310 2018.10

膵鈎部癌に対する上腸間膜動脈周囲郭清の郭清手技腫瘍進展に基づいたleft-lateral approach

吉田一博, 楳田祐三, 吉田龍一, 信岡大輔, 杭瀬崇, 安井和也, 田渕幹康, 西山岳芳, 白川靖博, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 448 - 448 2018.10

遠隔転移を有する膵神経内分泌腫瘍の治療戦略膵神経内分泌腫瘍(panNEN)における、肝転移症例の検討と外科的治療戦略

田渕幹康, 杭瀬崇, 西山岳芳, 安井和也, 吉田一博, 信岡大輔, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 79 ( 増刊 ) 332 - 332 2018.10

消化管がん治療の新展開食道癌におけるがん細胞及びがん関連線維芽細胞に対するDual-targeting Photoimmunotherapy(Developments in gastrointestinal cancer treatments Dual-targeting Photoimmunotherapy for esophageal cancer and cancer-associated fibroblasts in tumor microenvironment) Reviewed

佐藤浩明, 野間和広, 鳴坂徹, 河本慧, 大原利章, 田澤大, 藤原俊義

日本癌学会総会記事 77回 96 - 96 2018.9

[The Elucidation of Tumor Immunosuppression Affected by Cancer-Associated Fibroblasts]. Reviewed

Takuya Kato, Kazuhiro Noma, Yuki Katsura, Hiroaki Sato, Satoshi Kohmoto, Takayuki Ninomiya, Toshiaki Ohara, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 45 ( 9 ) 1279 - 1281 2018.9

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

Development of immunotherapy, especially checkpoint inhibitors, dramatically improved the prognosis of some malignancies. However, problems on the occurrence of severe adverse effects and limited responses to these checkpoint inhibitors remain. Recently, tumor infiltrating lymphocytes(TILs)are the predictive markers of immunotherapies based on clinical evidence. The proportion of cytotoxic T cells in the tumor has been reported to affect the antitumor effect. TILs in the tumor are thought to be controlled by the interaction between cancer and tumor microenvironment. As a cause of tumor immunosuppression, cancer-associated fibroblasts(CAFs)play the main role in the tumor microenvironment. We considered the strong involvement of tumor microenvironment, particularly the role of CAFs, and reported the interaction between CAFs and proliferation, invasion, angiogenesis, and resistance in the conventional therapy. The correlation between CAFs and tumor immunity and the immunosuppression promoted by CAFs were also evaluated. Their effects will be reported in our future studies.

炎症性微小環境-大腸がんクロストークにおけるEMTイメージング(Visualization of epithelial-mesenchymal transition in inflammatory microenvironment-colorectal cancer crosstalk) Reviewed

田澤大, 家田偉史, 矢野修也, 重安邦俊, 黒田新士, 大原利章, 野間和広, 岸本浩行, 西崎正彦, 香川俊輔, 斎藤卓, 今村健志, 藤原俊義

日本癌学会総会記事 77回 1204 - 1204 2018.9

癌関連線維芽細胞が放出するIL-6が腫瘍内に浸潤するCD8+ならびにFoxP3+T細胞に影響を与える(Cancer-associated fibroblasts affect the intra-tumoral infiltration of CD8+ and FoxP3+ T cells via IL-6)

加藤卓也, 野間和広, 佐藤浩明, 河本慧, 大原利章, 田澤大, 白川靖博, 藤原俊義

日本癌学会総会記事 77回 1860 - 1860 2018.9

HER増幅胃癌におけるアファチニブ耐性機序(Acquired resistant mechanism to afatinib in HER2 amplified gastric cancer cells)

吉岡貴裕, 枝園和彦, 難波圭, 冨田秀太, 山本寛斉, 宗淳一, 藤原俊義, 豊岡伸一

日本癌学会総会記事 77回 1449 - 1449 2018.9

p53誘導性腫瘍融解ウイルス療法は骨肉腫に強力な免疫原性細胞死を誘導する(Oncolytic adenoviral therapy with p53 transactivation induces profound immunogenic cell death in osteosarcoma)

出宮光二, 田澤大, 望月雄介, 小松原将, 杉生和久, 長谷井嬢, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 77回 2251 - 2251 2018.9

骨肉腫に対する抗PD-1抗体とテロメラーゼ特異的ウイルス療法による新規治療戦略(Novel therapeutic strategy with anti-PD-1 antibody and telomerase-specific oncolytic virotherapy in osteosarcoma)

望月雄介, 田澤大, 出宮光二, 小松原将, 杉生和久, 長谷井嬢, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 77回 1813 - 1813 2018.9

鉄キレート剤の幹細胞性制御による新規癌治療法(Stemness control by iron chelator is a novel strategy for cancer treatment) Reviewed

大原利章, 桂佑貴, 野間和広, 鳴坂徹, 佐藤浩明, 河本慧, 加藤卓也, 田澤大, 香川俊輔, 藤原俊義

日本癌学会総会記事 77回 2318 - 2318 2018.9

癌関連線維芽細胞が及ぼす腫瘍免疫逃避の解明 Reviewed

加藤卓也, 野間和広, 桂佑貴, 佐藤浩明, 河本慧, 二宮卓之, 大原利章, 田澤大, 香川俊輔, 白川靖博, 藤原俊義

癌と化学療法 45 ( 9 ) 1279 - 1281 2018.9

Language：Japanese Publisher：(株)癌と化学療法社

近年、免疫チェックポイント阻害薬をはじめがん免疫療法の発展により、飛躍的に予後の改善を認める癌腫が散見される。しかしながら、致命的な有害事象の発生や効果の得られる症例が限定的であることなど、克服すべき問題点も指摘されている。免疫チェックポイント阻害薬の治療効果予測因子として腫瘍浸潤リンパ球が注目されており、特に細胞傷害性T細胞の腫瘍内浸潤の程度が抗腫瘍効果に影響を与えていると報告されている。リンパ球の腫瘍浸潤においては、癌とがん微小環境の相互作用によって制御している可能性が指摘されている。そのなかで中心的な役割を担っている癌関連線維芽細胞(cancer-associated fibroblasts:CAFs)が注目されている。以前よりわれわれは、がん微小環境の強い関与を推測し、特にCAFsの作用に注目して癌の増殖・浸潤・血管新生・治療抵抗性について報告してきた。この度CAFsと腫瘍免疫に着目し、CAFsが寄与する腫瘍免疫抑制について検討している。今後、検討結果を随時報告する予定である。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00296&link_issn=&doc_id=20180920320008&doc_link_id=%2Fab8gtkrc%2F2018%2F004509%2F010%2F1279-1281%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2018%2F004509%2F010%2F1279-1281%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

ストーマ造設と管理における諸問題回腸人工肛門狭窄のリスク因子の抽出と予防 Reviewed

重安邦俊, 母里淑子, 戸嶋俊明, 矢野修也, 近藤喜太, 岸本浩行, 寺石文則, 藤原俊義

日本大腸肛門病学会雑誌 71 ( 抄録号 ) A61 - A61 2018.9

胃癌由来細胞外小胞によるマクロファージ分化誘導を介した腹膜播種の促進(Extracellular vesicles from gastric cancer promote peritoneal dissemination via M2 differentiation of macrophages)

伊藤雅典, 香川俊輔, 梶岡裕紀, 坂本修一, クワ田和也, 菊地覚次, 黒田新士, 西崎正彦, 吉田龍一, 田澤大, 藤原俊義

日本癌学会総会記事 77回 1021 - 1021 2018.9

腹腔内マクロファージはIL6を分泌し胃癌腹膜播種を促進する(IL6 derived from intraperitoneal macrophages is involved in peritoneal dissemination of gastric cancer)

香川俊輔, 坂本修一, 桑田和也, 伊藤雅典, 梶岡裕紀, 黒田新士, 菊地覚次, 吉田龍一, 田澤大, 藤原俊義

日本癌学会総会記事 77回 1020 - 1020 2018.9

腹膜播種を伴うスキルス胃癌に対する斬新なウイルス療法(Novel virotherapy for scirrhous gastric cancer with peritoneal metastasis)

石川亘, 菊地覚次, 田澤大, 黒田新士, 野間和広, 岸本浩行, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 77回 952 - 952 2018.9

膵癌に対するp53誘導性腫瘍融解ウイルスによる免疫原性細胞死の誘導効果(Oncolytic adenovirus-mediated p53 transactivation induces profound immunogenic cell death in pancreatic cancer)

荒木宏之, 田澤大, 伏見卓郎, 金谷信彦, 菊地覚次, 黒田新士, 吉田龍一, 岸本浩行, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 77回 949 - 949 2018.9

テロメライシンと抗PD-1抗体を用いた新たな複合免疫療法の開発(Telomelysin as an immunotherapy sensitizing gastrointestinal tumors to anti-PD-1 antibody)

金谷信彦, 黒田新士, 公文剣斗, 垣内慶彦, 森廣俊昭, 久保田哲史, 菊地覚次, 田澤大, 西崎正彦, 香川俊輔, 浦田泰生, 藤原俊義

日本癌学会総会記事 77回 104 - 104 2018.9

【周術期のリハビリテーション】周術期管理

田辺俊介, 白川靖博, 西脇紀之, 松田達雄, 前田直見, 櫻間教文, 野間和広, 藤原俊義

Journal of Clinical Rehabilitation 27 ( 10 ) 940 - 947 2018.9

神経芽腫に対する抗GD2抗体-光感受性物質結合体を用いた光線免疫療法(Near-infrared photoimmunotherapy using anti-GD2 antibody-photosensitizer conjugate for neuroblastoma)

納所洋, 田澤大, 谷本光隆, 谷守通, 尾山貴徳, 佐藤浩明, 野間和広, 香川俊輔, 小林久隆, 野田卓男, 藤原俊義

日本癌学会総会記事 77回 1948 - 1948 2018.9

抗ドナーHLA抗体陽性の肝移植の短期・長期成績と問題点抗ドナー抗体陽性生体肝移植の現状と問題点

楳田祐三, 八木孝仁, 田中健大, 吉田龍一, 信岡大輔, 杭瀬崇, 吉田一博, 安井和也, 吉田真里, 白川靖博, 柳井広行, 高木章乃夫, 藤原俊義

移植 53 ( 総会臨時 ) 257 - 257 2018.9

Successful wound treatment using negative pressure wound therapy without primary closure in a patient undergoing highly contaminated abdominal surgery. International journal

Takahiro Yoshioka, Yoshitaka Kondo, Toshiyoshi Fujiwara

Surgical case reports 4 ( 1 ) 85 - 85 2018.8

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

BACKGROUND: The indications for negative pressure wound therapy (NPWT) continue to expand, and NPWT has become a powerful tool for the treatment of interactive wounds. Recently, the use of NPWT over closed incisions has been shown to prevent surgical site infection (SSI) in patients undergoing contaminated or acute care surgery as prophylactic NPWT. In this article, we present our successful experience using NPWT without primary skin closure for wound treatment after a highly contaminated enterological surgery. The procedure we present in this case report is considerably different from the conventional prophylactic NPWT and a novel method in the field of gastrointestinal surgery. CASE PRESENTATION: A 33-year-old man with Crohn's disease underwent a dirty, infected enterological surgical procedure for the treatment of abdominal wall abscess and multiple fistulas around his colonic stoma. The stoma reconstruction and wound debridement resulted in a broad skin defect, and the incision was strategically left open. In addition to the infected wound condition (class IV), Crohn's disease itself is a risk factor for SSI; consequently, we induced NPWT immediately after the surgery and closed the incision from both ends in a stepwise manner using sutures each time we changed the dressing. This procedure was effective, enabling complete healing and closure at the surgical site on postoperative day 14 without infection or a skin defect. CONCLUSION: For highly contaminated enterological surgery, purposely leaving the incision open and starting NPWT immediately after the procedure is an effective strategy for early wound closure and the prevention of SSI.

DOI： 10.1186/s40792-018-0493-5

Heterogeneity of Epigenetic and Epithelial Mesenchymal Transition Marks in Hepatocellular Carcinoma with Keratin 19 Proficiency Reviewed

Naosuke Yokomichi, Naoshi Nishida, Yuzo Umeda, Fumitaka Taniguchi, Kazuya Yasui, Toshiaki Toshima, Yoshiko Mori, Akihiro Nyuya, Takehiro Tanaka, Takeshi Yamada, Takahito Yagi, Toshiyoshi Fujiwara, Yoshiyuki Yamaguchi, Ajay Goel, Masatoshi Kudo, Takeshi Nagasaka

Liver Cancer 2018.8

HER2-targeted gold nanoparticles potentially overcome resistance to trastuzumab in gastric cancer Reviewed International journal

Kubota Tetsushi, Kuroda Shinji, Kanaya Nobuhiko, Morihiro Toshiaki, Aoyama Katsuyuki, Kakiuchi Yoshihiko, Kikuchi Satoru, Nishizaki Masahiko, Kagawa Shunsuke, Tazawa Hiroshi, Fujiwara Toshiyoshi

NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 14 ( 6 ) 1919 - 1929 2018.8

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

An issue of concern is that no current HER2-targeted therapeutic agent is effective against Trastuzumab (Tmab)-resistant gastric cancer. Gold nanoparticles (AuNPs) are promising drug carriers with unique characteristics of a large surface area available for attachment of materials such as antibodies. Here, we created HER2-targeted AuNPs (T-AuNPs) and examined their therapeutic efficacy and cytotoxic mechanisms using HER2-postive Tmab-resistant (MKN7) or Tmab-sensitive (NCI-N87) gastric cancer cell lines. In vitro, T-AuNPs showed stronger cytotoxic effects than controls against MKN7 and NCI-N87 cells although Tmab had no effect on MKN7 cells. Autophagy played an important role in T-AuNP cytotoxic mechanisms, which was considered to be driven by internalization of T-AuNPs. Finally, T-AuNPs displayed potent antitumor effects against NCI-N87 and MKN7 subcutaneous tumors in in vivo mouse models. In conclusion, HER2-targeted AuNPs with conjugated Tmab is a promising strategy for the development of novel therapeutic agents to overcome Tmab resistance in gastric cancer.

DOI： 10.1016/j.nano.2018.05.019

癌関連線維芽細胞が引き起こす腫瘍免疫抑制の解明腫瘍浸潤リンパ球とIL-6と代謝の観点から Reviewed

加藤卓也, 野間和広, 賀島肇, 桂佑貴, 佐藤浩明, 河本慧, 二宮卓之, 大原利章, 田澤大, 白川靖博, 稲垣優, 岩垣博巳, 藤原俊義

日本がん免疫学会総会プログラム・抄録集 22回 95 - 95 2018.7

NCCNガイドラインにおける消化管神経内分泌腫瘍の内視鏡切除・手術適応の妥当性の検討 Reviewed

重安邦俊, 母里淑子, 戸嶋俊明, 矢野修也, 近藤喜太, 浅野博昭, 岸本浩行, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 73回 496 - 496 2018.7

消化管腫瘍において免疫原性telomelysinは抗PD-1抗体と協働作用する(Immunogenic Telomelysin synergizes with anti-PD-1 antibody in gastrointestinal tumors)

金谷信彦, 黒田新士, 公文剣斗, 垣内慶彦, 森廣俊昭, 久保田哲史, 菊地覚次, 西崎正彦, 浦田泰生, 田澤大, 香川俊輔, 藤原俊義

日本がん免疫学会総会プログラム・抄録集 22回 89 - 89 2018.7

胃癌腹膜播種に対する新たな治療戦略としてのウイルス療法

石川亘, 菊地覚次, 田澤大, 桑田和也, 黒田新士, 野間和広, 西崎正彦, 白川靖博, 香川俊輔, 藤原俊義

日本消化器外科学会総会 73回 1005 - 1005 2018.7

Closed-LECSの定型化と早期胃癌、十二指腸病変への応用

菊地覚次, 西崎正彦, 黒田新士, 加藤大, 桑田和也, 白川靖博, 香川俊輔, 藤原俊義

日本消化器外科学会総会 73回 655 - 655 2018.7

免疫原性がん細胞死を誘導するウイルス製剤と抗PD-1抗体を併用する新たな複合免疫療法の開発

金谷信彦, 黒田新士, 森廣俊昭, 垣内慶彦, 菊地覚次, 西崎正彦, 浦田泰生, 田澤大, 香川俊輔, 藤原俊義

日本消化器外科学会総会 73回 544 - 544 2018.7

腹腔鏡下観音開き法再建の手技ポイントと長期的QOL評価

黒田新士, 西崎正彦, 菊地覚次, 桑田和也, 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 73回 455 - 455 2018.7

【食道】胸部食道癌患者の周術期チーム医療食道癌外科診療における周術期チーム連携PERiO:Perioperative management center

白川靖博, 小川俊博, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 73回 264 - 264 2018.7

食道癌におけるoncologic emergencyに対する外科的手術の有用性

小川俊博, 白川靖博, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 73回 145 - 145 2018.7

当院における食道癌dCRT後Salvage食道切除術の工夫と治療成績

前田直見, 白川靖博, 小川俊博, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 楳田祐三, 藤原俊義

日本消化器外科学会総会 73回 79 - 79 2018.7

肝切除における血清アルブミン動態アルブミン製剤至適投与に向けて臨床指標を再考する

吉田一博, 楳田祐三, 吉田龍一, 信岡大輔, 杭瀬崇, 安井和也, 香川俊輔, 白川靖博, 八木孝仁, 藤原俊義

日本消化器外科学会総会 73回 914 - 914 2018.7

切除可能膵癌における早期再発予測因子の解析

吉田龍一, 楳田祐三, 信岡大輔, 杭瀬崇, 吉田一博, 安井和也, 八木孝仁, 藤原俊義

日本消化器外科学会総会 73回 175 - 175 2018.7

【肝】大腸癌多発肝転移に対する手術の工夫大腸癌多発肝転移に対する治療戦略遺伝子変異解析を踏まえた術前化学療法の適応選別

楳田祐三, 八木孝仁, 吉田龍一, 信岡大輔, 杭瀬崇, 吉田一博, 安井和也, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 73回 72 - 72 2018.7

The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis. Reviewed International journal

Takagi K, Umeda Y, Yoshida R, Nobuoka D, Kuise T, Fushimi T, Fujiwara T, Yagi T

Digestive surgery 36 ( 4 ) 1 - 8 2018.6

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

BACKGROUND/AIMS: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. METHODS: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. RESULTS: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). CONCLUSIONS: Although elderly -patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching.

DOI： 10.1159/000489826

膵癌における免疫療法の可能性 MSI、PD-1/PD-L1、免疫関連遺伝子多型解析を踏まえて

岡山大学病院における肥満外科治療の導入

香川俊輔, 黒田新士, 菊地覚次, 桑田和也, 西崎正彦, 利根淳仁, 中司敦子, 江口潤, 和田淳, 小林求, 藤原俊義

日本肥満症治療学会学術集会プログラム・抄録集 36回 129 - 129 2018.6

化学放射線療法の現状と新たなる展望〜制癌剤と照射法の工夫〜腫瘍融解ウイルス併用放射線療法の臨床研究の中間報告

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 黒田新士, 野間和広, 田澤大, 浦田泰生, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 59 - 59 2018.6

腹腔鏡下に切除再建を行ったToupet噴門形成術後の胃噴門部癌の一例

岡凌也, 白川靖博, 前田直見, 桑田和也, 二宮卓之, 菊地覚次, 田辺俊介, 黒田新士, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 79 ( 6 ) 1342 - 1342 2018.6

腹臥位胸腔鏡下食道切除における反回神経麻痺ゼロを目指した上縦隔郭清

野間和広, 白川靖博, 小川俊博, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 171 - 171 2018.6

食道癌手術ハイボリュームセンターとの連携において後方支援病院で求められる資質

櫻間教文, 平松聡, 二宮卓之, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 151 - 151 2018.6

食道外科教育における臨床応用解剖実習学習者アンケートから考える可能性

前田直見, 白川靖博, 小川俊博, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 123 - 123 2018.6

第4版ガイドラインの効果とさらなる普及への検証食道癌周術期におけるチーム医療のエビデンス創出に向けた取り組みと課題

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 53 - 53 2018.6

チーム医療と地域連携の現状と今後の展開食道癌手術患者に対して外来から開始する周術期管理センター(PERiO)の現状と展望

白川靖博, 小川俊博, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 西崎正彦, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 72回 41 - 41 2018.6

食道癌オリゴメタスターシスへの挑戦食道癌初回手術後の副腎転移に対して外科切除し長期生存を得られた1例

金谷信彦, 野間和広, 岡田剛, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 79 ( 6 ) 1342 - 1342 2018.6

ステルス効果を有する腫瘍融解アデノウイルス搭載リポソーム製剤の開発

垣内慶彦, 青山克幸, 黒田新士, 金谷信彦, 菊地覚次, 西崎正彦, 香川俊輔, 田澤大, 藤原俊義

日本DDS学会学術集会プログラム予稿集 34回 145 - 145 2018.5

藤智和, 楳田祐三, 吉田一博, 杭瀬崇, 信岡大輔, 吉田龍一, 八木孝仁, 藤原俊義

膵臓 33 ( 3 ) 472 - 472 2018.5

膵腫瘍におけるゲノム解析-病態解明と臨床的意義包括的アプローチによる浸潤性膵管癌の非侵襲的診断技術の構築

吉田一博, 楳田祐三, 吉田龍一, 信岡大輔, 杭瀬崇, 藤智和, 安井和也, Goel Ajay, 八木孝仁, 藤原俊義

膵臓 33 ( 3 ) 360 - 360 2018.5

神経芽腫に対する腫瘍融解ウイルス療法の研究を通して感じた、基礎研究の楽しさ・難しさ

谷本光隆, 田澤大, 納所洋, 尾山貴徳, 谷守通, 野田卓男, 藤原俊義

日本小児外科学会雑誌 54 ( 3 ) 640 - 640 2018.5

Lynch症候群子宮体癌におけるMMR statusとLynch症候群関連腫瘍家族歴との相関

原賀順子, 永坂岳司, 春間朋子, 西田傑, 入谷大洋, 母里淑子, 小川千加子, 中村圭一郎, 藤原俊義, 増山寿

日本外科系連合学会誌 43 ( 3 ) 401 - 401 2018.5

von Hippel-Lindau病に合併した膵NETの治療戦略

信岡大輔, 杭瀬崇, 楳田祐三, 吉田龍一, 吉田一博, 安井和也, 小西大輔, 岡林弘樹, 八木孝仁, 藤原俊義

膵臓 33 ( 3 ) 659 - 659 2018.5

大腸癌多発肝転移に対する肝切除多回肝切除と化学療法を見据えたParenchymal sparing & skeletonized hepatectomy

楳田祐三, 八木孝仁, 永坂岳司, 吉田龍一, 信岡大輔, 杭瀬崇, 伏見卓郎, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 118回 1085 - 1085 2018.4

外科学の新知見(2)がんの早期診断に向けてがん特異的蛍光ウイルス製剤を用いた簡便な循環がん細胞(CTC)の遺伝子プロファイリング技術の開発 Reviewed

重安邦俊, 田澤大, 橋本悠里, 母里淑子, 西崎正彦, 岸本浩行, 永坂岳司, 黒田新士, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 118回 282 - 282 2018.4

Preoperative Controlling Nutritional Status Score Predicts Mortality after Hepatectomy for Hepatocellular Carcinoma. Reviewed International journal

Takagi K, Umeda Y, Yoshida R, Nobuoka D, Kuise T, Fushimi T, Fujiwara T, Yagi T

Digestive surgery 36 ( 3 ) 226 - 232 2018.4

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

BACKGROUND: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. METHODS: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. -Results: The high CONUT group had a significantly higher -incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). CONCLUSIONS: Preoperative assessment of the CONUT score is helpful for evaluating patients' nutritional status and mortality risk after liver surgery.

DOI： 10.1159/000488215

【この手術に欠かせない必須デバイス紹介-こだわりの理由と正しい使用法】腹腔鏡下噴門側胃切除術に欠かせない必須デバイス超音波凝固切開装置,3D 内視鏡システム

上部消化管癌周術期における予後規定因子術前併存疾患を有する胃癌サルコペニアの術後他病死に対する予測因子としての有用性

黒田新士, 桑田和也, 菊地覚次, 楳田祐三, 西崎正彦, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 118回 662 - 662 2018.4

早期回復を目指した腹腔鏡補助下幽門側胃切除術の最適な術後鎮痛法

菊地覚次, 黒田新士, 桑田和也, 西崎正彦, 白川靖博, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 118回 1310 - 1310 2018.4

腫瘍融解ウイルス併用放射線療法による食道癌治療成績向上への取り組み

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 黒田新士, 野間和広, 楳田祐三, 田澤大, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 118回 944 - 944 2018.4

食道癌外科治療におけるBest mixを目指して

白川靖博, 鳴坂徹, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 楳田祐三, 西崎正彦, 香川俊輔, 野間和広, 藤原俊義

日本外科学会定期学術集会抄録集 118回 1613 - 1613 2018.4

外科医のトレーニング-技術の継承とは- カダバートレーニングにおける技術の継承

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 西崎正彦, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 118回 258 - 258 2018.4

Closed LECSにおける内視鏡・腹腔鏡手技のこつ

西崎正彦, 菊地覚次, 神崎洋光, 黒田新士, 桑田和也, 田邊俊介, 野間和弘, 白川靖博, 岡田裕之, 藤原俊義

Gastroenterological Endoscopy 60 ( Suppl.1 ) 690 - 690 2018.4

【これぞ達人の技!最新の消化器内視鏡外科手術】食道・胃の鏡視下手術腹腔鏡下噴門側胃切除術

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

消化器外科 41 ( 5 ) 583 - 589 2018.4

【上手な手術をするための基本手技】吻合腹腔鏡下手術

西崎正彦, 黒田新士, 菊地覚次, 藤原俊義

消化器外科 41 ( 4 ) 481 - 488 2018.4

食道癌術後急性期のサルコペニア食道癌術後急性期の筋肉量減少は予後予測因子となり得る

前田直見, 白川靖博, 鳴坂徹, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 118回 2337 - 2337 2018.4

術前補助化学療法を施行した進行胃癌症例の検討(Outcomes in patients with advanced gastric cancer treated with neoadjuvant chemotherapy)

香川俊輔, 黒田新士, 菊地覚次, 桑田和也, 西崎正彦, 野間和広, 田辺俊介, 二宮卓之, 前田直見, 白川靖博, 藤原俊義

日本胃癌学会総会記事 90回 375 - 375 2018.3

サルコペニアは胃癌術後の予後に関連する(Sarcopenia is associated with prognosis in gastric cancer patients undergoing gastrectomy)

桑田和也, 香川俊輔, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 藤原俊義

日本胃癌学会総会記事 90回 268 - 268 2018.3

予後因子に基づく残胃癌に対する治療戦略(Treatment strategy for remnant gastric cancer based on the prognostic factor)

Kikuchi Satoru, Kuroda Shinji, Kakiuchi Yoshihiko, Nishizaki Masahiko, Kuwada Kazuya, Shirakawa Yasuhiro, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本胃癌学会総会記事 90回 506 - 506 2018.3

高齢胃癌患者に対する胃全摘術は術後QOL低下の危険因子である(Total gastrectomy for elderly gastric cancer patients is a risk factor for QOL decline after surgery)

Kuroda Shinji, Ito Atene, Kuwada Kazaya, Kikuchi Satoru, Nishizaki Masahiko, Kagawa Shunsuke, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本胃癌学会総会記事 90回 301 - 301 2018.3

胃全摘術と噴門側胃切除 QOLを考慮した再建術 LPG後のダブルフラップ法による弁形成食道胃吻合術(Total gastrectomy and proximal gastrectomy: Reconstructive procedure considering quality of life Valvuloplastic esophagogastrostomy using double flap technique after LPG)

Nishizaki Masahiko, Kuroda Shinji, Kikuchi Satoru, Kuwada Kazuya, Tanabe Shunsuke, Noma Kazuhiro, Kagawa Shunsuke, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本胃癌学会総会記事 90回 233 - 233 2018.3

【食道胃接合部癌診療の最前線】食道胃接合部癌に対する噴門側胃切除術

西崎正彦, 野間和広, 黒田新士, 菊地覚次, 白川靖博, 藤原俊義

消化器外科 41 ( 2 ) 177 - 183 2018.2

体成分分析に基づいたNST栄養介入

田辺俊介, 櫻根裕子, 日野隼人, 谷口恵子, 長谷川祐子, 前田直見, 菊地覚次, 白川靖博, 四方賢一, 藤原俊義

日本静脈経腸栄養学会雑誌 33 ( Suppl. ) 565 - 565 2018.1

西崎正彦, 黒田新士, 菊地覚次, 野間和弘, 白川靖博, 藤原俊義

手術 72 ( 1 ) 23 - 29 2018.1

Factors Regulating Human Extravillous Trophoblast Invasion: Chemokine-peptidase and CD9-integrin Systems. Reviewed

Fujiwara H, Matsumoto H, Sato Y, Horie A, Ono M, Nakamura M, Mizumoto Y, Kagami K, Fujiwara T, Hattori A, Maida Y, Daikoku T, Imakawa K, Araki Y

Current pharmaceutical biotechnology 19 ( 10 ) 764 - 770 2018

切離断端の安全域を向上させる殺細胞性を兼ね備えた癌細胞特異的蛍光発現製剤を用いた内視鏡外科手術の開発

矢野修也, 岸本浩行, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) SF011 - 05 2017.12

多発筋炎/皮膚筋炎でみつかり腹腔鏡下に切除し得た直腸癌の一例 Reviewed

重安邦俊, 母里淑子, 矢野修也, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) EP218 - 02 2017.12

腹臥位胸腔鏡下食道亜全摘における臨床応用解剖実習の有用性

前田直見, 白川靖博, 鳴坂徹, 二宮卓之, 田辺俊介, 近藤喜太, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) SF108 - 01 2017.12

完全鏡視下幽門側胃切除におけるBook-binding techniqueによるBillroth-I法再建の検討

菊地覚次, 西崎正彦, 黒田新士, 桑田和也, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) EP125 - 07 2017.12

腹腔鏡下胃全摘術・腹腔鏡下噴門側胃切除:再建の工夫完全鏡視下手縫いによる逆流防止弁形成食道残胃吻合(観音開き法)

西崎正彦, 黒田新士, 菊地覚次, 野間和広, 桑田和也, 田邊俊介, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) WS1 - 1 2017.12

混合型食道裂孔ヘルニア手術のQOL改善への貢献

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 22 ( 7 ) EP036 - 02 2017.12

[Radical Thoracoscopic Esophagectomy for Elderly Patients with Advanced Esophageal Cancer].

