Faculty Profiles - IWATA Takehiro

Papers - IWATA Takehiro

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Nonintravesical Interventions for Preventing Intravesical Recurrence in Patients With Nonmuscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Robert J Schulz, Stefano Mancon, Tamás Fazekas, Marcin Miszczyk, Anna Cadenar, Ekaterina Laukhtina, Pawel Rajwa, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Takafumi Yanagisawa, Jun Miki, Takahiro Kimura, Koichiro Wada, Pierre I Karakiewicz, Piotr Chlosta, Jeremy Teoh, Motoo Araki, Shahrokh F Shariat

Clinical genitourinary cancer 23 ( 2 ) 102306 - 102306 2025.4

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

Despite currently used intravesical therapies in non-muscle-invasive bladder cancer (NMIBC), the rate of intravesical recurrence remains very high. We aimed to evaluate the effectiveness of adding nonintravesical interventions to standard intravesical therapies to prevent intravesical recurrence. In April 2024, 3 databases were queried for prospective studies evaluating nonintravesical interventions in addition to standard intravesical therapies for NMIBC (CRD42024490988). The primary outcome was intravesical recurrence-free survival (iRFS). Standard pairwise meta-analyses were performed using hazard ratios (HR) and 95% confidence intervals (95% CI) with a random-effects model. We identified 18 eligible studies (14 RCTs and 4 prospective trials) comprising 4,593 NMIBC patients, which investigated pharmacological interventions (eg, selenium, vitamins, Lactobacillus casei, celecoxib, metformin, mistletoe lectin) and lifestyle modifications (diet). The addition of Lactobacillus casei significantly improved iRFS (HR: 0.50; 95% CI: 0.34-0.73; P < .001). A high western diet pattern significantly worsened iRFS (HR:1.48, 95%CI:1.06-2.06, P = .03). The other nonintravesical interventions were not associated with iRFS. Our comprehensive review of the published literature highlights the need for further research into the efficacy of nonvesical interventions for NMIBC. While Lactobacillus was shown to improve iRFS in 2 RCTs, additional high-quality randomized studies are required to evaluate the effectiveness of other interventions.

DOI： 10.1016/j.clgc.2025.102306

Significance of targeted antimicrobial prophylaxis using rectal-culture selective screening media prior to transrectal prostate biopsy: A multicenter, randomized controlled trial. International journal

Takuya Sadahira, Takanori Sekito, Yuki Maruyama, Takaharu Ichikawa, Yuki Kurihara, Hiromasa Shiraishi, Takafumi Sakuma, Moto Tokunaga, Yosuke Mitsui, Norihiro Kusumi, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Masami Watanabe, Yoshiki Hiyama, Hiroki Yamada, Hiroki Kurata, Tsubasa Kondo, Masao Mitsui, Tadasu Takenaka, Hiroshi Kiyota, Motoo Araki, Jun Miyazaki, Satoshi Takahashi, Shingo Yamamoto, Koichiro Wada

Urology 2024.12

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

OBJECTIVE: To examine whether antimicrobial prophylaxis based on screening rectal cultures using selective media prevented acute bacterial prostatitis following transrectal prostate biopsy (TRPB). METHODS: In this multicenter, randomized controlled trial, we enrolled 403 patients undergoing TRPB with low risks of infectious complications. Patients were randomized into a cultured group (CG) or no cultured group (NCG). In the CG, patients with positive culture results for fluoroquinolone (FQ)-resistant or extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) used piperacillin/tazobactam as prophylaxis, and those with negative culture results and in the NCG used levofloxacin. The primary endpoint was the incidence of acute prostatitis after TRPB. The secondary endpoint was the accuracy of the selective media. RESULTS: Of 373 patients (CG, 187; NCG, 186), 67 were positive, and 120 were negative for rectal culture in the CG. The overall incidence of prostatitis after TRPB was 1.1% (n=4). The incidences in the CG and the NCG were 1.6% (n=3, all negative-culture cases) and 0.5% (n=1), respectively, without significant difference (P=0.3). No prostatitis occurred in the positive-culture group. The sensitivity and specificity of the levofloxacin-insusceptible selective media were 98.1% and 94.7%, respectively. CONCLUSION: Screening with selective media before TRPB in patients with low infectious risks may provide additive value to preventing post-biopsy prostatitis. Piperacillin/tazobactam can be considered when FQ-resistant or ESBL-producing E. coli is detected.

DOI： 10.1016/j.urology.2024.12.018

Propensity score-matched analysis comparing robot-assisted partial nephrectomy and image-guided percutaneous cryoablation for cT1 renal cell carcinoma. International journal

Tomoaki Yamanoi, Kensuke Bekku, Kasumi Yoshinaga, Yuki Maruyama, Kentaro Nagao, Tatsushi Kawada, Yusuke Tominaga, Noriyuki Umakoshi, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Mayu Uka, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Takao Hiraki, Motoo Araki

Urologic oncology 42 ( 12 ) 453.e15-453.e22 2024.12

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

OBJECTIVES: This study aimed to compare the clinical outcomes of robot-assisted partial nephrectomy (RAPN) and image-guided percutaneous cryoablation (IG-PCA) for clinical T1 renal cell carcinoma. MATERIALS AND METHODS: We conducted a retrospective analysis of 679 patients with clinical T1 renal cell carcinoma treated with RAPN or IG-PCA between 2012 and 2021. Propensity scores were calculated via logistic analysis to adjust for imbalances in baseline characteristics. We compared oncological and functional outcomes between the 2 treatment groups. RESULTS: Following the matching process, 108 patients were included in each group. No patient in the RAPN group developed local recurrence. In the IG-PCA group, three patients experienced local tumor progression. The patients underwent salvage thermal ablations by the secondary technique; 2 underwent IG-PCA and 1 underwent microwave ablation, resulting in a local control rate of 100%. The Kaplan-Meier analysis showed no statistically significant differences between the groups in terms of 5-year recurrence-free survival, metastasis-free survival, and overall survival (log-rank test; P = 0.11, P = 0.64, and P = 0.17, respectively). No significant differences were observed in the 2 treatments in major and overall complication rates (P = 0.75 and P = 0.82, respectively). Both groups showed similar rates of less than 10% estimated glomerular filtration rate decline at 12 months post-treatment and 5-year renal function preservation rates (P = 0.88 and P = 0.38, respectively). CONCLUSIONS: IG-PCA demonstrated oncological outcomes comparable to those of RAPN. RAPN addressed the disadvantages of conventional procedures and allowed for safety outcomes comparable to IG-PCA.

