研究者詳細 - 田邊　俊介

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. 国際誌

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年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Laparoscopic resection for oesophageal duplication cyst: A case report. 査読国際誌

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

International journal of surgery case reports 126 110572 - 110572 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Gastro-tracheal fistula following esophageal cancer surgery through the retrosternal route: a case report. 査読国際誌

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年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Perioperative gum-chewing training prevents a decrease in tongue pressure after esophagectomy in thoracic esophageal cancer patients: a nonrandomized trial 査読

Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Aya Yokoi, Naoaki Maeda, Shunsuke Tanabe, Kazuhiro Noma, Kazuyoshi Shimizu, Toshiharu Mituhashi, Yoshihide Nakamura, Souto Nanba, Yurika Uchida, Takayuki Maruyama, Manabu Morita, Daisuke Ekuni

Scientific Reports 14 ( 1 ) 2024年10月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

Tongue pressure (TP) decreases significantly after esophagectomy in esophageal cancer patients (ECPs). Meanwhile, 2 weeks of gum-chewing training (GCT) significantly increased TP in healthy university students. We examined whether perioperative GCT would decrease the proportion of patients exhibiting a decline in TP at 2 weeks postoperatively, and prevent postoperative complications, in thoracic ECPs (TECPs). This was a single-center interventional study, and nonrandomized study with a historical control group (HCG). TECPs who underwent first-stage radical esophagectomy were recruited. Thirty-two patients of 40 in the gum-chewing group (GCG) were completed perioperative GCT in 3 times daily. Propensity score matching was performed with covariates related to TP including preoperative age, sex, body mass index, and the repetitive saliva swallowing test result, and yielded a matched cohort of 25 case pairs. Eleven GCG patients [44.0%] exhibited significantly lower TP at 2 weeks postoperatively than before esophagectomy was significantly fewer than that of 19 patients [76.0%] in the HCG. The median number of fever days (> 38 °C) in the 2 weeks after esophagectomy in the GCG was significantly fewer than those in the HCG. Perioperative GCT may prevent postoperative TP decline and postoperative dysphagia-related complications after esophagectomy.

DOI： 10.1038/s41598-024-74090-4

その他リンク： https://www.nature.com/articles/s41598-024-74090-4

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年10月

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年10月

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年10月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

Subtotal esophagectomy and concurrent reconstruction with free jejunal flap for primary esophageal cancer after pancreatoduodenectomy. 査読国際誌

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年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年5月

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年4月

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年4月

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年4月

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年4月

Surgical repair for a parahiatal hernia with an esophageal hiatal hernia: A case report and literature review. 査読国際誌

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

International journal of surgery case reports 117 109565 - 109565 2024年4月

記述言語：英語

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

【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

進行食道癌におけるICIを用いた術後補助療法とその後の再発を見据えた治療戦略進行食道癌に対する術後補助免疫療法と再発後の治療成績

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

日本外科学会定期学術集会抄録集 124回 WS - 5 2024年4月

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年4月

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年3月

野間和広, 田辺俊介, 藤原俊義

手術 78 ( 4 ) 425 - 430 2024年3月

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年2月

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年2月

Perioperative and Postoperative Continuous Nutritional Counseling Improves Quality of Life of Gastric Cancer Patient Undergoing Gastrectomy. 査読国際誌

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年

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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

Journal of anesthesia 37 ( 6 ) 930 - 937 2023年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

PURPOSE: It remains unknown whether stroke volume variation (SVV), pulse pressure variation (PPV), and dynamic arterial elastance (Eadyn) are suitable for monitoring fluid management during thoracoscopic esophagectomy (TE) in the prone position with one-lung ventilation and artificial pneumothorax. Our study aimed to evaluate the accuracy of SVV, PVV, and Eadyn in predicting the fluid responsiveness in these patients. METHODS: We recruited 24 patients who had undergone TE. Patients with a mean arterial blood pressure ≤ 65 mmHg received a 200-ml bolus of 6% hydroxyethyl starch over 10 min. Fluid responders showed the stroke volume index ≥ 15% 5 min after the fluid bolus. Receiver operating characteristic (ROC) curves were generated and area under the ROC curve (AUROC) was calculated. RESULTS: We obtained 61 fluid bolus data points, of which 20 were responders and 41 were non-responders. The median SVV before the fluid bolus in responders was significantly higher than that in non-responders (18% [interquartile range (IQR) 13-21] vs. 12% [IQR 8-15], P = 0.001). Eadyn was significantly lower in responders than in non-responders (0.55 [IQR 0.45-0.78] vs. 0.91 [IQR 0.67-1.00], P < 0.001). There was no difference in the PPV between the groups. The AUROC was 0.76 for SVV (95% confidence interval [CI] 0.62-0.89, P = 0.001), 0.56 for PPV (95% CI 0.41-0.71, P = 0.44), and 0.82 for Eadyn (95% CI 0.69-0.95, P < 0.001). CONCLUSIONS: SVV and Eadyn are reliable parameters for predicting fluid responsiveness in patients undergoing TE.

DOI： 10.1007/s00540-023-03256-7

その他リンク： https://link.springer.com/article/10.1007/s00540-023-03256-7/fulltext.html

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

PD-L1-expressing cancer-associated fibroblasts induce tumor immunosuppression and contribute to poor clinical outcome in esophageal cancer. 査読国際誌

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年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

【まずはこれだけ消化器ナースがかかわる「ERAS」】

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年11月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年8月

Adenocarcinoma arising from widespread heterotopic gastric mucosa in the cervicothoracic esophagus: a case report. 査読国際誌

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

Surgical case reports 9 ( 1 ) 132 - 132 2023年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

【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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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

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

Asian journal of endoscopic surgery 16 ( 3 ) 505 - 509 2023年7月

記述言語：英語

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

【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年7月

【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年7月

Overcoming cancer-associated fibroblast-induced immunosuppression by anti-interleukin-6 receptor antibody. 査読国際誌

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 72 ( 7 ) 2029 - 2044 2023年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Outcomes of solitary postoperative recurrence of esophageal squamous cell carcinoma diagnosed with FDG-PET/CT and treated with definitive radiation therapy. 査読

Hiroki Ihara, Kotaro Yoshio, Shunsuke Tanabe, Soichi Sugiyama, Masashi Hashimoto, Naoaki Maeda, Shinsuke Akagi, Soshi Takao, Kazuhiro Noma, Takao Hiraki

Esophagus : official journal of the Japan Esophageal Society 20 ( 3 ) 548 - 556 2023年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Surgical resection of esophageal cancer is frequently performed to achieve a complete cure. However, the postoperative recurrence rate is 36.8-42.5%, leading to poor prognosis. Radiation therapy has been used to treat recurrences; solitary recurrence has been proposed as a prognostic factor for radiation therapy, though its significance is unclear. 18F-fluorodeoxyglucose positron emission tomography is a highly accurate diagnostic modality for esophageal cancer. This retrospective study aimed to analyze the outcomes of solitary postoperative recurrences of esophageal squamous cell carcinoma diagnosed with 18F-fluorodeoxyglucose positron emission tomography and treated with definitive radiation therapy. METHODS: We examined 27 patients who underwent definitive radiation therapy for single or multiple postoperative recurrences of esophageal squamous cell carcinoma between May 2015 and April 2021. 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed within 3 months before the commencement of radiation therapy. Kaplan-Meier, univariate, and multivariate analyses were performed to examine the overall survival and identify potential prognostic factors. RESULTS: The 1-, 2-, and 3-year overall survival rates were 85.2%, 62.6%, and 47.3%, respectively, and solitary recurrence was the only significant factor associated with overall survival (P = 0.003). The 1-, 2-, and 3-year overall survival rates in patients with solitary recurrence were 91.7%, 80.2%, and 80.2%, respectively, and in patients with multiple recurrences they were 80.0%, 50.3%, and 25.1%, respectively. Multivariate analysis also showed solitary recurrence as a significant factor for overall survival. CONCLUSIONS: When diagnosed with 18F-fluorodeoxyglucose positron emission tomography/computed tomography, solitary recurrence appears to have a more favorable prognosis than multiple recurrences.

DOI： 10.1007/s10388-023-01000-4

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年7月

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年7月

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年7月

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年7月

【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年7月

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年7月

MicroRNAs associated with postoperative outcomes in patients with limited stage neuroendocrine carcinoma of the esophagus. 査読国際誌

Tomoyuki Okumura, Tsutomu Fujii, Kenji Terabayashi, Takashi Kojima, Shigeru Takeda, Tomomi Kashiwada, Kazuhiro Toriyama, Susumu Hijioka, Tatsuya Miyazaki, Miho Yamamoto, Shunsuke Tanabe, Yasuhiro Shirakawa, Masayuki Furukawa, Yoshitaka Honma, Isamu Hoshino, Yoshihiro Nabeya, Hironori Yamaguchi, Shinji Uemoto, Yutaka Shimada, Hisahiro Matsubara, Soji Ozawa, Hiroyasu Makuuchi, Masayuki Imamura

Oncology letters 26 ( 1 ) 276 - 276 2023年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

Esophageal neuroendocrine carcinoma (E-NEC) is an aggressive disease with a poor prognosis. The present study aimed to assess the role of surgery in the treatment of patients with resectable E-NEC, and identify a microRNA (miRNA/miR) signature in association with positive postoperative outcomes. Between February 2017 and August 2019, 36 patients with E-NEC who underwent curative surgery at the Japan Neuroendocrine Tumor Society partner hospitals were enrolled in the study. A total of 16 (44.4%) patients achieved disease-free survival (non-relapse group), whereas 20 (55.6%) patients developed tumor relapse (relapse group) during the median follow-up time of 36.5 months (range, 1-242) after surgery with a 5-year overall survival rate of 100 and 10.8%, respectively (P<0.01). No clinicopathological parameters, such as histological type or TNM staging, were associated with tumor relapse. Microarray analysis of 2,630 miRNAs in 11 patients with sufficient quality RNA revealed 12 miRNAs (miR-1260a, -1260b, -1246, -4284, -612, -1249-3p, -296-5p, -575, -6805-3p, -12136, -6822-5p and -4454) that were differentially expressed between the relapse (n=6) and non-relapse (n=5) groups. Furthermore, the top three miRNAs (miR-1246, -1260a and -1260b) were associated with overall survival (P<0.01). These results demonstrated that surgery-based multidisciplinary treatment is effective in a distinct subpopulation of limited stage E-NEC. A specific miRNA gene set is suggested to be associated with treatment outcome.