Yuki Matsumi, Yasuhiro Shirakawa, Shunsuke Tanabe, Satoshi Komoto, Naoaki Maeda, Takayuki Ninomiya, Kazuhiro Noma, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 44 ( 12 ) 1784 - 1786 2017.11

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

We report a case of an elderly patient with advanced esophageal cancer who underwent multidisciplinary treatment. An 86-year-old male consulted our hospital with complaints of pharynx discomfort and difficulty in swallowing. He was preoperatively diagnosed with esophageal cancer, T3N2M0, Stage III . We performed 2 courses of cisplatin plus 5-FU therapy as neoadjuvant chemotherapy. The primary tumor and metastatic lymph nodes reduced in size, and thoracoscopic esophagectomy in the prone position was performed. Pathological findings were esophageal cancer, pT3-Ad, INF b, ly2, v1, IM0, pPM0, pDM0, pRM1, pN3, pStage III . As the radical margin was positive, chemoradiotherapy was performed. We continued postoperative chemotherapy for approximately 1 year, and the patient has survived without relapse for 4 years from esophagectomy. Even in patients over 80 years old, long-term prognosis can be expected by performing radical surgery and chemoradiotherapy.

[Successful Multimodality Treatment Including Three-Stage Operation for Esophageal Cancer with Esophagorespiratory Fistula - A Case Report].

Satoshi Komoto, Kazuhiro Noma, Naoaki Maeda, Yuki Matsumi, Takayuki Ninomiya, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 44 ( 12 ) 1053 - 1055 2017.11

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

The esophagorespiratory fistula(ERF)is a fatal complication ofesophageal cancer, because ofadvanced oncological status and poor conditions due to pneumonia and/or malnutrition.We report here a case of patient who was successfully treated for esophageal cancer with ERF with multimodality therapy including three-stage operation. A 65-year-old woman ofesophageal cancer received preoperative chemotherapy, and developed EFR before operation. Prolonged conservative therapies for ERF let her general condition get worse. Therefore, the patient underwent esophagostomy and gastrostomy to recover her condition. She received chemo-radiotherapy followed by esophagectomy. And she was performed the reconstruction next month. She is still alive without recurrence at 20 months after resection. In previous reports, a total of 6 cases have been performed esophagectomy for esophageal cancer with ERF in Japan. Only one case was reported that had survived longer than 12 months. This multimodality therapy can be one ofthe best strategies for the patients ofesophageal cancer with ERF, even ifthey have poor condition.

食道癌術後早期にAeromonas hydrophilaによる壊死性軟部組織感染症を発症した1例

放射線治療後の手術創に対する計画的陰圧閉鎖療法の経験

戸嶋俊明, 近藤喜太, 菊地覚次, 二宮卓之, 母里淑子, 黒田新士, 田邊俊介, 万代康弘, 野間和広, 浅野博昭, 岸本浩行, 永坂岳司, 西崎正彦, 佃和憲, 香川俊輔, 白川靖博, 藤原俊義

日本創傷治癒学会プログラム・抄録集 47回 151 - 151 2017.11

ここを工夫した私の手術手技(食道) Fusionに留意した食道癌に対する胸腔鏡下上縦隔リンパ節郭清

白川靖博, 鳴坂徹, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 78 ( 増刊 ) 436 - 436 2017.10

HER2陽性胃癌に対するS-1+docetaxel+trastuzumab併用療法の多施設共同第II相試験

香川俊輔, 村岡篤, 神原健, 中山洋, 濱野亮輔, 田中則光, 野間和広, 田中屋宏爾, 岸本浩行, 黒田新士, 菊地覚次, 桑田和也, 西崎正彦, 白川靖博, 藤原俊義

日本癌治療学会学術集会抄録集 55回 PS - 3 2017.10

切除困難局所進行食道癌に対するDCF併用放射線療法を用いた集学的治療

白川靖博, 鳴坂徹, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 55回 O19 - 3 2017.10

田辺俊介, 白川靖博, 金谷信彦, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 藤原俊義

日本外科感染症学会雑誌 14 ( 5 ) 602 - 602 2017.10

腹臥位胸腔鏡下手術での合併症を起こさせない手術手技

野間和広, 白川靖博, 鳴坂徹, 前田直見, 二宮卓之, 田辺俊介, 藤原俊義

日本臨床外科学会雑誌 78 ( 増刊 ) 514 - 514 2017.10

食道・胃癌術前補助療法CR症例[手術vs経過観察] 進行食道癌に対するDCF療法を軸にした集学的治療戦略著効例にも根治手術は必要か?

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本臨床外科学会雑誌 78 ( 増刊 ) 355 - 355 2017.10

新規光線力学療法としての蛍光タンパク質KillerRed誘導腫瘍融解ウイルスのin vivo抗腫瘍効果

竹原清人, 田澤大, 矢野修也, 岸本浩行, 水口裕之, 浦田泰生, ホフマン・ロバート, 香川俊輔, 藤原俊義

日本癌学会総会記事 76回 P - 3386 2017.9

遅発性に肝転移・骨盤内リンパ節転移をきたした直腸神経内分泌腫瘍の1例 Reviewed

重安邦俊, 杭瀬崇, 母里淑子, 河合毅, 矢野修也, 戸嶋俊明, 浅野博昭, 近藤喜太, 佃和憲, 永坂岳司, 八木孝仁, 藤原俊義

日本大腸肛門病学会雑誌 70 ( 抄録号 ) A85 - A85 2017.9

抗体結合磁性ナノ粒子による温熱療法癌播種病変への治療応用へ向けて

香川哲也, 岸本浩行, 松三雄騎, 田澤大, 大原利章, 永坂岳司, 香川俊輔, 藤原俊義

日本癌学会総会記事 76回 P - 2368 2017.9

HER2陽性胃癌に対するアファチニブ・ネラチニブの抗腫瘍効果

吉岡貴裕, 枝園和彦, 高橋優太, 栗原英祐, 難波圭, 鳥越英次郎, 佐藤博紀, 山本寛斉, 宗淳一, 浅野博昭, 佃憲徳, 藤原俊義, 豊岡伸一

日本癌学会総会記事 76回 P - 2336 2017.9

がん免疫療法の一段の進化へむけて腫瘍浸潤免疫細胞の代謝は抗腫瘍免疫応答を制御する

鵜殿平一郎, 榮川伸吾, 國定勇希, 上原健敬, 渡邉元嗣, 木村裕司, 佐々木朗, 尾崎敏文, 豊岡伸一, 藤原俊義

日本癌学会総会記事 76回 S10 - 5 2017.9

Role of zoledronic acid in oncolytic virotherapy: Promotion of antitumor effect and prevention of bone destruction. Reviewed

Yamakawa Y, Tazawa H, Hasei J, Osaki S, Omori T, Sugiu K, Komatsubara T, Uotani K, Fujiwara T, Yoshida A, Kunisada T, Urata Y, Kagawa S, Ozaki T, Fujiwara T

Cancer science 108 ( 9 ) 1870 - 1880 2017.9

インピーダンスモニタリングを用いた難治性胃食道逆流症の手術適応診断

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 藤原俊義

Gastroenterological Endoscopy 59 ( Suppl.2 ) 2223 - 2223 2017.9

胃癌患者の腹腔内マクロファージは分化し胃癌細胞の悪性形質を促進する

坂本修一, 香川俊輔, 桑田和也, 伊藤雅典, 菊地覚次, 黒田新士, 吉田龍一, 浦田泰生, 田澤大, 藤原俊義

日本癌学会総会記事 76回 P - 3225 2017.9

抗PD-1抗体の新たな治療戦略腫瘍選択的融解アデノウイルス療法との相乗効果の可能性

金谷信彦, 黒田新士, 森廣俊昭, 久保田哲史, 田澤大, 菊地覚次, 西崎正彦, 香川俊輔, 浦田泰生, 藤原俊義

日本癌学会総会記事 76回 P - 3178 2017.9

スキルス胃癌に対する蛍光発現腫瘍融解ウイルスと化学療法の併用による新たな診断的治療戦略

石川亘, 菊地覚次, 田澤大, 黒田新士, 野間和広, 岸本浩行, 永坂岳司, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 76回 E - 3031 2017.9

早期胃癌症例に対するClosed-LECS手技の可能性

菊地覚次, 西崎正彦, 藤原俊義

Gastroenterological Endoscopy 59 ( Suppl.2 ) 1912 - 1912 2017.9

早期胃癌症例に対するClosed-LECS手技の可能性

菊地覚次, 西崎正彦, 藤原俊義

肝臓 58 ( Suppl.2 ) A489 - A489 2017.9

早期胃癌症例に対するClosed-LECS手技の可能性

菊地覚次, 西崎正彦, 藤原俊義

日本消化器がん検診学会雑誌 55 ( Suppl. ) 918 - 918 2017.9

早期胃癌症例に対するClosed-LECS手技の可能性

菊地覚次, 西崎正彦, 藤原俊義

日本消化器病学会雑誌 114 ( 臨増大会 ) A418 - A418 2017.9

がん個別化医療の革新を目指す新規治療戦略がんの脆弱性 MYNC増幅神経芽細胞腫のMYCN依存性を標的とするテロメラーゼ特異的腫瘍融解アデノウイルス療法

谷本光隆, 田澤大, 家田偉史, 納所洋, 尾山貴徳, 浦田泰生, 香川俊輔, 野田卓男, 藤原俊義

日本癌学会総会記事 76回 S18 - 4 2017.9

軟部肉腫に対するp53発現テロメラーゼ依存型腫瘍融解アデノウイルスの放射線効果増強

小松原将, 田澤大, 望月雄介, 杉生和久, 大森敏規, 山川泰明, 尾崎修平, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 76回 J - 2008 2017.9

ドキソルビシン耐性骨肉腫細胞に対するp53発現腫瘍融解アデノウイルスによるMDR1発現抑制を介した薬剤耐性克服機序の検討

杉生和久, 田澤大, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1523 - S1523 2017.8

p53発現腫瘍融解アデノウイルスによる軟部肉腫に対する放射線治療併用効果の検討

小松原将, 望月雄介, 杉生和久, 大森敏規, 長谷井嬢, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1499 - S1499 2017.8

腫瘍融解ウイルスの骨・軟部腫瘍組織に対する感染効率の評価

吉田晶, 魚谷弘二, 藤原智洋, 長谷井嬢, 森田卓也, 清野正普, 杉生和久, 小松原将, 望月雄介, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1823 - S1823 2017.8

Hyperthermia at the single-cell level for disseminated cancer disease with immuno-magnetic nanoparticles Reviewed

Tetsuya Kagawa, Hiroyuki Kishimoto, Toshiaki Ohara, Hiroshi Tazawa, Shunsuke Kagawa, Takeshi Nagasaka, Satoshi Nohara, Ichiro Kato, Adarsh Sandhu, Hiromichi Aono, Toshiyoshi Fujiwara

American Association for Cancer Research 77 ( 13 ) 2017.7

癌細胞内特異的蛍光発現製剤による浸潤部の蛍光標識と殺細胞性を兼ね備えた高精度な低侵襲手術の開発

矢野修也, 岸本浩行, 田澤大, 竹原清人, 浦田泰生, ロバート・ホフマン, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 RS1 - 3 2017.7

PVT1は癌遺伝子MYCを駆動するエンハンサーでありStage II、III大腸癌の予後予測マーカーになりうる Reviewed

重安邦俊, 小澤毅士, 松山貴俊, 河合毅, 矢野修也, 母里淑子, 岸本浩行, 永坂岳司, Goel Ajay, 藤原俊義

日本消化器外科学会総会 72回 RS1 - 1 2017.7

胃上部癌に対する腹腔鏡下手術の郭清・再建手技の定型化胃上部早期胃癌に対する逆流防止弁形成食道残胃吻合(観音開き法)再建の定型化

西崎正彦, 黒田新士, 菊地覚次, 野間和広, 垣内慶彦, 田邊俊介, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 72回 SY10 - 10 2017.7

消化器癌腹膜播種の病態解明と新たな治療戦略腹腔内腫瘍微小環境におけるマクロファージの消化器癌悪性形質への影響

香川俊輔, 桑田和也, 坂本修一, 黒田新士, 菊地覚次, 伊藤雅典, 吉田龍一, 西崎正彦, 田澤大, 藤原俊義

日本消化器外科学会総会 72回 WS03 - 7 2017.7

関連進行胃癌に対する腹腔鏡下手術は標準化するのか? 現状と今後の展望神経解剖に基づいたD2リンパ節郭清を伴う腹腔鏡下幽門側胃切除術の短期・長期成績

黒田新士, 西崎正彦, 菊地覚次, 垣内慶彦, 桑田和也, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 O1 - 3 2017.7

当院における根治的放射線化学療法後の食道切除術(サルベージ治療)の検討

松三雄騎, 白川靖博, 河本慧, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 PL18 - 3 2017.7

食道胃接合部腺癌の至適リンパ節郭清と術式選択食道胃接合部癌125例から導かれる最適な術式根治性と術後QOLの併存を求めて

野間和広, 白川靖博, 河本慧, 松三雄騎, 前田直見, 二宮卓之, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 WS02 - 8 2017.7

食道癌術後再発予測と再発食道癌の治療食道癌根治術後Oligometastasisに対する治療戦略

二宮卓之, 金谷信彦, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊介, 白川靖博, 藤原俊義

日本消化器外科学会総会 72回 O3 - 5 2017.7

食道癌に対する縦隔リンパ節郭清の手術手技胸腔鏡下食道癌手術における微細解剖に基づいた上縦隔リンパ節郭清

白川靖博, 河本慧, 松三雄騎, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 SY09 - 3 2017.7

食道切除後再建法の工夫と成績胃管作製不能例に対する有茎空腸を用いた食道再建術

前田直見, 白川靖博, 河本慧, 松三雄騎, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会総会 72回 O1 - 2 2017.7

R0手術例の予後因子からみた残胃癌の治療戦略

垣内慶彦, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 72回 PH8 - 1 2017.7

食道胃接合部癌に対する術式選択食道胃接合部癌137例の経験から導かれる手術根治性と術後QOLの両立

野間和広, 白川靖博, 河本慧, 松三雄騎, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 PD1 - 6 2017.6

食道癌に対する化学療法の新しい展望標準的治療困難な食道癌症例に対する放射線併用ウイルス療法臨床研究の中間報告

西崎正彦, 白川靖博, 前田直見, 二宮卓之, 田辺俊介, 黒田新士, 野間和広, 田澤大, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 W2 - 3 2017.6

病態別に考える食道裂孔ヘルニア症例の手術適応と治療成績

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 P79 - 7 2017.6

食道癌切除術施行前後の患者における横隔膜脚部厚値と呼吸機能の変化について

野澤康明, 築山尚司, 太田晴之, 岩井賢司, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 P75 - 4 2017.6

同時性胃癌合併食道癌に対する治療戦略

二宮卓之, 河本慧, 松三雄騎, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 P74 - 3 2017.6

当科におけるサルベージ食道切除術の検討

前田直見, 白川靖博, 河本慧, 松三雄騎, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 P67 - 5 2017.6

80歳以上の超高齢者に対する食道癌手術の成績と周術期管理の工夫

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 71回 P34 - 6 2017.6

胸腔鏡下食道切除の定型化胸腔鏡下食道癌手術における膜と層に留意した上縦隔リンパ節郭清の定型化

白川靖博, 河本慧, 松三雄騎, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 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 71回 PD2 - 2 2017.6

軟部肉腫に対する腫瘍融解アデノウイルスによる放射線治療増感効果の検討

小松原将, 大森敏規, 望月雄介, 杉生和久, 長谷井嬢, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1385 - S1385 2017.6

p53発現腫瘍融解アデノウイルスの薬剤耐性骨肉腫細胞に対する抗腫瘍効果と耐性克服メカニズムの検討

杉生和久, 田澤大, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1385 - S1385 2017.6

周術期連携による術後合併症の予防と早期離床をめざして食道癌周術期におけるチーム医療導入の成果と展望

白川靖博, 河本慧, 松三雄騎, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本外科系連合学会誌 42 ( 3 ) 414 - 414 2017.5

Oncological emergency・がん治療における緊急対応食道癌診療におけるoncological emergencyに対する外科手術の役割

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 藤原俊義

日本外科系連合学会誌 42 ( 3 ) 485 - 485 2017.5

4つのモノヌクレオチドリピートマーカーのミスマッチ修復タンパク欠損を伴う大腸癌・子宮体癌スクリーニングの精確性の検討

母里淑子, 永坂岳司, 谷口文崇, 河合毅, 岸本浩行, 神原健, 藤原俊義

日本大腸肛門病学会雑誌 70 ( 5 ) 359 - 359 2017.5

ePTFEを用いた新規カテーテル挿入補助デバイスの開発 Reviewed

大原利章, 櫻間教文, 平松聡, 野間和広, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 117回 SF - 7 2017.4

成人横隔膜弛緩症に対し胸腔鏡下にてメッシュを用いて横隔膜形成し得た一例

神尾知宏, 白川靖博, 田辺俊介, 升田智也, 前田直見, 二宮卓之, 野間和広, 藤原俊義

岡山医学会雑誌 129 ( 1 ) 70 - 70 2017.4

食道胃接合部癌の手術手技食道胃接合部癌に対する術式の進化腹臥位併用完全鏡視下観音開き法再建の導入

野間和広, 白川靖博, 升田智也, 前田直見, 二宮卓之, 田辺俊介, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 117回 PD - 4 2017.4

高齢者胃癌手術症例の検討

伊藤雅典, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

岡山医学会雑誌 129 ( 1 ) 71 - 71 2017.4

食道SM癌に対する低侵襲治療高リスク食道癌症例に対する放射線併用ウイルス療法の臨床研究の中間報告

田辺俊介, 白川靖博, 藤原俊義

Gastroenterological Endoscopy 59 ( Suppl.1 ) 749 - 749 2017.4

胃管作製不能例に対する空腸を用いた食道再建術

前田直見, 白川靖博, 升田智也, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本外科学会定期学術集会抄録集 117回 PS - 4 2017.4

Dダイマーと造影CT検査を併用した胸部食道癌術後の潜在性血栓症に対するスクリーニングの有用性

二宮卓之, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 117回 PS - 7 2017.4

食道癌周術期管理におけるPERIOの取り組みと成果、そしてその新展開

白川靖博, 升田智也, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 117回 PS - 5 2017.4

根治困難な局所進行食道癌に対するDCF併用放射線療法を用いた集学的治療

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 117回 SF - 5 2017.4

下部消化管手術教育における私の工夫開腹手術と腹腔鏡下手術下部消化管領域におけるカダバートレーニングの実際

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 藤原俊義

日本外科学会定期学術集会抄録集 117回 WS - 7 2017.4

進行胃癌に対する術前補助化学療法施行症例の検討

香川俊輔, 黒田新士, 菊地覚次, 伊藤雅典, 西崎正彦, 藤原俊義

日本外科学会定期学術集会抄録集 117回 PS - 2 2017.4

テロメラーゼ標的蛍光発現ウイルスを用いた膵癌腹腔内微小環境の解析

桑田和也, 香川俊輔, 坂本修一, 渡邉めぐみ, 香川哲也, 菊地寛次, 黒田新士, 吉田龍一, 浦田泰生, 田澤大, 藤原俊義

日本外科学会定期学術集会抄録集 117回 SF - 1 2017.4

胃癌における組織型とPD-L1発現の患者予後および術後再発予測因子としての有用性

黒田新士, 森廣俊昭, 久保田哲史, 金谷信彦, 菊地覚次, 田澤大, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 117回 SF - 4 2017.4

Trastuzumab抵抗性胃癌に対する金ナノ技術を融合した新規HER2標的抗体療法

久保田哲史, 黒田新士, 金谷信彦, 森廣俊昭, 田澤大, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 117回 SF - 4 2017.4

cStage I上部胃癌の術式選択噴門側胃切除vs胃全摘噴門側胃切除

西崎正彦, 黒田新士, 菊地覚次, 野間和広, 田邊俊介, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 117回 DB - 1 2017.4

成人横隔膜弛緩症に対し胸腔鏡下にてメッシュを用いて横隔膜形成し得た一例

神尾知宏, 白川靖博, 田辺俊介, 升田智也, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本臨床外科学会雑誌 78 ( 3 ) 626 - 626 2017.3

食道胃接合部癌に対する腹腔鏡下観音開き法食道残胃吻合(Laparoscopic esophagogastorostomy using double flap technique for esophago-gastric junction cancer)

西崎正彦, 黒田新士, 菊地覚次, 野間和広, 田邊俊介, 香川俊輔, 白川靖博, 藤原俊義

日本胃癌学会総会記事 89回 286 - 286 2017.3

腹腔鏡補助下幽門側胃切除術の定型化とトレーニングシステム(Standardization and training system of laparoscopy-assisted distal gastrectomy)

黒田新士, 菊地寛次, 堀直人, 坂本修一, 香川哲也, 渡辺めぐみ, 久保田哲史, 桑田和也, 石田道拡, 岸本浩行, 宇野太, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 89回 270 - 270 2017.3

胃粘膜下腫瘍に対するClosed-LECS手技の改良と定型化(Standardization and modification of Closed-LECS procedure for gastric submucosal tumor)

菊地覚次, 西崎正彦, 黒田新士, 伊藤雅典, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 岡田裕之, 藤原俊義

日本胃癌学会総会記事 89回 269 - 269 2017.3

進行胃癌に対するSOX療法の経験と術前補助化学療法への期待(S-1 and oxaliplatin (SOX) for gastric cancer. Is this appropriated for neoadjuvant chemotherapy?)

香川俊輔, 黒田新士, 菊地覚次, 伊藤雅典, 西崎正彦, 藤原俊義

日本胃癌学会総会記事 89回 244 - 244 2017.3

高齢者胃癌手術症例の検討

伊藤雅典, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 78 ( 3 ) 627 - 627 2017.3

大腸癌卵巣転移に対する外科治療の検討

母里淑子, 永坂岳司, 岸本浩行, 近藤喜太, 工藤泰崇, 樹下真希, 浅野博昭, 佃和憲, 藤原俊義

日本大腸肛門病学会雑誌 70 ( 2 ) 145 - 145 2017.2

がん化学療法・放射線療法における栄養支持療法頭頸部癌に対する化学放射線療法完遂率向上を目指したPEGによる栄養管理

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本静脈経腸栄養学会雑誌 32 ( Suppl. ) 371 - 371 2017.1

食道癌手術における鏡視下手術導入による術前後の身体的・栄養学的変化についての検討

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 野間和広, 藤原俊義

日本静脈経腸栄養学会雑誌 32 ( Suppl. ) 395 - 395 2017.1

胸部食道癌の胸腔鏡下手術胸部食道癌に対する胸腔鏡下手術の短期成績についての検討

白川靖博, 升田智也, 前田直見, 二宮卓之, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊介, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) SY2 - 4 2016.12

腹腔鏡下胃切除術の定型化および若手医師への教育と進行癌への挑戦

黒田新士, 菊地覚次, 伊藤雅典, 近藤喜太, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) DP90 - 2 2016.12

腹腔鏡下幽門側胃切除におけるHand-sewn Book-Binding Techniqueによる鏡視下Billroth-I法再建

菊地覚次, 黒田新士, 西崎正彦, 伊藤雅典, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) OS106 - 6 2016.12

早期胃癌に対する噴門側胃切除術のメリットとデメリット噴門側胃切除のデメリットを克服する逆流防止弁形成食道残胃吻合

西崎正彦, 黒田新士, 菊地覚次, 伊藤雅典, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) RS40 - 5 2016.12

上部消化管良性疾患に対する内視鏡下手術の工夫食道裂孔ヘルニアに対する積極的手術適応

田辺俊介, 白川靖博, 土生智大, 升田智也, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) RS4 - 1 2016.12

反回神経麻痺を起こさせない工夫と治療成績臓器鞘を意識した腹臥位胸腔鏡下上縦隔郭清手技

野間和広, 白川靖博, 升田智也, 金谷信彦, 前田直見, 二宮卓之, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 21 ( 7 ) WS14 - 1 2016.12

観音開き法による噴門形成術を行った先天性食道狭窄症の1例

尾山貴徳, 野田卓男, 谷守通, 納所洋, 谷本光隆, 野間和広, 田邊俊介, 白川靖博, 藤原俊義

日本小児外科学会雑誌 52 ( 7 ) 1376 - 1376 2016.12

当院における膵頭十二指腸切除術の治療成績

高木弘誠, 八木孝仁, 吉田龍一, 藤智和, 杭瀬崇, 渡辺信之, 信岡大輔, 楳田祐三, 篠浦先, 藤原俊義

日本消化器外科学会雑誌 49 ( Suppl.2 ) 351 - 351 2016.11

腹腔鏡下胃切除術腹腔鏡下「観音開き法」食道残胃吻合手技の定型化と工夫

黒田新士, 西崎正彦, 藤原俊義

日本消化器外科学会雑誌 49 ( Suppl.2 ) 75 - 75 2016.11

[A Case of Multiple Liver Metastasis from Gastric Cancer Successfully Treated with CPT-11 as Third-Line Chemotherapy].