DOI： 10.1016/j.urolonc.2024.09.012

Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk.

Risa Kubota, Kensuke Bekku, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki

Acta medica Okayama 78 ( 6 ) 429 - 437 2024.12

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

Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers.

DOI： 10.18926/AMO/67868

The Impact of Concomitant Medications on the Overall Survival of Patients Treated with Systemic Therapy for Advanced or Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Marcin Miszczyk, Tamás Fazekas, Robert J Schulz, Stefano Mancon, Giulio Litterio, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Pawel Rajwa, Koichiro Wada, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat

Clinical genitourinary cancer 22 ( 6 ) 102237 - 102237 2024.12

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

Although immune checkpoint inhibitors (ICI) and/or tyrosine kinase inhibitors (TKI) are the standard treatment of advanced unresectable or metastatic renal cell carcinoma (RCC), the impact of concomitant medications remains unclear. We aimed to evaluate the impact of concomitant medications on survival outcomes in patients treated with systemic therapy for advanced unresectable or metastatic RCC. In August 2024, PubMed, Scopus, and Web of Science were queried for studies evaluating concomitant medications in patients with advanced unresectable or metastatic RCC (PROSPERO: CRD42024573252). The primary outcome was overall survival (OS). A fixed- or random-effects model was used for meta-analysis according to heterogeneity. We identified 22 eligible studies (5 prospective and 17 retrospective) comprising 16,072 patients. Concomitant medications included proton pump inhibitors (PPI) (n = 3959), antibiotics (n = 571), statins (n = 5466), renin-angiotensin system inhibitors (RASi) (n = 6615), and beta-blockers (n = 1964). Both concomitant PPI and antibiotics were significantly associated with worse OS in patients treated with ICI (PPI: HR: 1.22, P = .01, and antibiotics: HR: 2.09, P < .001). Concomitant statins, RASi, or beta-blocker were significantly associated with improved OS in patients treated with TKI (statins: HR: 0.81, P = .03, RASi: HR: 0.63, P < .001, beta-blocker: HR: 0.69, P < .001, respectively). In patients treated with ICI, RASi was significantly associated with improved OS (HR: 0.64, P = .02). Concomitant use of antibiotics or PPI with ICI can reduce its oncologic efficacy. Conversely, concomitant statins, RASi, or beta-blockers can enhance the oncologic efficacy of TKI. When initiating systemic therapy for metastatic RCC, it may be important for clinicians to assess baseline co-medications and recognize their possible positive or negative effects.

DOI： 10.1016/j.clgc.2024.102237

Oncological Outcomes of Active Surveillance versus Surgery or Ablation for Patients with Small Renal Masses: A Systematic Review and Quantitative Analysis. International journal

Ichiro Tsuboi, Pawel Rajwa, Riccardo Campi, Marcin Miszczyk, Tamás Fazekas, Akihiro Matsukawa, Mehdi Kardoust Parizi, Robert J Schulz, Stefano Mancon, Anna Cadenar, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Pierre I Karakiewicz, Mesut Remzi, Motoo Araki, Shahrokh F Shariat

European urology oncology 2024.10

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

BACKGROUND AND OBJECTIVE: While active surveillance (AS) is an alternative to surgical interventions in patients with small renal masses (SRMs), evidence regarding its oncological efficacy is still debated. We aimed to evaluate oncological outcomes for patients with SRMs who underwent AS in comparison to surgical interventions. METHODS: In April 2024, PubMed, Scopus, and Web of Science were queried for comparative studies evaluating AS in patients with SRMs (PROSPERO: CRD42024530299). The primary outcomes were overall (OS) and cancer-specific survival (CSS). A random-effects model was used for quantitative analysis. KEY FINDINGS AND LIMITATIONS: We identified eight eligible studies (three prospective, four retrospective, and one study based on Surveillance, Epidemiology and End Results [SEER] data) involving 4947 patients. Pooling of data with the SEER data set revealed significantly higher OS rates for patients receiving surgical interventions (hazard ratio [HR] 0.73; p = 0.007), especially partial nephrectomy (PN; HR 0.62; p < 0.001). However, in a sensitivity analysis excluding the SEER data set there was no significant difference in OS between AS and surgical interventions overall (HR 0.84; p = 0.3), but the PN subgroup had longer OS than the AS group (HR 0.6; p = 0.002). Only the study based on the SEER data set showed a significant difference in CSS. The main limitations include selection bias in retrospective studies, and classification of interventions in the SEER database study. CONCLUSIONS AND CLINICAL IMPLICATIONS: Patients treated with AS had similar OS to those who underwent surgery or ablation, although caution is needed in interpreting the data owing to the potential for selection bias and variability in AS protocols. Our review reinforces the need for personalized shared decision-making to identify patients with SRMs who are most likely to benefit from AS. PATIENT SUMMARY: For well-selected patients with a small kidney mass suspicious for cancer, active surveillance seems to be a safe alternative to surgery, with similar overall survival. However, the evidence is still limited and more studies are needed to help in identifying the best candidates for active surveillance.

DOI： 10.1016/j.euo.2024.10.008

What is the identity of Gerota fascia? Histological study with cadavers. International journal

Yasuyuki Kobayashi, Kohei Edamura, Takuya Sadahira, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Kobayashi, Keita Sato, Takaaki Komiyama, Ryusuke Momota, Hideyo Ohuchi, Motoo Araki

International journal of urology : official journal of the Japanese Urological Association 2024.10

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

OBJECTIVES: The advancement of laparoscopic surgery has allowed surgeons to see finer anatomical structures during surgery. As a result, several issues have arisen regarding Gerota fascia that cannot be explained by previous interpretations, such as its various forms observed during surgery. To address these issues, we histologically examined the structure of Gerota fascia. METHODS: Specimens for study were prepared from kidneys with Gerota fascia from four cadavers, and the structure was studied histologically. Its thickness and collagen fiber area ratios were measured using ImageJ and compared to those of the epimysium of the rectus abdominis muscle. RESULTS: Connective tissue that appeared to be Gerota fascia was observed in 26 specimens. Histologically, the basic structure of Gerota fascia was a sandwich-like structure with a thin layer of thick, long collagen fibers in the central layer, and small granular collagen fibers scattered at the edges. However, not all areas observed had a similar structure; eight specimens were composed only of small granular collagen fibers. The average thickness of the Gerota fascia was 466 μm, and the area ratio of collagen was 27.1%. In contrast, the epimysium was much thicker than Gerota fascia, and its collagen fibers were much thicker and denser. CONCLUSIONS: Gerota fascia, unlike the epimysium, was a very thin and fragile layer of collagen fibers, and its structure was diverse. This explains why Gerota fascia was observed in various states during surgery. It is important for surgeons to understand the properties of Gerota fascia and to treat it appropriately.