DOI： 10.3892/ol.2023.13862

Safe and curative modified two-stage operation for T4 esophageal cancer after definitive chemoradiotherapy: a case report. 査読国際誌

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年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Assessing the Role of Perioperative Nutritional Education in Improving Oral Intake after Oesophagectomy: A Retrospective Study. 査読国際誌

Mika Sonoi, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Yasuhiro Shirakawa, Hiroshi Morimatsu

Asian Pacific journal of cancer prevention : APJCP 24 ( 6 ) 2037 - 2041 2023年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: This study aimed to determine whether nutritional education, from the preoperative to postoperative period, and nutritional management designed to improve nutritional status alone, could improve patients' health-related self-management and nutritional management skills during the postoperative period. METHODS: We evaluated 101 hospitalised patients with oesophageal cancer who underwent surgery between 2015 and 2016 and received perioperative nutritional education (PERIO-N). The control group included 52 patients who underwent surgery between 2014 and 2015 and were supported only by normal interventions according to the Enhanced Recovery After Surgery protocol. The PERIO-N group paid specific attention to nutrition risk screening, nutrition assessment, nutrition monitoring, and lifestyle education. RESULTS: The patients in the PERIO-N group were 1.8 times more likely to be able to consume food orally than the control group (p=0.010). In the PERIO-N group, 50.5% of the patients could orally consume food, 42.6% received a combination of oral and enteral nutrition, and 6.9% only underwent enteral nutrition. In comparison, in the control group, 28.8% of the patients could orally consume food, 53.8% received a combination of oral and enteral nutrition, and 17.3% were only administered enteral nutrition (p=0.004). In addition, patients in the PERIO-N group were discharged at a 1.5 times higher rate than those in the control group (p=0.027). The readmission rate for malnutrition within 3 months was 4% in the PERIO group (5.4% for home discharge only) and 5.8% in the control group (10.5% for home discharge only) (p=0.61). CONCLUSION: This study found that perioperative nutrition education in patients who underwent oesophageal cancer surgery led to increase in the amount of oral intake at discharge. Moreover, the group that received nutrition education did not have an increased probability of hospitalisation due to the risk of malnutrition within 3 months after discharge.

DOI： 10.31557/APJCP.2023.24.6.2037

【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

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

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年6月

野間和広, 田辺俊介, 前田直見, 藤原俊義

手術 77 ( 6 ) 757 - 762 2023年5月

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年4月

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年4月

Validity of the 30-Second Chair-Stand Test to Assess Exercise Tolerance and Clinical Outcomes in Patients with Esophageal Cancer: A Retrospective Study with Reference to 6-Minute Walk Test Results. 査読

Tomohiro Ikeda, Kazuhiro Noma, Kazuki Okura, Sho Katayama, Yusuke Takahashi, Naoaki Maeda, Shunsuke Tanabe, Akiyuki Wakita, Masanori Hamada, Toshiyoshi Fujiwara, Masuo Senda

Acta medica Okayama 77 ( 2 ) 193 - 197 2023年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

This retrospective study aimed to investigate the validity of a 30-sec chair stand test (CS-30) as a simple test to assess exercise tolerance and clinical outcomes in 53 Japanese patients with esophageal cancer. There was a strong correlation between the results of CS-30 and the 6-min walk test (6MWT), the gold standard for assessing exercise tolerance (r=0.759). Furthermore, fewer patients whose CS-30 score was greater than 16 (the cutoff value defined based on 6MWT) experienced pneumonia in their postoperative course. These results suggest that exercise tolerance could be assessed using CS-30, and its cutoff value may be useful in predicting postoperative pneumonia risk.

DOI： 10.18926/AMO/65149

【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年4月

記述言語：日本語出版者・発行元：(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.

その他リンク： 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

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年4月

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年4月

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年4月

胸部下部食道癌縦郭浸潤に対し拡大切除,遊離筋弁移植を行った1例縦郭再建における胸腔内血管吻合の経験査読

濱田龍正, 松本洋, 太田智之, 田邊俊介, 野間和広, 木股敬裕

日本マイクロサージャリー学会会誌 36 ( 1 ) 22 - 26 2023年3月

記述言語：日本語出版者・発行元：(一社)日本マイクロサージャリー学会

症例は44歳女性で、胸部下部食道癌の右肺下葉浸潤により食道肺瘻を生じ、繰り返す肺炎のため頸部食道離断術および食道瘻、胃瘻造設がなされた。腫瘍切除に伴い右肺下葉切除後の気管支断端および下行大動脈留置ステントが露出予定となったため、再建目的に当科紹介となった。ステント露出部は広背筋弁で被覆し、右肺下葉気管支断端は縫合切離速度自動調整機能付き自動縫合器Signiaステープリングシステムで切離された後に、断端部を十分な面積の前鋸筋弁で被覆した。術後2日目に造影CTにて胸腔内所見および移植組織の血流が問題ないことを確認し、術後23日目には転院となった。移植組織は全生着し、術後のCTでは気管支断端とステント露出部は筋弁で適切に被覆されており、術後経過は良好であった。

胸部下部食道癌縦郭浸潤に対し拡大切除,遊離筋弁移植を行った1例縦郭再建における胸腔内血管吻合の経験

濱田龍正, 松本洋, 太田智之, 田邊俊介, 野間和広, 木股敬裕

日本マイクロサージャリー学会会誌 36 ( 1 ) 22 - 26 2023年3月

記述言語：日本語出版者・発行元：(一社)日本マイクロサージャリー学会

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02567&link_issn=&doc_id=20230406580004&doc_link_id=10.11270%2Fjjsrm.36.22&url=https%3A%2F%2Fdoi.org%2F10.11270%2Fjjsrm.36.22&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Effect of Patient-Participation Continuous Nutritional Counseling in Gastric Cancer Patients who Underwent Gastrectomy. 査読国際誌

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 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

早期栄養介入とNSTによる多職種連携により良好な転帰を得た多発褥瘡患者の1例

開原裕子, 深川真里, 片山祥子, 長谷川祐子, 高橋絢子, 大木晴美, 山重達也, 川西英明, 三浦太郎, 金聖暎, 山田太平, 安井和也, 菊地覚次, 田辺俊介, 四方賢一

学会誌JSPEN 4 ( Suppl.2 ) 160 - 161 2022年12月

A Multi-institutional Study to Diagnose the Risk of Lymph Node Metastasis Using a CRP Genetic Polymorphism Test Kit in pT1, cN0 Thoracic Esophageal Squamous Cell Carcinoma. 査読国際誌

Satoru Motoyama, Miki Hosaka, Takashi Kamei, Masaki Ueno, Masayuki Watanabe, Y U Ohkura, Shinji Mine, Shunsuke Tanabe, Takahiro Toyokawa, Akiyuki Wakita, Katsunori Nishikawa, Itasu Ninomiya, Kazuma Fujita, Mie Kanda, Mitsuharu Hirai, Manami Hoshi, Shih-Wei Chiu, Munenori Takata, Takuhiro Yamaguchi, Masatomo Miura

Anticancer research 42 ( 12 ) 6105 - 6112 2022年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIM: For patients with T1a muscularis mucosae (MM) esophageal squamous cell carcinoma (ESCC) with lymphovascular invasion (LVI) or T1b submucosal (SM) ESCC, endoscopic resection is non-curative, and adjuvant treatment entailing esophagectomy or definitive chemoradiotherapy is necessary. This is because about 30% of these cases have lymph node (LN) metastasis. The purpose of this study was to test the utility of a CRP genetic polymorphism test kit for determining the risk of LN metastasis with the aim of eliminating additional invasive adjuvant therapy. PATIENTS AND METHODS: This is a retrospective, multi-institutional, observational study. The CRP 1846C>T genetic polymorphisms were identified using a fully automated genotyping system. The primary end points were an 85% negative predictive value (NPV) for diagnosis of LN metastasis in pT1a (MM) and 80% NPV in pT1b (SM1) patients. RESULTS: A total of 742 ESCC (105 pMM, 166 pSM1 and 471 pSM2-3) patients who had received esophagectomy with 2- or 3-field LN dissection at 65 institutions were enrolled. According to this test, patients with the C/C and C/T genotypes were considered to be low risk. The NPVs using this test were 82.8% in pMM and 71.7% in pSM1 patients. CONCLUSION: CRP 1846C>T genetic polymorphism is not a useful diagnostic indicator for determining the risk of LN metastasis; however, the possibility that CRP gene polymorphisms are involved in the mechanism of lymph node metastasis in solid tumors still remains.