Satoru Kikuchi, Masahiko Nishizaki, Shinji Kuroda, Shunsuke Kagawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 43 ( 12 ) 2219 - 2221 2016.11

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

A 63-year-old man underwent proximal gastrectomy for early gastric cancer(pT1bN0M0, pStage I A). Twenty months after surgery, abdominal CT scans revealed multiple liver metastases. S-1 plus CDDP therapy was administered as first-line chemotherapy. After treatment, CT scans revealed tumor progression and nab-PTX was administrated. This treatment was ineffective; therefore, CPT-11 was administrated as third-line chemotherapy. Treatment with CPT-11 resulted in marked tumor reduction and improved the QOL of the patient; partial response was maintained for 8 months. After 17 courses of CPT-11 treatment, tumor regrowth was detected, and the patient was treated with S-1 plus oxaliplatin, DTX, and ramucirumab. Subsequently, the patient died of cancer 31 months after tumor recurrence. CPT-11 is potentially a key drug for the prevention of liver metastasis of gastric cancer, and using all active agents in patients with advanced gastric cancer over several lines of therapy could prolong survival.

高リスク神経芽腫に対するhTERT標的化膿瘍融解ウイルス療法(hTERT-targeted oncolytic virotherapy against high-risk neuroblastomas)

多視点3D映像システムによる次世代の手術解剖教育

信岡大輔, 八木孝仁, 近藤喜太, 篠浦先, 楳田祐三, 吉田龍一, 渡辺信之, 杭瀬崇, 藤智和, 高木弘誠, 藤原俊義

日本消化器外科学会雑誌 49 ( Suppl.2 ) 358 - 358 2016.11

谷本光隆, 田澤大, 家田偉史, 納所洋, 尾山貴徳, 浦田泰生, 香川俊輔, 野田卓男, 藤原俊義

日本小児血液・がん学会雑誌 53 ( 4 ) 202 - 202 2016.11

p53活性化能を有するテロメラーゼ標的型ウイルス療法による腹腔内胃癌微小環境の浄化作用

田澤大, 堀直人, 國府島健, 谷本光隆, 家田偉史, 渡邉めぐみ, 黒田新士, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 75回 E - 2069 2016.10

鉄代謝は癌幹細胞の新規治療ターゲットとなり得る Reviewed

大原利章, 二宮卓之, 桂佑貴, 賀島肇, 加藤卓也, 野間和広, 田澤大, 藤原俊義

日本癌学会総会記事 75回 E - 1109 2016.10

癌関連線維芽細胞(CAFs)が及ぼす腫瘍免疫逃避の解明 CAFsと腫瘍浸潤リンパ球の検討 Reviewed

加藤卓也, 野間和広, 賀島肇, 桂佑貴, 二宮卓之, 大原利章, 田澤大, 香川俊輔, 白川靖博, 藤原俊義

日本癌学会総会記事 75回 E - 1068 2016.10

腹腔鏡下食道裂孔ヘルニア・逆流性食道炎手術の適応と術式高齢化社会における食道裂孔ヘルニア手術の積極的適応

田辺俊介, 白川靖博, 土生智大, 升田智也, 前田直見, 二宮卓之, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 348 - 348 2016.10

蛍光ウイルスによる腹腔内の腫瘍関連マクロファージと膵癌細胞の関連性の解析

桑田和也, 香川俊輔, 坂本修一, 渡邉めぐみ, 香川哲也, 菊地覚次, 黒田新士, 吉田龍一, 浦田泰生, 田澤大, 藤原俊義

日本癌学会総会記事 75回 P - 1320 2016.10

胃癌根治切除後におけるPD-L1発現に基づいた予後および再発パターンの予測

森廣俊昭, 黒田新士, 久保田哲史, 田澤大, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

日本癌学会総会記事 75回 E - 3064 2016.10

Stage 4胃癌の化学療法奏効例に対するconversion surgery

香川俊輔, 黒田新士, 菊地覚次, 伊藤雅典, 西崎正彦, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 708 - 708 2016.10

高齢者胃癌治療の検討根治性と術後QOLの面から

伊藤雅典, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 530 - 530 2016.10

胃癌外科治療におけるサルコペニアの予後予測因子としての重要性

黒田新士, 桑田和也, 菊地覚次, 伊藤雅典, 吉田龍一, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 463 - 463 2016.10

腹腔鏡下胃癌手術における脾門部郭清アプローチ脾門部の解剖に基づく腹腔鏡下脾温存リンパ節郭清

西崎正彦, 黒田新士, 菊地覚次, 伊藤雅典, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 446 - 446 2016.10

LECSの現状と課題胃粘膜下腫瘍に対するClosed-LECSの治療成績と今後の展望

菊地覚次, 西崎正彦, 黒田新士, 伊藤雅典, 香川俊輔, 岡田裕之, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 404 - 404 2016.10

低侵襲性手術のトレーニング技の磨練に向けて内視鏡手術におけるカダバートレーニングシステムの構築

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 361 - 361 2016.10

金ナノ粒子を用いた新規HER2標的抗体療法

久保田哲史, 黒田新士, 森廣俊昭, 田澤大, 香川俊輔, 藤原俊義

癌と化学療法 43 ( 10 ) 1237 - 1239 2016.10

Language：Japanese Publisher：(株)癌と化学療法社

trastuzumab(Tmab)は、human epidermal growth factor receptor 2(HER2)に対するヒト化モノクローナル抗体で、現在乳癌や胃癌に対して臨床使用され予後を改善しているが、HER2の低発現(約20%)やTmab抵抗性の問題がある。Tmab抵抗例に対して新たなHER2標的製剤が開発されているが胃癌に対して臨床的に有効なものはまだなく、新たな治療法が望まれる。ナノ技術はその発展に伴い医療へ応用されてきている。金ナノ粒子は生体内での安定性と表面修飾の容易性などの特性があり、autophagyやoxidative stressを介したアポトーシスを誘導することも報告されている。われわれは、HER2標的金ナノ粒子製剤(Tmab-AuNPs)を作製し、Tmab抵抗性胃癌細胞株に対する抗腫瘍効果とHER2細胞外領域を強制発現させたHER2陰性株に対する抗腫瘍効果を確認しており、Tmab-AuNPsがTmab抵抗性胃癌に対する新たなHER2標的製剤になり得ると考えている。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00296&link_issn=&doc_id=20161104480020&doc_link_id=%2Fab8gtkrc%2F2016%2F004310%2F021%2F1237-1239%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2016%2F004310%2F021%2F1237-1239%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

内視鏡治療と鏡視下手術のコラボレーション胃粘膜下腫瘍に対するClosed-LECS手技の確立と早期胃癌への応用

菊地覚次, 西崎正彦, 藤原俊義

Gastroenterological Endoscopy 58 ( Suppl.2 ) 1745 - 1745 2016.10

転移性大腸癌における治療標的となりうるマイクロRNAの同定

河合毅, 永坂岳司, 藤智和, 戸嶋俊明, 安井和也, 母里淑子, 藤原俊義

日本癌学会総会記事 75回 P - 1273 2016.10

ウイルスによる遺伝子導入は抗原陰性胃癌に対する光線免疫療法を可能にする

香川俊輔, 石田道拡, 下山京子, 竹原清人, 野間和広, 田辺俊介, 白川靖博, 田澤大, 小林久隆, 藤原俊義

日本癌学会総会記事 75回 E - 2094 2016.10

気管浸潤を伴う局所進行食道癌CRT後遺残に対してsalvage手術を施行した一例

土生智大, 白川靖博, 升田智也, 前田直見, 二宮卓之, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 997 - 997 2016.10

合併症ゼロを目指した食道癌周術期チーム医療成功のための外科医の役割

白川靖博, 升田智也, 二宮卓之, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊介, 藤原俊義

日本臨床外科学会雑誌 77 ( 増刊 ) 475 - 475 2016.10

高悪性度神経芽細胞種に対するhTERT標的型腫瘍融解ウイルス療法の抗腫瘍活性

谷本光隆, 田澤大, 家田偉史, 納所洋, 尾山貴徳, 浦田泰生, 香川俊輔, 野田卓男, 藤原俊義

日本癌学会総会記事 75回 P - 2312 2016.10

Modified FOLFOXIRIの当院における有効性と安全性

母里淑子, 永坂岳司, 河合毅, 岸本浩行, 吉岡貴裕, 佃和宣, 中谷紳, 嶋村廣視, 冨岡憲明, 森谷行利, 瀧上隆夫, 藤原俊義

日本大腸肛門病学会雑誌 69 ( 抄録号 ) A206 - A206 2016.10

StageIV大腸がんの治療遺伝子変異情報を考慮したStageIV大腸癌に対する予後の検討及び治療戦略の構築

永坂岳司, 母里淑子, 岸本浩行, 神原健, 河合毅, 中谷紳, 嶋村廣視, 富岡憲明, 森谷行利, 瀧上隆夫, 佃和憲, 藤原俊義

日本大腸肛門病学会雑誌 69 ( 抄録号 ) A35 - A35 2016.10

circulating cell free DNAのメチル化解析による大腸癌化学療法の治療効果判定の診断

戸嶋俊明, 永坂岳司, 木村圭佑, 安井和也, 河合毅, 母里淑子, 藤原俊義

日本癌学会総会記事 75回 P - 1071 2016.10

軟部肉腫に対するテロメラーゼ標的型腫瘍融解アデノウイルスの放射線効果増強

小松原将, 大森敏規, 田澤大, 杉生和久, 望月雄介, 山川泰明, 尾崎修平, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 75回 P - 3306 2016.10

腫瘍融解ウイルス療法による骨肉腫のABC Transporterを介した薬剤耐性の克服

杉生和久, 田澤大, 長谷井嬢, 尾崎修平, 山川泰明, 大森敏規, 小松原将, 望月雄介, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 75回 J - 3020 2016.10

放射線抵抗性を示す骨・軟部肉腫に対する腫瘍融解アデノウイルスの放射線増感作用

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 杉生和久, 藤原智洋, 吉田晶, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1564 - S1564 2016.8

p53発現腫瘍融解アデノウイルスはMDR-1発現を抑制することにより薬剤耐性骨肉腫細胞に対して強力な抗腫瘍効果を示す

杉生和久, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1554 - S1554 2016.8

臨床検体を用いた腫瘍融解アデノウイルスの骨・軟部腫瘍への適応に関する検討

吉田晶, 魚谷弘二, 藤原智洋, 長谷井嬢, 大森敏規, 杉生和久, 小松原将, 森田卓也, 清野正晋, 望月雄介, 武田健, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1627 - S1627 2016.8

外科における基礎的研究セレンディピティーを求めて鉄コントロールによる新規癌幹細胞治療 Reviewed

二宮卓之, 大原利章, 桂佑貴, 賀島肇, 加藤卓也, 野間和広, 田辺俊介, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 71回 WS7 - 2 2016.7

さらなる微細解剖の理解から目指す鏡視下食道手術根治性と低侵襲性の共存

野間和広, 白川靖博, 金谷信彦, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 71回 P3 - 7 2016.7

食道癌術後早期にAeromonas hydrophilaによる壊死性軟部組織感染症を発症した1例

金谷信彦, 白川靖博, 九十九悠太, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 77 ( 7 ) 1861 - 1861 2016.7

リンパ節転移分布からみた残胃進行癌の治療戦略

菊地覚次, 黒田新士, 渡邉めぐみ, 白川靖博, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 71回 P3 - 6 2016.7

膵上縁リンパ節郭清における自律神経解剖の役割

西崎正彦, 黒田新士, 菊地覚次, 渡邉めぐみ, 前田直見, 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 71回 P1 - 9 2016.7

胃癌腹膜播種の基礎と臨床新たなエビデンスの創出に向けて胃癌個別化治療に向けた腹腔内遊離癌細胞イメージング技術の応用

渡辺めぐみ, 香川俊輔, 桑田和也, 坂本修一, 菊地覚次, 黒田新士, 岸本浩行, 西崎正彦, 田澤大, 藤原俊義

日本消化器外科学会総会 71回 WS15 - 6 2016.7

消化器外科領域における最新のトランスレーショナルリサーチ食道癌に対する放射線併用ウイルス療法の臨床研究低用量群(Level 1)の薬理動態解析

藤原俊義, 香川俊輔, 田辺俊介, 田澤大, 野間和広, 黒田新士, 菊地覚次, 白川靖博

日本消化器外科学会総会 71回 WS5 - 1 2016.7

若手外科医育成のための工夫当科におけるカタバートレーニング運用の実際とその効用

近藤喜太, 信岡大輔, 前田直見, 黒田新士, 藤原俊義

日本消化器外科学会総会 71回 WS1 - 5 2016.7

胃癌における機能温存手術と機能再建手術「観音開き法」食道残胃吻合噴門機能の再構築を目指した形態的・機能的再建法

黒田新士, 西崎正彦, 菊地覚次, 渡邉めぐみ, 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 71回 SY12 - 3 2016.7

明日の食道癌非手術治療食道癌に対する放射線併用ウイルス療法の臨床研究の中間報告

田辺俊介, 白川靖博, 金谷信彦, 岡田剛, 前田直見, 黒田新士, 野間和広, 田澤大, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 58 - 58 2016.7

ここまで来た、ESD後狭窄予防策食道がん周術期チーム医療成功のための外科医の役割

白川靖博, 金谷信彦, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 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 70回 29 - 29 2016.7

食道癌術後の縫合不全は再発・予後を増悪させるのか

金谷信彦, 白川靖博, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 71回 P2 - 1 2016.7

胃切除後の食道再建術式胃管作成不能例に対する空腸を用いた食道再建術における工夫

白川靖博, 金谷信彦, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 71回 PD1 - 2 2016.7

標的陰性癌に対するPhotoimmunotherapy 抗原修飾による抗原陽転化と不均一性の克服

香川俊輔, 石田道拡, 下山京子, 竹原清人, 野間和広, 田辺俊介, 渡邉めぐみ, 田澤大, 小林久隆, 藤原俊義

日本消化器外科学会総会 71回 SS9 - 8 2016.7

術前食道がん患者の抑うつ傾向と心理的適応に関する因子

伊藤真理, 廣川万里子, 市川あい, 足羽孝子, 前田直見, 田辺俊介, 野間和宏, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 149 - 149 2016.7

食道癌術後患者に分粥食は必要か?

園井みか, 足羽孝子, 伊藤真理, 廣川万里子, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 147 - 147 2016.7

あきらめない食道癌治療 Oligometastasisへの挑戦

金谷信彦, 白川靖博, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 104 - 104 2016.7

腹臥位胸腔鏡下食道切除術における拡大視効果と術視野共有の利点と成果

白川靖博, 金谷信彦, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 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 70回 64 - 64 2016.7

食道切除後再建法より良い術後QOLをめざして胃管作製不能例に対する空腸を用いた食道再建術

前田直見, 白川靖博, 金谷信彦, 岡田剛, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 51 - 51 2016.7

食道胃接合部腺癌の至適郭清範囲と切除範囲食道胃接合部癌125例の検討から導かれる最適な手術

野間和広, 白川靖博, 金谷信彦, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 香川俊輔, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 39 - 39 2016.7

食道癌患者の口腔感染管理と咬合回復が周術期の体重変化に影響した可能性のある一症例

樋口智子, 花岡愛弓, 山中玲子, 仲田直樹, 曽我賢彦, 飯田征二, 田邊俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 70回 193 - 193 2016.7

腹部外科における慢性感染創治療の現況と未来クローン病術後創における局所陰圧閉鎖療法の適応と今後の方向性

吉岡貴裕, 近藤喜太, 工藤泰崇, 河合毅, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本消化器外科学会総会 71回 WS10 - 8 2016.7

高難度手術におけるカダバートレーニングの意義と当科における実際

近藤喜太, 吉岡貴裕, 工藤泰崇, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本臨床外科学会雑誌 77 ( 7 ) 1864 - 1864 2016.7

TIL関連遺伝子アッセイを用いた化学療法効果予測および予後予測に関する検討

河内麻里子, 岩本高行, 新倉直樹, 溝尾妙子, 野上智弘, 枝園忠彦, 元木崇之, 増田しのぶ, 土井原博義, 藤原俊義, 徳田裕, 松岡順治

日本乳癌学会総会プログラム抄録集 24回 345 - 345 2016.6

薬物療法を受けている患者のQOL 多職種からのアプローチエベロリムス投与における有害事象の評価患者と医療者の認識の違い、各職種間における認識の違い

松岡順治, 河内麻里子, 岩本高之, 元木崇之, 土井原博義, 平成人, 露無祐子, 藤原俊義

日本乳癌学会総会プログラム抄録集 24回 209 - 209 2016.6

右側肝円索・門脈分枝走行異常を伴った進行胆嚢癌切除の経験

吉田龍一, 高木弘誠, 須井健太, 藤智和, 杭瀬崇, 渡辺信之, 信岡大輔, 楳田佑三, 篠浦先, 八木孝仁, 藤原俊義

日本肝胆膵外科学会・学術集会プログラム・抄録集 28回 429 - 429 2016.6

骨・軟部肉腫に対する腫瘍融解ウイルスの放射線増感作用

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 杉生和久, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1260 - S1260 2016.6

鉄コントロールによる新規がん幹細胞治療 Reviewed

二宮卓之, 大原利章, 加藤卓也, 賀島肇, 野間和広, 田澤大, 田辺俊介, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 8 2016.4

治癒切除し得た腺癌成分をともなった胃yolk sac tumorの1例

李云成, 菊地覚次, 坂本修一, 黒田新士, 西崎正彦, 白川靖博, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 116回 RS - 8 2016.4

胃癌におけるPD-L1の臨床病理学的特徴

黒田新士, 森廣俊昭, 久保田哲史, 田中健大, 坂本修一, 菊地覚次, 田澤大, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 4 2016.4

次世代の外科治療における早期探索的医療研究の役割食道癌外科治療を補完する新たな治療戦略としての腫瘍融解ウイルスと放射線との新規併用療法の臨床研究

香川俊輔, 田辺俊介, 田澤大, 野間和広, 國府島健, 賀島肇, 加藤卓也, 黒田新士, 菊地覚次, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 116回 WS - 5 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術で起こりやすい逆流症状はどうして起こるの? どう注意すればいい?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 144 - 145 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術で起こりやすい胃内容排出遅延って何? どうして起こるの? どう注意すればいい?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 142 - 143 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術で起こりやすいダンピング症状って何? どうして起こるの? どう注意すればいい?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 140 - 141 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除後はなぜ貧血が起こりやすいの? どう注意すればいい?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 138 - 139 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術後にはいつ・どの部位で・何を観察すればいいの?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 136 - 137 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術後に起こりうる合併症にはどのようなものがあるの?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 134 - 135 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術後に生じうるドレーン排液にはどのようなものがあるの? 排液から何がわかるの?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 132 - 133 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術後のドレーン留置部位は? なぜそこに留置されるの?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 130 - 131 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術後の再建法にはどのようなものがある? 各再建法で術後の注意点に違いはある?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 128 - 129 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術ではどこを切除するの? 切除法によって術後の注意点に違いはある?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 126 - 127 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A どのようなときに胃が切除されるの?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 124 - 125 2016.4

【でっかくド〜ン!オールカラー図解でみるみるわかる新人ナースのための消化器外科術前術後ケアQ&A102】(4章)胃の手術と術前術後ケアQ&A 胃切除術の術前ケアではどのようなことが行われるの? 注意すべきことは?

菊地覚次, 藤原俊義

消化器外科Nursing ( 2016春季増刊 ) 122 - 123 2016.4

食道癌ESD後の追加治療としての手術症例ならびにESD後再発手術症例の検討 ESD後の適切な追加・補助治療とは

田辺俊介, 白川靖博, 九十九悠太, 桂佑貴, 前田直見, 野間和広, 櫻間教文, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 3 2016.4

胸部食道癌手術における食道胃管吻合法の比較 Gambee吻合法と三角吻合法

前田直見, 白川靖博, 九十九悠太, 桂佑貴, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 7 2016.4

食道癌困難症例に対する腹臥位胸腔鏡下手術の工夫

白川靖博, 九十九悠太, 桂祐貴, 前田直見, 田辺俊介, 野間和広, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 8 2016.4

食道表在癌の内視鏡診断・治療の現状と限界食道ESD後追加手術例と再発後手術例から考える食道ESD後の適切な補助療法

田辺俊介, 白川靖博, 藤原俊義

Gastroenterological Endoscopy 58 ( Suppl.1 ) 506 - 506 2016.4

食道癌術後早期にAeromonas hydrophilaによる壊死性軟部組織感染症を発症した1例

金谷信彦, 白川靖博, 九十九悠太, 岡田剛, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

岡山医学会雑誌 128 ( 1 ) 77 - 77 2016.4

切除可能局所進行直腸癌に対する術前化学療法および術前放射線化学療法の検討

母里淑子, 永坂岳司, 岸本浩行, 河合毅, 工藤泰崇, 樹下真希, 近藤喜太, 浅野博昭, 佃和憲, 藤原俊義

日本外科学会定期学術集会抄録集 116回 PS - 2 2016.4

大腸癌脳転移に対する集学的治療で長期生存を得た2例の検討

吉川公見子, 母里淑子, 永坂岳司, 岸本浩行, 河合毅, 藤原俊義

日本外科学会定期学術集会抄録集 116回 RS - 9 2016.4

高難度手術におけるカダバートレーニングの意義と当科における実際

近藤喜太, 吉岡貴裕, 工藤泰崇, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

岡山医学会雑誌 128 ( 1 ) 82 - 82 2016.4

Relative Prognostic and Predictive Value of Gene Signature and Histologic Grade in Estrogen Receptor-Positive, HER2-Negative Breast Cancer. International journal

Takayuki Iwamoto, Catherine Kelly, Taeko Mizoo, Tomohiro Nogami, Takayuki Motoki, Tadahiko Shien, Naruto Taira, Naoki Hayashi, Naoki Niikura, Toshiyoshi Fujiwara, Hiroyoshi Doihara, Junji Matsuoka

Clinical breast cancer 16 ( 2 ) 95 - 100 2016.4

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

BACKGROUND: In estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer, first-generation genomic signatures serve predominately as prognostic biomarkers and secondarily as predictors of response to chemotherapy. We compared both the prognostic and predictive value of histologic grades and genomic markers. METHODS: We retrieved publicly available cDNA microarray data from 1373 primary ER(+)/HER2(-) breast cancers and developed a genomic signature simulated from Recurrence Online (http://www.recurrenceonline.com/) to calculate the recurrence score and risk using predefined sets of genes in the cDNA microarray. We then compared the prognostic and predictive information provided by histologic grade and genomic signature. RESULTS: Based on genomic signatures, 55%, 28%, and 17% of breast cancers were classified as low, intermediate, and high risk, respectively, whereas the histologic grades were I, II, and III in 22%, 59%, and 19% of breast cancers, respectively. Univariate analysis in the untreated cohort revealed that both histologic grade (overall P = .007) and genomic signature (P < .001) could predict prognosis. Results were similar using the genomic signature, with pathologic complete response rates of 4.6%, 5.7%, and 16.5% for low-, intermediate-, and high-risk cancers, respectively. Neither biomarker was statistically significant in multivariate analysis for predictive response to neoadjuvant chemotherapy (NAC). CONCLUSION: Genomic signature was better at identifying low-risk cases compared to histologic grade alone, but both markers had similar predictive values for NAC response. Better predictive biomarkers for NAC response are still needed.

DOI： 10.1016/j.clbc.2015.10.004

A Case of a Fish Bone Detected in the Upper Bile Duct after Gastrectomy and Choledochoduodenostomy

腹腔内播種に対する取り組み外科医の役割腹膜内播種に関する洞察のための胃がん細胞の蛍光誘導によるイメージング(Challenge to peritoneal dissemination: Role of surgeons Fluorescence-guided imaging of gastric cancer cells for an insight into peritoneal dissemination)

Kagawa Shunsuke, Watanabe Megumi, Kuwata Kazuya, Kikuchi Satoru, Kuroda Shinji, Sakamoto Shuichi, Nishizaki Masahiko, Tazawa Hiroshi, Fujiwara Toshiyoshi

日本胃癌学会総会記事 88回 180 - 180 2016.3

スキルス胃癌細胞に対するテロメラーゼ依存的腫瘍融解ウイルス治療の前臨床評価

堀直人, 田澤大, 西崎正彦, 渡邉めぐみ, 田村周太, 國府島健, 黒田新士, 浦田泰生, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 88回 452 - 452 2016.3

腹腔鏡下・ロボット支援下噴門側胃切除後「観音開き法」再建(Esophagogastrostomy with double flap technique after laparoscopic and robotic proximal gastrectomy)

西崎正彦, 黒田新士, 菊地覚次, 渡邉めぐみ, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本胃癌学会総会記事 88回 272 - 272 2016.3

低侵襲性と高QOLを追求した腹腔鏡下噴門側胃切除+観音開き法再建の食道胃接合部癌への適応拡大(Laparoscopic proximal gastrectomy with valvuloplastic esophagogastrostomy for EGJ cancer)

黒田新士, 西崎正彦, 野間和広, 菊地覚次, 坂本修一, 香川俊輔, 白川靖博, 藤原俊義

日本胃癌学会総会記事 88回 261 - 261 2016.3

残胃癌手術症例の予後因子の検討

菊地覚次, 黒田新士, 坂本修一, 白川靖博, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 88回 198 - 198 2016.3

食道癌手術における鏡視下手術導入による術前後の身体的変化についての検討

田辺俊介, 白川靖博, 前田直見, 野間和広, 藤原俊義

日本静脈経腸栄養学会雑誌 31 ( 1 ) 611 - 611 2016.1

BASIC AND PRACTICAL METHODS FOR SURGICAL CLINICAL STUDY

Fujiwara Toshiyoshi

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 77 ( 5 ) 1288 - 1288 2016

HORI Naoto, MATSUDA Tadakazu, KATSUBE Ryoichi, LEE JeonUk, KAMIKAWA Yasuaki, FUJIWARA Toshiyoshi

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 77 ( 8 ) 2033 - 2038 2016

Language：Japanese Publisher：Japan Surgical Association

A case of cholangitis of the right hepatic duct caused by an ingested fish bone is reported. A 70-year-old man developed symptoms of acute cholangitis and was admitted to our hospital two times within the space of half a year. Abdominal CT and MRI showed evidence of acute cholangitis with dilatation of the right hepatic duct. Underlying intrahepatic bile duct cancer was considered as the cause of the relapsing cholangitis and dilatation of the right hepatic duct. Under the suspected diagnosis of intrahepatic bile duct cancer, an exploratory laparotomy was performed. The junction between the duodenum and common bile duct was cut, and the intrabiliary wall was observed with a cholangioscope. A foreign body was found to be stuck to the bile duct wall, which was considered to be the cause of the acute cholangitis. The foreign body was removed endoscopically with forceps. Histopathologically, the foreign body was diagnosed as a bone stump, and the needle-shaped appearance suggested that it was a fish bone. This is the first reported case of an ingested fish bone found in the upper bile duct.