DOI： 10.1111/iju.15596

The efficacy of adjuvant mitotane therapy and radiotherapy following adrenalectomy in patients with adrenocortical carcinoma: A systematic review and meta-analysis. International journal

Ichiro Tsuboi, Mehdi Kardoust Parizi, Akihiro Matsukawa, Stefano Mancon, Marcin Miszczyk, Robert J Schulz, Tamás Fazekas, Anna Cadenar, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Mesut Remzi, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat

Urologic oncology 2024.10

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

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a high recurrence rate after surgical therapy with curative intent. Adjuvant radiotherapy (RT) and mitotane therapy have been proposed as options following the adrenalectomy. However, the efficacy of adjuvant RT or mitotane therapy remains controversial. We aimed to evaluate the efficacy of adjuvant therapy in patients who underwent adrenalectomy for localised ACC. The PubMed, Scopus, and Web of Science databases were queried on March 2024 for studies evaluating adjuvant therapies in patients treated with surgery for localized ACC (PROSPERO: CRD42024512849). The endpoints of interest were overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) with 95% confidence intervals (95%CI) were pooled in a random-effects model meta-analysis. One randomized controlled trial (n = 91) and eleven retrospective studies (n = 4,515) were included. Adjuvant mitotane therapy was associated with improved RFS (HR: 0.63, 95%CI: 0.44-0.92, p = 0.016), while adjuvant RT did not reach conventional levels of statistical significance (HR:0.79, 95%CI:0.58-1.06, p = 0.11). Conversely, Adjuvant RT was associated with improved OS (HR:0.69, 95%CI:0.58-0.83, p<0.001), whereas adjuvant mitotane did not (HR: 0.76, 95%CI: 0.57-1.02, p = 0.07). In the subgroup analyses, adjuvant mitotane was associated with better OS (HR:0.46, 95%CI: 0.30-0.69, p < 0.001) and RFS (HR:0.56, 95%CI: 0.32-0.98, p = 0.04) in patients with negative surgical margin. Both adjuvant RT and mitotane were found to be associated with improved oncologic outcomes in patients treated with adrenalectomy for localised ACC. While adjuvant RT significantly improved OS in general population, mitotane appears as an especially promising treatment option in patients with negative surgical margin. These data can support the shared decision-making process, better understanding of the risks, benefits, and effectiveness of these therapies is still needed to guide tailored management of each individual patient.

DOI： 10.1016/j.urolonc.2024.09.014

Correction: Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Motoo Araki, Shahrokh F Shariat

World journal of urology 42 ( 1 ) 522 - 522 2024.9

トランス男性のホルモン治療に対する期待度の調査

森分貴俊, 富永悠介, 藤澤諒多, 奥村美紗, 堀井聡, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林泰之, 荒木元朗

日本性科学会雑誌 42 ( 2 ) 63 - 63 2024.9

Differential effect of surgical technique on intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial cancer: a systematic review and Meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Robert J Schulz, Anna Cadenar, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Marcin Miszczyk, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Paolo Gontero, Morgan Rouprêt, Jeremy Teoh, Nirmish Singla, Motoo Araki, Shahrokh F Shariat

World journal of urology 42 ( 1 ) 488 - 488 2024.8

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

CONTEXT: Radical nephroureterectomy (RNU) with bladder cuff resection is the standard treatment in patients with high-risk upper tract urothelial cancer (UTUC). However, it is unclear which specific surgical technique may lead to improve oncological outcomes in term of intravesical recurrence (IVR) in patients with UTUC. OBJECTIVE: To evaluate the efficacy of surgical techniques and approaches of RNU in reducing IVR in UTUC patients. EVIDENCE ACQUISITION: Three databases were queried in January 2024 for studies analyzing UTUC patients who underwent RNU. The primary outcome of interest was the rate of IVR among various types of surgical techniques and approaches of RNU. EVIDENCE SYNTHESIS: Thirty-one studies, comprising 1 randomized controlled trial and 1 prospective study, were included for a systematic review and meta-analysis. The rate of IVR was significantly lower in RNU patients who had an early ligation (EL) of the ureter compared to those who did not (HR: 0.64, 95% CI: 0.44-0.94, p = 0.02). Laparoscopic RNU significantly increased the IVR compared to open RNU (HR: 1.28, 95% CI: 1.06-1.54, p < 0.001). Intravesical bladder cuff removal significantly reduced the IVR compared to both extravesical and transurethral bladder cuff removal (HR: 0.65, 95% CI: 0.51-0.83, p = 0.02 and HR: 1.64, 95% CI: 1.15-2.34, p = 0.006, respectively). CONCLUSIONS: EL of the affected upper tract system, ureteral management, open RNU, and intravesical bladder cuff removal seem to yield the lowest IVR rate in patients with UTUC. Well-designed prospective studies are needed to conclusively elucidate the optimal surgical technique in the setting of single post-operative intravesical chemotherapy.

DOI： 10.1007/s00345-024-05185-w

LOH症候群における精神症状がテストステロン補充療法に与える影響について

富永悠介, 小林知子, 森分貴俊, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林泰之, 佐古智子, 杉本盛人, 渡部昌実, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 167 - 167 2024.8

男性低ゴナドトロピン性性腺機能低下症(MHH)に対するテストステロン補充療法(TRT)についての検討

藤澤諒多, 富永悠介, 奥村美紗, 堀井聡, 森分貴俊, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 杉本盛人, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 170 - 170 2024.8

当院に受診したクラインフェルター症候群患者の性機能についての検討

森分貴俊, 富永悠介, 藤澤諒多, 奥村美紗, 堀井聡, 松本裕子, 小林知子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 杉本盛人, 荒木元朗

日本性機能学会雑誌 39 ( 2 ) 169 - 169 2024.8

上部尿路上皮癌に対するThulium:YAGレーザーとHo:YAGレーザーを用いた内視鏡下レーザー焼灼術の適応と治療成績

片山聡, 長崎直也, 津川卓士, 奥村美紗, 川合裕也, 井上翔太, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 森分貴俊, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号2 ) 190 - 190 2024.6