DOI： 10.21873/anticanres.16123

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

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年10月

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

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年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

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年9月

【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年9月

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年9月

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年9月

Effectiveness of early exercise on reducing skeletal muscle loss during preoperative neoadjuvant chemotherapy for esophageal cancer. 査読

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年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Verrucous carcinoma of the esophagus with complete response after chemoradiotherapy. 査読国際誌

Masashi Hashimoto, Yasuhiro Shirakawa, Shunsuke Tanabe, Takehiro Tanaka, Naoaki Maeda, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Surgical case reports 8 ( 1 ) 128 - 128 2022年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年7月

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年7月

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年7月

Impact of Amino Acids Nutrition Following Gastrectomy in Gastric Cancer Patients. 査読国際誌

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年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

【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年7月

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年7月

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年7月

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年7月

【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年7月

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年7月

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年7月

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年7月

周術期のガム咀嚼トレーニングは胸部食道がん患者の術後舌圧減少を安全に予防する

山中玲子, 白川靖博, 中村吉秀, 難波奏人, 田辺俊介, 野間和広, 清水一好, 曽我賢彦

日本口腔科学会雑誌 71 ( 2 ) 143 - 144 2022年7月

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年5月

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年5月

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年5月

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年5月

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年4月

周術期のガム咀嚼トレーニングは胸部食道がん患者の咀嚼能力を維持・向上させる

山中玲子, 白川靖博, 横井彩, 中村吉秀, 難波奏人, 田辺俊介, 野間和広, 清水一好, 内田悠理香, 吉冨愛子, 丸山貴之, 江國大輔, 森田学

口腔衛生学会雑誌 72 ( 増刊 ) 101 - 101 2022年4月

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年4月

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年4月

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年4月

胃穹窿部にみられた扁平上皮化生の1例査読

岩室雅也, 田中健大, 倉岡紗樹子, 小橋真由, 里見拓也, 岡上昇太郎, 田邊俊介, 藤原敬士, 河原祥朗, 岡田裕之

Gastroenterological Endoscopy 64 ( 4 ) 999 - 1004 2022年4月

記述言語：日本語出版者・発行元：(一社)日本消化器内視鏡学会

症例は87歳男性.75歳時に逆流性食道炎に対して下部食道および胃噴門部切除,空腸間置法再建を実施.87歳時の上部消化管内視鏡検査にて,穹窿部に境界明瞭な約10mmの白色調の領域を認め,narrow-band imaging観察では白色～緑色調であり,腺管構造は不明瞭であった.生検にて胃扁平上皮化生と診断した.以後,1年毎に上部消化管内視鏡検査を施行.経過中に扁平上皮化生領域は軽度増大し,92歳時点では地図状の形態となっていた.胃扁平上皮化生が食道粘膜から非連続性に発生することはまれであるが,上記の内視鏡所見を認める場合は,本症を鑑別に挙げるべきと考えられた.(著者抄録)

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年3月

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年3月

Desquamative esophagitis followed by esophageal cancer in a stem cell transplant recipient. 査読国際誌

Masaya Iwamuro, Nobuharu Fujii, Shunsuke Tanabe, Hiroyuki Okada

Gastrointestinal endoscopy 95 ( 1 ) 188 - 189 2022年1月

Paraesophageal hernia repair can decrease BNP levels. 査読国際誌

Shunsuke Tanabe, Yasuhiro Shirakawa, Naoaki Maeda, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Surgical endoscopy 35 ( 12 ) 6921 - 6929 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Initial introduction of robot-assisted, minimally invasive esophagectomy using the microanatomy-based concept in the upper mediastinum. 査読国際誌

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

Surgical endoscopy 35 ( 12 ) 6568 - 6576 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

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年12月

Left Hemihepatectomy for Hepatocellular Carcinoma Following Esophagectomy with Retrosternal Gastric Tube Reconstruction for Esophageal Cancer. 査読

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年12月

記述言語：英語

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

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年11月

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年11月

Early intervention of the perioperative multidisciplinary team approach decreases the adverse events during neoadjuvant chemotherapy for esophageal cancer patients. 査読

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年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

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年10月

重症感染症を伴った菌状息肉症症例へのNST介入の経験

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, 森山裕美, 山本昌直, 前田直見, 菊地覚次, 田辺俊介, 四方賢一

学会誌JSPEN 3 ( Suppl.1 ) 574 - 574 2021年10月

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年10月

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年10月

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年9月

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年9月

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年9月

食道がん周術期チーム医療の現状と今後の課題食道癌患者における術前補助化学療法期間の骨格筋萎縮に対する早期運動療法の影響

池田朋大, 野間和広, 前田直見, 田邊俊介, 堅山佳美, 濱田全紀, 千田益生

日本食道学会学術集会プログラム・抄録集 75回 69 - 69 2021年9月

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年9月

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年9月

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年9月

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年9月

Phase I dose-escalation study of endoscopic intratumoral injection of OBP-301 (Telomelysin) with radiotherapy in oesophageal cancer patients unfit for standard treatments. 査読国際誌

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年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年7月

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年7月

女性に発症した食道扁平上皮癌の臨床病理学的特徴に関する検討

小橋真由, 川野誠司, 倉岡紗樹子, 岡上昇太郎, 里見拓也, 濱田健太, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 田邊俊介, 藤原俊義, 田中健大, 岡田裕之

日本高齢消化器病学会誌 24 ( 1 ) 186 - 186 2021年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年7月

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年6月

A case of esophageal cancer with an aberrant right subclavian artery treated with mediastinoscopic esophagectomy. 査読

Masashi Hashimoto, Yasuhiro Shirakawa, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 14 ( 2 ) 293 - 296 2021年4月

記述言語：英語

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

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年4月

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年4月

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年4月

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年4月

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年3月

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年3月

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年3月

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年3月

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年3月

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年3月

Association of dental occlusal support with the Prognostic Nutritional Index in patients with esophageal cancer who underwent esophagectomy. 査読

Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Mami Inoue-Minakuchi, Aya Yokoi, Misato Muro, Hirotaka Kosaki, Shunsuke Tanabe, Toshiyoshi Fujiwara, Manabu Morita

Esophagus : official journal of the Japan Esophageal Society 18 ( 1 ) 49 - 55 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The Prognostic Nutritional Index is useful for predicting surgical risk and overall survival based on preoperative immunological and nutritional status in patients undergoing digestive organ cancer surgery. The purpose of this study was to examine the association between the Prognostic Nutritional Index and dental status in patients with esophageal cancer who underwent esophagectomy. METHODS: This retrospective case-control study included 73 patients who underwent resection of esophageal cancer (69 males, 4 females; age 36-83). General and dental status were evaluated. The Prognostic Nutritional Index was calculated based on the serum albumin concentration and the total lymphocyte count, and subjects were divided into two groups based on index scores: a higher group, characterized by scores ≥ 45 (n = 54); and a lower group, characterized by scores < 45 (n = 19). Univariate analysis and multiple logistic regression analyses were used to compare between groups. RESULTS: Total protein, C-reactive protein, the number of sound and total decayed, missing and filled teeth, and the rate of patients with poor dental occlusal support showed significant differences between the lower and higher Prognostic Nutritional Index groups (p < 0.05). Stepwise logistic regression analysis by backward selection approach showed that low total protein, few sound teeth, and poor status of dental occlusal support were significantly associated with the lower Prognostic Nutritional Index (p = 0.007, 0.042, and 0.009, respectively). CONCLUSION: Dental status, especially dental occlusal support and the number of sound teeth, showed a positive relationship with the Prognostic Nutritional Index in esophageal cancer patients who underwent esophagectomy.

DOI： 10.1007/s10388-020-00751-8

Microanatomy-based standardization of left upper mediastinal lymph node dissection in thoracoscopic esophagectomy in the prone position. 査読国際誌

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara

Surgical endoscopy 35 ( 1 ) 349 - 357 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）

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

DOI： 10.1007/s00423-020-02017-4

女性に発症した食道扁平上皮癌の臨床病理学的特徴に関する検討

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年12月

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

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

日本消化器外科学会総会 75回 VSY9 - 3 2020年12月

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年10月

松枝真由, 川野誠司, 岡上昇太郎, 里見拓也, 岡本雄貴, 大林由佳, 濱田健太, 馬場雄己, 榮浩行, 安倍真, 神崎洋光, 岩室雅也, 河原祥朗, 田邊俊介, 白川靖博, 藤原俊義, 田中健大, 岡田裕之

日本消化器病学会雑誌 117 ( 臨増大会 ) A693 - A693 2020年10月

High incidence of tracheobronchial diverticulum in esophageal cancer patients: a retrospective survey alerting pitfall during thoracoscopic esophagectomy. 査読

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

General thoracic and cardiovascular surgery 68 ( 9 ) 1018 - 1023 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

[Esophageal Reconstruction with Vascular Anastomosis and Perioperative Management].

Shunsuke Tanabe, Yasuhiro Shirakawa

Kyobu geka. The Japanese journal of thoracic surgery 73 ( 10 ) 887 - 891 2020年9月

記述言語：日本語掲載種別：研究論文（学術雑誌）

Esophageal reconstruction using intestine is often performed for esophageal cancer patients in cases where the stomach cannot be used. We have previously performed reconstruction using ileocolon with supercharge and drainage as our 1st choice in those cases. However, a less invasive, simpler, and safer reconstructive technique using pedicled jejunal flap has recently become popular at our facility. When making the pedicled jejunal flap, the 1st jejunal vascular arcade was preserved, which in many cases allowed it to be pulled up to the cervical region by processing and transection up to the 2nd jejunal vascular branch. But supercharge and superdrainage may be required for pedicled jejunal flap reconstruction when blood flow of jejunal flap is not good condition. And free jejunal reconstruction is performed to reconstruction after cervical esophagectomy. Vascular anastomosis is essential for free jejunal reconstruction. This article describes the surgical technique and perioperative management of esophageal reconstruction with vascular anastomosis.