DOI： 10.3919/jjsa.77.2033

CiNii Article

p53 Replacement Therapy for Cancer. Reviewed

Tazawa H, Kagawa S, Fujiwara T

Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer 209 1 - 15 2016

食道癌への内視鏡外科手術を評価する低侵襲性と長期成績食道癌手術における胸腔鏡手術導入による低侵襲化の検討術後超短期評価と長期評価

田辺俊介, 白川靖博, 九十九悠太, 桂佑貴, 前田直見, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) SY31 - 8 2015.12

進行胃癌に対する審査腹腔鏡のルチーン化と新たな探索的研究

菊地覚次, 香川俊輔, 坂本修一, 渡邉めぐみ, 黒田新士, 岸本浩行, 西崎正彦, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) OS312 - 6 2015.12

腹腔鏡下噴門側胃切除後の再建革新を目指して完全体腔内「観音開き法」食道残胃吻合

黒田新士, 西崎正彦, 菊地覚次, 坂本修一, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) PD10 - 5 2015.12

内視鏡外科のこれからの教育工夫を持ち寄って最善を探るカダバートレーニングにおける指導経験の効用

近藤喜太, 前田直見, 黒田新士, 信岡大輔, 吉田龍一, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) WS2 - 6 2015.12

腹腔鏡下噴門側胃切除後の再建ベストな再建方法はどれか逆流防止弁形成食道残胃吻合(観音開き法)

西崎正彦, 黒田新士, 菊地覚次, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) DS12 - 1 2015.12

気管周囲微細解剖に留意した左反回神経リンパ節郭清の工夫

白川靖博, 九十九悠太, 桂佑貴, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) OS309 - 4 2015.12

内視鏡視下食道手術のピットフォールとその対策腹臥位胸腔鏡下食道切除における偶発症と当科におけるその対策

野間和広, 白川靖博, 李云成, 九十九悠太, 桂佑貴, 前田直見, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 7 ) WS13 - 3 2015.12

腹会陰式直腸切断術の術後会陰感染創に対する局所陰圧閉鎖療法の有用性

近藤喜太, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本創傷治癒学会プログラム・抄録集 45回 108 - 108 2015.11

[Therapeutic Potential of Targeting Cancer-Associated Fibroblasts in Esophageal Cancer]. Reviewed

Kazuhiro Noma, Hajime Kashima, Takayuki Ninomiya, Ryoichi Katsube, Shinichiro Watanabe, Toshiaki Ohara, Hiroshi Tazawa, Shunsuke Kagawa, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 42 ( 10 ) 1228 - 30 2015.10

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

Advances in molecular and cellular biochemistry, such as the development of targeted cancer therapy, have dramatically improved the prognosis of cancer patients. Emerging data have suggested that bevacizumab treatment may act by controlling the cancer microenvironment. Many reports have examined the interaction of cancer cells with the tumor microenvironment, and cancer-associated fibroblasts (CAFs) are thought to play a central role in this process. We speculated that the cancer microenvironment and in particular, CAFs, strongly influence the development of esophageal cancer. We have analyzed the signaling pathways of molecular targets. However, inhibition of a single signaling pathway is insufficient to treat cancer effectively. Photoimmunotherapy is a molecular-targeted specific cancer therapy using near-infrared radiation, which was introduced by Mitsunaga et al. in 2011. We are using its specific method of killing cells to target CAFs. We will report the results of its effect on cancer cells in the future.

【LECS(laparoscopy and endoscopy cooperative surgery)の新たな展開】各種LECS手技 Closed LECS

西崎正彦, 黒田新士, 加藤大, 松村年久, 岡田裕之, 藤原俊義

臨床消化器内科 30 ( 12 ) 1503 - 1509 2015.10

Language：Japanese Publisher：(株)日本メディカルセンター

5cm以下の管内発育型GIST(gastrointestinal stromal tumor)を主体とした胃粘膜下腫瘍の手術療法は,LECS(laparoscopy and endoscopy cooperative surgery)の登場により必要最小限の胃部分切除を低侵襲手術として行うことが可能となった.しかし,LECS原法(Classical LECS)では腫瘍切除の過程で胃内腔と腹腔が交通し,腫瘍も腹腔内に露出するため,潰瘍のあるGISTや早期胃癌への応用は禁忌と考えられてきた.胃壁を開放しない,あるいは,胃内容物を撒布しない方法として,すでに,いくつかの手技が臨床応用されているが,筆者らはClassical LECSを発展させたClosed LECSを考案したので,手術手技,臨床応用について概説する.(著者抄録)

左副腎腺によるCushing症候群にて腹腔鏡下副腎摘出術を施行した1例

喀痰を用いたCpGのメチル化検出による非侵襲的なスクリーニングの開発

河合毅, 永坂岳司, 藤智和, 谷口文崇, 戸嶋俊明, 母里淑子, 豊岡伸一, 藤原俊義

日本癌学会総会記事 74回 P - 3314 2015.10

循環Ago2-miRNA検出技術を用いた化学療法効果予測の検証

藤智和, 永坂岳司, 母里淑子, 河合毅, 谷口文崇, 戸嶋俊明, 藤原俊義

日本癌学会総会記事 74回 P - 3313 2015.10

血中のcirculating cell-freeDNAのメチル化検出による大腸癌の同定

戸嶋俊明, 永坂岳司, 河合毅, 藤智和, 谷口文崇, 木村圭佑, 安井和也, 母里淑子, 藤原俊義

日本癌学会総会記事 74回 P - 2007 2015.10

遺伝性大腸癌における系統的遺伝子解析

谷口文崇, 永坂岳司, 母里淑子, 河合毅, 藤智和, 戸嶋俊明, 藤原俊義

日本癌学会総会記事 74回 P - 1170 2015.10

食道疾患手術後の吻合・修復部における縫合不全対策胃管作成不能例に対する空腸を用いた食道再建および吻合の工夫

白川靖博, 九十九悠太, 桂佑貴, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 76 ( 増刊 ) 488 - 488 2015.10

食道疾患に対する手術手技気管周囲微細解剖に留意した反回神経リンパ節郭清の工夫

白川靖博, 九十九悠太, 桂佑貴, 前田直晃, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 76 ( 増刊 ) 382 - 382 2015.10

分化型胃癌細胞による癌関連線維芽細胞の活性化機構

李云成, 田澤大, 西崎正彦, 橋本悠里, 堀直人, 勝部亮一, 黒田新士, 野間和広, 香川俊輔, 藤原俊義

日本癌学会総会記事 74回 P - 3127 2015.10

胃癌個別化治療に向けた、蛍光ウイルスによる腹腔内遊離胃癌細胞の検出技術の開発

渡邉めぐみ, 香川俊輔, 桑田和也, 橋本悠里, 堀直人, 菊地覚次, 黒田新士, 岸本浩行, 西崎正彦, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 74回 E - 1291 2015.10

ナノ技術と抗体療法の融合による新規HER2標的金ナノ製剤の開発と治療効果の検討

久保田哲史, 黒田新士, 森廣俊昭, 青山克幸, 田澤大, 香川俊輔, 藤原俊義

日本癌学会総会記事 74回 E - 1332 2015.10

スキルス胃癌細胞に対する腫瘍特異的p53遺伝子治療の前臨床評価

堀直人, 田澤大, 西崎正彦, 渡邉めぐみ, 田村周太, 國府島健, 黒田新士, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 74回 E - 1272 2015.10

基礎研究の外科臨床への応用早期消化管がんに対する新規リンパ節転移治療の可能性

菊地覚次, 岸本浩行, 田澤大, 黒田新士, 西崎正彦, 香川俊輔, 浦田泰生, Hoffman Robert M., 藤原俊義

日本癌学会総会記事 74回 S16 - 3 2015.10

KRAS/BRAF変異を持つ大腸癌に対する新たな腫瘍融解ウイルス療法の開発

田村周太, 田澤大, 堀直人, 國府島健, 菊地覚次, 黒田新士, 岸本浩行, 永坂岳司, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 74回 E - 1066 2015.10

遊走能・浸潤能を有する膵臓癌細胞に対する新たな腫瘍融解ウイルス療法の開発

國府島健, 田澤大, 堀直人, 田村周太, 黒田新士, 岸本浩行, 西崎正彦, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 74回 E - 1064 2015.10

胃疾患に対する内視鏡外科手術手技腹腔鏡下噴門側胃切除術におけるリンパ節郭清手技の定型化

西崎正彦, 黒田新士, 菊地覚次, 坂本修一, 田邊俊介, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 76 ( 増刊 ) 389 - 389 2015.10

結腸右半切除を伴う拡大膵頭十二指腸切除術後の再建の工夫

佐藤博紀, 信岡大輔, 安井和也, 高木弘誠, 杭瀬崇, 内海方嗣, 吉田龍一, 楳田祐三, 篠浦先, 八木孝仁, 藤原俊義

日本消化器外科学会雑誌 48 ( Suppl.2 ) 203 - 203 2015.10

谷本光隆, 野田卓男, 尾山貴徳, 西崎正彦, 藤原俊義, 長谷川高誠

日本小児外科学会雑誌 51 ( 6 ) 1126 - 1126 2015.10

腹腔鏡下肝切除の適応拡大に向けたcadaver trainingの実際

信岡大輔, 八木孝仁, 近藤喜太, 佐藤博紀, 森廣俊昭, 高木弘誠, 安井和也, 杭瀬崇, 内海方嗣, 吉田龍一, 楳田祐三, 篠浦先, 大塚愛二, 藤原俊義

日本消化器外科学会雑誌 48 ( Suppl.2 ) 206 - 206 2015.10

骨軟部肉腫細胞に対する腫瘍融解ウイルスの放射線増感作用

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 佐々木剛, 杉生和久, 魚谷弘二, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 74回 E - 1276 2015.10

骨肉腫に対するドキソルビシンとp53発現腫瘍融解アデノウイルス製剤の併用療法

杉生和久, 田澤大, 長谷井嬢, 尾崎修平, 山川泰明, 大森敏規, 小松原将, 魚谷弘二, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 74回 P - 1382 2015.10

当科における表在型頭頸部癌の長期成績と重複癌の検討

田辺俊介, 白川靖博, 加藤卓也, 竹原清人, 前田直見, 櫻間教文, 野間和広, 藤原俊義

Gastroenterological Endoscopy 57 ( Suppl.2 ) 2115 - 2115 2015.9

胃胃がんのPDL-1発現と免疫療法胃癌組織におけるPD-L1発現と予後との関連

黒田新士, 森廣俊昭, 久保田哲史, 菊地覚次, 田澤大, 西崎正彦, 香川俊輔, 藤原俊義

日本癌治療学会誌 50 ( 3 ) 141 - 141 2015.9

胃癌合併Bochdalek孔ヘルニアに対する用手補助腹腔鏡下手術による一期的根治手術の1例

堀直人, 香川俊輔, 黒田新士, 岸本浩行, 西崎正彦, 藤原俊義

日本内視鏡外科学会雑誌 20 ( 5 ) 473 - 479 2015.9

Language：Japanese Publisher：(一社)日本内視鏡外科学会

患者は65歳,男性.腹痛・嘔吐を主訴に前医を受診し,上部消化管内視鏡検査で早期胃癌を,CTで左横隔膜にBochdalek孔ヘルニアを指摘された.胃癌に対する内視鏡的切除が非治癒切除となり,追加切除目的に当院紹介となった.胃癌のリンパ節郭清と今後のヘルニア嵌頓のリスクを考慮し,同時手術にて腹腔鏡補助下に胃切除およびヘルニア修復術を行った.気腹による胸腔内圧上昇に胸腔トロッカーを要し,ヘルニア門修復での視野確保には用手補助を追加したが,腹腔鏡下に幽門側胃切除とヘルニア根治術を完遂した.これまでに横隔膜ヘルニアと悪性腫瘍とを同時に手術した報告はなく,若干の文献的考察を加えて報告する.(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J03270&link_issn=&doc_id=20150925140005&doc_link_id=10.11477%2Fmf.4426200166&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.4426200166&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

手術手技腹腔鏡下噴門側胃切除後の「観音開き法」による完全体腔内食道残胃吻合

黒田新士, 西崎正彦, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

手術 69 ( 10 ) 1487 - 1492 2015.9

新規免疫療法と化学療法早期消化管癌患者のリンパ節転移に対する生物学的アブレーションの利用可能性(Novel Immunotherapy and Chemothnorty The possibility of biological ablation of lymphatic metastasis for early gastrointestinal cancer patients)

Kikuchi Satoru, Kishimoto Hiroyuki, Tazawa Hiroshi, Kuroda Shinji, Nishizaki Masahiko, Kagawa Shunsuke, Urata Yasuo, Hoffman Robert M., Fujiwara Toshiyoshi

日本癌治療学会誌 50 ( 3 ) 1117 - 1117 2015.9

新規免疫療法と化学療法食道癌に対する放射線療法との併用におけるテロメラーゼ標的腫瘍溶解性ウイルス、OBP-301の内視鏡的腫瘍内投与の第1/2相研究(Novel Immunotherapy and Chemothnorty A phase I/II study of endoscopic intratumoral administration of a telomerase targeted oncolytic virus, OBP-301, in combination with radiotherapy for esophageal cancer)

Kagawa Shunsuke, Tanabe Shunsuke, Tazawa Hiroshi, Noma Kazuhiro, Koujima Takeshi, Kashima Hajime, Kato Takuya, Kuroda Shinji, Kikuchi Satoru, Shirakawa Yasuhiro, Fujiwara Toshiyoshi

日本癌治療学会誌 50 ( 3 ) 1116 - 1116 2015.9

食道癌と胃癌2 トランスレーショナル研究新規HER2標的療法としてのtrastuzumab結合金ナノ粒子(Esophageal and Gastric Cancer: Translational Research Trastuzumab-conjugated gold nanoparticles as a novel HER2-targeted therapy)

Kuroda Shinji, Kubota Tetsushi, Morihiro Toshiaki, Kikuchi Satoru, Tazawa Hiroshi, Nishizaki Masahiko, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本癌治療学会誌 50 ( 3 ) 1076 - 1076 2015.9

大腸癌卵巣転移に対する治療と予後

母里淑子, 永坂岳司, 竹原裕子, 佃和憲, 中谷紳, 嶋村廣視, 瀧上隆夫, 冨岡憲明, 森谷行利, 藤原俊義

日本大腸肛門病学会雑誌 68 ( 9 ) 753 - 753 2015.9

腫瘍融解アデノウイルスの骨・軟部腫瘍臨床組織検体に対する感染効率および適応症例の検討

吉田晶, 藤原智洋, 魚谷弘二, 長谷井嬢, 山川泰明, 大森敏規, 杉生和久, 武田健, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1673 - S1673 2015.9

骨肉腫に対するテロメラーゼ依存性腫瘍融解アデノウイルスと骨周囲環境制御による新規治療戦略

山川泰明, 長谷井嬢, 田澤大, 杉生和久, 魚谷弘二, 大森敏規, 尾崎修平, 吉田晶, 藤原智洋, 武田健, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1798 - S1798 2015.9

骨・軟部肉腫に対する腫瘍融解アデノウイルスと放射線療法の併用効果

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 杉生和久, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1673 - S1673 2015.9

骨肉腫に対する化学療法とp53発現腫瘍融解アデノウイルス治療の併用効果

杉生和久, 小松原将, 大森敏規, 山川泰明, 吉田晶, 藤原智洋, 武田健, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1799 - S1799 2015.9

超高齢者(95歳)の進行盲腸癌に対して腹腔鏡下回盲部切除を施行した1例

渡邉彩子, 稲田涼, 永坂岳司, 八木朝彦, 松本聖, 戸嶋俊明, 菊池覚次, 黒田新士, 近藤喜太, 母里淑子, 岸本浩行, 藤原俊義

岡山医学会雑誌 127 ( 2 ) 117 - 121 2015.8

Language：Japanese Publisher：岡山医学会

症例は95歳男性で、便秘を主訴に受診した。腹部X線検査にて鏡面像を認めた。CEA、CA19-9の上昇を認めた。下部消化管内視鏡検査では、バウヒン弁にかかる全周性の狭窄を伴う腫瘍を盲腸に認め、スコープは通過不可能であった。ガストログラフィン造影にて狭窄を回盲部に認めた、腫瘍部の生検にて、高分化腺癌と診断した。膜部CT検査では、盲腸の壁肥厚を認め、周囲に腫大したリンパ節を複数認めた。また回盲部付近の脂肪組織の毛羽立ちを認めた。精査の結果、盲腸癌の診断に至った。腹腔鏡下回盲部切除を施行した。術後ICUに入室した。第1病日に一般床に転床後、離床、飲水を開始した。第2病日より流動食を開始した。周術期に大きな合併症は無く経過し、第11病日に自宅退院となった。術後補助化学療法は行わず、経過観察中である。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00175&link_issn=&doc_id=20150825270003&doc_link_id=10.4044%2Fjoma.127.117&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.127.117&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

当科における食道憩室手術症例の検討 Reviewed

賀島肇, 白川靖博, 前田直見, 田辺俊介, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 70回 P - 5 2015.7

食道癌の内視鏡下手術 2015年までの総括当科における腹臥位胸腔鏡下食道手術200例の総括

白川靖博, 加藤卓也, 前田直見, 竹原清人, 田辺俊介, 櫻間教史, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 69回 11 - 11 2015.7

内視鏡腹腔鏡併用手術治療の工夫 Closed LECS手術手技のコツとピットフォール

西崎正彦, 黒田新士, 加藤大, 菊地覚次, 香川哲也, 田邊俊介, 香川俊輔, 白川靖博, 岡田裕之, 藤原俊義

日本消化器外科学会総会 70回 RS - 5 2015.7

胃癌腹膜播種の病態と診断・治療腫瘍特異的蛍光発現virus試薬による腹腔洗浄液中の遊離胃癌細胞診断の臨床的意義

香川俊輔, 渡邉めぐみ, 石田道拡, 桑田和也, 黒田新士, 菊地覚次, 香川哲也, 西崎正彦, 田澤大, 藤原俊義

日本消化器外科学会総会 70回 WS - 4 2015.7

食道癌に対する放射線併用ウイルス療法の臨床研究レベル1投与量群の中間報告

田邊俊介, 白川靖博, 加藤卓也, 竹原清人, 前田直見, 黒田新士, 野間和広, 田澤大, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 O - 6 2015.7

早期胃癌に対する遺伝子改変ウイルスを用いたリンパ節転移アブレーションによる低侵襲治療の開発

菊地覚次, 岸本浩行, 香川哲也, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 O - 3 2015.7

術後QOL向上を目指した胃癌手術の工夫噴門側胃切除+観音開き法再建の術後QOLに及ぼす影響

黒田新士, 西崎正彦, 香川哲也, 菊地覚次, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 WS - 7 2015.7

当院における胃GIST手術症例の検討

香川哲也, 黒田新士, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 P - 1 2015.7

腹臥位胸腔鏡下食道切除術における反回神経麻痺を起こさない術野展開と郭清の工夫

白川靖博, 加藤卓也, 前田直見, 竹原清人, 田辺俊介, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 O - 2 2015.7

早期食道胃接合部癌に対する治療戦略当科におけるcT1食道胃接合部癌に対する治療戦略

野間和広, 白川靖博, 加藤卓也, 竹原清人, 前田直見, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 70回 WS - 7 2015.7

高齢者消化器癌に対する治療戦略 80歳以上超高齢者食道癌症例に対する安全な外科治療と手術成績向上のための取り組み

竹原清人, 白川靖博, 加藤卓也, 前田直見, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会総会 70回 RS - 1 2015.7

Stage II/III食道癌の治療 DCF vs. CF Stage II/III食道癌100例の検討

前田直見, 白川靖博, 賀島肇, 加藤卓也, 竹原清人, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会総会 70回 O - 3 2015.7

多視点3D解剖システムを用いた臨床教育

前田直見, 白川靖博, 加藤卓也, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 69回 205 - 205 2015.7

Y字胃管を用いた食道バイパス術8例の経験食道ステントと比較して優位性は?

田辺俊介, 白川靖博, 賀島肇, 加藤卓也, 竹原清人, 前田直見, 櫻間教文, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 69回 135 - 135 2015.7

迅速果断な術後合併症対応を目指して術後3日目造影CT検査の有用性

前田直見, 白川靖博, 加藤卓也, 竹原清人, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 69回 96 - 96 2015.7

食道再建法・吻合法最良の方法は胃管作成不能例に対する至適再建の検討手術侵襲とQOLを考慮した空腸再建の有用性

野間和広, 白川靖博, 加藤卓也, 竹原清人, 前田直見, 田辺俊介, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 69回 37 - 37 2015.7

潰瘍性大腸炎における緊急手術症例の検討

渡邉佑介, 近藤喜太, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本消化器外科学会総会 70回 P - 5 2015.7

内視鏡手術時代における消化器外科医の教育消化器外科内視鏡手術教育におけるカダバートレーニングの有用性

近藤喜太, 渡辺裕介, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本消化器外科学会総会 70回 SS - 6 2015.7

【食道手術-合併症対処の各施設の工夫-】ハイリスク食道癌手術当施設の合併症対処の工夫ハイリスク食道癌手術の対策低肺機能症例の対策

白川靖博, 加藤卓也, 前田直見, 田辺俊介, 野間和広, 藤原俊義

手術 69 ( 7 ) 991 - 994 2015.6

リポソームを用いたテロメラーゼ特異的全身ウイルス療法の可能性

森廣俊昭, 青山克幸, 久保田哲史, 黒田新士, 田澤大, 香川俊輔, 藤原俊義

日本DDS学会学術集会プログラム予稿集 31回 200 - 200 2015.6

金ナノ粒子を用いたHER2標的抗体療法新標的化技術の応用

久保田哲史, 黒田新士, 青山克幸, 森廣俊昭, 田澤大, 藤原俊義

日本DDS学会学術集会プログラム予稿集 31回 153 - 153 2015.6

骨・軟部肉腫に対する腫瘍融解アデノウイルスと放射線療法の併用効果

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 杉生和久, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1244 - S1244 2015.6

ゾレドロン酸とテロメラーゼ依存性腫瘍融解アデノウイルスの併用療法は骨肉腫に対する抗腫瘍効果を増強し、骨破壊を抑制する

山川泰明, 長谷井嬢, 田澤大, 杉生和久, 魚谷弘二, 尾崎修平, 吉田晶, 藤原智洋, 武田健, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1244 - S1244 2015.6

次世代シーケンサーによるリンチ症候群の解析

永坂岳司, 谷口文崇, 母里淑子, 藤原俊義

家族性腫瘍 15 ( 2 ) A65 - A65 2015.5

家族性大腸腺腫症におけるデスモイド腫瘍に対するタモキシフェンの有効性の検討

母里淑子, 永坂岳司, 谷口文崇, 河合毅, 藤原俊義

家族性腫瘍 15 ( 2 ) A81 - A81 2015.5

高齢者大腸癌に対するD3郭清の短期・長期成績の検討

稲田涼, 永坂岳司, 渡邉彩子, 松本聖, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 浅野博昭, 佃和憲, 藤原俊義

日本大腸肛門病学会雑誌 68 ( 5 ) 355 - 355 2015.5

その他鉄コントロールによるがん幹細胞に対する新規治療 Reviewed

二宮卓之, 大原利章, 浦野真一, 勝部亮一, 野間和広, 田澤大, 白川靖博, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 115回 OP - 7 2015.4

上部消化管超高齢者食道癌手術への取り組みと放射線併用ウイルス療法の可能性 Reviewed

田辺俊介, 白川靖博, 賀島肇, 国府島健, 前田直見, 大原利章, 黒田新士, 櫻間教文, 野間和広, 田澤大, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 115回 OP - 2 2015.4

上部消化管 HER2陰性癌細胞に対するHER2細胞外ドメインによる非機能性HER2抗原遺伝子修飾とTrastuzumabを用いた分子標的光免疫療法を併用した治療戦略

石田道拡, 香川俊輔, 下山京子, 竹原清人, 渡邉めぐみ, 菊地覚次, 黒田新士, 野間和広, 岸本浩行, 田澤大, 田邊俊介, 小林久隆, 藤原俊義

日本外科学会定期学術集会抄録集 115回 OP - 3 2015.4

上部消化管早期胃癌におけるリンパ節転移データからみた生物学的リンパ節転移アブレーション療法の可能性

菊地覚次, 岸本浩行, 桑田和也, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 115回 YIA - 4 2015.4

上部消化管胃癌に対する腹膜洗浄術についての蛍光発現ウイルスTelomescanによる新規細胞学的診断(Novel cytological diagnosis of peritoneal wash for gastric cancer by fluorescence-emitting virus TelomeScan)

香川俊輔, 渡邉めぐみ, 石田道拡, 黒田新士, 菊地覚次, 田澤大, 岸本浩行, 桑田和也, 久保田哲史, 堀直人, 田邊俊介, 西崎正彦, 浦田泰生, 藤原俊義

日本外科学会定期学術集会抄録集 115回 IS - 6 2015.4

噴門側胃切除術後の再建空腸間置vs食道胃吻合上部消化管食道胃吻合

西崎正彦, 黒田新士, 野間和広, 菊地覚次, 桑田和也, 前田直見, 田邊俊介, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会定期学術集会抄録集 115回 DB - 2 2015.4

胸腔鏡下食道切除術の定型化上部消化管腹臥位胸腔鏡下食道切除術における適応拡大に伴う術野展開定型化の工夫

白川靖博, 野間和広, 賀島肇, 前田直見, 田辺俊介, 櫻間教文, 藤原俊義

日本外科学会定期学術集会抄録集 115回 SY - 1 2015.4

当科における食道悪性黒色腫の治療経験

八木朝彦, 白川靖博, 賀島肇, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

岡山医学会雑誌 127 ( 1 ) 77 - 77 2015.4

下部消化管超高齢者(95歳)の進行盲腸癌に対し腹腔鏡下回盲部切除を施行した1例

渡邉彩子, 稲田涼, 永坂岳司, 八木朝彦, 松本聖, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

日本外科学会定期学術集会抄録集 115回 RS - 1 2015.4

肛門管に発生し印環細胞癌・粘液癌・低分化腺癌が混在した早期大腸癌の1例

中谷紳, 脇直久, 山下和城, 永坂岳司, 母里淑子, 藤原俊義

日本大腸肛門病学会雑誌 68 ( 4 ) 239 - 245 2015.4

Language：Japanese Publisher：(一社)日本大腸肛門病学会

症例は74歳,女性.肛門からの腫瘤脱出を主訴に,当院受診した.肛門管3時方向に小指頭大の柔らかな隆起性病変を認め,直腸粘膜脱症候群の診断にて,経肛門的に腫瘤切除した.病理組織検査では病変は径10mm,充実型低分化腺癌・印環細胞癌・粘液癌が混在(por1>sig>muc)し,深達度SM200μm,水平断端陽性で,腹腔鏡下Miles手術を施行した.右鼡径リンパ節転移を認め,最終診断はanal canal adenocarcinoma and its inguinal lymph node metastasis,pT1aNxM1a stage IVだった.術後放射線化学療法を行い,現在慎重に経過観察中である.大腸印環細胞癌は腹膜播種・リンパ節転移を伴いやすく,進行癌の状態で発見されることが多いため,予後不良である.われわれは本疾患を早期に診断・治療するよう努めなければならない.(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J01146&link_issn=&doc_id=20150402340005&doc_link_id=10.3862%2Fjcoloproctology.68.239&url=https%3A%2F%2Fdoi.org%2F10.3862%2Fjcoloproctology.68.239&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

食道胃接合部癌の治療戦略内視鏡治療から集学的治療まで当科における食道胃接合部癌の治療経験

野間和広, 白川靖博, 加藤卓也, 竹原清人, 前田直見, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 87回 180 - 180 2015.3

非機能性HER2抗原で遺伝子修飾したHER2陰性癌細胞に対する分子標的光免疫療法

石田道拡, 香川俊輔, 下山京子, 竹原清人, 渡邉めぐみ, 菊地覚次, 黒田新士, 野間和広, 岸本浩行, 西崎正彦, 田澤大, 田邊俊介, 小林久隆, 藤原俊義

日本胃癌学会総会記事 87回 402 - 402 2015.3

Netrin-1 RecepterのGenetic/Epigenetic変異の腫瘍進展による相加的欠損と胃癌の染色体不安定性との関連

竹原裕子, 永坂岳司, 岸本浩行, 竹原清人, 菊地覚次, 黒田新士, 西崎正彦, 香川俊輔, 合地明, 藤原俊義

日本胃癌学会総会記事 87回 289 - 289 2015.3

上部胃癌に対する腹腔鏡下脾温存リンパ節郭清手技の工夫

西崎正彦, 黒田新士, 菊地覚次, 桑田和也, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本胃癌学会総会記事 87回 233 - 233 2015.3

ESD後遺残・再発病変の現状とその対応当院におけるESD後遺残・再発症例および非治癒切除症例の検討

菊地覚次, 阿部真, 神崎洋光, 桑田和也, 石田道拡, 黒田新士, 西崎正彦, 香川俊輔, 岡田裕之, 藤原俊義

日本胃癌学会総会記事 87回 214 - 214 2015.3

腹腔鏡下噴門側胃切除術の再建手技 3D内視鏡システムを用いた完全体腔内「観音開き法」食道残胃吻合

黒田新士, 西崎正彦, 桑田和也, 菊地覚次, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本胃癌学会総会記事 87回 204 - 204 2015.3