転移性腎癌に対してPembrolizumab投与中,サイトカイン放出症候群を認めた一例

川合裕也, 西村慎吾, 長崎直也, 奥村美紗, 津川卓士, 井上翔太, 渡部智文, 関戸崇了, 堀井聡, 森分貴俊, 吉永香澄, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号2 ) 193 - 194 2024.6

尿路結石治療の坂と雲～新たな時代の幕開け～結石手術における効率化・費用対効果向上のための新しいデバイスについて

富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科 86 ( 増刊号2 ) 126 - 127 2024.6

Language：Japanese Publisher：(一社)西日本泌尿器科学会

尿路結石症手術における内視鏡やレーザーなどのデバイスは目覚ましい進歩を遂げている。近年登場したディスポーザブル軟性尿管鏡は軽量で操作性に優れており,破損に伴うリスクが軽減され費用対効果の向上を生み出す可能性がある。経皮的腎砕石術(percutaneous nephrolithotomy;PNL)や内視鏡併用腎内手術(Endoscopic Combined Intrarenal Surgery;ECIRS)でも新しいデバイス(ClearPetraやSwiss LithoClast Trilogy)が登場しており,安全性や効率性の向上が期待されている。(著者抄録)

ロボット支援腹腔鏡下前立腺全摘術(RARP)における術後感染症に関する後方視的研究 CefazolinとSulbactam/Ampicillinの比較

三井將雄, 定平卓也, 岩田健宏, 荒木元朗, 長崎直也, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 98回・72回 np288 - np288 2024.5

Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Motoo Araki, Shahrokh F Shariat

World journal of urology 42 ( 1 ) 252 - 252 2024.4

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

BACKGROUND: To prevent infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB), some studies have investigated the efficacy of rectal disinfection using povidone-iodine (PI) and antibiotic prophylaxis (AP). OBJECTIVE: To summarize available data and compare the efficacy of rectal disinfection using PI with non-PI methods prior to TRUS-PB. EVIDENCE ACQUISITION: Three databases were queried through November 2023 for randomized controlled trials (RCTs) analyzing patients who underwent TRUS-PB. We compared the effectiveness of rectal disinfection between PI groups and non-PI groups with or without AP. The primary outcomes of interest were the rates of overall infectious complications, fever, and sepsis. Subgroups analyses were conducted to assess the differential outcomes in patients using fluoroquinolone groups compared to those using other antibiotics groups. EVIDENCE SYNTHESIS: We included ten RCTs in the meta-analyses. The overall rates of infectious complications were significantly lower when rectal disinfection with PI was performed (RR 0.56, 95% CI 0.42-0.74, p < 0.001). Compared to AP monotherapy, the combination of AP and PI was associated with significantly lower risk of infectious complications (RR 0.54, 95% CI 0.40-0.73, p < 0.001) and fever (RR 0.47, 95% CI 0.30-0.75, p = 0.001), but not with sepsis (RR 0.49, 95% CI 0.23-1.04, p = 0.06). The use of fluoroquinolone antibiotics was associated with a lower risk of infectious complications and fever compared to non-FQ antibiotics. CONCLUSION: Rectal disinfection with PI significantly reduces the rates of infectious complications and fever in patients undergoing TRUS-PB. However, this approach does not show a significant impact on reducing the rate of sepsis following the procedure.

DOI： 10.1007/s00345-024-04941-2

A Systematic Review and Meta-analysis of the Impact of Local Therapies on Local Event Suppression in Metastatic Hormone-sensitive Prostate Cancer. International journal

Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Marcin Miszczyk, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Pierre Karakiewicz, Koichiro Wada, Morgan Rouprêt, Motoo Araki, Shahrokh F Shariat

European urology oncology 2024.4

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

CONTEXT: It remains unclear to what extent the therapy of the primary local tumor, such as radical prostatectomy (RP) and radiation therapy (RT), improves overall survival in patients with low-volume metastatic hormone-sensitive prostate cancer (mHSPC). However, data suggest a benefit of these therapies in preventing local events secondary to local tumor progression. OBJECTIVE: To evaluate the efficacy of adding local therapy (RP or RT) to systemic therapies, including androgen deprivation therapy, docetaxel, and/or androgen receptor axis-targeted agents, in preventing local events in mHSPC patients compared with systemic therapy alone (ie, without RT of the prostate or RP). EVIDENCE ACQUISITION: Three databases and meeting abstracts were queried in November 2023 for studies analyzing mHSPC patients treated with local therapy. The primary outcome of interest was the prevention of overall local events (urinary tract infection, urinary tract obstruction, and gross hematuria) due to local disease progression. Subgroup analyses were conducted to assess the differential outcomes according to the type of local therapy (RP or RT). EVIDENCE SYNTHESIS: Overall, six studies, comprising two randomized controlled trials, were included for a systematic review and meta-analysis. The overall incidence of local events was significantly lower in the local treatment plus systemic therapy group than in the systemic therapy only groups (relative risk [RR]: 0.50, 95% confidence interval [CI]: 0.28-0.88, p = 0.016). RP significantly reduced the incidence of overall local events (RR: 0.24, 95% CI: 0.11-0.52) and that of local events requiring surgical intervention (RR: 0.08, 95% CI: 0.03-0.25). Although there was no statistically significant difference between the RT plus systemic therapy and systemic therapy only groups in terms of overall local events, the incidence of local events requiring surgical intervention was significantly lower in the RT plus systemic therapy group (RR: 0.70, 95% CI: 0.49-0.99); local events requiring surgical intervention of the upper urinary tract was significantly lower in local treatment groups (RR: 0.60, 95% CI: 0.37-0.98, p = 0.04). However, a subgroup analysis revealed that neither RP nor RT significantly impacted the prevention of local events requiring surgical intervention of the upper urinary tract. CONCLUSIONS: In some patients with mHSPC, RP or RT of primary tumor seems to reduce the incidence of local progression and events requiring surgical intervention. Identifying which patients are most likely to benefit from local therapy, and at what time point (eg, after response of metastases), will be necessary to set up a study assessing the risk, benefits, and alternatives to therapy of the primary tumor in the mHSPC setting. PATIENT SUMMARY: Our study suggests that local therapy of the prostate, such as radical prostatectomy or radiotherapy, in patients with metastatic hormone-sensitive prostate cancer can prevent local events, such as urinary obstruction and gross hematuria.