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年7月

Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor. 査読国際誌

Naoaki Maeda, Yasuhiro Shirakawa, Shunsuke Tanabe, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

World journal of surgical oncology 18 ( 1 ) 143 - 143 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Surgical site infection caused by Aeromonas hydrophila presenting as necrotizing soft tissue infection after esophagectomy. 査読国際誌

Osamu Yamasaki, Eizo Takahashi, Kazuyo Noda, Nobuhiko Kanaya, Shunsuke Tanabe, Yasuhiro Shirakawa, Shin Morizane

The Journal of dermatology 47 ( 6 ) 673 - 676 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Several virulence factors of Aeromonas such as hemolysin, proteases and lipases have been characterized. The relationship between these virulence factors and disease remains unclear. A 71-year-old man underwent thoracoscopic esophagectomy, lymph node dissection and Roux-en-Y reconstruction for esophageal cancer. On postoperative day 1, redness around the wound on the thoracic abdominal wall gradually enlarged and necrosis became apparent with septic shock. Necrotizing soft tissue infection was suspected and emergency surgical debridement was performed. Blood and wound cultures were positive for Aeromonas hydrophila. The strain was found to have hemolytic activity, proteolytic activity and extremely high elastolytic activity. In addition, the strain actively produced elastolytic metalloprotease, which may contribute to extensive tissue necrosis.

DOI： 10.1111/1346-8138.15323

Intraoperative fluid therapy and postoperative complications during minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study. 査読

Yukiko Hikasa, Satoshi Suzuki, Yuko Mihara, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

Journal of anesthesia 34 ( 3 ) 404 - 412 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Induction chemoradiotherapy including docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal cancer. 査読

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年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Flap Reconstruction for Esophageal Perforation Following Anterior Cervical Plate Fixation. 査読

Mio Morita, Hiroshi Matsumoto, Yasuhiro Shirakawa, Kazuhiro Noma, Shunsuke Tanabe, Yoshihiro Kimata

Acta medica Okayama 73 ( 1 ) 77 - 80 2019年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Anterior cervical plate fixation is a common surgical treatment for cervical spine trauma, disc herniation, or cervical spondylosis. Esophageal perforation following anterior cervical plate fixation is a rare but serious complication. Management of esophageal perforation is controversial; however, we suggest treating most cases surgically because this condition is slow to heal and often fatal. We managed 2 cases of esophageal perforation following anterior cervical plate fixation by flap reconstruction with the pectoralis major muscle in one case and a jejunal free flap in the other. Here, we report our experience and review the surgical indications.

DOI： 10.18926/AMO/56462

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年2月

Multicenter retrospective study to evaluate the efficacy and safety of the double-flap technique as antireflux esophagogastrostomy after proximal gastrectomy (rD-FLAP Study). 査読

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年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

[Forefront of perioperative team medicine for esophageal cancer surgery].

Yasuhiro Shirakawa, Shunsuke Tanabe, Toshiyoshi Fujiwara

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 116 ( 2 ) 138 - 144 2019年

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年12月

Clinical characteristics and management of gastric tube cancer after esophagectomy. 査読

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Takayuki Ninomiya, Shunsuke Tanabe, Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Shunsuke Kagawa, Yoshiro Kawahara, Hiroyuki Okada, Toshiyoshi Fujiwara

Esophagus : official journal of the Japan Esophageal Society 15 ( 3 ) 180 - 189 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Gastric cancer is the second most common malignancy, overlapping with thoracic esophageal cancer (TEC). Among them, metachronous gastric tube cancers after TEC surgery have been increasing. The aims of this study were to examine the clinicopathological factors and treatment outcomes of gastric tube cancer (GTC) after TEC surgery. METHODS: Thirty-three GTCs in 30 cases after TEC treated between 1997 and 2016 were investigated retrospectively. RESULTS: Most cases were males. The median interval from TEC surgery to GTC occurrence was 57 (6.5-107.5) months. Almost 2/3 lesions occurred in the lower third of the gastric tube (21/33); 29 lesions (in 26 cases) were superficial cancers, and 4 lesions were advanced cancers. Twenty-two lesions of superficial cancer were differentiated type, and the remaining seven lesions were undifferentiated type. Treatment for superficial cancer had previously been performed with partial gastric tube resection (10 lesions), and the number of cases undergoing endoscopic submucosal dissection (ESD) had increased recently (19 lesions). Most cases with superficial cancer survived without relapse. Four lesions of advanced cancer were found after a relatively long interval following TEC surgery. Most lesions of advanced cancer were scirrhous, undifferentiated type, and they died due to GTC. CONCLUSION: GTCs may occur late in the postoperative course following TEC surgery. If they are discovered at an early stage, these lesions can be cured with ESD. Long-term periodic endoscopic examinations after TEC surgery are important.

DOI： 10.1007/s10388-018-0611-2

尾山貴徳, 野田卓男, 谷守通, 納所洋, 谷本光隆, 田邊俊介, 白川靖博

小児外科 50 ( 5 ) 520 - 524 2018年5月

記述言語：日本語出版者・発行元：(株)東京医学社

4歳7ヵ月女児。食道通過障害を主訴とした。出生時に食道閉鎖症と診断され、気管食道瘻切除術、食道端々吻合、胃瘻造設術が施行されていた。生後9ヵ月頃に食道吻合部狭窄を指摘されていたが、成長により改善すると考えられ無処置であった。食事ごとに食物が詰まるため、4歳7ヵ月時に当科紹介となった。上部消化管像にて、食道中部に狭窄を認めたため、食道バルーン拡張術を施行したが、バルーンが破裂し、極めて硬い狭窄と考えられた。胸部CTにて狭窄部に比較的厚い組織を認め、RIC法にて切除可能な瘢痕組織と判断した。まず狭窄部を十字に切開し、切開した間の瘢痕組織を、スコープを回転し進めながら徐々に切除した。術後は、直後に縦隔気腫を認めたが、翌日に軽快し、術後7日目には、穿孔部は閉鎖していた。軽度の狭窄が残存していた箇所は、バルーンにて12mmまで拡張可能となった。流動食と経鼻胃管による経管栄養を併用しつつ、術後23日目に退院した。退院後は瘢痕化が完了するまでに週に1回、バルーン拡張術を行い、手押しの加圧のみで容易に拡張可能となった。食事は術後7ヵ月にはパン、ご飯、糸こんにゃくなどを摂取可能となり、狭窄は解除され瘢痕組織切除部は食道粘膜に覆われていた。術後11ヵ月には、唐揚げを通常の大きさで摂取可能となり、狭窄は認めず口側の拡張も改善した。術後約6年経過したが再狭窄は認めなかった。

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年4月

Visualized Evaluation of Blood Flow to the Gastric Conduit and Complications in Esophageal Reconstruction. 査読国際誌

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年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年3月

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

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年

記述言語：日本語掲載種別：研究論文（学術雑誌）

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

A case of long-term survival after surgical resection for solitary adrenal recurrence of esophageal squamous carcinoma. 査読国際誌

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

Surgical case reports 3 ( 1 ) 61 - 61 2017年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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年12月

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

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年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

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]. 査読

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年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

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.

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年11月

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年10月

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年7月

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年6月

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

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年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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年4月

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年3月

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年3月

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年2月

40年経過した食道アカラシア術後の食道拡張・下部食道狭窄症に対して胸腔鏡下食道亜全摘が著効した1例査読

桂佑貴, 白川靖博, 田邊俊介, 前田直見, 野間和広, 藤原俊義

岡山医学会雑誌 129 ( 1 ) 41 - 44 2017年

記述言語：日本語出版者・発行元：岡山医学会

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

POEM (Per-Oral Endoscopic Myotomy) を施行した食道アカラシアの1例査読

その他リンク： http://search.jamas.or.jp/link/ui/2017219750

杉原雄策, 原田馨太, 加藤諒, 山内健司, 高嶋志保, 竹井大介, 井口俊博, 高原政宏, 川野誠司, 平岡佐規子, 田辺俊介, 野間和宏, 白川靖博, 眞部紀明, 井上晴洋, 岡田裕之

岡山医学会雑誌 129 ( 2 ) 115 - 121 2017年

記述言語：日本語出版者・発行元：岡山医学会

&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

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

その他リンク： 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年12月

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年12月

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年10月

Double-Flap Technique as an Antireflux Procedure in Esophagogastrostomy after Proximal Gastrectomy. 査読国際誌

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

Journal of the American College of Surgeons 223 ( 2 ) e7-e13 2016年8月

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年7月

Trastuzumab-Based Photoimmunotherapy Integrated with Viral HER2 Transduction Inhibits Peritoneally Disseminated HER2-Negative Cancer. 査読国際誌

Michihiro Ishida, Shunsuke Kagawa, Kyoko Shimoyama, Kiyoto Takehara, Kazuhiro Noma, Shunsuke Tanabe, Yasuhiro Shirakawa, Hiroshi Tazawa, Hisataka Kobayashi, Toshiyoshi Fujiwara

Molecular cancer therapeutics 15 ( 3 ) 402 - 11 2016年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Peritoneal dissemination is the most frequent metastasis in gastric cancer and is associated with poor prognosis. The lack of particular target antigens in gastric cancer other than HER2 has hampered the development of treatments for peritoneal dissemination of gastric cancer. We hypothesized that HER2-extracellular domain (HER2-ECD) gene transduction combined with trastuzumab-based photoimmunotherapy (PIT) might provide excellent and selective antitumor effects for peritoneal dissemination of gastric cancer. In vitro, adenovirus/HER2-ECD (Ad/HER2-ECD) efficiently transduced HER2-ECD into HER2-negative gastric cancer cells. Trastuzumab-IR700 (Tra-IR700)-mediated PIT induced selective cell death of HER2-ECD-transduced tumor cells. Ad/HER2-ECD also induced homogenous expression of HER2 in heterogeneous gastric cancer cells, resulting in uniform sensitivity of the cells to Tra-IR700-mediated PIT. Anti-HER2 PIT integrated with adenoviral HER2-ECD gene transfer was applied in mice bearing peritoneal dissemination of HER2-negative gastric cancer. Intraperitoneal administration of Ad/HER2-ECD and Tra-IR700 with PIT inhibited peritoneal metastasis and prolonged the survival of mice bearing MKN45. Furthermore, minimal side effects allowed the integrated therapy to be used repeatedly, providing better control of peritoneal dissemination. In conclusion, the novel therapy of molecular-targeted PIT integrated with gene transfer technology is a promising approach for the treatment of peritoneal dissemination in gastric cancer.