高齢化社会に向けたこれからの胃癌治療戦略治療すべきか経過観察かサルコペニアが高齢胃癌患者の予後に及ぼす影響

桑田和也, 高木弘誠, 菊地覚次, 黒田新士, 吉田龍一, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 87回 175 - 175 2015.3

腹腔内の遊離胃がん細胞のウイルス標識による蛍光イメージング(Virus-guided fluorescence imaging of intraperitoneal free gastric cancer cells)

Watanabe Megumi, Kagawa Shunsuke, Ishida Michihiro, Hashimoto Yuuri, Hori Naoto, Kikuchi Satoru, Kuroda Shinji, Kishimoto Hiroyuki, Nishizaki Masahiko, Tazawa Hiroshi, Urata Yasuo, Fujiwara Toshiyoshi

日本胃癌学会総会記事 87回 497 - 497 2015.3

食道癌術後再建胃管癌症例の検討

田辺俊介, 白川靖博, 賀島肇, 前田直見, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 87回 302 - 302 2015.3

HER2陽性進行・再発胃癌に対するTrastuzumabを含む化学療法

香川俊輔, 黒田新士, 菊地覚次, 桑田和也, 久保田哲史, 堀直人, 渡邉めぐみ, 石田道拡, 岸本浩行, 西崎正彦, 白川靖博, 藤原俊義

日本胃癌学会総会記事 87回 442 - 442 2015.3

骨・軟部肉腫に対する腫瘍融解アデノウイルスと放射線療法の併用効果

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 杉生和久, 藤原智洋, 国定俊之, 浦田泰夫, 藤原俊義

日本整形外科学会雑誌 89 ( 2 ) S142 - S142 2015.3

原発不明癌として治療を受けていた虫垂癌の1例

松本聖, 稲田涼, 永坂岳司, 渡邉彩子, 八木朝彦, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

癌と化学療法 42 ( 2 ) 229 - 231 2015.2

Language：Japanese Publisher：(株)癌と化学療法社

われわれは原発不明癌として治療を受けていたが増悪し、開腹手術による確定診断後にmodified FOLFOX6(mFOLFOX6)+panitumumab療法を施行し、部分寛解となり原発巣切除となった症例を経験したので報告する。症例は50歳台、男性。腹部膨満、食思不振を主訴に前医受診。腹水貯留を伴う腹膜結節を認め癌性腹膜炎と診断された。腹水細胞診の結果、消化管由来と診断される腺癌を認めたが、PET-CT検査、上下部消化管内視鏡検査にて原発巣の診断は得られなかった。原発不明癌としてCBDCA+PTX療法、GEM療法にて加療するも腹水増大し、播種結節に伴う腸管閉塞を認め、2013年1月当院を紹介された。腸閉塞解除目的で開腹手術施行。腹腔内は虫垂の壁肥厚および播種による回腸末端付近の閉塞を認めたため、回腸人工肛門造設および播種結節切除を行った。虫垂癌の診断を得て、mFOLFOX6+panitumumab療法を3コース施行し、部分寛解を得た後、再び開腹し、拡大右半結腸切除術にて原発巣および一部播種結節を切除した。現在、原発不明癌に対しては標準的治療レジメンが存在しないばかりか、化学療法によって患者の予後改善を得られるのかも明確ではない。確定診断を得るためにも可能であれば開腹手術を考慮する必要がある。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00296&link_issn=&doc_id=20150219340019&doc_link_id=%2Fab8gtkrc%2F2015%2F004202%2F020%2F0229-0231%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2015%2F004202%2F020%2F0229-0231%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

集学的治療にて長期生存を得たKRAS遺伝子変異を伴う再発直腸癌の1例

渡邉彩子, 稲田涼, 永坂岳司, 八木朝彦, 松本聖, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

癌と化学療法 42 ( 2 ) 237 - 239 2015.2

Language：Japanese Publisher：(株)癌と化学療法社

進行・再発大腸癌に対する新規抗癌剤や分子標的薬の登場により多くの患者が生存期間の延長を得られるようになった。しかしさらなる長期生存を得るためには全身化学療法のみではなく、転移巣に対する局所療法も組み合わせる必要がある。とりわけKRAS変異を伴う大腸癌は有効薬剤が限られるため、より集学的な治療が必要となる。今回われわれは、KRAS変異を伴う直腸癌術後肺再発・骨盤内リンパ節再発を来した50代の男性に対して全身化学療法に加え、肺切除、経皮的ラジオ波焼灼術(radiofrequency ablation:RFA)、リンパ節切除といった集学的治療を行うことにより、初回再発時より3年以上、活動性病変のない状態で生存している症例を報告する。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00296&link_issn=&doc_id=20150219340021&doc_link_id=%2Fab8gtkrc%2F2015%2F004202%2F022%2F0237-0239%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2015%2F004202%2F022%2F0237-0239%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

A Case of Intestinal Penetration Due to Small Intestinal Recurrence of Cecal Cancer

Watanabe Ayako, Inada Ryo, Nagasaka Takeshi, Yagi Tomohiko, Matsumoto Hijiri, Toshima Toshiaki, Mori Yoshiko, Kondo Yoshitaka, Kishimoto Hiroyuki, Fujiwara Toshiyoshi

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 40 ( 2 ) 251 - 255 2015

Language：Japanese Publisher：Japanese College of Surgeons

We report herein a case of solitary small intestinal recurrence of colorectal cancer. A man in his 70s underwent ileocecal resection with regional lymph node dissection for cecal cancer at Okayama University Hospital in December 2004. The tumor was diagnosed as moderately differentiated adenocarcinoma, and graded as pStage Ⅱ (pT2pN0cM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. Thirty-six months after initial surgery, he presented complaining of severe abdominal pain and high fever. Abdominal computed tomography showed localized intra-abdominal abscess. Based on the diagnosis of intestinal penetration, we performed an emergent operation. Intraoperatively, a small intestinal tumor was found to be the cause of the penetration; therefore, both partial resection of the ileum and abscess drainage were performed. Although the patient underwent adjuvant chemotherapy, the tumor recurred in the retroperitoneum in November 2008. He then underwent multimodal therapy, including palliative local resection, radiotherapy, and systemic chemotherapy, to the site of recurrence; however, he died of the cancer about six years after initial recurrence.

DOI： 10.4030/jjcs.40.251

CiNii Article

Other Link： http://search.jamas.or.jp/link/ui/2015332071

[False-positive local recurrences on FDG-PET/CT due to postoperative infection - a case report].

Yoshiko Mori, Takeshi Nagasaka, Ryo Inada, Ayako Watanabe, Hiroyuki Kishimoto, Yoshitaka Kondou, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 41 ( 12 ) 1599 - 601 2014.11

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

Although ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is a powerful tool for detecting the recurrence of colorectal cancer, FDG uptake is not tumor specific. Herein, we report a case of a 65-year- old man who underwent emergency colectomy for perforation of colon cancer. FDG-PET/CT after surgery showed 2 tumors that were difficult to differentiate from peritoneal metastases with invasion to the spleen. Splenectomy was performed, and the histopathology revealed that the tumors in fact were abscesses. This is a clinically thought-provoking case that showed the difficulty of the differential diagnosis between early recurrence after emergent surgery of colorectal cancer and the postoperative changes.

骨転移におけるゾレドロン酸と腫瘍融解アデノウイルスの併用治療

内視鏡外科の低侵襲性を評価する腹臥位胸腔鏡下食道切除術の栄養学的評価の検討

白川靖博, 賀島肇, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 316 - 316 2014.10

早期胃癌に対するESD非治癒切除後の追加治療としてのLADGの治療成績の検討

菊地覚次, 堀直人, 桑田和也, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 681 - 681 2014.10

腹腔鏡下胃切除術後の利尿期への早期移行は低侵襲性を反映する

桑田和也, 吉田龍一, 菊池覚次, 黒田新士, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 674 - 674 2014.10

腹腔鏡下手術の低侵襲性は胃切除術後の癒着性腸閉塞の低減に寄与する

香川俊輔, 黒田新士, 菊地覚次, 岸本浩行, 桑田和也, 久保田哲史, 堀直人, 渡邉めぐみ, 石田道拡, 浅野博昭, 永坂岳司, 佃和憲, 西崎正彦, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 674 - 674 2014.10

高齢者胃癌(75歳以上)に対する腹腔鏡手術の妥当性

黒田新士, 桑田和也, 菊地覚次, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 632 - 632 2014.10

ロボット支援胃切除術 Pros and Cons ロボット支援下胃切除術における郭清と体腔内手縫い吻合

西崎正彦, 黒田新士, 菊地覚次, 桑田和也, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 316 - 316 2014.10

手術の教育法開胸・開腹vs内視鏡下手術教育におけるカダバートレーニングの有用性と可能性

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 311 - 311 2014.10

小児先天性食道狭窄症に対する下部食道・噴門側胃切除後漿膜筋層フラップによる噴門形成術(観音開き法)

野田卓男, 尾山貴徳, 谷本光隆, 野間和広, 田邊俊介, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 458 - 458 2014.10

高齢者大腸癌に対するD3郭清の短期・長期成績の検討

稲田涼, 永坂岳司, 渡邉彩子, 八木朝彦, 松本聖, 母里淑子, 近藤喜太, 岸本浩行, 浅野博昭, 佃和憲, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 640 - 640 2014.10

Colitic cancer/high grade dysplasiaを合併した潰瘍性大腸炎に対する腹腔鏡下大腸全摘の治療成績の検討

稲田涼, 近藤喜太, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 506 - 506 2014.10

クローン病に対する腹腔鏡下手術の成績開腹手術と比較して

戸嶋俊明, 近藤喜太, 稲田涼, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本内視鏡外科学会雑誌 19 ( 7 ) 578 - 578 2014.10

集学的治療にて長期生存を得たKRAS遺伝子変異を伴う再発直腸癌の1例

渡邉彩子, 稲田涼, 永坂岳司, 八木朝彦, 松本聖, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 843 - 843 2014.10

結腸腸間膜デスモイド線維腫症の1例

八木朝彦, 稲田涼, 永坂岳司, 渡邉彩子, 松本聖, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 859 - 859 2014.10

進行直腸癌術後再発に対して積極的な集学的治療によって長期生存を得た1例

松本聖, 稲田涼, 永坂岳司, 八木朝彦, 渡邉彩子, 戸嶋俊明, 母里淑子, 近藤喜太, 岸本浩行, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 843 - 843 2014.10

Miles手術における会陰創のSSIに対するVAC療法の経験

戸嶋俊明, 近藤喜太, 稲田涼, 母里淑子, 岸本浩行, 永坂岳司, 藤原俊義

日本臨床外科学会雑誌 75 ( 増刊 ) 440 - 440 2014.10

大腸癌の遠隔転移(肝以外)の切除の限界とは大腸癌肺転移に対するCTガイド下経皮的ラジオ波焼灼術(RFA)の短期・長期成績の検討

稲田涼, 永坂岳司, 母里淑子, 竹原裕子, 竹原清人, 佃和憲, 平木隆夫, 金澤右, 藤原俊義

日本大腸肛門病学会雑誌 67 ( 9 ) 634 - 634 2014.9

ヒトスキルス胃癌細胞に対する腫瘍融解アデノウイルスの抗腫瘍効果(Antitumor effect of tumor-specific oncolytic adenovirus in human scirrhous gastric cancer cells)

堀直人, 田澤大, 西崎正彦, 菊地覚次, 矢野修也, 石田道拡, 渡辺めぐみ, 浦田泰生, 香川俊輔, 藤原俊義

日本癌学会総会記事 73回 P - 2355 2014.9

全身送達を目指したリポソーム抱合テロメラーゼ特異的腫瘍融解アデノウイルスプラスミドDNA(Telomerase-specific oncolytic adenoviral plasmid DNA conjugated with liposome for systemic delivery)

青山克幸, 黒田新士, 田澤大, 香川俊輔, 藤原俊義

日本癌学会総会記事 73回 P - 3420 2014.9

HER2抗原で修飾された癌細胞に対するTrastuzumabを用いた近赤外線光線免疫療法の効果(Genetic decoration with HER2-antigen makes cancer cells vulnerable to trastuzumab-based photoimmunotherapy)

石田道拡, 香川俊輔, 下山京子, 竹原清人, 野間和広, 田澤大, 黒田新士, 岸本浩行, 田邊俊介, 小林久隆, 藤原俊義

日本癌学会総会記事 73回 E - 3040 2014.9

蛍光発現ウイルスを用いた腹腔内がん細胞の検出技術の開発(A FEASIBILITY STUDY TO VISUALIZE INTRAPERITONEAL DESSEMINATED GASTRIC CANCER BY FLUORESCENCE-EMITTING VIRUS, TELOMESCAN)

渡邉めぐみ, 香川俊輔, 石田道拡, 橋本悠里, 堀直人, 菊地覚次, 黒田新士, 岸本浩行, 西崎正彦, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 73回 E - 2019 2014.9

テロメラーゼ依存性増殖型アデノウイルス製剤を用いた早期大腸癌の微小リンパ節転移制御(The eradication of lymph node metastasis of early colorectal cancers using telomerase-dependent replicating adenovirus)

菊地覚次, 岸本浩行, 田澤大, 黒田新士, 西崎正彦, 香川俊輔, 浦田泰生, ロバート・ホフマン, 藤原俊義

日本癌学会総会記事 73回 E - 1115 2014.9

StageIV大腸がんの予後マーカーとしてのMGMTメチル化ステータスの有用性

母里淑子, 永坂岳史, 稲田涼, 戸嶋俊明, 竹原裕子, 中谷紳, 竹原清人, 森川達也, 久保田暢人, 宇野太, 滝上隆夫, 嶋村廣視, 森谷行利, 富岡憲明, 藤原俊義

日本大腸肛門病学会雑誌 67 ( 9 ) 752 - 752 2014.9

肛門管に発生した早期印環細胞癌の1例

中谷紳, 脇直久, 山下和城, 永坂岳司, 母里淑子, 藤原俊義

日本大腸肛門病学会雑誌 67 ( 9 ) 782 - 782 2014.9

Colitic cancerおよびhigh grade dysplasiaを合併した潰瘍性大腸炎の臨床病理学的特徴

稲田涼, 近藤喜太, 母里淑子, 岸本浩行, 永坂岳司, 平岡佐規子, 藤原俊義

日本消化器病学会雑誌 111 ( 臨増大会 ) A889 - A889 2014.9

大腸癌検診の短期・長期治療成績における有用性の検討

戸嶋俊明, 稲田涼, 永坂岳司, 母里淑子, 竹原裕子, 竹原清人, 佃和憲, 藤原俊義

日本大腸肛門病学会雑誌 67 ( 9 ) 688 - 688 2014.9

超高齢者における胃癌術後せん妄の検討

久保田哲史, 香川俊輔, 菊地覚次, 黒田新士, 西崎正彦, 藤原俊義

岡山医学会雑誌 126 ( 2 ) 179 - 179 2014.8

山川泰明, 長谷井嬢, 杉生和久, 大森敏規, 尾崎修平, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 88 ( 8 ) S1684 - S1684 2014.8

腫瘍融解アデノウイルスと放射線療法を併用した骨・軟部肉腫に対する新規治療戦略

大森敏規, 長谷井嬢, 杉生和久, 山川泰明, 尾崎修平, 藤原智洋, 武田健, 吉田晶, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 88 ( 8 ) S1362 - S1362 2014.8

進行食道癌による食道狭窄に起因した経口摂取困難症例に対して、PEGを用いた術前栄養療法の有用性 Reviewed

國府島健, 白川靖博, 前田直見, 田邊俊介, 大原利章, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会総会 69回 P - 3 2014.7

ANTITUMOR EFFECT OF TELOMERASE-SPECIFIC ONCOLYTIC ADENOVIRUS ON HUMAN BONE AND SOFT TISSUE SARCOMA CELLS Reviewed

Tazawa Hiroshi, Sasaki Tsuyoshi, Hasei Jo, Hashimoto Yuuri, Urata Yasuo, Ozaki Toshifumi, Fujiwara Toshiyoshi

JOURNAL OF GENE MEDICINE 16 ( 7-8 ) 261 - 262 2014.7

当科における食道胃接合部癌の経験および治療戦略 Reviewed

野間和広, 白川靖博, 国府島健, 前田直見, 大原利章, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 69回 O - 2 2014.7

食道癌手術における安全な吻合法空腸を用いた食道再建及び吻合の工夫全例に血管吻合が必要か? Reviewed

白川靖博, 國府島健, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 69回 VSY - 8 2014.7

食道切除・再建術におけるリスク評価と治療成績向上に向けた対策食食道癌術前の呼吸機能管理目標設定とチーム介入の成果 Reviewed

大原利章, 白川靖博, 國府島健, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 69回 PD - 12 2014.7

鏡視下手術導入と多職種組織横断的周術期管理による高齢者食道癌手術への取り組み Reviewed

田辺俊介, 白川靖博, 國府島健, 前田直見, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 68回 78 - 78 2014.7

食道がん手術患者の集中治療体験とその後の心理状態<第二報> Reviewed

足羽孝子, 伊藤真理, 岩谷美貴子, 國府島健, 前田直見, 大原利章, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 68回 131 - 131 2014.7

ウイルスを用いたHER2陰性胃癌の強制的HER2標識化とTrastuzumabによる分子標的光免疫療法

香川俊輔, 石田道拡, 田澤大, 下山京子, 竹原清人, 野間和広, 渡辺めぐみ, 田辺俊介, 小林久隆, 藤原俊義

日本消化器外科学会総会 69回 O - 4 2014.7

高齢者胃癌(80歳以上)に対する根治手術の治療成績

黒田新士, 久保田哲史, 菊地覚次, 岸本浩行, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 69回 RS - 5 2014.7

HER2陽性進行再発胃癌に対するTrastuzumabを用いた集学的治療の有効性

菊地覚次, 香川俊輔, 黒田新士, 久保田哲史, 岸本浩行, 西崎正彦, 藤原俊義

日本消化器外科学会総会 69回 RS - 3 2014.7

胃切除術におけるda Vinciを用いたリンパ節郭清および体腔内手縫い吻合

西崎正彦, 黒田新士, 菊地覚次, 久保田哲史, 野間和広, 永坂岳司, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 69回 O - 2 2014.7

リポソームを用いた全身投与可能なテロメラーゼ特異的腫瘍融解ウイルス製剤の開発

青山克幸, 黒田新士, 田澤大, 香川俊輔, 藤原俊義

日本DDS学会学術集会プログラム予稿集 30回 221 - 221 2014.7

外科専門教育における献体を使用した臨床応用解剖実習および多視点多層解剖映像の有用性

近藤喜太, 信岡大輔, 黒田新士, 前田直見, 藤原俊義, 大塚愛二

医学教育 45 ( Suppl. ) 158 - 158 2014.7

局所進行直腸癌に対する術前放射線化学療法CapeOx RTの有効性・安全性の検討

母里淑子, 永坂岳司, 稲田涼, 岸本浩行, 近藤喜太, 藤智和, 谷口崇文, 浅野博昭, 佃和憲, 藤原俊義

日本消化器外科学会総会 69回 O - 4 2014.7

大腸癌におけるprognostic factorとしてのmiRNAの検討

久保田暢人, 永坂岳司, 吉田一博, 竹原裕子, 竹原清人, 稲田涼, 河合毅, 谷口文崇, 藤智和, 藤原俊義

日本消化器外科学会総会 69回 O - 5 2014.7

消化器癌に対する個別化治療 Genetic/epigenetic変異を基盤とした大腸癌個別化治療の構築

永坂岳司, 母里淑子, 稲田涼, 岸本浩行, 近藤喜太, 浅野博昭, 佃和憲, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 69回 SY - 8 2014.7

切除可能高リスク直腸癌に対する術前CapeOX+RTの安全性・有効性の検討

母里淑子, 永坂岳司, 稲田涼, 岸本浩行, 近藤喜太, 竹原裕子, 河合毅, 藤智和, 谷口文崇, 藤原俊義

日本癌治療学会誌 49 ( 3 ) 1316 - 1316 2014.6

HER2陽性胃癌に対するtrastuzumabを含む化学療法施行症例の解析

香川俊輔, 黒田新士, 菊地覚次, 西崎正彦, 渡辺めぐみ, 石田道拡, 堀直人, 岸本浩行, 藤原俊義

日本癌治療学会誌 49 ( 3 ) 2376 - 2376 2014.6

化学療法後切除により組織学的完全奏効が得られた高度進行胃癌の3例

菊地覚次, 香川俊輔, 久保田哲史, 黒田新士, 西崎正彦, 藤原俊義

日本癌治療学会誌 49 ( 3 ) 1977 - 1977 2014.6

Colitic cancerおよびhigh grade dysplasiaを合併した潰瘍性大腸炎の臨床病理学的検討

稲田涼, 近藤喜太, 母里淑子, 岸本浩行, 永坂岳司, 平岡佐規子, 藤原俊義

日本癌治療学会誌 49 ( 3 ) 904 - 904 2014.6

消化器外科領域におけるマイクロサージェリー空腸を用いた食道再建おけるマイクロサージェリーの適応とその工夫 Reviewed

白川靖博, 國府島健, 前田直見, 田辺俊介, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本外科系連合学会誌 39 ( 3 ) 506 - 506 2014.5

食道癌の狭窄による経口摂取困難症例に対するPEGを用いた術前管理の利点 Reviewed

田辺俊介, 白川靖博, 國府島健, 前田直見, 勝部亮一, 大原利章, 櫻間教文, 野間和広, 藤原俊義

Gastroenterological Endoscopy 56 ( Suppl.1 ) 1220 - 1220 2014.4

食道癌周術期における外科医の負担軽減に対しチーム医療が果たした役割 Reviewed

白川靖博, 二宮卓之, 前田直見, 大原利章, 田辺俊助, 櫻間教文, 野間和広, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 379 - 379 2014.3

野間和広, 白川靖博, 二宮卓之, 勝部亮一, 前田直見, 田辺俊介, 大原利章, 田澤大, 香川俊輔, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 678 - 678 2014.3

肝臓癌における除鉄併用分子標的薬治療の可能性 Reviewed

浦野真一, 大原利章, 白川靖博, 勝部亮一, 前田直見, 田辺俊介, 友野靖子, 野間和広, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 489 - 489 2014.3

高度狭窄を伴う進行食道癌患者におけるPEGを用いた術前栄養管理の効果術前後筋肉量変化に着目して Reviewed

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 464 - 464 2014.3

胃腫瘍に対する腹腔鏡内視鏡合同手術の可能性当院におけるLECSの工夫 Closed LECSの可能性

西崎正彦, 黒田新士, 堀直人, 岸本浩行, 香川俊輔, 岡田裕之, 藤原俊義

日本胃癌学会総会記事 86回 170 - 170 2014.3

ハイリスク患者に対する腹腔鏡下胃切除の意義高リスク症例に対する腹腔鏡下胃切除術と開腹胃切除の短期成績に関する比較検討

黒田新士, 香川俊輔, 堀直人, 岸本浩行, 西崎正彦, 藤原俊義

日本胃癌学会総会記事 86回 166 - 166 2014.3

HER2陽性進行再発胃癌に対するTrastuzumabの使用経験とその有効性について

黒田新士, 香川俊輔, 渡邊めぐみ, 堀直人, 石田道拡, 岸本浩行, 西崎正彦, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 692 - 692 2014.3

食道癌・胃癌におけるロボット支援手術の有用性ロボット支援下噴門側胃切除術後のロボットによる体腔内手縫い食道残胃吻合

西崎正彦, 黒田新士, 岸本浩行, 野間和広, 香川俊輔, 白川靖博, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 189 - 189 2014.3

テロメラーゼ依存性増殖型アデノウイルス製剤を用いた早期大腸癌に対する低侵襲治療の開発

菊地覚次, 岸本浩行, 田澤大, 西崎正彦, 香川俊輔, 浦田泰生, Hoffman Robert, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 401 - 401 2014.3

私の工夫エンドクローズによるポート孔閉創のコツ

二宮卓之, 田辺俊介, 前田直見, 野間和広, 白川靖博, 藤原俊義

臨床外科 69 ( 3 ) 382 - 383 2014.3

HER2陰性胃癌におけるウイルスベクターを用いたHER2標識化とそれに対する分子標的光免疫療法

石田道拡, 香川俊輔, 田澤大, 下山京子, 竹原清人, 黒田新士, 野間和広, 岸本浩行, 西崎正彦, 小林久隆, 藤原俊義

日本胃癌学会総会記事 86回 316 - 316 2014.3

ESD/EMR非治癒切除後の外科切除症例の検討

堀直人, 香川俊輔, 黒田新士, 岸本浩行, 西崎正彦, 藤原俊義

日本胃癌学会総会記事 86回 224 - 224 2014.3

術前診断に難渋した原発性小腸癌の1例

松本聖, 稲田涼, 近藤喜太, 母里淑子, 永坂岳司, 藤原俊義

日本外科学会雑誌 115 ( 臨増2 ) 1039 - 1039 2014.3

イマチニブで長期病勢コントロール中の再発消化管間質腫瘍に胃癌を発症した1例

宇野太, 岸本浩行, 香川俊輔, 藤原俊義

日本外科系連合学会誌 39 ( 1 ) 45 - 51 2014.2

Language：Japanese Publisher：日本外科系連合学会

症例は81歳女性で,当院で同時性肝転移を伴う胃の消化管間質腫瘍(gastrointestinal stromal tumor:GIST)に対し,胃局所切除と肝切除が施行されていた.その後術後8ヵ月で肝転移再発し,イマチニブ投与され4年間病勢コントロールされていたが,胃癌を発症し胃全摘術施行した.病理結果では高分化型腺癌とともに局所再発と思われるGISTも併存していた.胃全摘1ヵ月後からイマチニブ投与を再開し,現在外来通院にて経過観察中である.当院での胃癌切除症例の685例のうち切除胃に同時性GISTを指摘した症例が11例(1.6%)あったが,胃GIST術後再発加療中に胃癌を発症した例は初めて経験した.しかし切除不能再発GISTもイマチニブなどの分子標的薬出現により長期の生存が期待されることを考えると,再発GIST症例においても2次癌を念頭においた慎重な経過観察が重要であると思われる.(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01066&link_issn=&doc_id=20140306110009&doc_link_id=10.4030%2Fjjcs.39.45&url=https%3A%2F%2Fdoi.org%2F10.4030%2Fjjcs.39.45&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

進行食道癌狭窄症例に対する術前栄養管理経鼻胃管からPEGへの変遷 Reviewed

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 大原利章, 櫻間教文, 野間和広, 長谷川祐子, 平健太郎, 名和秀起, 岡田恵子, 坂本八千代, 藤原俊義

静脈経腸栄養 29 ( 1 ) 552 - 552 2014.1

A Case of Gastric Cancer with Stable Disease Controlled Recurrence of Gastrointestinal Stromal Tumor with Imatinib

Uno Futoshi, Kishimoto Hiroyuki, Kagawa Shunsuke, Fujiwara Toshiyoshi

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 39 ( 1 ) 45 - 51 2014

Language：Japanese Publisher：Japanese College of Surgeons

A case was 81-year-old woman with gastrointestinal stromal tumor (GIST) of stomach accompanied by liver metastases, who underwent partial gastrectomy and hepatectomy. Multiple liver metastases were diagnosed 8 months after R0 surgery. While metastases disease was well controlled with administration of imatinib for 4 years, gastric cancer in remnant stomach was diagnosed. Total gastrectomy was undergone, pathological findings were that well differentiated tubular adenocarcinoma cells were localized in mucosa and no lymph node metastases was found but local recurrence of GIST was pointed out. One month after total gastrectomy, she resumed administration of imatinib and she has no sign of progression with neither gastric cancer nor GIST. Only 11 synchronous GIST cases of 685 gastric cancer cases were found and it is first case for our institution that gastric cancer was occurred during imatinib therapy for recurrence GIST. But secondary cancer should be concern because of long survival time for unresectable metastases GIST patients with imatinib.