DOI： 10.1016/j.euo.2024.03.007

Trans men can achieve adequate muscular development through low-dose testosterone therapy: A long-term study on body composition changes. International journal

Yusuke Tominaga, Tomoko Kobayashi, Yuko Matsumoto, Takatoshi Moriwake, Yoshitaka Oshima, Misa Okumura, Satoshi Horii, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Morito Sugimoto, Yasuyuki Kobayashi, Masami Watanabe, Yuzaburo Namba, Yosuke Matsumoto, Mikiya Nakatsuka, Motoo Araki

Andrology 2024.4

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

BACKGROUND: Transgender individuals undergo the gender-affirming hormone therapy (GAHT) to achieve physical changes consistent with their gender identity. Few studies are available on the long-term safety and efficacy of GAHT. OBJECTIVES: To investigate the long-term physical effects and the safety of the testosterone therapy for trans men and to assess the impact of differential hormone dose. MATERIALS AND METHODS: Trans men who initiated GAHT between May 2000 and December 2021 were included in this retrospective analysis. Physical findings (body mass index, body fat percentage (BFP), lean body mass (LBM), and grip strength), blood testing results (hemoglobin, hematocrit, uric acid, creatinine, total cholesterol, triglycerides, and total testosterone), and menstrual cessation were recorded. We assessed the effects of testosterone on body composition changes and laboratory parameters, comparing a low-dose group (≤ 62.5 mg/wk) to a high-dose group (> 62.5 mg/wk). RESULTS: Of 291 participants, 188 patients (64.6%) were in the low-dose group and 103 (35.4%) in the high-dose group. Cumulative menstrual cessation rates up to 12 months were not significantly different between groups. Both groups showed a decrease in BFP and an increase in LBM during the first year of therapy, followed by a slight increase in both over the long term. The high-dose group exhibited greater LBM gains during the first year. Higher hormone doses and lower initial LBM values were associated with LBM increases at 3 and 6 months (3 mo, P = 0.006, P < 0.001; 6 mo, P = 0.015, P < 0.001). There were no long-term, dose-dependent side effects such as polycythemia or dyslipidemia. CONCLUSION: Long-term GAHT for trans men is safe and effective. Low-dose testosterone administration is sufficient to increase LBM in trans men. Higher testosterone doses can lead to an earlier increase in muscle mass.

DOI： 10.1111/andr.13640

Effect of antacids on the survival of patients with metastatic urothelial carcinoma treated with pembrolizumab

Takanori Sekito, Kensuke Bekku, Satoshi Katayama, Tomofumi Watanabe, Ichiro Tsuboi, Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Tatsushi Kawada, Yusuke Tominaga, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Norihiro Kusumi, Kohei Edamura, Tomoko Kobayashi, Kyohei Kurose, Takaharu Ichikawa, Yoshiyuki Miyaji, Koichiro Wada, Yasuyuki Kobayashi, Motoo Araki

Clinical Genitourinary Cancer 102097 - 102097 2024.4

脳腫瘍に対する放射線化学療法前に顕微鏡下精巣内精子採取術により精子回収が可能であったKlinefelter症候群の1例

富永悠介, 杉山星哲, 原綾英, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 羽原俊宏, 荒木元朗

日本生殖医学会雑誌 69 ( 1-2 ) 109 - 109 2024.4

尿路結石治療の坂と雲～新たな時代の幕開け～結石手術における効率化・費用対効果向上のための新しいデバイスについて

富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科 86 ( 4 ) 193 - 194 2024.4

Language：Japanese Publisher：(一社)西日本泌尿器科学会

尿路結石症手術における内視鏡やレーザーなどのデバイスは目覚ましい進歩を遂げている。近年登場したディスポーザブル軟性尿管鏡は軽量で操作性に優れており,破損に伴うリスクが軽減され費用対効果の向上を生み出す可能性がある。経皮的腎砕石術(percutaneous nephrolithotomy;PNL)や内視鏡併用腎内手術(Endoscopic Combined Intrarenal Surgery;ECIRS)でも新しいデバイス(ClearPetraやSwissLithoClast Trilogy)が登場しており,安全性や効率性の向上が期待されている。(著者抄録)

Current status and future perspectives on robot-assisted kidney autotransplantation: A literature review. International journal

Takanori Sekito, Tomoaki Yamanoi, Takuya Sadahira, Kasumi Yoshinaga, Yuki Maruyama, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki

International journal of urology : official journal of the Japanese Urological Association 2024.2

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

This review presents the latest insights on robot-assisted kidney autotransplantation (RAKAT). RAKAT is a minimally invasive surgical procedure and represents a promising alternative to conventional laparoscopic nephrectomy followed by open kidney transplantation for the treatment of various complex urological and vascular conditions. RAKAT can be performed either extracorporeally or intracorporeally. Additionally, a single-port approach can be performed through one small incision without the need to reposition the patient. Of 86 patients undergoing RAKAT, 8 (9.3%) developed postoperative > Grade 2 Clavien-Dindo (CD) complications. Although the feasibility of RAKAT was established in 2014, the long-term efficacy and safety along with outcomes of this surgical approach are still being evaluated, and additional studies are needed. With improvements in the technology of RAKAT and as surgeons gain more experience, RAKAT should become increasingly used and further refined, thereby leading to improved surgical outcomes and improved patients' quality of life.

DOI： 10.1111/iju.15426

活躍する女性腎移植医女性腎移植医への期待

荒木元朗, 吉永香澄, 窪田理沙, 西村慎吾, 関戸崇了, 丸山雄樹, 定平卓也, 山野井友昭, 富永悠介, 片山聡, 岩田健宏, 別宮謙介, 枝村康平, 小林知子, 小林泰之

日本臨床腎移植学会プログラム・抄録集 57回 117 - 117 2024.2

当院における先行的生体腎移植の検討

吉永香澄, 関戸崇了, 丸山雄樹, 山野井友昭, 西村慎吾, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 大西康博, 竹内英実, 田邊克幸, 森永裕士, 和田淳, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本臨床腎移植学会プログラム・抄録集 57回 210 - 210 2024.2

Discontinuation of Immune-oncology Combinations due to Immune-related Adverse Events in Patients With Advanced Renal Cancers. International journal

Kensuke Bekku, Manuela Schmidinger, Satoshi Katayama, Tatsushi Kawada, Takafumi Yanagisawa, Takehiro Iwata, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki, Shahrokh F Shariat