DOI： 10.1158/1535-7163.MCT-15-0644

Genetic polymorphism at codon 546 of the human RAD17 contributes to the risk for esophageal squamous cell carcinoma. 査読国際誌

Yukiko Yasuda, Akiko Sakai, Sachio Ito, Yuichiro Mita, Takayuki Sonoyama, Shunsuke Tanabe, Yasuhiro Shirakawa, Yoshio Naomoto, Hiroshi Katayama, Kenji Shimizu

International journal of molecular epidemiology and genetics 7 ( 1 ) 58 - 66 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

Human RAD17, a human homolog of the Schizosaccharomyces pombe cell cycle checkpoint gene RAD17, plays a significant role in activating checkpoint signals in response to DNA damage. We evaluated the association of hRAD17 Leu546Arg (rs1045051), a missense single nucleotide polymorphism, with the risk of esophageal squamous cell carcinoma in relation to smoking and alcohol consumption history in 154 esophageal squamous cell carcinoma male patients and 695 cancer-free male controls by a case-control study conducted in Japan. The results showed that the hRAD17 Arg/Arg genotype compared to the Leu/Leu and Leu/Arg genotypes was significantly associated with the risk of the esophageal squamous cell carcinoma with an adjusted odds ratios of 2.22 (95% CI: 1.19-4.16 P=0.013). In stratified studies, the risk of esophageal squamous cell carcinoma was markedly higher in light drinkers (less than 23 g ethanol/day) with the Arg/Arg genotype than in heavy drinkers (excess of 23 g ethanol/day) with the Arg/Arg genotype (OR=2.83, 95% CI: 1.05-7.61, P=0.04). We concluded that the genetic variant of hRAD17 Leu546Arg polymorphism exerts a significant effect on esophageal squamous cell carcinoma risk among Japanese men.

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年12月

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年10月

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年9月

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年7月

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年7月

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年4月

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年4月

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年4月

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年3月

Prone-position thoracoscopic resection of posterior mediastinal lymph node metastasis from rectal cancer. 査読国際誌

Yasuhiro Shirakawa, Kazuhiro Noma, Takeshi Koujima, Naoaki Maeda, Shunsuke Tanabe, Toshiaki Ohara, Toshiyoshi Fujiwara

World journal of surgical oncology 13 45 - 45 2015年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Mediastinal lymph node metastasis from colorectal cancer is rare, and barely any reports have described resection of this pathology. We report herein a successful thoracoscopic resection of mediastinal lymph node metastasis in a prone position. A 65-year-old man presented with posterior mediastinal lymph node metastasis after resection of the primary rectal cancer and metachronous hepatic metastasis. Metastatic lymph nodes were resected completely using thoracoscopic surgery in the prone position, which provided advantages of minimal invasiveness, good surgical field, and reduced ergonomic burden on the surgeon. Thoracoscopic resection in the prone position was thought to have the potential to become the standard procedure of posterior mediastinal tumors.

DOI： 10.1186/s12957-015-0466-0

Viral transduction of the HER2-extracellular domain expands trastuzumab-based photoimmunotherapy for HER2-negative breast cancer cells. 査読国際誌

Kyoko Shimoyama, Shunsuke Kagawa, Michihiro Ishida, Shinichiro Watanabe, Kazuhiro Noma, Kiyoto Takehara, Hiroshi Tazawa, Yuuri Hashimoto, Shunsuke Tanabe, Junji Matsuoka, Hisataka Kobayashi, Toshiyoshi Fujiwara

Breast cancer research and treatment 149 ( 3 ) 597 - 605 2015年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

The prognosis of HER2-positive breast cancer has been improved by trastuzumab therapy, which features high specificity and limited side effects. However, trastuzumab-based therapy has shortcomings. Firstly, HER2-targeted therapy is only applicable to HER2-expressing tumors, which comprise only 20-25% of primary breast cancers. Secondly, many patients who initially respond to trastuzumab ultimately develop disease progression. To overcome these problems, we employed virus-mediated HER2 transduction and photoimmunotherapy (PIT) which involves trastuzumab conjugated with a photosensitizer, trastuzumab-IR700, and irradiation of near-infrared light. We hypothesized that the gene transduction technique together with PIT would expand the range of tumor entities suitable for trastuzumab-based therapy and improve its antitumor activity. The HER2-extracellular domain (ECD) was transduced by the adenoviral vector, Ad-HER2-ECD, and PIT with trastuzumab-IR700 was applied in the HER2-negative cancer cells. Ad-HER2-ECD can efficiently transduce HER2-ECD into HER2-negative human cancer cells. PIT with trastuzumab-IR700 induced direct cell membrane destruction of Ad-HER2-ECD-transduced HER2-negative cancer cells. Novel combination of viral transduction of a target antigen and an antibody-based PIT would expand and potentiate molecular-targeted therapy even for target-negative or attenuated cancer cells.

DOI： 10.1007/s10549-015-3265-y

Prone-Position Thoracoscopic Ligation of the Thoracic Duct for Chyle Leak Following Radical Neck Dissection in a Patient with a Right Aortic Arch. 査読

Yasuhiro Shirakawa, Kazuhiro Noma, Toshiaki Ohara, Hajime Kashima, Naoaki Maeda, Shunsuke Tanabe, Shunsuke Kagawa, Toshiyoshi Fujiwara

Acta medica Okayama 69 ( 3 ) 173 - 6 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (typeⅢB1 of Edward's classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position.

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年10月

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年9月

Assistant-based standardization of prone position thoracoscopic esophagectomy. 査読

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Ryoichi Katsube, Shunsuke Tanabe, Toshiaki Ohara, Kazufumi Sakurama, Toshiyoshi Fujiwara

Acta medica Okayama 68 ( 2 ) 111 - 7 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）

Thoracoscopic esophagectomy in the prone position (TEPP) might enable solo-surgery in cases requiring resection of the esophagus and the surrounding lymph nodes due to the associated advantages of good exposure of the surgical field and ergonomic considerations for the surgeon. However, no one approach can be for all patients requiring extensive lymphadenectomy. We recently developed an assistant-based procedure to standardize exposure of the surgical field. Patients were divided into 1 of 2 groups:a pre-standardization group (n=37) and a post-standardization group (n=28). The thoracoscopic operative time was significantly shorter (p=0.0037) in the post-standardization group (n=28; 267 ± 31 min) than in the pre-standardization group (n=37;301 ± 53 min). Further, learning curve analysis using the moving average method showed stabilization of the thoracoscopic operative time after the standardization. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the 2 groups. There were also no significant differences in the complication rate. Assistant-based surgery and standardization of the procedure resulted in a well-exposed and safe surgical field. TEPP decreased the operative time, even in patients requiring extensive lymphadenectomy.

Direct observation diverticulectomy for Zenker's diverticulum carcinoma 査読

Toshiaki Ohara, Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Ryouichi Katsube, Shunsuke Tanabe, Toshiyoshi Fujiwara

ESOPHAGUS 10 ( 4 ) 235 - 238 2013年12月

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

Zenker's diverticulum carcinoma is a rare disease. Recent technological endoscopic innovation has enabled the detection of early stage Zenker's diverticulum carcinoma. Here we report a case in which a 56-year-old woman was diagnosed with early stage Zenker's diverticulum carcinoma. Narrow band imaging (NBI) endoscopic examination was useful for diagnosis and identifying the borders of the carcinoma. A successful surgical treatment was performed using direct observation diverticulectomy. A minimally invasive cervical procedure was used, and the area of the carcinoma was confirmed intraoperatively with Lugol's solution.

DOI： 10.1007/s10388-013-0376-6

Web of Science

[Current status of neoadjuvant chemotherapy for advanced esophageal cancer]. 査読

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年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

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.

