Faculty Profiles - TANABE Shunsuke

Papers - TANABE Shunsuke

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Visualized Evaluation of Blood Flow to the Gastric Conduit and Complications in Esophageal Reconstruction. Reviewed International journal

Kazuhiro Noma, Yasuhiro Shirakawa, Nobuhiko Kanaya, Tsuyoshi Okada, Naoaki Maeda, Takayuki Ninomiya, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara

Journal of the American College of Surgeons 226 ( 3 ) 241 - 251 2018.3

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

BACKGROUND: Evaluation of the blood supply to gastric conduits is critically important to avoid complications after esophagectomy. We began visual evaluation of blood flow using indocyanine green (ICG) fluorescent imaging in July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. STUDY DESIGN: A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into 2 groups: before and after introduction of ICG evaluation. The entire cohort and 68 patient pairs after propensity score matching (PS-M) were evaluated for clinical outcomes and the effect of visualized evaluation on reducing the risk of complication. RESULTS: The leakage rate in the ICG group was significantly lower than in the non-ICG group for each severity grade, both in the entire cohort (285 subjects) and after PS-M; the rates of other major complications, including recurrent laryngeal nerve palsy and pneumonia, were not different. The duration of postoperative ICU stay was approximately 1 day shorter in the ICG group than in the non-ICG group in the entire cohort, and approximately 2 days shorter after PS-M. Visualized evaluation of blood flow with ICG methods significantly reduced the rate of anastomotic complications of all Clavien-Dindo (CD) grades. Odds ratios for ICG evaluation decreased with CD grade (0.3419 for CD ≥ 1; 0.241 for CD ≥ 2; and 0.2153 for CD ≥ 3). CONCLUSIONS: Objective evaluation of blood supply to the reconstructed conduit using ICG fluorescent imaging reduces the risk and degree of anastomotic complication.

DOI： 10.1016/j.jamcollsurg.2017.11.007

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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

[Conservative management of gastric emphysema and hepatic portal venous gas: a case report]. Reviewed

Masaya Iwamuro, Yuki Okamoto, Hiromitsu Kanzaki, Seiji Kawano, Shunsuke Tanabe, Hiromasa Yamamoto, Yoshiro Kawahara, Hiroyuki Okada

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 115 ( 7 ) 655 - 661 2018

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

A 69-year-old Japanese man underwent successful percutaneous endoscopic gastrostomy (PEG) without any intra-procedural adverse event. However, 3 days postoperatively, he presented with melena and bloody discharge from the gastrostomy tube. Computed tomography revealed gastric emphysema, hepatic portal venous gas, portal vein thrombosis, and swelling of the ascending colon. We administered antibiotics and discontinued enteral feeding; this resulted in resolution of gastric emphysema, hepatic portal venous gas, and portal vein thrombosis and an improvement in the swelling of the ascending colon. To the best of our knowledge, till date, only three patients have been reported to develop gastric emphysema and hepatic portal venous gas after PEG. All previously reported patients were treated with antibiotics and/or discontinuation of enteral feeding, exhibiting recovery within 6-14 days. Although the occurrence of gastric emphysema and hepatic portal venous gas after a PEG procedure is rare, conservative management can ensure recovery in such patients.

DOI： 10.11405/nisshoshi.115.655

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A case of long-term survival after surgical resection for solitary adrenal recurrence of esophageal squamous carcinoma. Reviewed International journal

Nobuhiko Kanaya, Kazuhiro Noma, Tsuyoshi Okada, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Surgical case reports 3 ( 1 ) 61 - 61 2017.12