Anticancer research 44 ( 1 ) 379 - 386 2024.1

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

BACKGROUND/AIM: Patients with advanced renal cell carcinoma (aRCC) treated with immune-oncology (IO) drugs may need to discontinue the treatment when severe immune-related adverse events (irAE) occur; however, the impact of discontinuation on survival remains unknown. PATIENTS AND METHODS: This is a retrospective multicenter analysis using a database of 183 aRCC patients treated with first-line IO drugs combination. The patients were divided into two groups according to the necessity of discontinuation due to irAEs. The primary endpoint was overall survival (OS). Cox proportional hazard models determined the predictive factors on OS. RESULTS: Among a total of 135 patients who experienced irAE, 38 patients had to discontinue and 52 continued the treatment while treating irAE. When compared to patients who were able to continue treatment, discontinuation was associated with significantly higher rates of IO-IO doublet use, severe irAE (grade ≥3), steroid use, and the occurrence of immune-related pneumonitis (p=0.03, p<0.001, p<0.001, and p=0.02, respectively). The objective response rates were comparable between the two groups (discontinuation 55.6% vs. no discontinuation 56.0%, p=0.7). On univariate analysis, patients who discontinued had a significantly worse OS when compared to those who continued treatment (p=0.02). On the contrary, on multivariate analysis treatment discontinuation was not associated with poor OS (HR=1.1, p=0.9). CONCLUSION: Treatment discontinuation due to irAE was not associated with poor prognosis in aRCC patients treated with ICI-based combination therapy. Treatment discontinuation may be a reasonable treatment option for well-selected patients, specifically for those who experienced good treatment responses.

DOI： 10.21873/anticanres.16822

グラフト感染が契機と考えられる腎動脈破綻を認めた自家腎移植の一例

西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 枝木大治, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 57 - 57 2024.1

腎提供後11年経過の若年ドナーに認めたT3a腎細胞癌の1例

原尚史, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 川野香, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 24 - 24 2024.1

高度腸骨動脈石灰化を有するレシピエントに対する脳死献腎移植の経験

吉永香澄, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 三浦望, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 56 - 57 2024.1

生体腎移植レシピエントの周術期尿路感染症リスク因子の検討

西村慎吾, 長崎直也, 奥村美紗, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 56 - 56 2024.1

グラフト感染が契機と考えられる腎動脈破綻を認めた自家腎移植の一例

西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 枝木大治, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 57 - 57 2024.1

腎提供後11年経過の若年ドナーに認めたT3a腎細胞癌の1例

原尚史, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 川野香, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 24 - 24 2024.1

生体腎移植レシピエントの周術期尿路感染症リスク因子の検討

西村慎吾, 長崎直也, 奥村美紗, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 86 ( 増刊号1 ) 56 - 56 2024.1

高度腸骨動脈石灰化を有するレシピエントに対する脳死献腎移植の経験

吉永香澄, 西村慎吾, 長崎直也, 奥村美紗, 尾地晃典, 原尚史, 川野香, 横山周平, 渡部智文, 関戸崇了, 堀井聡, 丸山雄樹, 長尾賢太郎, 山野井友昭, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗, 三浦望, 加藤源太郎

西日本泌尿器科 86 ( 増刊号1 ) 56 - 57 2024.1

The current status and novel advances of boron neutron capture therapy clinical trials. International journal

Tianyun Zhou, Kazuyo Igawa, Tomonari Kasai, Takuya Sadahira, Wei Wang, Tomofumi Watanabe, Kensuke Bekku, Satoshi Katayama, Takehiro Iwata, Tadashi Hanafusa, Abai Xu, Motoo Araki, Hiroyuki Michiue, Peng Huang

American journal of cancer research 14 ( 2 ) 429 - 447 2024

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

Boron neutron capture therapy (BNCT) is a treatment method that focuses on improving the cure rate of patients with cancer who are difficult to treat using traditional clinical methods. By utilizing the high neutron absorption cross-section of boron, material rich in boron inside tumor cells can absorb neutrons and release high-energy ions, thereby destroying tumor cells. Owing to the short range of alpha particles, this method can precisely target tumor cells while minimizing the inflicted damage to the surrounding normal tissues, making it a potentially advantageous method for treating tumors. Globally, institutions have progressed in registered clinical trials of BNCT for multiple body parts. This review summarized the current achievements in registered clinical trials, Investigator-initiated clinical trials, aimed to integrate the latest clinical research literature on BNCT and to shed light on future study directions.

腎移植術における血管吻合ロボット手術もふまえて

荒木元朗, 西村慎吾, 吉永香澄, 窪田理沙, 関戸崇了, 丸山雄樹, 山野井友昭, 富永悠介, 片山聡, 岩田健宏, 別宮謙介, 枝村康平, 小林知子, 小林泰之

日本血管外科学会雑誌 33 ( Suppl. ) SP2 - 5 2024

The Diagnosis and Treatment Approach for Oligo-Recurrent and Oligo-Progressive Renal Cell Carcinoma. International journal

Kensuke Bekku, Tatsushi Kawada, Takanori Sekito, Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Yusuke Tominaga, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki, Yuzuru Niibe

Cancers 15 ( 24 ) 2023.12

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

One-third of renal cell carcinomas (RCCs) without metastases develop metastatic disease after extirpative surgery for the primary tumors. The majority of metastatic RCC cases, along with treated primary lesions, involve limited lesions termed "oligo-recurrent" disease. The role of metastasis-directed therapy (MDT), including stereotactic body radiation therapy (SBRT) and metastasectomy, in the treatment of oligo-recurrent RCC has evolved. Although the surgical resection of all lesions alone can have a curative intent, SBRT is a valuable treatment option, especially for patients concurrently receiving systemic therapy. Contemporary immune checkpoint inhibitor (ICI) combination therapies remain central to the management of metastatic RCC. However, one objective of MDT is to delay the initiation of systemic therapies, thereby sparing patients from potentially unnecessary burdens. Undertaking MDT for cases showing progression under systemic therapies, known as "oligo-progression", can be complex in considering the treatment approach. Its efficacy may be diminished compared to patients with stable disease. SBRT combined with ICI can be a promising treatment for these cases because radiation therapy has been shown to affect the tumor microenvironment and areas beyond the irradiated sites. This may enhance the efficacy of ICIs, although their efficacy has only been demonstrated in clinical trials.