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年11月

HER2遺伝子導入技術を用いたHER2陰性癌細胞に対する分子標的光免疫療法(Neotargeting HER2 negative cancer cells with photoimmunotherapy by virally transduction of HER2- extracellular domain)

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, 松岡順治, 小林久隆, 篠原俊義

日本癌学会総会記事 72回 495 - 495 2013年10月

Utilization of partition analysis to evaluate the incidence on deep vein thrombosis following esophagectomy 査読

Yasuhiro Fujiwara, Tomoki Yamatsuji, Shunsuke Tanabe, Kazufumi Sakurama, Takayuki Motoki, Munenori Takaoka, Takuya Fukazawa, Yasuhiro Shirakawa, Minoru Haisa, Junji Matsuoka, Yoshio Naomoto

Esophagus 10 ( 1 ) 1 - 5 2013年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: We performed a retrospective observational study to examine the involvement of suspicious factors and causes of deep vein thrombosis using cases of esophagectomy that were done to treat esophageal carcinoma. Methods: The 144 patients received esophagectomy in Okayama University Hospital from January 2005 to June 2007. All patients had an enhanced CT or an ultrasound examination after their operations. The incidence of deep vein thrombosis was then determined. For cases that found deep vein thrombosis, the anticoagulant treatment was strengthened. When the thrombosis was already so large to be seen in the inferior vena cava, the IVC filter was left to prevent a pulmonary embolism. Using JMP5.0.1 statistical analysis software, we analyzed the relationship between various clinical factors and the incidence of deep vein thrombosis. Results: Using JMP5.0.1, factors causing deep vein thrombosis were analyzed and partitioning was done. The most significant risk factor causing deep vein thrombosis is leaving the central venous catheter inserted into the inguinal femoral area. Logistic analysis also showed that only the catheter if inserted from the inguinal femoral area, was significantly related to cause deep vein thrombosis (p &lt
0.0055). No other factor was a significant risk to cause deep vein thrombosis. Conclusions: We analyzed the relationship between suspicious factors and the causes of deep vein thrombosis in cases of esophagectomy. The most relevant factors were inserting the central venous catheter from the inguinal femoral route. This evidence can be applied to both pre-operative and postoperative management to prevent deep vein thrombosis. © 2012 The Japan Esophageal Society and Springer Japan.

DOI： 10.1007/s10388-012-0350-8

Scopus

Successfully treated pneumatosis cystoides intestinalis with pneumoperitoneum onset in a patient administered α-glucosidase inhibitor. 査読

Shunsuke Tanabe, Yasuhiro Shirakawa, Yuko Takehara, Naoaki Maeda, Ryoichi Katsube, Toshiaki Ohara, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Acta medica Okayama 67 ( 2 ) 123 - 8 2013年

記述言語：英語掲載種別：研究論文（学術雑誌）

An 80-year-old woman, who had been administered α-glucosidase inhibitor for diabetes, was brought to the hospital with the sensation of abdominal fullness and pain. Abdominal computed tomography indicated pneumatosis cystoides intestinalis (PCI) in the small intestinal wall, with free air within the abdomen. A blood examination showed no increases in white blood cells or C-reactive protein level. The patient's condition improved with conservative therapy. PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. In PCI with pneumoperitoneum, differentiation from gastrointestinal perforation is important and following the clinical symptoms over time is vital.

Jejunal interposition reconstruction with a stomach preserving esophagectomy improves postoperative weight loss and reflux symptoms for esophageal cancer patients. 査読国際誌

Eiji Yamada, Yasuhiro Shirakawa, Tomoki Yamatsuji, Leon Sakuma, Munenori Takaoka, Takako Yamada, Kazuhiro Noma, Kazufumi Sakurama, Yasuhiro Fujiwara, Shunsuke Tanabe, Takeshi Nagasaka, Toshiyoshi Fujiwara, Yoshio Naomoto

The Journal of surgical research 178 ( 2 ) 700 - 7 2012年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Conventional reconstruction after an esophagectomy uses a gastric tube, which commonly causes several postoperative complaints such as gastric acid reflux in long-term survival cases. Intestinal interposition between the remnant esophagus and the stomach is an option to reduce complaints, and in this study, the advantages of jejunal interposition reconstruction with a stomach preserving esophagectomy (SPE) were assessed. MATERIALS AND METHODS: Eleven cases of jejunal interposition with an SPE and 16 cases with gastric tube reconstruction as a control were subject to a comparison of operation time, amount of bleeding, postoperative quality of life, and endoscopic findings. RESULTS: The SPE group had a longer operation time (SPE: 560 ± 121 min, control 414 ± 83 min, P = 0.038), whereas there was no significant difference in blood loss. Postoperative weight loss was significantly recovered in the SPE group (SPE versus control = 94.0 ± 5.4% versus 87.5 ± 4.7% at 3 mo, P = 0.017; 97.2 ± 7.5% versus 85.0 ± 5.2% at 6 mo, P = 0.010), and there was a significant decrease in the occurrence of reflux symptoms such as heartburn, odynophagia, and cough when jejunal interposition with an SPE was done. Furthermore, reflux esophagitis and Barrett's epithelium were found in six out of 12 cases (50%) of the control group by postoperative endoscopy, while no cases in the SPE group had either condition (P < 0.01). CONCLUSIONS: This reconstruction method is a promising option to improve postoperative quality of life, mainly due to the long-term elimination of reflux esophagitis, which assists in the recovery of postoperative weight loss.

DOI： 10.1016/j.jss.2012.07.057

Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma. 査読国際誌

Takehiro Tanaka, Atsushi Fujimura, Koichi Ichimura, Hiroyuki Yanai, Yasuharu Sato, Katsuyohi Takata, Hiroyuki Okada, Seiji Kawano, Shunsuke Tanabe, Tadashi Yoshino

World journal of gastroenterology 18 ( 43 ) 6263 - 8 2012年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan. METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients. RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients. CONCLUSION: Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage.

DOI： 10.3748/wjg.v18.i43.6263

ロボット支援下幽門側胃切除術の安全な導入

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年3月

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年12月

F-18 FDG PET/CT contributes to more accurate detection of lymph nodal metastasis from actively proliferating esophageal squamous cell carcinoma. 査読国際誌

Shunsuke Tanabe, Yoshio Naomoto, Yasuhiro Shirakawa, Yasuhiro Fujiwara, Kazufumi Sakurama, Kazuhiro Noma, Munenori Takaoka, Tomoki Yamatsuji, Takao Hiraki, Yoshihiro Okumura, Masahiko Mitani, Mitsumasa Kaji, Susumu Kanazawa, Toshiyoshi Fujiwara

Clinical nuclear medicine 36 ( 10 ) 854 - 9 2011年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Evaluating the status of disease progression is critical for planning a therapeutic strategy for esophageal cancer. In this regard, F-18 fluorodeoxyglucose-labeled positron emission tomography (PET) is one of the most useful diagnostic modalities. However, there is room to improve its diagnostic performance, such as distinguishing lymph nodal metastases from false positives. In this study, we examined the diagnostic accuracy of fluorodeoxyglucose PET accompanied by computed tomography imaging (PET/CT) to detect regional lymph nodal metastasis from esophageal squamous cell carcinoma (ESCC). METHODS: A total of 102 patients diagnosed as ESCC were subjected to this study. These patients had a preoperative PET/CT examination to evaluate the existence of metastasis. The values of maximum standardized uptake value (SUVmax) in primary tumors and in metastasized lymph nodes were measured to analyze their relationship with various clinicopathologic characteristics including the status of tumor cell proliferation, which was assessed by immunohistochemistry for Ki-67. RESULTS: The SUVmax of the primary tumor was positively correlated with tumor size and vessel invasion, and was positively related with the SUVmax of lymph nodal metastasis, especially in cases of poorly differentiated ESCC. The SUVmax of metastasized lymph nodes was higher in larger-sized metastasized lymph nodes, whereas the Ki-labeling index of lymph nodal metastasis was positively related with the SUVmax per unit area (SUVmax/mm). The diagnostic accuracy of PET/CT (87.3%) was higher than that of conventional CT scans (78.4%). CONCLUSIONS: The improved diagnostic accuracy of PET/CT can be explained by its ability to detect actively progressive metastasis at an early phase regardless of size.

DOI： 10.1097/RLU.0b013e318217adc9

胸部食道癌に対する頸部郭清の意義と頸部郭清簡略化の妥当性の検討査読

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年10月

[Surgery for cancers at the esophagogastric junction and Barrett's esophageal cancers].

Yasuhiro Shirakawa, Shunsuke Tanabe, Kazuhiro Noma, Kazufumi Sakurama, Toshiyoshi Fujiwara

Nihon rinsho. Japanese journal of clinical medicine 69 Suppl 6 322 - 8 2011年8月

猶本良夫, 山田英司, 田邊俊介, 藤原康宏, 櫻間一史, 野間和広, 元木崇之, 高岡宗徳, 白川靖博, 山辻知樹

日本外科系連合学会誌 35 ( 4 ) 509 - 515 2010年8月

記述言語：日本語出版者・発行元：Japanese College of Surgeons

目的:胸部食道癌に対する頸部郭清の意義と手術侵襲の軽減を目的とした頸部郭清簡略化の妥当性を検討した．方法:1997年１月１日から2006年12月31日までの当院における胸部食道癌425例を対象とした．当院での胸部食道癌に対する頸部郭清の基準は，Ut症例，Mt・Ltのうち術前の画像診断でリンパ節転移が疑われる症例，術中迅速病理診断で＃101あるいは＃106recが陽性の症例にのみ＃104の郭清を施行している．結果:Mt・Lt症例について，＃104の郭清を行った89例中39例（43.8％）にリンパ節転移を認めた．＃104の郭清を行わなかった254例中６例（2.4％）に同リンパ節に転移を認め，３例に追加郭清を行い良好な結果であった．予後をみると，＃104郭清の有無で有意差は認めなかった．結語:FDG-PETなど術前の画像診断と術中迅速病理診断により，Mt・Lt食道癌における頸部郭清の簡略化は可能と考えられた．また頸部転移に対しては追加郭清が有効であった．