DOI： 10.4030/jjcs.39.45

DOI： 10.3919/jjsa.81.2225_references_DOI_HvAPNRy8vi3arMN5Gv9eBAuRYyx

CiNii Article

当科における進行食道癌における合理的胸腔鏡下手術の試み Reviewed

野間和広, 白川靖博, 前田直見, 二宮卓之, 大原利章, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 549 - 549 2013.11

胸部食道癌に対する合理的縦隔郭清腹臥位胸腔鏡下食道切除術における縦隔リンパ節郭清での助手による積極的術野展開とその定型化 Reviewed

白川靖博, 二宮卓之, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 339 - 339 2013.11

80歳以上の超高齢者食道癌症例に対する胸腔鏡下手術の現況 Reviewed

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 502 - 502 2013.11

[Current status of neoadjuvant chemotherapy for advanced esophageal cancer]. Reviewed

Shunsuke Tanabe, Yasuhiro Shirakawa, Naoaki Maeda, Ryoichi Katsube, Toshiaki Ohara, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 40 ( 12 ) 1612 - 4 2013.11

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

Since reported in the JCOG9907 trial, neoadjuvant chemotherapy prior to surgery has become the standard treatment for advanced (Stage II/III) esophageal cancers. However, more powerful neoadjuvant chemotherapy is required for the treatment of locally advanced cases or cases involving multiple lymph node metastases. At our institute, DCF therapy (docetaxel, cisplatin, and 5-fluorouracil) is administered selectively for the treatment of patients with far-advanced esophageal cancer. We treated 53 thoracic esophageal cancer patients who underwent surgery following neoadjuvant chemotherapy between January 2010 and December 2012. FP therapy (cisplatin and 5-fluorouracil) was administered to 43 patients, and DCF therapy to 7 patients who had far-advanced esophageal cancer. All patients treated with DCF therapy experienced grade 3 and 4 adverse events. With the exception of 1 patient, all patients who received DCF therapy could undergo curative surgery. DCF therapy could become an effective preoperative chemotherapy.

腹臥位胸腔鏡下食道亜全摘のための新しい解剖教材の開発多視点3D解剖システム Reviewed

前田直見, 白川靖博, 二宮卓之, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 508 - 508 2013.11

胃癌切除 #8〜#13の郭清法(開腹術と同等に行えるか) 神経解剖を軸とした膵上縁郭清の工夫と実際

黒田新士, 西崎正彦, 堀直人, 岸本浩行, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 371 - 371 2013.11

Closed LECSの開発と臨床応用

西崎正彦, 加藤大, 黒田新士, 田邊俊介, 堀直人, 岸本浩行, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 499 - 499 2013.11

腹腔鏡下有茎直腸による腟形成術の3例

永坂岳司, 宇野太, 稲田涼, 杉本盛人, 母里淑子, 近藤喜太, 黒田新二, 浅野博昭, 岸本浩行, 西崎正彦, 佃和憲, 香川俊輔, 長谷川健二郎, 難波祐三郎, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 757 - 757 2013.11

潰瘍性大腸炎に対する腹腔鏡下大腸全摘術のmatched case control studyによる開腹群との治療成績の比較

稲田涼, 近藤喜太, 久保田暢人, 森川達也, 母里淑子, 永坂岳司, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 613 - 613 2013.11

成人Bochdalek孔ヘルニアを合併した胃癌に対し腹腔鏡手術にて一期的に根治手術し得た1例

堀直人, 香川俊輔, 黒田信士, 岸本浩行, 西崎正彦, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 639 - 639 2013.11

食道胃接合部癌の手術当科における食道胃接合部癌の治療経験郭清範囲と再建法について Reviewed

野間和広, 白川靖博, 前田直見, 二宮卓之, 大原利章, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊介, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 467 - 467 2013.10

Zenker憩室症の8例 Reviewed

二宮卓之, 田辺俊介, 前田直見, 大原利章, 野間和広, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 842 - 842 2013.10

食道癌に対するESDの適応と限界食道癌ESD後再発症例から考えるESDの適応と補助治療のあり方について Reviewed

田辺俊介, 白川靖博, 前田直見, 二宮卓之, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 369 - 369 2013.10

食道癌のサルベージ手術(適応と手技と成績と) 当科における食道癌サルベージ手術の検討 Reviewed

前田直見, 白川靖博, 二宮卓之, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 413 - 413 2013.10

吻合、再建の手術手技(食道) 当科における食道胃管吻合の変遷とその工夫 Reviewed

白川靖博, 二宮卓之, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 360 - 360 2013.10

食道癌患者のより良い周術期医療のために歯科はどのような貢献ができるのか? 周術期管理センター(PERIO) Reviewed

山中玲子, 曽我賢彦, 前田直見, 田辺俊介, 大原利章, 野間和広, 白川靖博, 森田学, 佐藤健治, 森松博史, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 478 - 478 2013.10

鉄欠乏状態は肝細胞癌におけるソラフェニブの感受性を改善しうる(Iron depletion status has a possibility to improve the sensitivity of sorafenib in HCC) Reviewed

浦野真一, 大原利章, 勝部亮一, 渡邉伸一郎, 野間和広, 友野靖子, 田澤大, 能祖一裕, 白川靖博, 貞森裕, 藤原俊義

日本癌学会総会記事 72回 345 - 345 2013.10

食道癌術後亜急性期の後方支援病院におけるスコアリング化されたがんリハビリテーションの取り組み

櫻間教文, 平松聡, 杉生久実, 前田直見, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 479 - 479 2013.10

胃癌患者の腹腔洗浄液における蛍光発現ウイルス試薬による新たな生物学的診断(Biological assessment of peritoneal lavage cytology of gastric cancer by fluorescence-expressing virus TelomeScan)

香川俊輔, 石田道拡, 渡邉めぐみ, 田澤大, 黒田新士, 岸本浩行, 橋本悠里, 西崎正彦, 藤原俊義

日本癌学会総会記事 72回 187 - 187 2013.10

進行胃癌に対する手術進行胃癌に対し自律神経解剖を郭清範囲決定に応用したD2郭清

西崎正彦, 黒田新士, 堀直人, 岸本浩行, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 461 - 461 2013.10

早期大腸癌のリンパ節転移制御に向けた新規治療(Novel strategy for eradicating lymph node metastasis of earlystage colorectal cancers)

菊地覚次, 岸本浩行, 田澤大, 橋本悠里, 宇野太, 西崎正彦, 香川俊輔, 浦田泰生, ロバート・ホフマン, 藤原俊義

日本癌学会総会記事 72回 178 - 178 2013.10

術後難治性創感染に対しVAC療法にて創し開を回避し創治癒を得た3例

濱田侑紀, 稲田涼, 母里淑子, 近藤喜太, 宇野太, 永坂岳司, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 1034 - 1034 2013.10

原発不明癌として治療を受けていた、診断に苦慮した虫垂癌の1例

松本聖, 稲田涼, 母里淑子, 近藤喜太, 永坂岳司, 藤原俊義

日本臨床外科学会雑誌 74 ( 増刊 ) 594 - 594 2013.10

新規光線力学療法を目指したウイルスを用いた光感受性細胞傷害性蛍光タンパク質KillerRedの治療効果(Virus-mediated delivery system of photosensitive cytotoxic fluorescent protein KillerRed for novel photodynamic therapy)

竹原清人, 田澤大, 橋本悠里, 岸本浩行, 水口裕之, 藤原俊義

日本癌学会総会記事 72回 503 - 503 2013.10

蛍光標識による血中遊離癌細胞のLiquid Biopsy技術のバイオマーカー解析への応用 Reviewed

重安邦俊, 橋本悠里, 竹原清人, 宇野太, 永坂岳司, 田澤大, 香川俊輔, 浦田泰生, 藤原俊義

日本癌治療学会誌 48 ( 3 ) 2759 - 2759 2013.9

透視を用いず位置確認が可能な内視鏡的バルーン拡張術の工夫 Reviewed

田辺俊介, 白川靖博, 前田直見, 勝部亮一, 大原利章, 櫻間教文, 野間和広, 藤原俊義

Gastroenterological Endoscopy 55 ( Suppl.2 ) 2890 - 2890 2013.9

がん選択的生物製剤を用いた早期大腸癌の低侵襲治療の開発

菊地覚次, 岸本浩行, 田澤大, 西崎正彦, 香川俊輔, 浦田泰生, Hoffman Robert M., 藤原俊義

日本癌治療学会誌 48 ( 3 ) 1918 - 1918 2013.9

異時性/同時性多発大腸がん症例の遺伝子変異不均一性の検討

永坂岳司, 森川達也, 母里淑子, 稲田涼, 久保田暢人, 竹原祐子, 竹原清人, 宇野太, 佃和憲, 中谷紳, 冨岡憲明, 嶋村廣視, 森谷行利, 瀧上隆夫, 藤原俊義

日本大腸肛門病学会雑誌 66 ( 9 ) 743 - 743 2013.9

大腸癌予後不良因子BRAF変異のvariation BRAF VK600-601E変異大腸癌の一例

母里淑子, 永坂岳司, 稲田涼, 竹原裕子, 竹原清人, 森川達也, 久保田暢人, 宇野太, 佃和憲, 瀧上隆夫, 嶋村廣視, 森谷行利, 冨岡憲明, 中谷紳, 藤原俊義

日本大腸肛門病学会雑誌 66 ( 9 ) 910 - 910 2013.9

直腸癌術後尿管再発の一例

松本聖, 稲田涼, 母里淑子, 近藤喜太, 永坂岳司, 江原伸, 戸田博子, 柳井広之, 藤原俊義

日本癌治療学会誌 48 ( 3 ) 2310 - 2310 2013.9

遺伝子情報を用いたStage IV大腸癌の治療戦略の構築

稲田涼, 永坂岳司, 母里淑子, 竹原裕子, 竹原清人, 森川達也, 久保田暢人, 宇野太, 佃和憲, 瀧上隆夫, 嶋村廣視, 森谷行利, 冨岡憲明, 中谷紳, 藤原俊義

日本大腸肛門病学会雑誌 66 ( 9 ) 743 - 743 2013.9

肛門脱出を契機に診断された同時性6多発大腸癌の一例

森谷行利, 高木敏行, 冨岡憲明, 森川達也, 永坂岳司, 白川靖博, 瀧上隆夫, 藤原俊義

日本大腸肛門病学会雑誌 66 ( 9 ) 876 - 876 2013.9

Selectively Replicating Oncolytic Adenoviruses Combined with Chemotherapy, Radiotherapy, or Molecular Targeted Therapy for Treatment of Human Cancers Reviewed

Shinji Kuroda, Shunsuke Kagawa, Toshiyoshi Fujiwara

Gene Therapy of Cancer: Translational Approaches from Preclinical Studies to Clinical Implementation: Third Edition 171 - 183 2013.8

Language：English Publishing type：Part of collection (book) Publisher：Elsevier Inc.

Oncolytic adenovirotherapy presents a novel approach for cancer therapy. Oncolytic adenoviruses are modified to replicate and induce oncolytic cell death in cancer cells but not in normal somatic cells. The first oncolytic adenovirus to be developed was ONYX-015, an E1B-55. kDa gene-deleted oncolytic adenovirus
after which many inventive oncolytic adenoviruses have followed. H101, an oncolytic adenovirus with very similar gene constructs as ONYX-015, was approved in China as the world's first adenovirus cancer treatment in humans in 2005. Many clinical trials have revealed that oncolytic adenoviruses produce synergistic antitumor effects in combination with conventional chemotherapeutic agents, radiation, and some molecular targeted agents, although monotherapy with oncolytic adenoviruses shows limited effects. In this chapter, we discuss the developments of oncolytic adenoviruses, focusing on their synergistic effects when combined with other treatment modalities. Then we discuss the problems that must be overcome for adenoviruses to become more attractive as cancer treatment agents and to expand their clinical applications. © 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/B978-0-12-394295-1.00012-3

当科における腹臥位胸腔鏡下食道切除術定型化の工夫 Reviewed

青山克幸, 白川靖博, 勝部亮一, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 68回 O - 6 2013.7

胃が使用できない食道癌症例における空腸による食道再建術の工夫血管吻合は全例に必要か? Reviewed

渡邊伸一郎, 白川靖博, 勝部亮一, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 68回 RV - 5 2013.7

当科における低侵襲再建術の試み用手補助的腹腔鏡下胃管作製の60例の検討 Reviewed

前田直見, 白川靖博, 勝部亮一, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会総会 68回 RV - 3 2013.7

胸部食道癌のよりよい周術期管理を目指して PERIOと鏡視下手術の融合 Reviewed

白川靖博, 勝部亮一, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本消化器外科学会総会 68回 O - 1 2013.7

食道胃接合部癌の外科治療戦略当科における食道胃接合部癌の治療経験下縦隔リンパ節転移症例の検討 Reviewed

野間和広, 白川靖博, 前田直見, 勝部亮一, 大原利章, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 68回 PD - 5 2013.7

患者負担軽減のためのPEGを用いた食道癌術前補助栄養療法の現状について Reviewed

勝部亮一, 白川靖博, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和宏, 藤原俊義

日本消化器外科学会総会 68回 RS - 1 2013.7

テロメラーゼ依存性増殖型アデノウイルス製剤を用いた早期大腸癌の低侵襲治療の開発

菊地覚次, 岸本浩行, 田澤大, 橋本悠里, 宇野太, 西崎正彦, 香川俊輔, 浦田泰生, ロバート・ホフマン, 藤原俊義

日本消化器外科学会総会 68回 RS - 2 2013.7

腹腔鏡補助下噴門側胃切除術における郭清手技と「観音開き法」食道残胃吻合

西崎正彦, 黒田新士, 野間和広, 渡邉めぐみ, 岸本浩行, 香川俊輔, 白川靖博, 藤原俊義

日本消化器外科学会総会 68回 O - 6 2013.7

HER2陽性胃癌の臨床病理学的特徴と当院におけるtrastuzumabの使用経験

渡辺めぐみ, 香川俊輔, 石田道拡, 黒田新士, 岸本浩行, 宇野太, 西崎正彦, 藤原俊義

日本消化器外科学会総会 68回 RS - 2 2013.7

LADG、D2における神経解剖を軸とした膵上縁リンパ節郭清

黒田新士, 西崎正彦, 渡邊めぐみ, 石田道拡, 岸本浩行, 宇野太, 香川俊輔, 藤原俊義

日本消化器外科学会総会 68回 RV - 2 2013.7

三次元解剖映像教材を用いた次世代の手術解剖教育

近藤喜太, 稲田涼, 宇野太, 永坂岳司, 武田吉正, 大塚愛二, 藤原俊義

日本消化器外科学会総会 68回 O - 6 2013.7

地域一体型NSTの取り組みと効果について

西川みか, 櫻間教文, 多田仁美, 前田直見, 大原利章, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 67回 224 - 224 2013.6

Accumulation of Epigenetic Alteration Could Predict Malignant Formation in Intraductal Papillary Mucinous Neoplasm (IPMN) Reviewed

Yoshida Kazuhiro, Nagasaka Takeshi, Umeda Yuzo, Yokomichi Naosuke, Mori Yoshiko, Kubota Nobuhito, Morikawa Tatsuya, Takehara Yuko, Takehara Kiyoto, Shigeyasu Kunitoshi, Nyuya Akihiro, Shiwaku Rikiya, Suno Manabu, Nishida Naoshi, Fujiwara Toshiyoshi, Goel Ajay

GASTROENTEROLOGY 144 ( 5 ) S98 - S98 2013.5

Fecal DNA Methylation Assay for the Identification of a Multiple Gastrointestinal Cancers Including Pancreatic Caner Reviewed

Morikawa Tatsuya, Nagasaka Takeshi, Yoshida Kazuhiro, Mori Yoshiko, Kubota Nobuhito, Takehara Yuko, Yokomichi Naosuke, Nishida Naoshi, Takehara Kiyoto, Shigeyasu Kunitoshi, Nyuya Akihiro, Shiwaku Rikiya, Suno Manabu, Fujiwara Toshiyoshi, Goel Ajay

GASTROENTEROLOGY 144 ( 5 ) S601 - S602 2013.5

Genetic and Epigenetic Alterations in the Netrin-1 Receptors, UNC5c and DCC, Constitutes a Previously Unrecognized Pathway in Gastric Cancer Progression Reviewed

Kubota Nobuhito, Nagasaka Takeshi, Toda Keisuke, Mori Yoshiko, Morikawa Tatsuya, Umeda Yuzo, Yokomichi Naosuke, Yoshida Kazuhiro, Takehara Yuko, Takehara Kiyoto, Nyuya Akihiro, Shiwaku Rikiya, Shigeyasu Kunitoshi, Suno Manabu, Nishida Naoshi, Fujiwara Toshiyoshi, Goel Ajay

GASTROENTEROLOGY 144 ( 5 ) S527 2013.5

Cytokeratin 19 Staining Is a Novel, Predictive Biomarker for Extra-Hepatic Metastasis in Hepatocellular Carcinoma Reviewed

Yokomichi Naosuke, Nagasaka Takeshi, Nishida Naoshi, Umeda Yuzo, Mori Yoshiko, Morikawa Tatsuya, Kubota Nobuhito, Yoshida Kazuhiro, Takehara Yuko, Takehara Kiyoto, Shigeyasu Kunitoshi, Nyuya Akihiro, Shiwaku Rikiya, Suno Manabu, Fujiwara Toshiyoshi, Goel Ajay

GASTROENTEROLOGY 144 ( 5 ) S719 - S720 2013.5

MGMT Methylation As a Novel Biomarker for the Identification of Stage III Colorectal Cancers At High-Risk of Disease Recurrence Following Curative Surgery Reviewed

Mori Yoshiko, Nagasaka Takeshi, Tazawa Hiroshi, Umeda Yuzo, Morikawa Tatsuya, Kubota Nobuhito, Yoshida Kazuhiro, Takehara Yuko, Yokomichi Naosuke, Takehara Kiyoto, Shigeyasu Kunitoshi, Nyuya Akihiro, Shiwaku Rikiya, Suno Manabu, Nishida Naoshi, Fujiwara Toshiyoshi, Goel Ajay

GASTROENTEROLOGY 144 ( 5 ) S85 - S85 2013.5

食道癌手術の周術期管理におけるチーム医療当院での胸部食道癌周術期管理におけるPERIO導入についての検討 Reviewed

白川靖博, 勝部亮一, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本外科系連合学会誌 38 ( 3 ) 605 - 605 2013.5

術後難治性創感染に対し、VAC療法にて創し開を回避し創治癒を得た2例

濱田侑紀, 稲田涼, 母里淑子, 近藤喜太, 宇野太, 永坂岳司, 藤原俊義

日本外科系連合学会誌 38 ( 3 ) 651 - 651 2013.5

Application of percutaneous endoscopic gastrostomy with jejunal extension in a case of post-gastrectomy Roux Stasis syndrome

Masahiko Oiwa, Shunsuke Kagawa, Kunitoshi Shigeyasu, Nobuhiko Kanaya, Futoshi Uno, Hiroyuki Kishimoto, Masahiko Nishizaki, Toshiyoshi Fujiwara

Gastroenterological Endoscopy 55 ( 5 ) 1650 - 1654 2013.5

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

We present herein on a 74-years-old man, who underwent distal gastrectomy and Roux-en-Y reconstruction for stomach cancer, and developed gastro-jejunostomy obstruction. Re-anastomosis, however, did not relieve the symptoms. Delayed gastric emptying without mechanical obstruction lead to a diagnosis of Roux stasis syndrome (RSS). To achieve both gastric decompression and nutritional therapy, a percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) was performed in two steps. Firstly, a gastrostomy was placed endoscopically and then a jejunal catheter was inserted through the gastrostomy tube. This system can feed nutritional solution through the jejunal catheter while gastric juice is drained from the gastrostomy tube. The patient was spared an uncomfortable nasal gastric tube and long-term central-venous hyperalimentation, and his RSS was completely cleared 134 days later. This experience suggested that PEG-J can be one of the options in the conservative treatment of RSS.

パラチノースを主糖質源とした流動食MHN-01を用いた食道癌周術期管理の意義 Reviewed

病期診断に難渋した早期食道癌の一例術前PET-CT偽陽性症例の検討 Reviewed

山辻知樹, 平林葉子, 高岡宗徳, 深澤拓也, 繁光薫, 林次郎, 浦上淳, 吉田和弘, 中島一毅, 森田一郎, 大原利章, 田辺俊介, 櫻間教文, 野間和広, 白川靖博, 藤原俊義, 河本博文, 猶本良夫

Gastroenterological Endoscopy 55 ( Suppl.1 ) 1160 - 1160 2013.4

術後5年を経過して発症した肛門管粘液癌局所再発に対して治癒切除を施行した1例

濱田侑紀, 稲田涼, 母里淑子, 近藤喜太, 宇野太, 永坂岳司, 藤原俊義

岡山医学会雑誌 125 ( 1 ) 93 - 93 2013.4

Gene therapy for cancer treatment Reviewed

Shunsuke Kagawa, Toshiyoshi Fujiwara

Gene Therapy: Technologies and Applications 70 - 83 2013.3

血清鉄コントロールを用いた新たな肝細胞癌治療戦略 Reviewed

大原利章, 白川靖博, 浦野真一, 前田直見, 渡邊伸一郎, 田辺俊介, 野間和広, 能祖一裕, 貞森裕, 八木孝仁, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 634 - 634 2013.3

山辻知樹, 田村卓也, 小池良和, 平林葉子, 高岡宗徳, 深澤拓也, 林次郎, 繁光薫, 浦上淳, 吉田和弘, 大原利章, 田辺俊介, 藤原康宏, 櫻間教文, 野間和広, 白川靖博, 羽井佐実, 中島一毅, 森田一郎, 藤原俊義, 猶本良夫

日本外科学会雑誌 114 ( 臨増2 ) 919 - 919 2013.3

消化器癌における血中遊離癌細胞の検出と臨床応用テロメラーゼ活性を指標とする血中遊離癌細胞の高感度検出法の開発と遺伝子解析技術への応用 Reviewed

重安邦俊, 橋本悠里, 宇野太, 永坂岳司, 田澤大, 香川俊輔, 水口裕之, 浦田泰生, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 338 - 338 2013.3

超高齢者に対する外科治療の問題点消化管外科、術式の選択当科における80歳以上の超高齢者食道癌症例に対する外科治療の変遷 Reviewed

田辺俊介, 白川靖博, 青山克幸, 前田直見, 大原利章, 櫻間教文, 野間和広, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 317 - 317 2013.3

腹臥位胸腔鏡下食道亜全摘術においてEndoCAMeleonがもたらした新たな視野展開 Reviewed

野間和広, 白川靖博, 青山克幸, 前田直見, 大原利章, 田辺俊介, 櫻間教文, 西崎正彦, 香川俊輔, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 451 - 451 2013.3

血清鉄コントロールによる食道癌細胞の浸潤・転移能制御の可能性 Reviewed

浦野真一, 野間和広, 大原利章, 西谷正史, 前田直見, 渡邉伸一郎, 田辺俊介, 櫻間教文, 友野靖子, 白川靖博, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 747 - 747 2013.3

高リスクGIST症例の検討無作為化比較試験SSGXVIII/AIOの報告をうけて Reviewed

宇野太, 永坂岳司, 香川俊輔, 西崎正彦, 岸本浩行, 黒田新士, 石田道拡, 青山克幸, 稲田涼, 前田直見, 大原利章, 近藤喜太, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 891 - 891 2013.3

再発食道がんに対する新しい集学的アプローチとその意義

猶本良夫, 山辻知樹, 繁光薫, 高岡宗徳, 吉田和弘, 林次郎, 田村卓也, 浦上淳, 深澤拓也, 平林葉子, 小池良和, 中島一毅, 白川靖博, 田辺俊介, 野間和広, 藤原康宏, 櫻間教文, 羽井佐実, 藤原俊義, 森田一郎

日本外科学会雑誌 114 ( 臨増2 ) 756 - 756 2013.3

ロボット支援下幽門側胃切除術におけるリンパ節郭清手技

西崎正彦, 香川俊輔, 石田道拡, 黒田新士, 近藤喜太, 野間和広, 岸本浩行, 宇野太, 永坂岳司, 白川靖博, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 438 - 438 2013.3

テロメラーゼ依存性増殖型アデノウイルス製剤を用いた早期大腸癌の低侵襲治療の開発

菊地覚次, 岸本浩行, 田澤大, 橋本悠里, 宇野太, 西崎正彦, 香川俊輔, 浦田泰生, Robert Hoffman, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 612 - 612 2013.3

直腸癌術後10年を経過して発症した局所再発に対して治癒切除を施行した1例

西江尚貴, 稲田涼, 近藤喜太, 宇野太, 永坂岳司, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 1071 - 1071 2013.3

若手外科医のための3次元立体解剖教材の有用性

近藤喜太, 稲田涼, 永坂岳司, 藤原俊義

日本外科学会雑誌 114 ( 臨増2 ) 982 - 982 2013.3

腹腔鏡下胃切除術におけるリンパ節郭清のコツ da Vinci手術からLADGへのfeedback 幽門下リンパ節郭清

西崎正彦, 香川俊輔, 宇野太, 石田道拡, 黒田新士, 岸本浩行, 白川靖博, 藤原俊義

日本胃癌学会総会記事 85回 202 - 202 2013.2

腹腔細胞診陽性胃癌症例に対する外科的切除の検討

香川俊輔, 岸本浩行, 宇野太, 西崎正彦, 黒田新士, 石田道拡, 藤原俊義

日本胃癌学会総会記事 85回 283 - 283 2013.2

[Development of a detection system for circulating tumor cells in peripheral blood using a next generation conditionally-replicating adenovirus]. Reviewed

Fuminori Sakurai, Toshiyoshi Fujiwara, Hiroyuki Mizuguchi

Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan 133 ( 3 ) 291 - 6 2013

Language：Japanese

An easy and sensitive detection method for circulating tumor cells (CTC) is expected to be developed because CTC are a promising biomarker for early diagnosis of tumors and prognosis prediction of tumor patients. Our group has already developed a CTC detection method using a conditionally replicating adenovirus (Ad) which efficiently replicates and expresses GFP in telomerase-positive tumor cells. However, malignant tumor cells express much low levels of coxsackievirus and adenovirus receptor (CAR), leading to inefficient infection with a conventional conditionally replicating Ad. In addition, a tiny fraction of normal blood cells, including lymphocytes, express GFP following infection. To overcome these problems, we have developed a next-generation conditionally replicating Ad. The next-generation conditionally replicating Ad possesses the fiber protein derived from Ad serotype 35, leading to efficient infection in both CAR-positive and -negative tumor cells, because the fiber protein of Ad serotype 35 binds to CD46, which is expressed on almost all human cells. Furthermore, sequences complementary to blood cell-specific miRNA (miR-142-3p) were inserted into the 3' untranslated region of the E1 gene and GFP gene, leading to the suppression of GFP expression in normal blood cells. In this symposium, we will not only introduce the importance of CTC as a biomarker and conventional CTC detection methods but also show our data of the novel CTC detection using the next-generation conditionally replicating Ad.

内視鏡外科におけるチーム医療の在り方食道癌鏡視下手術の周術期におけるチーム医療の関わり Reviewed

白川靖博, 青山克幸, 前田直見, 田辺俊介, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本内視鏡外科学会雑誌 17 ( 7 ) 313 - 313 2012.12

我々の目指すチーム内視鏡外科当科における腹臥位胸腔鏡下食道亜全摘における術者助手のコラボレーション Reviewed

野間和広, 白川靖博, 青山克幸, 前田直見, 大原利章, 田辺俊介, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 17 ( 7 ) 604 - 604 2012.12

Non-recurrent inferior laryngeal nerveを伴う胸部食道癌に対して胸腔鏡下食道亜全摘を施行した1例 Reviewed

前田直見, 白川靖博, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本内視鏡外科学会雑誌 17 ( 7 ) 696 - 696 2012.12

Robotic Surgeryによる胃切除 Double bipolar techniqueによる術野展開の工夫と郭清手技

西崎正彦, 石田道拡, 黒田新士, 岸本浩行, 宇野太, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 17 ( 7 ) 296 - 296 2012.12

腹腔鏡手術における腹腔内癒着マッピングの有用性と意義

近藤喜太, 稲田涼, 永坂岳司, 西崎正彦, 藤原俊義

日本内視鏡外科学会雑誌 17 ( 7 ) 537 - 537 2012.12

[A case of transverse myelopathy due to spinal bone metastasis of gastric cancer].