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

BACKGROUND: Esophageal carcinomas are highly malignant tumors with a high frequency of lymph node and distant organ metastasis. Treatment for recurrent tumors is generally decided on an individual basis. Although multidisciplinary treatments involving chemotherapy, surgical resection, and radiation are performed, the prognosis remains poor. Here, we report a case of prolonged recurrence-free survival (38 months) after esophageal carcinoma surgery and subsequent laparoscopic adrenalectomy for right adrenal metastasis. CASE PRESENTATION: An 83-year-old man was diagnosed with type 3 esophageal squamous cell carcinoma (T3N1M0, cStage IIIA, UICC-7), spreading from the lower thoracic esophagus to the abdominal esophagus. He underwent thoracoscopic esophagectomy with a two-field lymph node dissection followed by substernal gastric tube reconstruction. The final diagnosis was moderately differentiated squamous cell carcinoma (T3N2M0, fStage IIIB). Adjuvant chemotherapy was not administered because of the advanced age and postoperative condition of the patient. Computed tomography (CT) at 14 months postoperatively showed a mass with a 2-cm diameter at the right adrenal gland. Positron emission tomography (PET)/CT revealed a high fluorodeoxyglucose (FDG) uptake in the mass. It was suspected that the mass was a metastatic lesion secondary to the primary esophageal carcinoma. No metastases to lymph nodes or other distant organs were identified. The patient underwent laparoscopic right adrenalectomy. The histopathological examination revealed moderately differentiated squamous cell carcinoma, suggesting metastasis from the primary esophageal carcinoma. He has survived without recurrence for 38 months since laparoscopic adrenalectomy to remove the right adrenal metastastic mass after the esophageal carcinoma surgery. CONCLUSIONS: We describe a very elderly male who survived laparoadrenalectomy for right adrenal metastasis following esophageal cancer surgery without recurrence for 38 months postoperatively. Therefore, surgical resection might be an option for solitary adrenal recurrence.

DOI： 10.1186/s40792-017-0337-8

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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

[Radical Thoracoscopic Esophagectomy for Elderly Patients with Advanced Esophageal Cancer]. Reviewed

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.

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[Successful Multimodality Treatment Including Three-Stage Operation for Esophageal Cancer with Esophagorespiratory Fistula - A Case Report]. Reviewed

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.

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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

Closed LECSの開発と早期胃癌への応用

西崎正彦, 菊地覚次, 黒田新士, 桑田和也, 田邊俊介, 野間和弘, 加藤大, 香川俊輔, 白川靖博, 藤原俊儀

日本臨床外科学会雑誌 78 ( 増刊 ) 505 - 505 2017.10

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

食道がん患者の術前看護外来前と入院時の抑うつ傾向と心理的適応の変化

廣川万里子, 市川あい, 伊藤真理, 足羽孝子, 前田直見, 二宮卓之, 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 71回 P73 - 8 2017.6

Nonexposure laparoscopic and endoscopic cooperative surgery (closed laparoscopic and endoscopic cooperative surgery) for gastric submucosal tumor. Reviewed

Satoru Kikuchi, Masahiko Nishizaki, Shinji Kuroda, Shunsuke Tanabe, Kazuhiro Noma, Shunsuke Kagawa, Yasuhiro Shirakawa, Hiroshi Kato, Hiroyuki Okada, Toshiyoshi Fujiwara

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 20 ( 3 ) 553 - 557 2017.5

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

Laparoscopic and endoscopic cooperative surgery (LECS) is increasingly applied for gastric submucosal tumors (SMTs) such as gastrointestinal stromal tumors. However, the conventional LECS procedure has the potential risk that gastric contents and even tumor cells could spread into the abdominal cavity because the gastric wall has to be opened during the resection. To avoid this problem, we have developed a modified LECS procedure named "closed LECS." Ten patients underwent closed LECS for the resection of gastric SMTs. Closed LECS consists of the following steps: endoscopic submucosal layer dissection around the tumor, laparoscopic marking of a resection line on the serosal surface along submucosal dissection line, seromuscular suturing with the marked lesion inverted into the inside of the stomach, endoscopic circumferential seromuscular dissection, and peroral retrieval. In three of the initial five cases, the closed LECS procedure was not completed as planned because of the tumor size and endoscopic inappropriate seromuscular dissection. After modification of the procedure, the entire procedure was successful in all five cases. The mean resected tumor diameter was 24.1 ± 7.6 mm. The mean operation time was 253 ± 45 min. One patient experienced an intra-abdominal abscess potentially related to delayed perforation as a postoperative complication. The closed LECS procedure for gastric SMTs can theoretically be applied without contamination and tumor cell dissemination into the abdominal cavity.

DOI： 10.1007/s10120-016-0641-1

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Outcome of Radiation Monotherapy for High-risk Patients with Stage I Esophageal Cancer. Reviewed

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Shunsuke Tanabe, Shinji Kuroda, Shunsuke Kagawa, Kuniaki Katsui, Norihisa Katayama, Susumu Kanazawa, Toshiyoshi Fujiwara