DOI： 10.4030/jjcs.35.509

その他リンク： http://search.jamas.or.jp/link/ui/2011131874

Preferential up-regulation of heparanase and cyclooxygenase-2 in carcinogenesis of Barrett's oesophagus and intestinal-type gastric carcinoma. 査読国際誌

Ryotaro Sonoda, Yoshio Naomoto, Yasuhiro Shirakawa, Yasuhiro Fujiwara, Tomoki Yamatsuji, Kazuhiro Noma, Shunsuke Tanabe, Munenori Takaoka, Mehmet Gunduz, Hidetsugu Tsujigiwa, Hitoshi Nagatsuka, Nobuya Ohara, Tadashi Yoshino, Kaiyo Takubo, Michael Vieth, Noriaki Tanaka

Histopathology 57 ( 1 ) 90 - 100 2010年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIMS: Metaplastic changes secondary to chronic inflammation at the gastro-oesophageal junction and at the pyloric antrum are recognized as the premalignant conditions of Barrett's oesophageal adenocarcinoma and intestinal-type gastric carcinoma (GC), respectively. Heparanase (HPSE) and cyclooxygenase (COX)-2 have been proved to play critical roles in inflammation as well as in cancer. The aim was to examine the meaning of their expression in inflammation-related carcinogenesis. METHODS AND RESULTS: First, expression of HPSE and COX-2 in 78 clinical tissues of Barrett's oesophagus was examined by immunohistochemistry and in situ hybridization. Their expression was increased during the metaplasia-dysplasia sequence with increased neovascularization. Successively, their expression in Barrett's dysplasia was compared with that of GC (22 cases of diffuse-type and 10 of intestinal-type). Interestingly, the expression pattern in Barrett's dysplasia was similar to that in intestinal-type GC, which mainly arises from chronic inflammation. Furthermore, cultured cell lines isolated from differentiated GC tissues, which are often found to be of intestinal-type, revealed up-regulated mRNA expression of HPSE and COX-2. CONCLUSIONS: HPSE and COX-2 are preferentially up-regulated in Barrett's oesophagus and intestinal-type GC. These molecules may play an important role during the development of inflammation-related adenocarcinoma of the upper gastrointestinal tract.

DOI： 10.1111/j.1365-2559.2010.03594.x

RAD001 offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer. 査読国際誌

Zhi Gang Wang, Takuya Fukazawa, Toshio Nishikawa, Nobuyuki Watanabe, Kazufumi Sakurama, Takayuki Motoki, Shinji Hatakeyama, Osamu Omori, Toshiaki Ohara, Shunsuke Tanabe, Yasuhiro Fujiwara, Munenori Takaoka, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Yoshio Naomoto

Oncology reports 23 ( 4 ) 1167 - 72 2010年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

Esophageal cancer is one of the most frequently occurring cancers in the world. Targeting therapy strategy of cancer with specific inhibitors is developing and has showed promising antitumor efficacy. It is known that mTOR is an important controller of cell growth. RAD001 (everolimus) is a specific inhibitor of mTOR that can block the mTOR signaling pathway. The purposes of this study was to explore the inhibitory effects of RAD001 on mTOR signaling and the mechanism of cell growth suppression by RAD001. We examined both the expression of mTOR, p70S6K and S6 in SEG-1 esophageal cancer cells and KOB-13 normal esophageal epithelial cells and the efficacy of RAD001 against SEG-1 esophageal cancer cells. mTOR, p70S6K and S6 were overexpressed in SEG-1 esophageal cancer cells compared with KOB-13 normal esophageal epithelial cells. SEG-1 esophageal cancer cells were sensitive to RAD001. The survival rate of the cells treated with RAD001 over 0.33 microM was significantly different compared with that of control (P<0.01). RAD001 inhibited the phosphorylation of mTOR (Ser2448) and S6 (Ser240/244) in different grades and the expressions of mTOR, p70S6K and S6. As a result, RAD001 induced a dose-dependent decrease in cell proliferation, G1/S arrest and damage of cell shape. Taken together, these data showed that RAD001 can inhibit mTOR signaling and proliferation in SEG-1 esophageal cancer cells in vitro. It offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer.

Missense polymorphisms of PTPRJ and PTPN13 genes affect susceptibility to a variety of human cancers. 査読国際誌

Yuichiro Mita, Yukiko Yasuda, Akiko Sakai, Hiromasa Yamamoto, Shinichi Toyooka, Mehmet Gunduz, Shunsuke Tanabe, Yoshio Naomoto, Mamoru Ouchida, Kenji Shimizu

Journal of cancer research and clinical oncology 136 ( 2 ) 249 - 59 2010年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: We investigated the association between incidence of various cancers and four single nucleotide polymorphisms (SNPs), two each in two protein tyrosine phosphatase (PTP) genes, PTPRJ and PTPN13, by a case-control study conducted in Japan. METHODS: The study samples comprised 819 cancer-free controls and 569 cancer cases including lung, head and neck, colorectal, and esophageal cancers. RESULTS: Compared with the major homozygotes at the Arg326Gln SNP in PTPRJ, a likely homologue of the mouse SCC1 (susceptible to colon cancer), Arg/Gln or Gln/Gln genotypes exhibited an increased colorectal cancer risk with adjusted odds ratios (aOR) of 1.71 (P = 0.021) and 3.74 (P = 4.14 x 10(-4)), respectively. Increased risks were observed with one or more of the combination genotypes of Gln276Pro and Arg326Gln in PTPRJ for most cancer types (aOR range 10.13-55.08, Bonferroni-corrected P = 0.0454-7.20 x 10(-9)). In the PTPN13, major homozygotes of Ile1522Met showed an increased risk for lung squamous cell carcinomas (aOR 1.86), compared to the heterozygotes. Increased risks were observed with at least one of the combination genotypes of the two SNPs, Ile1522Met and Tyr2081Asp, for all but esophageal cancer examined (aOR 3.36-13.75), compared with double heterozygotes. Moreover, these high risks were seen also when all cancer cases were combined (aOR 1.81-6.84). CONCLUSIONS: PTPRJ and PTPN13 SNPs were found to influence susceptibility to a wide spectrum of cancers. Because allelic frequencies of these SNPs are relatively common in many ethnic groups, these findings are worthy of further study.

DOI： 10.1007/s00432-009-0656-7

小腸穿通した腹腔内異物に対し鏡視下手術が有用であった一例

近藤喜太, 田邊俊介, 藤原康宏, 野間和弘, 永坂岳司, 白川靖弘, 山辻知樹, 小林直哉, 猶本良夫

日本腹部救急医学会雑誌 30 ( 2 ) 330 - 330 2010年2月

[The transition of therapy for recurrent esophageal cancer by PET-CT]. 査読

Yasuhiro Shirakawa, Shunsuke Tanabe, Yasuhiro Fujiwara, Kazuhiro Noma, Kazufumi Sakurama, Munenori Takaoka, Tomoki Yamatsuji, Minoru Haisa, Yoshio Naomoto

Gan to kagaku ryoho. Cancer & chemotherapy 36 ( 12 ) 2465 - 7 2009年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

In our institute, we introduced PET-CT examination as the preoperative and postoperative screening for esophageal cancer patients in April 2006. During two years before the introduction of PET-CT examination, we performed an intensive local control therapy (operation, RFA, definitive chemoradiotherapy) to 13 cases with single region recurrence (including 5 cases of cervical lymph nodes recurrence, 5 of local recurrence, 3 of distant metastatic recurrence). On the other hand, we performed an intensive local control therapy to 21 cases (including 4 cases of cervical lymph nodes recurrence, 10 of local recurrence, and 7 of distant metastatic recurrence) during two years after the introduction of PET-CT examination. In any pattern, there was a tendency of improvement in the prognosis of recurrent esophageal cancer patients. These results raised the possibility that PET-CT examination was useful for an early detection of the recurrent lesions in postoperative follow-up for esophageal cancer patients. And there might be a chance of curability in patients with single region recurrence by the early detection.

Endoscopic submucosal dissection (ESD) 後に短期間に著明な縦隔リンパ節転移を来した食道表在扁平上皮癌の1例

全胃十二指腸が脱出した食道裂孔ヘルニアに対し、鏡視下手術が有用であった一例

近藤喜太, 田邊俊介, 永坂岳司, 小林直哉, 白川靖弘, 山辻知樹, 猶本良夫, 田中紀章

日本外科系連合学会誌 34 ( 4 ) 714 - 714 2009年8月

藤原康宏, 猶本良夫, 田邊俊介, 桜間一史, 高岡宗徳, 白川靖博, 山辻知樹, 田中紀章

日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 51 ( 5 ) 1284 - 1289 2009年5月

記述言語：日本語出版者・発行元：Japan Gastroenterological Endoscopy Society

食道表在癌治療では内視鏡的粘膜下層剥離術（ESD）が急速に普及している．ESDの切除標本でSM浸潤を認め，追加外科手術施行前に，急速に縦隔リンパ節（n106recR）転移を来した食道表在扁平上皮癌の1例を経験した．ESD前のCTではn106recRリンパ節の存在を認め，転移は否定しえない状態であった．ESD後に急速増大したリンパ節転移とESD手技との間の関連は不明であるが，ESDの適応拡大には細心の注意が必要であると考えられた．

DOI： 10.11280/gee.51.1284

その他リンク： http://search.jamas.or.jp/link/ui/2009275658

[A case report of FOLFOX treatment for primary duodenal carcinoma with multiple liver metastases]. 査読

Yasuhiro Fujiwara, Yoshio Naomoto, Shunsuke Tanabe, Kazufumi Sakurama, Kazuhiro Noma, Toshio Nishikawa, Takayuki Motoki, Munenori Takaoka, Yasuhiro Shirakawa, Tomoki Yamatsuji, Junji Matsuoka, Noriaki Tanaka

Gan to kagaku ryoho. Cancer & chemotherapy 36 ( 4 ) 655 - 7 2009年4月

記述言語：日本語掲載種別：研究論文（学術雑誌）

We report a case of a woman in her sixties having primary duodenal carcinoma with multiple liver metastases who was treated with oxaliplatin in combination with infusional 5-fluorouracil/Leucovorin(FOLFOX regimen). After completing 2 courses of the chemotherapy, computed tomography showed a partial response without any severe adverse events. Now at 8 months, the PR stage has been maintained. So far, no standard therapeutic strategy for metastatic duodenal carcinoma has been developed. However, we suggest a FOLFOX regimen can be highly effective as a safe approach for continuously maintaining the quality of life of patients with this rare type of cancer.