DOI： 10.3390/cancers15245873

Prognostic impact of radiological tumor burden in patients with metastatic urothelial carcinoma treated with pembrolizumab

Satoshi Katayama, Takehiro Iwata, Tasushi Kawada, Yusuke Okamoto, Yuho Sano, Yuya Kawago, Shuji Miyake, Takatoshi Moriwake, Aya Kuinose, Yuhei Horikawa, Kazuma Tsuboi, Ichiro Tsuboi, Kazuma Sakaeda, Hirokazu Nakatsuka, Atsushi Takamoto, Takeshi Hirata, Yoshinori Shirasaki, Taku Yamasaki, Hirofumi Morinaka, Naoya Nagasaki, Takafumi Hara, Akinori Ochi, Misa Okumura, Tomofumi Watanabe, Takanori Sekito, Kaoru Kawano, Satoshi Horii, Tomoaki Yamanoi, Kentaro Nagao, Kasumi Yoshinaga, Yuki Maruyama, Yusuke Tominaga, Takuya Sadahira, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Norihiro Kusumi, Kyohei Kurose, Yasuo Yamamoto, Morito Sugimoto, Tetsuya Nakada, Katsumi Sasaki, Tadasu Takenaka, Shin Ebara, Yoshiyuki Miyaji, Koichiro Wada, Yasuyuki Kobayashi, Motoo Araki

Urologic Oncology: Seminars and Original Investigations 2023.12

性同一性障害に対するフィナステリドの安全性の検討について:中間報告

富永悠介, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 渡部昌実, 荒木元朗

GID(性同一性障害)学会雑誌 16 ( 1 ) 165 - 167 2023.12

Language：Japanese Publisher：GID(性同一性障害)学会

ホルモン療法に伴う男性型脱毛症(AGA)を有する性同一性障害(GID-FTM)に対するフィナステリドの安全性・治療効果を前向きに検討した.選択基準はNorwood-Hamilton(N-H)分類II以上などで,性別適合手術後の症例は除外した.被験者にはフィナステリド0.2mgを3ヵ月経口投与し,継続可能であった症例については,1.0mgに増量しさらに3ヵ月投与した.登録した2例において,フィナステリドに関連した有害事象を認めず,6ヵ月間の内服継続が可能であった.2例ともに多血症の改善およびN-H分類で脱毛の改善を認めた.1例で1度の月経再開を認めた.フィナステリドはホルモン療法中の身体的男性化に影響を与える可能性がある.本試験においては,良好な安全性・有効性を示唆する結果が得られた.(著者抄録)

閉経後の反復性膀胱炎を有する女性における尿および腟内の大腸菌の相同性の比較

関戸崇了, 定平卓也, 岩田健宏, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 239 - 239 2023.11

超高齢膀胱癌患者に対するロボット支援膀胱全摘除術(RARC)の外科的達成評価の検討

山野井友昭, 小林泰之, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 209 - 209 2023.11

Calciphylaxisによると考えられた陰茎亀頭部潰瘍の一例

川野香, 長尾賢太郎, 岩田健宏, 富永悠介, 片山聡, 定平卓也, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平井陽至

西日本泌尿器科学会総会抄録集 75回 233 - 233 2023.11

ロボット支援下前立腺全摘除術(RARP)の周術期抗菌薬投与方法と術後感染症発生率に関する後方視的研究

長崎直也, 定平卓也, 岩田健宏, 渡部智文, 山野井友昭, 河田達志, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 236 - 236 2023.11

Treg細胞の活性化CTLA-4非依存性免疫抑制によるCTLA-4遮断の不安定な抗腫瘍効果(Disturbed anti-tumor effect of CTLA-4 blockade by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 河田達志, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

西日本泌尿器科学会総会抄録集 75回 185 - 185 2023.11

Treg細胞の活性化CTLA-4非依存性免疫抑制によるCTLA-4遮断の不安定な抗腫瘍効果(Disturbed anti-tumor effect of CTLA-4 blockade by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 河田達志, 定平卓也, 岩田健宏, 片山聡, 枝村康平, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

西日本泌尿器科学会総会抄録集 75回 185 - 185 2023.11

Calciphylaxisによると考えられた陰茎亀頭部潰瘍の一例

川野香, 長尾賢太郎, 岩田健宏, 富永悠介, 片山聡, 定平卓也, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平井陽至

西日本泌尿器科学会総会抄録集 75回 233 - 233 2023.11

超高齢膀胱癌患者に対するロボット支援膀胱全摘除術(RARC)の外科的達成評価の検討

山野井友昭, 小林泰之, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 209 - 209 2023.11

閉経後の反復性膀胱炎を有する女性における尿および腟内の大腸菌の相同性の比較

関戸崇了, 定平卓也, 岩田健宏, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 239 - 239 2023.11

ロボット支援下前立腺全摘除術(RARP)の周術期抗菌薬投与方法と術後感染症発生率に関する後方視的研究

長崎直也, 定平卓也, 岩田健宏, 渡部智文, 山野井友昭, 河田達志, 富永悠介, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科学会総会抄録集 75回 236 - 236 2023.11

当科におけるロボット支援膀胱全摘除術・体腔内尿路変向の技術継承の取り組み

山野井友昭, 小林泰之, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 6 2023.11

岡山大学病院におけるRAPN再発・転移症例の検討

吉永香澄, 冨永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 3 2023.11

当科におけるロボット支援膀胱全摘除術・体腔内尿路変向の技術継承の取り組み

山野井友昭, 小林泰之, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 6 2023.11

岡山大学病院におけるRAPN再発・転移症例の検討

吉永香澄, 冨永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 O - 3 2023.11

AirSealがロボット支援腹腔鏡下膀胱全摘除術の臨床経過に及ぼす影響に関する検討

河田達志, 山野井友昭, 長尾賢太郎, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 37回 P - 2 2023.11

転移性去勢抵抗性前立腺癌におけるBRCA遺伝子バリアントの検討

岩田健宏, 吉永香澄, 丸山雄樹, 河田達志, 定平卓也, 富永悠介, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

日本癌治療学会学術集会抄録集 61回 P12 - 5 2023.10

CTLA-4の単純な阻害はTreg細胞のCTLA-4以外の免疫抑制機構の活性化を引き起こす(Anti-tumor effects of CTLA-4 blockade are distrubed by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 丸山雄樹, 河田達志, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

日本癌学会総会記事 82回 1380 - 1380 2023.9

CTLA-4の単純な阻害はTreg細胞のCTLA-4以外の免疫抑制機構の活性化を引き起こす(Anti-tumor effects of CTLA-4 blockade are distrubed by activated CTLA-4-independent immunosuppression of Treg cells)

渡部智文, 石野貴雅, 上田優輝, 長崎譲慈, 丸山雄樹, 河田達志, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 團迫浩方, 荒木元朗, 冨樫庸介

日本癌学会総会記事 82回 1380 - 1380 2023.9

LOH症候群における各種質問票の有用性について

富永悠介, 小林知子, 松本裕子, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 佐古智子, 杉本盛人, 渡部昌実, 荒木元朗