Acta medica Okayama 71 ( 2 ) 127 - 133 2017.4

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

Currently, chemoradiation is the most widely used nonsurgical treatment for esophageal cancer. However, some patients, particularly the very elderly or those with severe vital organ dysfunction, face difficulty with the chemotherapy component. We therefore examined the outcome of radiation therapy (RT) alone for patients with esophageal cancer at our facility. Between January 2005 and December 2014, 84 patients underwent RT at our hospital, and 78 of these patients received concomitant chemotherapy. The remaining 6 patients underwent RT alone; these patients were considered to be high-risk and to have no lymph node metastasis (stage I). Five of them received irradiation up to a curative dose: 4 showed a complete response (CR) and 1 showed a partial response (PR). Of the patients exhibiting CR, 3 are currently living recurrence-free, whereas 1 patient underwent endoscopic submucosal dissection (ESD) as salvage therapy for local recurrence, with no subsequent recurrence. High-risk stage I esophageal cancer patients can be treated radically with RT alone under certain conditions. In the future, to broaden the indications for RT monotherapy to include some degree of advanced cancers, a novel concurrent therapy should be identified.

DOI： 10.18926/AMO/54981

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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

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

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

反復する合併症で治療に難渋するB型食道閉鎖症に対する胃管・遊離空腸を用いた食道再建術

尾山貴徳, 野田卓男, 谷守通, 納所洋, 谷本光隆, 田邊俊介, 升田智也, 二宮卓之, 前田直見, 野間和広, 白川靖博, 松本洋

日本小児外科学会雑誌 53 ( 1 ) 178 - 178 2017.2

Thoracoscopic esophagectomy was effective in a case of lower esophageal stenosis due to recurrence of achalasia after myotomy 40 years previously Reviewed

Katsura Yuki, Shirakawa Yasuhiro, Tanabe Shunsuke, Maeda Naomi, Noma Kazuhiro, Fujiwara Toshiyoshi

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 129 ( 1 ) 41 - 44 2017

Language：Japanese Publisher：Okayama Medical Association

When planning surgery for achalasia, it is important to plan for adequate myotomy and prevention of reflux. However, achalasia may recur if the procedure was inadequate or in patients with a long-term course. The present case is a 68-year-old woman who underwent myotomy of the lower esophageal sphincter 40 years ago, but recently reported difficulty in swallowing. Dilatation of the thoracic esophagus and stenosis of the abdominal esophagus were identified by examination, and the patient was diagnosed with recurrence of achalasia. After percutaneous endoscopic gastrostomy was performed to recover nutritional status, thoracoscopic esophagectomy was carried out. The patient's post-operative course was uneventful and oral intake was enabled. At the time of writing, there has been no re-recurrence. There is no standard therapy for post-operative recurrence of achalasia. We believe that thoracoscopic esophagectomy for the recurrence of achalasia is a safe and minimally invasive alternative to conventional surgery.

DOI： 10.4044/joma.129.41

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Other Link： http://search.jamas.or.jp/link/ui/2017219750

Achalasia treated with per-oral endoscopic myotomy (POEM) Reviewed

Sugihara Yuusaku, Harada Keita, Kato Ryo, Yamauchi Kenji, Takashima Shiho, Takei Daisuke, Inokuchia Toshihiro, Takahara Masahiro, Kawano Seiji, Hiraoka Sakiko, Tanabe Shunsuke, Noma Kazuhiro, Shirakawa Yasuhiro, Manabe Noriaki, Inoue Haruhiro, Okada Hiroyuki

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 129 ( 2 ) 115 - 121 2017

Language：Japanese Publisher：Okayama Medical Association

&emsp;Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Patients present with dysphagia, chest pain, vomiting, and aspiration. Esophageal achalasia had traditionally been treated with esophageal achalasia balloon dilatation and the Heller-Dor method, but in recent years, the use of per-oral endoscopic myotomy (POEM) has increased. Our patient, a 39-yr-old male, began experiencing dysphagia 4 years prior to his referral to our hospital. Based on the results of esophagogastroduodenoscopy, esophageal radiography and high-resolution manometry, we made the diagnosis of esophageal achalasia (Chicago classification type I) . After informed consent from the patient and his family and approval from our hospital's ethics committee were obtained, we performed a POEM. The patient was discharged on the 4th day post-surgery. At the 1-year post-operative examination, no worsening of symptoms and no relapse were observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect and prevention of invasion. We recommend that it be considered as the first-choice treatment for achalasia. However, accessibility to the procedure itself is limited due to the few adequately trained operators worldwide. POEM should thus be performed by an expert operator at a high-volume center.

DOI： 10.4044/joma.129.115

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Other Link： http://search.jamas.or.jp/link/ui/2017339773

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

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Papers - TANABE Shunsuke