活動性SLEを伴う進行食道癌の一例根治切除後4年間無再発生存例の検討招待

元木崇之, 猶本良夫, 藤原康宏, 白川靖博, 山辻知樹, 高岡宗徳, 田邊俊介, 大原利章, 松岡順治, 田中紀章

外科治療 100 ( 3 ) 315 - 318 2009年3月

記述言語：日本語掲載種別：論文集(書籍)内論文出版者・発行元：(株)永井書店

42歳女。下腿の浮腫、全身倦怠感、嚥下困難、38℃をこえる発熱で近医を受診し、Systemic lupus Erythematosus(SLE)と診断された。上部消化管内視鏡で下部食道から胃噴門部に2型病変を認め、生検より食道扁平上皮癌と診断され当院入院となった。貧血、血小板数低下と低アルブミン血症を認め、上部消化管内視鏡で右壁中心に胃噴門部へ浸潤する高い隆起性病変を認め、腹部造影CTで#7リンパ節の腫大、胸腹水、脾腫を認めた。以上よりEsophageal cancer、AeG Type2、T3N2M0 StageIIIと術前診断した。SLEは強い活動性を示したためSLEの治療を先行し、ステロイドパルス療法とPSL維持療法により術前準備を行った。縫合不全の合併症のリスクを考慮して分割手術として開腹・頸部・経横隔膜操作による食道・胃噴門部切除、胃管皮下経路再建(未吻合)・胆嚢摘出術を行い、術後10ヵ月目に食道・胃管吻合を施行した。初回術後の大量の胸水に対して、胸腔腹腔間にデンバーシャントを留置して胸水の減量と胸水に含まれ漏出した蛋白の腹腔内での再吸収により血中の蛋白濃度が改善できた。I期目手術後4年経過した現在、再発もなく社会復帰した。

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J00396&link_issn=&doc_id=20090309180019&doc_link_id=%2Faf2gktye%2F2009%2F010003%2F019%2F0315-0318%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faf2gktye%2F2009%2F010003%2F019%2F0315-0318%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Establishment of a lymph node metastasis model from subcutaneous tumors of gastrointestinal stromal tumor model cells. 査読国際誌

Kazufumi Sakurama, Yoshio Naomoto, Toshiaki Ohara, Nobuyuki Watanabe, Munenori Takaoka, Hitoshi Nagatsuka, Yasuko Tomono, Toru Tanida, Kazuhiro Noma, Shunsuke Tanabe, Yasuhiro Fujiwara, Takayuki Motoki, Yasuhiro Shirakawa, Tomoki Yamatsuji, Seiichi Hirota, Takahiro Taguchi, Noriaki Tanaka

Oncology reports 21 ( 2 ) 407 - 11 2009年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

There is currently no suitable animal model of metastasis using cultured human gastrointestinal stromal tumor cells even though the molecular mechanisms of c-KIT-mediated progression and metastasis should be clarified. Ba/F3 murine lymphocyte cells transduced with mutant c-KIT have been utilized to analyze some molecular mechanisms related to a constitutively activated c-KIT signaling and to assess the efficacy of molecular-targeted inhibitors. Using this cellular system, we coincidentally discovered the development of axillary and inguinal lymph node swelling three weeks after subcutaneous injection of Ba/F3 cells with c-KIT mutation into nude mice. Mutation-specific PCR detected c-KIT mutation in the swollen lymph nodes but not in unmetastasized normal lymph nodes, indicating that the lymph nodes contain tumor cells which should come from a primary subcutaneous tumor. Microscopic observation revealed tumor cells infiltrating through lymphatic follicles with Ki-67-positive staining to distinguish them from lymphocytes. The significance of this model is helpful to understand the molecular mechanisms of c-KIT-mediated metastasis and is useful for assessments of molecular therapeutics and in vivo imaging.

TAE226, a dual inhibitor for FAK and IGF-IR, has inhibitory effects on mTOR signaling in esophageal cancer cells. 査読国際誌

Zhi Gang Wang, Takuya Fukazawa, Toshio Nishikawa, Nobuyuki Watanabe, Kazufumi Sakurama, Takayuki Motoki, Munenori Takaoka, Shinji Hatakeyama, Osamu Omori, Toshiaki Ohara, Shunsuke Tanabe, Yasuhiro Fujiwara, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Yoshio Naomoto

Oncology reports 20 ( 6 ) 1473 - 7 2008年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Esophageal cancer is one of the most aggressive cancers in the world. Novel preventive and therapeutic strategies tend to target the key molecules involved in the signaling transduction pathways for cell growth. It is known that FAK and mTOR are important controllers of cell growth. TAE226, a novel small molecule compound, is a potent ATP competitive inhibitor of FAK and IGF-IR. TAE226 can block FAK and IGF-IR signaling pathways. The purpose of this study was to explore the inhibitory effects on mTOR signaling and the mechanism of cell growth suppression by TAE226. We examined the expression of mTOR and S6 in esophageal cancer cells (SEG-1) and normal esophageal epithelial cells (KOB-13) and the efficacy of TAE226 against SEG-1 cells. mTOR and S6 were overexpressed in SEG-1 cells compared with KOB-13 cells. TAE226 inhibited the expression of mTOR, Akt, p70S6K and S6 as well as the phosphorylation of mTOR (Ser2448), Akt (Ser473), p70S6K (Thr389) and S6 (Ser240/244). As a result, TAE226 induced a dose-dependent decrease in cell growth (number) and damage in the cell shape. Together, these data show that TAE226 has potent inhibitory effects on mTOR signaling and esophageal cancer cell growth indicating that TAE226 has potential application in esophageal cancer treatment.

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年8月

[Clinicopathological significance of pyrimidine nucleoside phosphorylase (PyNPase) and dihydropyrimidine dehydrogenase (DPD) in advanced colorectal cancer]. 査読

Shinya Otsuka, Shunsuke Tanabe, Yousuke Tsunemitsu, Norifumi Ariki, Kazuya Miyoshi, Masaru Inagaki, Masahiko Takahashi, Toshihide Oosaki, Sadanori Fuchimoto, Masahito Yumura

Gan to kagaku ryoho. Cancer & chemotherapy 32 ( 11 ) 1679 - 81 2005年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）

We examined clinicopathological characteristics and prognoses of seventy advanced colorectal cancer cases by measuring pyrimidine nucleoside phosphorylase (PyNPase) and dihydropyrimidine dehydrogenase (DPD) in tumor and normal tissue. PyNPase activities in cancerous tissue obtained from resected were 82.7 +/- 41.9 U/mg protein, which were significantly higher than 37.2 +/- 24.0 U/mg protein in normal tissue (p < 0.001). On the other hand, DPD activities in cancerous tissue were significantly lower in normal tissue (p < 0.05). In cases with lymphnode metastases, PyNPase activities of cancerous tissue were significantly higher than that of no lymphnode metastases cases (p < 0.05). In cases with grade 2 side-effects or higher by oral adjuvant chemotherapy, DPD activities in normal tissue were significantly lower than that of other cases (p < 0.05). With regard to Dukes' B and C cases that were resected curatively, PyNPase activities of cancerous tissue of higher group's prognosis were worse than that of the lower group. In the group received 5'-DFUR as adjuvant chemotherapy, non-recurrent survival rate of the group exhibiting higher PyNPase activities was better than that of the lower group.

Sudden death from metastatic esophageal cancer to the ventricular septum. 査読

Masafumi Kataoka, Kaori Shigemitsu, Shunsuke Tanabe, Toshinori Ohara, Takaomi Takahata, Soichiro Nose

The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi 53 ( 7 ) 365 - 8 2005年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 67-year-old man was admitted to our hospital due to esophageal cancer. Cancer existed at the lower esophagus and subtotal esophagectomy and lymphadenectomy was performed. The postoperative course was uneventful. Pathological findings revealed moderately differentiated squamous cell carcinoma that metastasized to the abdominal lymph nodes which include the paraaortic lymph nodes. He complained of anorexia three months after the operation and was found to have multiple liver and mediastinal lymph node metastases. He was admitted for chemotherapy. Before starting chemotherapy, he suddenly died without any sign of hemorrhage or respiratory disorder. Autopsy showed metastatic lesions to the heart and mediastinal lymph nodes, liver, thoracic vertebrae, kidney, adrenal gland and heart. Metastatic nodules in the heart were on the ventricular septum where the conducting system exists. No direct invasion from the pericardium was observed. Blockade of the conducting system of the heart was considered to have caused the severe arrhythmia and sudden cardiac arrest.