Aiko Kono, Shunsuke Kagawa, Hiroyuki Kishimoto, Futoshi Uno, Masahiko Nishizaki, Masahiko Oiwa, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 39 ( 12 ) 2357 - 9 2012.11

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

We report a case of gastric cancer that presented as transverse myelopathy due to spinal bone metastasis. A 45-year- old man with advanced gastric cancer underwent distal gastrectomy and lymph node dissection for curative intent. However, pathological examination of the specimen revealed positive cytological findings in the peritoneal lavage fluid in addition to serosal invasion and lymph node metastasis(pT4aN3bCY1, stage IV). Three months after the operation, during the second course of chemotherapy with S-1, he began to complain of back pain, and positron emission tomography-computed tomography revealed spinal bone metastasis. Despite immediate radiotherapy for the bone metastasis, he soon suffered from paraplegia in the lower extremities followed by disturbances of bladder and bowel function. We created a sigmoid colostomy, which enabled self-care for defecation, and resumed radiotherapy and chemotherapy. Bone metastasis of gastric cancer is rare but the prognosis is very poor. Because of a rapidly deteriorating clinical course, early diagnosis and multidisciplinary approaches are important for gastric cancer patients with spinal metastasis.

[Stent placement using a double-balloon endoscope for malignant duodenal obstruction with Roux-en-Y Anastomosis-a case report].

Masahiko Oiwa, Shunsuke Kagawa, Hiroyuki Kishimoto, Futoshi Uno, Masahiko Nishizaki, Aiko Kono, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 39 ( 12 ) 2372 - 4 2012.11

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

A 79-year-old man who had previously undergone partial resection of the remnant stomach and Roux-en-Y reconstruction was diagnosed as having peritoneal recurrence near the ligament of Treitz. In the course of chemotherapy for recurrent gastric cancer, he complained of colic pain. CT examination revealed a marked dilation of the duodenum suggesting the presence of a distal duodenal stricture resulting from the known recurrent tumor. To palliate this intestinal obstruction, we successfully placed an expandable metal stent(EMS) using a double-balloon enteroscope(DBE), which achieved immediate relief of the obstruction and enabled the resumption of oral intake and chemotherapy. While the endoscopic placement of an EMS is available for malignant gastro-intestinal obstruction, it is considerably more difficult to approach the duodenum with Roux-en-Y anastomosis. A DBE has made it possible to place an EMS deep in the small intestine. In the present case, this minimally invasive procedure avoided the need for surgery and greatly contributed to palliation. Thus, EMS placement using a DBE is a possible palliative treatment for malignant small bowel obstruction.

【食道癌-基礎・臨床研究の進歩-】食道癌の治療外科治療食道胃接合部癌・Barrett食道癌に対する手術

当科における食道胃接合部癌に対する再建法の工夫胸腔内観音開き法吻合の経験 Reviewed

野間和広, 白川靖博, 青山克幸, 前田直見, 大原利章, 田辺俊介, 西崎正彦, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 525 - 525 2012.10

出血性ショックをきたした回腸静脈瘤破裂に対しバルーン下逆行性経静脈的塞栓術(BRTO)が奏功した1例

濱田侑紀, 竹原裕子, 竹原清人, 大原利章, 近藤喜太, 永坂岳司, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 1084 - 1084 2012.10

低肺機能合併の胸部食道癌症例に対する腹臥位胸腔鏡下食道切除の経験 Reviewed

前田直見, 白川靖博, 青山克幸, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 706 - 706 2012.10

Zenker憩室に合併した頸部食道表在癌の1例 Reviewed

大原利章, 白川靖博, 青山克幸, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 945 - 945 2012.10

食道癌手術における再建法の安全性とQOL 胃が使用できない食道癌症例におけるQOL向上を目指した腸管による食道再建法 Reviewed

田辺俊介, 白川靖博, 青山克幸, 前田直見, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 383 - 383 2012.10

チームで乗り切る食道癌手術(当院での周術期管理センター:PERIOの取り組み) Reviewed

白川靖博, 青山克幸, 前田直見, 田辺俊介, 大原利章, 櫻間教文, 野間和広, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 481 - 481 2012.10

コンポジットメッシュと非吸収性タックを用い腹腔鏡下にて修復した腹壁瘢痕ヘルニアの一例

石田道拡, 香川俊輔, 岸本浩行, 黒田新士, 西崎正彦, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 947 - 947 2012.10

腹腔鏡下胃全摘術・噴門切除術とその再建術式腹腔鏡補助下噴門側胃切除術のための「観音開き法」食道残胃吻合の工夫

西崎正彦, 石田道拡, 黒田新士, 岸本浩行, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 73 ( 増刊 ) 372 - 372 2012.10

大腸癌の悪性度診断と臨床応用 Genetic/epigenetic変異を基盤とした大腸癌個別化治療の構築と臨床応用

永坂岳司, 母里淑子, 森川達也, 久保田暢人, 竹原清人, 稲田涼, 宇野太, 三嶋秀行, 藤原俊義

日本大腸肛門病学会雑誌 65 ( 9 ) 539 - 539 2012.9

消化器がん検診における新しい診断法の展開便中メチル化CpG検出による消化器癌スクリーニング

永坂岳司, 森川達也, 藤原俊義

Gastroenterological Endoscopy 54 ( Suppl.2 ) 2625 - 2625 2012.9

腫瘍特異的制限増殖型アデノウイルスを用いた血液循環腫瘍細胞の遺伝子解析技術の開発(Development of genetic analysis of circulating tumor cells using a telomerase-specific replication-competent adenovirus) Reviewed

重安邦俊, 橋本悠里, 宇野太, 永坂岳司, 田澤大, 香川俊輔, 水口裕之, 浦田泰生, 藤原俊義

日本癌学会総会記事 71回 50 - 50 2012.8

頭頸部表在癌のESDにおける工夫 Reviewed

田辺俊介, 白川靖博, 前田直見, 大原利章, 櫻間教文, 野間和広, 藤原俊義

耳鼻咽喉科展望 55 ( 4 ) 262 - 263 2012.8

癌関連線維芽細胞が食道癌の増殖に寄与する(Cancer-associated fibroblasts contribute to progression of esophageal cancer) Reviewed

渡邉伸一郎, 野間和広, 浦野真一, 大原利章, 橋本悠里, 田澤大, 藤原俊義

日本癌学会総会記事 71回 143 - 143 2012.8

テロメラーゼ依存性増殖型アデノウイルス製剤を用いた早期大腸癌の低侵襲治療の開発(Less invasive therapeutic intervention for early colorectal cancers using telomerase-dependent replicating adenovirus)

菊地覚次, 岸本浩行, 田澤大, 橋本悠里, 宇野太, 西崎正彦, 香川俊輔, 浦田泰生, ロバート・ホフマン, 藤原俊義

日本癌学会総会記事 71回 202 - 202 2012.8

食道癌転移診断におけるPET-CT検査の限界 PET-CT偽陽性症例の検討

山辻知樹, 櫻間教文, 高岡宗徳, 林次郎, 繁光薫, 田辺俊介, 野間和広, 白川靖博, 藤原俊義, 猶本良夫

日本消化器外科学会総会 67回 2 - 2 2012.7

がん特異的増殖アデノウイルス製剤OBP-401を用いた生体内癌組織蛍光イメージング

岸本浩行, 菊地覚次, 橋本悠里, 宇野太, 田澤大, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 67回 1 - 1 2012.7

同時性/異時性多発大腸癌に認められたsomatic mutation spectrumの不均一性

森川達也, 永坂岳司, 母里淑子, 久保田暢人, 杉原正大, 竹原清人, 吉田一博, 富岡憲明, 森谷行利, 藤原俊義

日本消化器外科学会総会 67回 2 - 2 2012.7

ロボット支援下胃切除術の術野展開と郭清手技

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 藤原俊義

日本消化器外科学会総会 67回 1 - 1 2012.7

鉄コントロールによる新しい食道癌治療法の開発 Reviewed

大原利章, 白川靖博, 青山克幸, 前田直見, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 66回 196 - 196 2012.6

食道癌転移診断におけるPET-CT偽陽性症例の検討

山辻知樹, 高岡宗徳, 繁光薫, 田辺俊介, 野間和広, 櫻間教文, 白川靖博, 羽井佐実, 藤原俊義, 猶本良夫

日本食道学会学術集会プログラム・抄録集 66回 261 - 261 2012.6

食道疾患;最良の手術とは胸部食道癌に対する適切な頸部・上縦隔郭清とその意義

猶本良夫, 高岡宗徳, 繁光薫, 田辺俊介, 野間和広, 櫻間教文, 白川靖博, 山辻知樹, 藤原俊義, 羽井佐実

日本食道学会学術集会プログラム・抄録集 66回 143 - 143 2012.6

食道アカラシアに対する腹腔鏡下手術

尾山貴徳, 野田卓男, 西崎正彦, 田辺俊介, 藤原俊義

日本小児外科学会雑誌 48 ( 3 ) 446 - 446 2012.5

大学病院の特殊な疾患群に対する胃瘻造設の現況 Reviewed

田辺俊介, 白川靖博, 前田直見, 大原利章, 櫻間教文, 野間和広, 藤原俊義

Gastroenterological Endoscopy 54 ( Suppl.1 ) 1201 - 1201 2012.4

当科における中下咽頭表在癌に対するESDの工夫 Reviewed

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

Gastroenterological Endoscopy 54 ( Suppl.1 ) 1154 - 1154 2012.4

高齢者食道癌症例に対する手術術式と周術期管理 Reviewed

田辺俊介, 白川靖博, 前田直見, 大原利章, 野間和広, 櫻間教文, 藤原俊義

日本外科学会雑誌 113 ( 臨増2 ) 362 - 362 2012.3

当科での胸部食道癌手術の低侵襲化の推移とその成果 Reviewed

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本外科学会雑誌 113 ( 臨増2 ) 736 - 736 2012.3

ロボット支援下幽門側胃切除術の安全な導入 Reviewed

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 近藤喜太, 田邊俊介, 大原利章, 野間和広, 永坂岳志, 白川靖博, 藤原俊義

日本外科学会雑誌 113 ( 臨増2 ) 490 - 490 2012.3

胃癌術後再発症例に対する放射線療法の経験

香川俊輔, 宇野太, 岸本浩行, 西崎まさひこ, 白川靖博, 永坂岳司, 野間和広, 藤原俊義

日本胃癌学会総会記事 84回 334 - 334 2012.2

当院における胃GISTに対するイマチニブ投与の位置づけ

宇野太, 香川俊輔, 西崎正彦, 岸本浩行, 藤原俊義

日本胃癌学会総会記事 84回 359 - 359 2012.2

The modulation of portal venous hemodynamics in living donor liver transplantation

Hiroshi Sadamori, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara

Hemodynamics: Monitoring, Theory and Applications 217 - 230 2012

各領域におけるロボット手術現状と今後の展望(消化器) ロボット支援下幽門側胃切除術の安全な導入を目指して導入初期3例の検討

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 近藤喜太, 田邊俊介, 野間和広, 永坂岳司, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 16 ( 7 ) 247 - 247 2011.12

当科における高齢者食道癌手術症例の術式選択の工夫 Reviewed

田辺俊介, 白川靖博, 前田直見, 大原利章, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 533 - 533 2011.10

当科における食道癌頭頸部癌重複症例の検討 Reviewed

前田直見, 白川靖博, 田辺俊介, 大原利章, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 557 - 557 2011.10

当科における食道胃接合部の食道癌についての検討 Reviewed

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 501 - 501 2011.10

当科における胃管再建作成および吻合における工夫 Reviewed

野間和広, 白川康博, 前田直見, 大原利章, 田辺俊介, 永坂岳司, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 517 - 517 2011.10

当科におけるT4食道癌に対する治療戦略についての検討 Reviewed

大原利章, 白川靖博, 前田直見, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 531 - 531 2011.10

当科における食道及び中下咽頭表在癌に対するESDの工夫 Reviewed

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床外科学会雑誌 72 ( 増刊 ) 593 - 593 2011.10

当科における後期高齢者食道癌手術症例に対する術式選択の検討

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会雑誌 44 ( Suppl.2 ) 267 - 267 2011.10

胸部食道癌における縦隔郭清左反回神経沿い106recLの郭清について

猶本良夫, 田辺俊介, 野間和広, 白川靖博, 藤原俊義, 羽井佐実, 木下真一郎, 山田貴子, 高岡宗徳, 深澤拓也, 林次郎, 繁光薫, 山辻知樹, 吉田和弘, 森田一郎

日本臨床外科学会雑誌 72 ( 増刊 ) 515 - 515 2011.10

胃癌に対するRobot Assisted Gastrectomyの導入経験

西崎正彦, 近藤喜太, 田邊俊介, 野間和広, 岸本浩行, 宇野太, 永坂岳司, 香川俊輔, 白川靖弘, 藤原俊義

日本消化器外科学会雑誌 44 ( Suppl.2 ) 185 - 185 2011.10

HER2陰性胃癌細胞におけるHER2細胞外ドメイン発現によるトラスツズマブへの感受性誘導

吉田亮介, 田澤大, 橋本悠里, 大西哲平, 岸本浩行, 宇野太, 西崎正彦, 香川俊輔, 藤原俊義

日本癌治療学会誌 46 ( 2 ) 655 - 655 2011.9

胃癌幹細胞に対するテロメラーゼ特異的腫瘍融解ウイルス治療

香川俊輔, 矢野修也, 田澤大, 橋本悠里, 宇野太, 岸本浩行, 西崎正彦, 浦田泰生, 藤原俊義

日本癌治療学会誌 46 ( 2 ) 395 - 395 2011.9

鉄欠乏状態は食道がんにおいてNカドヘリンを低下させることでEMTを抑制する(Iron deficiency suppress EMT through downregulation of N-cadherin in esophageal cancer) Reviewed

西谷正史, 野間和広, 大原利章, 長谷井嬢, 佐々木剛, 渡邊伸一郎, 大西哲平, 吉田亮介, 橋本悠里, 田澤大, 宇野太, 香川俊輔, 藤原俊義

日本癌学会総会記事 70回 467 - 468 2011.9

胸部食道癌術後の早期抜管を目指したチーム医療の取り組み

足羽孝子, 伊藤真理, 白川靖博, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本食道学会学術集会プログラム・抄録集 65回 185 - 185 2011.9

胸部食道癌に対する頸部・上縦隔郭清術とその意義

猶本良夫, 田辺俊介, 野間和広, 櫻間教文, 高岡宗徳, 繁光薫, 白川靖博, 山辻知樹, 藤原俊義, 羽井佐実

日本食道学会学術集会プログラム・抄録集 65回 262 - 262 2011.9

食道癌術後再発症例・異時性重複癌症例の集学的治療におけるPET/CTの活用

田辺俊介, 白川靖博, 野間和広, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 65回 236 - 236 2011.9

食道癌転移診断におけるPET-CT検査の有用性と限界 PET-CT偽陽性症例の検討から

山辻知樹, 田辺俊介, 野間和広, 櫻間教文, 高岡宗徳, 繁光薫, 白川靖博, 羽井佐実, 藤原俊義, 猶本良夫

日本食道学会学術集会プログラム・抄録集 65回 289 - 289 2011.9

当科における食道胃接合部癌に対する治療方針とその成績

白川靖博, 田辺俊介, 野間和広, 櫻間教文, 羽井佐実, 山辻知樹, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 65回 271 - 271 2011.9

当科において胃管作成および再建術における最近の取り組み

野間和広, 白川靖博, 横道直佑, 田辺俊介, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 65回 297 - 297 2011.9

当科において胃管作成および再建術における最近の取り組み

野間和広, 白川靖博, 横道直佑, 田辺俊介, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 65回 297 - 297 2011.9

頭頸部癌・食道癌におけるPEGを用いた栄養管理の有用性の検討

田辺俊介, 白川靖博, 野間和広, 横道直佑, 森川達也, 近藤喜太, 櫻間教文, 岸本浩行, 宇野太, 永坂岳司, 西崎正彦, 香川俊輔, 藤原俊義

岡山医学会雑誌 123 ( 2 ) 166 - 166 2011.8

白川靖博, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本臨床 69 ( 増刊6 食道癌 ) 322 - 328 2011.8

岡山大学病院における胃癌に対するダビンチS(da Vinci S surgical system)によるロボット支援腹腔鏡下手術の導入

香川俊輔, 西崎正彦, 宇野太, 岸本浩行, 白川靖博, 永坂岳司, 野間和広, 田辺俊介, 近藤喜太, 横道直佑, 森川達也, 佃和憲, 浅野博昭, 内藤稔, 藤原俊義

岡山医学会雑誌 123 ( 2 ) 167 - 167 2011.8

悪性リンパ腫合併胸部食道癌症例の治療経験

横道直佑, 白川靖博, 野間和広, 田辺俊介, 森川達也, 近藤喜太, 櫻間教文, 岸本浩行, 宇野太, 永坂岳司, 西崎正彦, 香川俊輔, 藤原俊義

岡山医学会雑誌 123 ( 2 ) 166 - 166 2011.8

胃癌に対する腹腔鏡下手術の新たな考え方と工夫肝十二指腸間膜左側アプローチによるNo.12a郭清

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 合地明, 藤原俊義

日本消化器外科学会総会 66回 276 - 276 2011.7

当科における食道胃接合部領域の食道癌に対する治療

白川靖博, 横道直佑, 田辺俊介, 野間和広, 櫻間教文, 山辻知樹, 猶本良夫, 羽井佐実, 藤原俊義

日本消化器外科学会総会 66回 774 - 774 2011.7

消化器外科周術期における栄養療法の進歩 FITMATEを用いて呼吸商から基礎代謝を測定し、術後栄養管理に利用する新しい試み

櫻間教文, 西川みか, 平松聡, 繁光薫, 山辻知樹, 猶本良夫, 田辺俊介, 野間和広, 白川靖博, 藤原俊義

日本消化器外科学会総会 66回 263 - 263 2011.7

当科における胃管作成および再建術の工夫

野間和広, 白川靖博, 横道直佑, 田辺俊介, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本消化器外科学会総会 66回 499 - 499 2011.7

同時多発性胃癌術後の残胃癌に関する検討

香川俊輔, 宇野太, 岸本浩行, 西崎正彦, 白川靖博, 永坂岳司, 野間和広, 近藤喜太, 田辺俊介, 藤原俊義

日本消化器外科学会総会 66回 297 - 297 2011.7

岡山大学外科研修マネージメントセンター医局を超えた外科研修教育の取り組み

菊地覚次, 香川俊輔, 篠浦先, 野間和広, 松岡順治, 土井原博義, 八木孝仁, 佐野俊二, 三好新一郎, 藤原俊義

日本消化器外科学会総会 66回 185 - 185 2011.7

体内鉄コントロールによるN-cadheinの発現低下が癌細胞の浸潤・転移能にどのような影響を与えるかについての検討 Reviewed

西谷正史, 野間和広, 大原利章, 友野靖子, 田邊俊介, 白川靖博, 藤原俊義

日本外科学会雑誌 112 ( 臨増1-2 ) 595 - 595 2011.5

体内鉄コントロールを利用したBevacizumabの新規治療法 Reviewed

大原利章, 野間和広, 友野靖子, 西谷正史, 田辺俊介, 田澤大, 白川靖博, 藤原俊義

日本外科学会雑誌 112 ( 臨増1-2 ) 771 - 771 2011.5

食道癌転移診断におけるPET-CT偽陽性症例の検討 Reviewed

山辻知樹, 関亮太, 木下真一郎, 深澤拓也, 林次郎, 繁光薫, 吉田和弘, 森田一郎, 山田英司, 西谷正史, 大原利章, 田邊俊介, 藤原康宏, 櫻間教文, 野間和広, 高岡宗徳, 白川靖博, 松岡順治, 羽井佐実, 藤原俊義, 猶本良夫

日本外科学会雑誌 112 ( 臨増1-2 ) 837 - 837 2011.5

Preclinical Evaluation of Telomerase-Specific Oncolytic Virotherapy for Human Bone and Soft Tissue Sarcomas Reviewed

Tsuyoshi Sasaki, Hiroshi Tazawa, Jo Hasei, Toshiyuki Kunisada, Aki Yoshida, Yuuri Hashimoto, Shuya Yano, Ryosuke Yoshida, Futoshi Uno, Shunsuke Kagawa, Yuki Morimoto, Yasuo Urata, Toshifumi Ozaki, Toshiyoshi Fujiwara

CLINICAL CANCER RESEARCH 17 ( 7 ) 1828 - 1838 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER ASSOC CANCER RESEARCH

Purpose: Tumor-specific replication-selective oncolytic virotherapy is a promising antitumor therapy for induction of cell death in tumor cells but not of normal cells. We previously developed an oncolytic adenovirus, OBP-301, that kills human epithelial malignant cells in a telomerase-dependent manner. Recent evidence suggests that nonepithelial malignant cells, which have low telomerase activity, maintain telomere length through alternative lengthening of telomeres (ALT). However, it remains unclear whether OBP-301 is cytopathic for nonepithelial malignant cells. Here, we evaluated the antitumor effect of OBP-301 on human bone and soft tissue sarcoma cells.
Experimental Design: The cytopathic activity of OBP-301, coxsackie and adenovirus receptor (CAR) expression, and telomerase activity were examined in 10 bone (OST, U2OS, HOS, HuO9, MNNG/HOS, SaOS-2, NOS-2, NOS-10, NDCS-1, and OUMS-27) and in 4 soft tissue (CCS, NMS-2, SYO-1, and NMFH-1) sarcoma cell lines. OBP-301 antitumor effects were assessed using orthotopic tumor xenograft models. The fiber-modified OBP-301 (termed OBP-405) was used to confirm an antitumor effect on OBP-301-resistant sarcomas.
Results: OBP-301 was cytopathic for 12 sarcoma cell lines but not for the non-CAR-expressing OUMS27 and NMFH-1 cells. Sensitivity to OBP-301 was dependent on CAR expression and not on telomerase activity. ALT-type sarcomas were also sensitive to OBP-301 because of upregulation of human telomerase reverse transcriptase (hTERT) mRNA following virus infection. Intratumoral injection of OBP-301 significantly suppressed the growth of OST and SYO-1 tumors. Furthermore, fiber-modified OBP-405 showed antitumor effects on OBP-301-resistant OUMS-27 and NMFH-1 cells.
Conclusions: A telomerase-specific oncolytic adenovirus is a promising antitumor reagent for the treatment of bone and soft tissue sarcomas. Clin Cancer Res; 17(7); 1828-38. (C) 2011 AACR.

DOI： 10.1158/1078-0432.CCR-10-2066

Treatment of gastric cancer with situs inversus totalis: a case report

Journal of Okayama Medical Association 123 ( 1 ) 45 - 48 2011.4

Stage IVa食道癌の治療方針の検討

田辺俊介, 白川靖博, 井筒将斗, 近藤喜太, 野間和広, 櫻間教文, 宇野太, 永坂岳司, 香川俊輔, 繁光薫, 山辻知樹, 羽井佐実, 松岡順治, 猶本良夫, 藤原俊義

岡山医学会雑誌 123 ( 1 ) 74 - 74 2011.4

食道GISTの切除例2例の経験

井筒将斗, 白川靖博, 田辺俊介, 近藤喜太, 野間和広, 櫻間教文, 宇野太, 永坂岳司, 香川俊輔, 繁光薫, 山辻知樹, 羽井佐実, 松岡順治, 猶本良夫, 藤原俊義

岡山医学会雑誌 123 ( 1 ) 74 - 74 2011.4

KRAS/BRAF/MSI分類による術前からの大腸癌治療戦略構築の提案

永坂岳司, 近藤喜太, 母里淑子, 神原健, 松原長秀, 田中紀章, 三嶋秀行, 藤原俊義

日本大腸肛門病学会雑誌 64 ( 4 ) 266 - 266 2011.4

MicroRNAs as potential target gene in cancer gene therapy of gastrointestinal tumors Reviewed

Hiroshi Tazawa, Shunsuke Kagawa, Toshiyoshi Fujiwara

EXPERT OPINION ON BIOLOGICAL THERAPY 11 ( 2 ) 145 - 155 2011.2

Language：English Publisher：INFORMA HEALTHCARE

Introduction: MicroRNA (miRNA) is a small non-coding RNA, which negatively regulates the expression of many target genes, thereby contributing to the modulation of diverse cell fates. Recent advances in molecular biology have revealed the potential role of miRNAs in tumor initiation, progression and metastasis. Aberrant regulation of miRNAs has been frequently reported in a variety of cancers, including gastrointestinal tumors, suggesting that cancer-related miRNAs are promising as novel biomarkers for tumor diagnosis and are potential target genes for cancer gene therapy against gastrointestinal tumors.
Areas covered: The review focuses on the role of specific miRNAs (miR-192/194/215 and miR-7) in the differentiation of gastrointestinal epithelium and on the role of tumor-suppressive (miR-34, miR-143, miR-145) and oncogenic miRNAs (miR-21, miR-17-92 cluster) in gastrointestinal tumors. Furthermore, the potential role of miRNAs as novel biomarkers and target genes for cancer gene therapy against gastrointestinal tumors are discussed. We will also outline the potential clinical application of miRNAs for tumor diagnosis and cancer gene therapy against gastrointestinal tumors.
Expert opinion: Exploration of tumor-related miRNAs would provide important opportunities for the development of novel cancer gene therapies aimed at normalizing the critical miRNAs that are deregulated in gastrointestinal tumors.

DOI： 10.1517/14712598.2011.542749

右鎖骨下動脈起始異常と反回神経走行異常を伴う食道癌に対する手術経験

二萬英斗, 白川靖博, 渡邉伸一郎, 田辺俊介, 野間和広, 櫻間教文, 繁光薫, 山辻知樹, 羽井佐実, 松岡順治, 猶本良夫, 藤原俊義

岡山医学会雑誌 122 ( 3 ) 281 - 281 2010.12

大腸ポリペクトミー後の横行結腸穿孔症例に対し、腹腔鏡下手術が有効であった一例

伏見卓郎, 近藤喜太, 母里淑子, 永坂岳司, 藤原俊義

岡山医学会雑誌 122 ( 3 ) 281 - 281 2010.12

Telomerase-dependent oncolytic adenovirus sensitizes human cancer cells to ionizing radiation via inhibition of DNA repair machinery. Reviewed International journal

Kuroda S, Fujiwara T, Shirakawa Y, Yamasaki Y, Yano S, Uno F, Tazawa H, Hashimoto Y, Watanabe Y, Noma K, Urata Y, Kagawa S, Fujiwara T

Cancer research 70 ( 22 ) 9339 - 9348 2010.11

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

The inability to repair DNA double-strand breaks (DSB) leads to radiosensitization, such that ionizing radiation combined with molecular inhibition of cellular DSB processing may greatly affect treatment of human cancer. As a variety of viral products interact with the DNA repair machinery, oncolytic virotherapy may improve the therapeutic window of conventional radiotherapy. Here, we describe the mechanistic basis for synergy of irradiation and OBP-301 (Telomelysin), an attenuated type-5 adenovirus with oncolytic potency that contains the human telomerase reverse transcriptase promoter to regulate viral replication. OBP-301 infection led to E1B55kDa viral protein expression that degraded the complex formed by Mre11, Rad50, and NBS1, which senses DSBs. Subsequently, the phosphorylation of cellular ataxia-telangiectasia mutated protein was inhibited, disrupting the signaling pathway controlling DNA repair. Thus, tumor cells infected with OBP-301 could be rendered sensitive to ionizing radiation. Moreover, by using noninvasive whole-body imaging, we showed that intratumoral injection of OBP-301 followed by regional irradiation induces a substantial antitumor effect, resulting from tumor cell-specific radiosensitization, in an orthotopic human esophageal cancer xenograft model. These results illustrate the potential of combining oncolytic virotherapy and ionizing radiation as a promising strategy in the management of human cancer.

DOI： 10.1158/0008-5472.CAN-10-2333

The 2009 Okayama Medical Association Awards: Analysis of fecal DNA methylation to detect gastrointestinal neoplasia

クリニカルパスを用いた食道癌患者周術期管理術後離床状況に着目して

田辺俊介, 白川靖博, 足羽孝子, 伊藤真理, 野間和広, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本臨床外科学会雑誌 71 ( 増刊 ) 736 - 736 2010.10

食道原発小細胞癌の一治療例

井筒将斗, 白川靖博, 田辺俊介, 野間和広, 櫻間教文, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本臨床外科学会雑誌 71 ( 増刊 ) 956 - 956 2010.10

5つのモノヌクレオチドマーカーを用いたPentaplex PCR法のミスマッチ修復タンパク欠損大腸癌に対するスクリーニング効果

永坂岳司, 白川靖博, 中谷紳, 松原長秀, 藤原俊義

日本大腸肛門病学会雑誌 63 ( 9 ) 641 - 641 2010.9

Journal of Okayama Medical Association 122 ( 2 ) 107 - 112 2010.8

食道癌患者におけるクリニカルパスを用いた術前オリエンテーション効果と術後離床状況

伊藤真理, 足羽孝子, 田辺俊介, 白川靖博, 渡邉伸一郎, 野間和広, 櫻間教文, 山辻知樹, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 64回 199 - 199 2010.8

食道疾患に対する前向き比較試験、多施設研究、全国登録報告パラチノースを糖質源とした調整流動食MHN-01を用いた食道癌周術期管理の有用性

山辻知樹, 田辺俊介, 藤原康宏, 野間和広, 櫻間教文, 白川靖博, 繁光薫, 藤原俊義, 羽井佐実, 猶本良夫

日本食道学会学術集会プログラム・抄録集 64回 95 - 95 2010.8

当科における食道憩室手術症例の報告

田辺俊介, 藤原裕子, 近藤喜太, 藤原康宏, 野間和広, 櫻間教文, 宇野太, 永坂岳司, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 羽井佐実, 松岡順治, 猶本良夫

岡山医学会雑誌 122 ( 2 ) 180 - 180 2010.8

再発食道癌の診断と治療におけるPET-CTの意義

山辻知樹, 田辺俊介, 藤原康宏, 野間和広, 櫻間教文, 繁光薫, 白川靖博, 羽井佐実, 藤原俊義, 猶本良夫

日本食道学会学術集会プログラム・抄録集 64回 180 - 180 2010.8

食道再建術・吻合法の工夫小腸間置による胃機能温存食道切除術Gastric function preserving esophagectomy:GPE

猶本良夫, 山田英司, 田辺俊介, 藤原康宏, 野間和広, 白川靖博, 繁光薫, 山辻知樹, 羽井佐実, 藤原俊義

日本食道学会学術集会プログラム・抄録集 64回 108 - 108 2010.8

当科におけるStage4a食道癌の治療方針の検討

田辺俊介, 白川靖博, 渡邉伸一郎, 野間和広, 櫻間教文, 繁光薫, 山辻知樹, 羽井佐実, 猶本良夫, 藤原俊義

日本食道学会学術集会プログラム・抄録集 64回 230 - 230 2010.8

Lynch症候群大腸癌とMSH2メチル化(Somatic hypermethylation of MSH2 is a frequent event in lynch syndrome colorectal cancers)

永坂岳司, 田中紀章, 松原長秀, 藤原俊義

日本癌学会総会記事 69回 351 - 351 2010.8

パラチノースを糖質源とした調整流動食MHN-01による周術期管理基礎実験から臨床試験まで

山辻知樹, 田辺俊介, 藤原康宏, 野間和広, 櫻間教文, 白川靖博, 藤原俊義, 八木孝仁, 羽井佐実, 猶本良夫

日本消化器外科学会総会 65回 798 - 798 2010.7

In vivo biological purging for lymph node metastasis of human colorectal cancer by telomerase-specific oncolytic virotherapy. Reviewed

Kojima T, Watanabe Y, Hashimoto Y, Kuroda S, Yamasaki Y, Yano S, Ouchi M, Tazawa H, Uno F, Kagawa S, Kyo S, Mizuguchi H, Urata Y, Tanaka N, Fujiwara T

Annals of surgery 251 ( 6 ) 1079 - 1086 2010.6

当科における食道癌を含む三重複癌の検討

井筒将斗, 田辺俊介, 藤原康宏, 野間和広, 櫻間教文, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 貞森裕, 八木孝仁, 松岡順治, 猶本良夫

岡山医学会雑誌 122 ( 1 ) 90 - 90 2010.4

当科における食道憩室切除症例の検討 Reviewed

山辻知樹, 山田英司, 西谷正史, 大原利章, 田辺俊介, 藤原康宏, 野間和広, 櫻間一史, 高岡宗徳, 白川靖博, 貞森裕, 小林直哉, 藤原俊義, 八木孝仁, 羽井佐実, 松岡順治, 猶本良夫

日本外科学会雑誌 111 ( 臨増2 ) 582 - 582 2010.3

当院における内視鏡的胃瘻造設の現況

田辺俊介, 白川靖博, 近藤喜太, 藤原康宏, 野間和広, 宇野太, 永坂岳司, 香川俊輔, 山辻知樹, 小林直哉, 藤原俊義, 内藤稔, 猶本良夫

岡山医学会雑誌 121 ( 3 ) 230 - 231 2009.12

腹腔鏡補助下胃切除術における術野展開の工夫

香川俊輔, 宇野太, 合地明, 小林直哉, 山辻知樹, 白川靖博, 永坂岳司, 野間和広, 藤原康宏, 田辺俊介, 近藤喜太, 猶本良夫, 藤原俊義

日本内視鏡外科学会雑誌 14 ( 7 ) 562 - 562 2009.12

分子標的治療薬に伴うOncologic Emergencyに対する外科手術の適応

山辻知樹, 田辺俊介, 藤原康宏, 野間和広, 櫻間一史, 高岡宗徳, 白川靖博, 小林直哉, 藤原俊義, 松岡順治, 羽井佐実

日本臨床外科学会雑誌 70 ( 増刊 ) 658 - 658 2009.10

Bevacizumab化学療法により回腸-腸骨動脈瘻を来たした大腸癌腹膜播種再発の1例

藤原康宏, 猶本良夫, 田辺俊介, 櫻間一史, 野間和広, 元木崇之, 永坂岳志, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 羽井佐実, 松岡順治, 田中紀章

日本消化器病学会雑誌 106 ( 臨増大会 ) A857 - A857 2009.9

ゲノム研究が切り開く肺がんの新たな予防・治療戦略肺癌に対する遺伝子およびベクターを用いた分子治療(Novel therapeutic and preventive strategies blazed by genome research on lung cancer Gene and Vector-based Molecular Therapy for Lung Cancer)

香川俊輔, 黒田新士, 宇野太, 田澤大, 浦田泰生, 藤原俊義

日本癌学会総会記事 68回 56 - 56 2009.8

食道原発小細胞癌の一治療例の報告

田辺俊介, 猶本良夫, 近藤喜太, 藤原康宏, 野間和広, 櫻間一史, 高岡宗徳, 宇野太, 永坂岳司, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松岡順治, 田中紀章, 羽井佐実

岡山医学会雑誌 121 ( 2 ) 132 - 132 2009.8

進行再発大腸癌に対するセツキシマブの治療経験

藤原康宏, 猶本良夫, 近藤喜太, 田辺俊介, 桜間一史, 野間和広, 高岡宗徳, 宇野太, 永坂岳司, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松岡順治, 田中紀章, 羽井佐実

岡山医学会雑誌 121 ( 2 ) 133 - 133 2009.8

当科におけるバレット食道癌症例の検討

野間和広, 猶本良夫, 田辺俊介, 近藤喜太, 藤原康宏, 櫻間一史, 高岡宗徳, 宇野太, 永坂岳司, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松岡順治, 田中紀章, 羽井佐実

岡山医学会雑誌 121 ( 2 ) 133 - 133 2009.8

テロメラーゼ依存的制限増殖型GFP発現アデノウイルスによる末梢血中ヒト循環がん細胞の検出(A simple biological imaging method for detection of viable human circulating tumor cells in the blood)

橋本悠里, 児島亨, 宇野太, 香川俊輔, 渡邉雄一, 黒田新士, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 68回 244 - 244 2009.8

オーバーチューブによる頸部食道穿孔に対して手術を施行した2症例の検討

田辺俊介, 猶本良夫, 西谷正史, 近藤喜太, 藤原康宏, 野間和広, 櫻間一史, 高岡宗徳, 宇野太, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

岡山医学会雑誌 121 ( 1 ) 65 - 66 2009.4

当科における胃機能温存食道切除再建術の工夫

野間和広, 藤原康宏, 田辺俊介, 猶本良夫, 西谷正史, 近藤喜太, 櫻間一史, 高岡宗徳, 宇野太, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

岡山医学会雑誌 121 ( 1 ) 66 - 66 2009.4

分子標的薬治療中のOncologic emergencyに対する対応

山辻知樹, 猶本良夫, 西谷正史, 田辺俊介, 近藤喜太, 藤原康宏, 野間和広, 櫻間一史, 高岡宗徳, 宇野太, 香川俊輔, 白川靖博, 小林直哉, 藤原俊義, 松原長秀, 松岡順治, 田中紀章

岡山医学会雑誌 121 ( 1 ) 65 - 65 2009.4

イマチニブ抵抗性GISTに対するスニチニブの使用経験

藤原康宏, 田辺俊介, 猶本良夫, 西谷正史, 近藤喜太, 野間和広, 櫻間一史, 高岡宗徳, 宇野太, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 松岡順治, 田中紀章

岡山医学会雑誌 121 ( 1 ) 64 - 64 2009.4

食道原発悪性黒色腫長期生存症例の検討

山辻知樹, 猶本良夫, 田辺俊介, 藤原康宏, 櫻間一史, 野間和広, 高岡宗徳, 元木崇之, 白川靖博, 藤原俊義, 小林直哉, 松原長秀, 松岡順治, 羽井佐実, 田中紀章

日本臨床外科学会雑誌 69 ( 増刊 ) 359 - 359 2008.10

テロメアーゼ特異的制限増殖型アデノウイルスによる末梢血中ヒトがん細胞検出方法の開発(A three-step simple imaging method to detect viable human circulating tumor cells in the peripheral blood)

橋本悠里, 児島亨, 渡邉雄一, 黒田新士, 宇野太, 香川俊輔, 水口裕之, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 67回 486 - 486 2008.9

肺癌細胞株に対するテロメラーゼ特異的腫瘍溶解性アデノウイルス製剤とゲムシタビンの併用効果の検討(Preclinical study of multidisciplinary approach with telomerase-specific virotherapy and gemcitabine for lung cancer)

大内正明, 劉東, 児島亨, 黒田新士, 橋本悠里, 鬼松秀樹, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 67回 72 - 72 2008.9

当院における早期胃癌に対する腹腔鏡補助下胃切除術と開腹胃切除術との比較検討

香川俊輔, 宇野太, 合地明, 松原長秀, 小林直哉, 山辻知樹, 白川靖博, 藤原康宏, 近藤喜太, 田辺俊介, 猶本良夫, 藤原俊義, 田中紀章

日本内視鏡外科学会雑誌 13 ( 7 ) 232 - 232 2008.9

テロメラーゼ依存性腫瘍融解アデノウイルスによる放射線感受性増強 E1B55kDaによるATMリン酸化阻害(Radiosensitization by telomerase-specific oncolytic adenovirus via E1B 55kDa-mediated inhibition of ATM phosphorylation)

黒田新士, 藤原俊哉, 矢野修也, 山崎泰源, 児島亨, 宇野太, 香川俊輔, 田澤大, 橋本悠里, 大内正明, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 67回 90 - 90 2008.9

胃癌幹細胞に対する新規治療テロメラーゼ特異的腫瘍融解ウイルス治療(A Novel Telomerase-Specific Oncolytic Virotherapy Targeting Human Gastric Cancer Stem Cells)

矢野修也, 橋本悠里, 山崎泰源, 黒田新士, 児島亨, 田澤大, 宇野太, 香川俊輔, 大内正明, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 67回 73 - 74 2008.9

テロメラーゼ特異的腫瘍融解ウイルスによる大腸がんモデルにおけるリンパ節内転移癌細胞の粛清効果の検討(In vivo Purging of Lymph Node Metastasis by Telomerase-Specific Virotherapy in an Orthotopic Colorectal Cancer Model)

児島亨, 渡辺雄一, 橋本悠里, 黒田新士, 宇野太, 大川俊輔, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 67回 420 - 420 2008.9

テロメラーゼ依存性腫瘍融解ウイルスの抗腫瘍活性における抗がん剤併用の相乗効果(Preclinical study of telomerase-selective oncolytic adenovirus in combination with chemotherapeutic agents)

田澤大, 橋本悠里, 黒田新士, 浦田泰生, 藤原俊義

日本癌学会総会記事 67回 239 - 239 2008.9

食道癌化学療法中にウェルニッケ脳症を発症した1例

藤原康宏, 猶本良夫, 田辺俊介, 近藤喜太, 河本洋伸, 元木崇之, 宇野太, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 松岡順治, 田中紀章

岡山医学会雑誌 120 ( 2 ) 241 - 241 2008.8

当科における食道類基底細胞癌切除症例の検討

田辺俊介, 猶本良夫, 近藤喜太, 河本洋伸, 藤原康宏, 櫻間一史, 宇野太, 高岡宗徳, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

岡山医学会雑誌 120 ( 2 ) 241 - 241 2008.8

EUS-FNA後の出血により緊急手術を行った胃GISTの1例

藤智和, 猶本良夫, 田邊俊介, 近藤喜太, 藤原康宏, 吉田亮介, 野間和広, 櫻間一史, 宇野太, 香川俊輔, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 松岡順治, 田中紀章

岡山医学会雑誌 120 ( 2 ) 249 - 250 2008.8

気管合併切除を行い遺残なく切除し得た頸部食道癌の1例

田辺俊介, 猶本良夫, 藤原康宏, 櫻間一史, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

岡山医学会雑誌 120 ( 1 ) 111 - 111 2008.5

ESD後急激にリンパ節転移が増大した食道表在癌の1例

白川靖博, 猶本良夫, 田辺俊介, 藤原康宏, 櫻間一史, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

岡山医学会雑誌 120 ( 1 ) 111 - 111 2008.5

術前に鑑別診断が困難であった空腸癌の1切除例

櫻間一史, 猶本良夫, 田辺俊介, 藤原康宏, 高岡宗徳, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 平松聡, 田中紀章

岡山医学会雑誌 119 ( 3 ) 339 - 339 2008.1

食道癌術後に発生した肺小細胞癌の2例

高岡宗徳, 猶本良夫, 田辺俊介, 桜間一史, 藤原康宏, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 羽井佐実, 田中紀章

岡山医学会雑誌 119 ( 3 ) 337 - 337 2008.1

大腿骨軟骨肉腫術後の巨大腹壁ヘルニア内に発生した大腸癌の1例

田辺俊介, 猶本良夫, 桜間一史, 藤原康宏, 高岡宗徳, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 羽井佐実, 田中紀章

岡山医学会雑誌 119 ( 3 ) 340 - 340 2008.1

Specific in vivo labeling with GFP retroviruses, lentiviruses, and adenoviruses for imaging

Robert M. Hoffman, Hiroyuki Kishimoto, Toshiyoshi Fujiwara

Progress in Biomedical Optics and Imaging - Proceedings of SPIE 6868 2008

Language：English Publishing type：Research paper (international conference proceedings)

Fluorescent proteins have revolutionized the field of imaging. Our laboratory pioneered in vivo imaging with fluorescent proteins. Fluorescent proteins have enabled imaging at the subcellular level in mice. We review here the use of different vectors carrying fluorescent proteins to selectively label normal and tumor tissue in vivo. We show that a GFP retrovirus and telomerase-driven GFP adenovirus can selectively label tumors in mice. We also show that a GFP lentivirus can selectively label the liver in mice. The practical application of these results are discussed.

DOI： 10.1117/12.773308

食道癌術前診断におけるPET/CTの有用性ならびに術後病理組織診断との整合性についての検討

田辺俊介, 猶本良夫, 藤原康宏, 櫻間一史, 高岡宗徳, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 羽井佐実, 松岡順治, 田中紀章

日本臨床外科学会雑誌 68 ( 増刊 ) 437 - 437 2007.11

テロメラーゼ依存性腫瘍融解ウイルス療法と放射線療法の相互増感作用(Mutual sensitization with telomerase-specific oncolytic virotherapy and ionizing radiation in antitumor activity)

黒田新士, 藤原俊哉, 児島亨, 渡邊雄一, 橋本悠里, 宇野太, 香川俊輔, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 66回 385 - 385 2007.8

リンパ節微小転移を標的としたテロメラーゼ依存性腫瘍融解ウイルス療法(Telomerase-specific virotherapy targeting lymph node micrometastasis of human cancer)

児島亨, 渡辺雄一, 橋本悠里, 黒田新士, 宇野太, 香川俊輔, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 66回 91 - 91 2007.8

食道癌化学療法後骨髄異形成症候群の検討

田辺俊介, 猶本良夫, 藤原康宏, 高岡宗徳, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 羽井佐実, 田中紀章

岡山医学会雑誌 119 ( 1 ) 99 - 99 2007.5

G-CSF産生食道癌の1例

高岡宗徳, 猶本良夫, 田辺俊介, 藤原康宏, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 羽井佐実, 田中紀章

岡山医学会雑誌 119 ( 1 ) 99 - 99 2007.5

食道癌と甲状腺癌同時切除例の検討

藤原康宏, 猶本良夫, 田辺俊介, 高岡宗徳, 白川靖博, 山辻知樹, 小林直哉, 藤原俊義, 松原長秀, 岩垣博巳, 松岡順治, 羽井佐実, 田中紀章

岡山医学会雑誌 119 ( 1 ) 99 - 99 2007.5

テロメラーゼ特異的GFP発現ナノバイオ・ウイルス製剤(OBP-401)を用いた微小癌組織のin vivoイメージング・システム

児島亨, 藤原俊義, 岸本浩行, 橋本悠里, 香川俊輔, 宇野太, 浦田泰生, 田中紀章

日本癌学会総会記事 65回 258 - 258 2006.9

A case report--The marked response to gemcitabine combined with irinotecan and low-dose cisplatin chemotherapy for advanced gastric cancer with multiple liver metastases.

Fuminori Teraishi, Futoshi Uno, Shunsuke Kagawa, Akira Gochi, Toshiyoshi Fujiwara, Noriaki Tanaka

Gan to kagaku ryoho. Cancer & chemotherapy 33 ( 12 ) 1885 - 1887 2006

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

A 69-year-old man with no sign of symptoms was admitted to our hospital for further examination and treatment of gastric cancer. Endoscopy revealed a Borrmann 3-type tumor in the cardia of the stomach. CT of the abdomen demonstrated a marked thickening of the stomach wall near the esophago-gastric junction, multiple liver metastases in bilateral liver lobes, and regional lymph node swelling around the cardia of the stomach. He consented and received systemic chemotherapy consisting of 0.5 h infusion of cisplatin (25 mg/body) followed by 0.5 h infusion of gemcitabine (800 mg/body) and 2.5 h infusion of irinotecan (60 mg/body) every 14 days as described below. Only the initial 1 course was administered with 5-FU (500 mg/body) as an inpatient, and further courses were performed as an outpatient with no severe adverse events. His tumors responded immediately to the chemotherapy, and restaging abdominal CT after 4-cycles of chemotherapy showed almost complete regression of liver metastases, and partial response to lymphadenopathy. The patient currently undergoes regular chemotherapy and remains in remission more than 6 months after the diagnosis of unresectable gastric cancer with liver metastases. It may be possible that the current chemotherapy will be neoadjuvant chemotherapy, and curative surgical resection can be performed.

Stenting and radiotherapy for malignant tracheal stenosis due to mediastinal lymph node recurrence from gastric cancer--a case report

Shunsuke Kagawa, Toshiyoshi Fujiwara, Masahiko Nishizaki, Naoyuki Tokunaga, Akira Gochi, Noriaki Tanaka

Gan to kagaku ryoho. Cancer & chemotherapy 33 ( 1 ) 91 - 93 2006

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

The case is a 74-year-old woman,who underwent curative resection six years earlier for stomach cancer in the cardia extending to the esophagus (Stage IIIA). She noticed hoarseness and cough in September 2004, and CT revealed lymph node metastasis of the cancer in the upper mediastinum. The tumor pressured the SVC, the esophagus,and especially the trachea that narrowed up to a diameter of 5 mm.To secure the air way, first, a self-expandable metallic stent was placed in the narrowed trachea under general anesthesia. Irradiation to the upper mediastinal tumor was further applied for a total of 46 Gy from October to November, 2004.Symptom relief was obtained over the course by a marked reduction in the size of the metastatic tumor, and the disease remained stable for 5 months. In general,a stomach cancer that is mostly adenocarcinoma has been recognized to have low receptivity for radiotherapy. Nevertheless,this case suggests that radiotherapy can play an important role in local control and symptom relief for symptomatic stomach cancer patients.

A case of advanced gastric cancer with liver metastasis completely responding to CPT-11+low-dose 5-FU+CDDP chemotherapy

Shunsuke Kagawa, Toshiyoshi Fujiwara, Naoyuki Tokunaga, Masahiko Nishizaki, Futoshi Uno, Fuminori Teraishi, Akira Gouchi, Junji Matsuoka, Noriaki Tanaka

Gan to kagaku ryoho. Cancer & chemotherapy 33 ( 9 ) 1317 - 1320 2006

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

The case was a 54-year-old man with type-3 gastric cancer in the cardia accompanied by multiple liver metastasis. He received combination chemotherapy consisting of CPT-11 (60 mg/body, day 1 and 8)+low-dose 5-FU and CDDP (5-FU 500 mg/body/day and CDDP 5 mg/body/day, day 1-5 and 8-12, continuous infusion) every 3 weeks. The initial 2 courses were administered on an inpatient basis,and further courses as an outpatient. After 7 courses of therapy without severe adverse events, not only primary lesion but also hepatic metastasis disappeared. He has been free from disease for 4 months, and chemotherapy was further continued with TS-1 (100 mg/body, day 1-14)+CPT-11 60 mg/body, day 1, 8), every 3 weeks. CPT-11 in combination with low-dose 5-FU+CDDP can be one of the most effective regimens for unresectable advanced gastric cancer.

テロメラーゼ依存性GFP蛍光発現ウイルス製剤OBP-401を用いた微小癌組織ナビゲーション・システムの開発

藤原俊義, 岸本浩行, 香川俊輔, 宇野太, 田中紀章, 河村仁, 浦田泰生

日本癌治療学会誌 40 ( 2 ) 350 - 350 2005.9

抗癌剤耐性細胞におけるテロメラーゼ特異的制限増殖型アデノウイルスTelomelysin(OBP-301)の抗腫瘍効果の検討

藤原俊哉, 藤原俊義, 香川俊輔, 岸本浩行, 遠藤芳克, 酒井亮, 日置勝義, 池田義博, 浦田泰生, 田中紀章

日本癌学会総会記事 64回 434 - 434 2005.9

テロメラーゼ特異的腫瘍融解アデノウイルス(Telomelysin:OBP301)新たな抗腫瘍分子機構腫瘍免疫系への影響の解析

遠藤芳克, 徳永尚之, 池田義博, 酒井亮, 日置勝義, 岸本浩行, 藤原俊哉, 香川俊輔, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 64回 484 - 484 2005.9

がん特異的増殖可能アデノウイルス製剤OBP-401を用いた生体内癌組織診断がん特異的GFP蛍光イメージング技術の開発

岸本浩行, 香川俊輔, 藤原俊哉, 遠藤芳克, 池田義博, 日置義勝, 酒井亮, 浦田泰生, 田中紀章, 藤原俊義

日本癌学会総会記事 64回 447 - 448 2005.9

食道癌縦隔再発に対するラジオ波焼灼術

浅海信也, 猶本良夫, 櫻間一史, 野間和広, 白川靖博, 山辻知樹, 藤原俊義, 松原長秀, 羽井佐実, 岩垣博巳, 田中紀章, 花崎元彦, 多賀直行, 中塚秀輝, 森田潔, 郷原英夫, 三村秀文, 金澤右

岡山医学会雑誌 116 ( 3 ) 318 - 318 2005.1

GFP発現テロメラーゼ特異的制限増殖型ウイルスTelomelysin-GFPを用いた腫瘍組織ナビゲーション・システム

岸本浩行, 香川俊輔, 滝正樹, 藤原俊哉, 渡辺貴紀, 遠藤芳克, 京哲, 水口裕之, 田中紀章, 藤原俊義

日本癌学会総会記事 63回 454 - 454 2004.9

HDAC阻害剤FR901228によるテロメラーゼ特異的制限増殖型アデノウイルスTelomelysinの選択的抗腫瘍効果の増強

渡邉貴紀, 西崎正彦, 香川俊輔, 滝正樹, 岸本浩行, 藤原俊哉, 遠藤芳克, 京哲, 水口裕之, 田中紀章, 藤原俊義

日本癌学会総会記事 63回 499 - 499 2004.9

A case of advanced non-small lung cancer responding to tumor suppressor p53 gene therapy

Shunsuke Kagawa, Shoichiro Ohtani, Noriaki Tanaka, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 31 ( 11 ) 1788 - 1790 2004

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

The phase I study of the tumor suppressor p53 gene therapy for advanced lung cancer was performed. A 57-year-old man with locally advanced squamous cell carcinoma at the tracheal bifurcation, clinical stage IIIB, had previously been treated by radiotherapy and chemotherapy. Because of the local recurrence, he was enrolled to the study. He was treated by a local injection of ADVEXIN once every 4 weeks for 14 times without marked adverse events, which resulted in tumor regression and relief of his symptom for a year. In conclusion, gene therapy with ADVEXIN may be an effective treatment for locally advanced non-small lung cancer.

制限増殖型アデノウイルスによる非増殖型p53遺伝子発現アデノウイルスベクター(Ad5CMV-p53)の腫瘍選択的増殖

谷本光隆, 藤原俊義, 高田佳子, 大谷彰一郎, 川嶋健, 香川俊輔, 西崎正彦, 田中紀章

日本癌学会総会記事 61回 187 - 187 2002.10

Efficient Cre/loxP site-specific recombination in a HepG2 human liver cell line

Naoya Kobayashi, Hirofumi Noguchi, Karen A. Westerman, Toshihisa Matsumura, Takamasa Watanabe, Toshinori Totsugawa, Toshiyoshi Fujiwara, Philippe Leboulch, Noriaki Tanaka

Cell Transplantation 9 ( 5 ) 737 - 742 2000

Language：English Publishing type：Research paper (international conference proceedings) Publisher：Cognizant Communication Corporation

A worldwide shortage of donor livers is a limiting factor of the clinical application of hepatocyte transplantation (HTX). To resolve this issue, we focused on a reversible immortalization system that allows temporary expansion of primary hepatocyte populations by transfer of an oncogene that can be subsequently excised. As a preliminary test toward this goal, we examined the efficacy of Cre/loxP site-specific recombination in a transformed human liver cell line, HepG2. The present study utilized retroviral transfer of a prototypical immortalizing gene, simian virus 40 large T antigen (SV40Tag), flanked by a pair of loxP recombination targets and adenovirus-mediated Cre/loxP recombination. Here we report that complete elimination of the retroviral transferred oncogene was achieved by site-specific recombination using a replication-deficient recombinant adenovirus vector producing Cre recombinase (Ad-Cre).

DOI： 10.1177/096368970000900525