日本性機能学会雑誌 38 ( 2 ) 182 - 182 2023.8

ロボット支援腹腔鏡下膀胱全摘除術における予防的全腟閉鎖術併用の試み

小林知子, 西村慎吾, 富永悠介, 宇埜誠, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

日本女性骨盤底医学会プログラム・抄録集 25回 91 - 91 2023.8

ロボット支援腹腔鏡下膀胱全摘除術における予防的全腟閉鎖術併用の試み

小林知子, 西村慎吾, 富永悠介, 宇埜誠, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

日本女性骨盤底医学会プログラム・抄録集 25回 91 - 91 2023.8

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 493 - 493 2023.7

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本化学療法学会雑誌 71 ( 4 ) 522 - 523 2023.7

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗, 関戸崇之, 吉永香澄, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 526 - 526 2023.7

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 493 - 493 2023.7

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本化学療法学会雑誌 71 ( 4 ) 522 - 523 2023.7

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗, 関戸崇之, 吉永香澄, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 光畑律子

日本化学療法学会雑誌 71 ( 4 ) 526 - 526 2023.7

Exploration of the protein-dependent mechanism of Lactobacillus crispatus GAI98322 to prevent recurrent cystitis. International journal

Tomofumi Watanabe, Takuya Sadahira, Hidetada Hirakawa, Peng Huang, Tianyun Zhou, Takehiro Iwata, Takanori Sekito, Ayano Ishii, Masami Watanabe, Motoo Araki

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 29 ( 10 ) 1001 - 1004 2023.6

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

OBJECTIVES: To elucidate the mechanism of Lactobacillus crispatus (L. crispatus) suppositories to prevent patients from recurrent cystitis (RC), independent from viable-Lactobacilli-bacteria- and acid-dependent ones such as hydrogen peroxide and lactate. METHODS: We used the GAI98322 strain of L. crispatus in all experiments and pH-matched. cell-free culture supernatant of L. crispatus (CFCS) was collected. The growth inhibitory activity and the biofilm formation inhibitory activity of the CFCS against uropathogenic Escherichia coli (UPEC), Extended Spectrum beta (β) Lactamase producing (ESBL+) UPEC, and Pseudomonas aeruginosa (P. aeruginosa) was assessed by agar-disk diffusion tests and crystal violet assay. Also, CFCS was subjected to mass spectrometry to specify ingredients. RESULTS: The CFCS suppressed the proliferation of E. coli, ESBL + E. coli, and P. aeruginosa. Also, the CFCS at a concentration of 40% significantly impeded the biofilm formation of these three bacteria. The aggregation-promoting factor and Lysin was detected from CFCS. CONCLUSIONS: The cell-free supernatant from the GAI98322 strain of L. crispatus inhibits the growth/biofilm formation of broad pathogens by aggregation promoting factor and lysin, which may prevent hosts from RC regardless of the antimicrobial resistance of the pathogens and even under pH modulation.

DOI： 10.1016/j.jiac.2023.06.013

RPLND後の難治性リンパ漏に対して開腹リンパ管結紮術が奏功した1例

鵜川聖也, 長崎直也, 原惇也, 松島萌希, 奥村美紗, 渡部智文, 宇埜誠, 堀井聡, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 富永悠介, 定平卓也, 岩田健宏, 片山聡, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 85 ( 増刊号2 ) 148 - 148 2023.6

Staphylococcus saprophyticusによる感染結石の1例

渡部智文, 鵜川聖也, 長崎直也, 奥村美紗, 宇埜誠, 堀井聡, 吉永香澄, 丸山雄樹, 山野井智昭, 長尾賢太郎, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科 85 ( 増刊号2 ) 148 - 148 2023.6

アンドロロジー;Next 10 Years 男性不妊症における性機能障害について

富永悠介, 松本裕子, 吉永香澄, 丸山雄樹, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗

西日本泌尿器科 85 ( 5 ) 324 - 329 2023.6

【ロボット時代の若手への腹腔鏡教育を考える】ロボット時代の若手への腹腔鏡教育を考える腎副腎メンターの立場から

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 小林知子, 荒木元朗

Japanese Journal of Endourology and Robotics 36 ( 1 ) 57 - 60 2023.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

ロボット手術の普及により,腹腔鏡手術教育は大きく変化しつつある.一番の問題点は,ロボット支援下部分切除術の普及に伴い,これまでより難易度の高い症例が腹腔鏡下腎摘除術の対象となり,相対的に初心者が行う腹腔鏡手術件数が減少していることである.加えて,手術環境の急激な変化により,初心者のトレーニング背景も複雑化してきており,手術教育もそれらに対応すべく変化が求められている.岡山大学病院では,従来通りの模範手術を核とした集団指導に加えて,ある程度の執刀経験のある術者に対して,個別指導を行い対応している.加えて,最近のWeb会議システムを用い,関連施設の垣根を超えたWeb勉強会を行っている.(著者抄録)

前立腺癌:Next 10 years～どうなる,どうする,前立腺癌～限局性前立腺癌に対するFocal therapy

小林泰之, 枝村康平, 西村慎吾, 岩田健宏, 片山聡, 定平卓也, 小林知子, 荒木元朗

西日本泌尿器科 85 ( 4 ) 106 - 109 2023.4

Language：Japanese Publisher：(一社)西日本泌尿器科学会

限局性前立腺癌の治療は臨床的Insignificant cancerに対してActive surveillance,Significant cancerに対しては根治的治療が選択される。しかしながら,癌制御とQOL維持の両立の点を考慮するといずれの治療も十分とは言えない患者群が存在し,このような症例に対する治療としてFocal therapyが期待されている。Focal therapyに関する諸家らの報告では,短～中期腫瘍学的結果は良好であり,尿禁制や性機能も優れていた。本邦においては,2021年4月に日本泌尿器科学会より「前立腺癌局所治療医療機器の臨床評価方法に関するガイドライン」が出され,今後,Focal therapyのエビデンスが蓄積されていくものと期待される。(著者抄録)

Gerota fasciaとは何物なのか cadaverを用いた組織学的検討

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 小林知子, 小見山高明, 百田龍輔, 荒木元朗

Japanese Journal of Endourology and Robotics 36 ( 1 ) 118 - 123 2023.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

腹腔鏡下腎摘除術において,Gerota fascia(以下:Gf)は経腹的アプローチでは膜構造として容易に認識できるが,後腹膜アプローチではその見え方が経腹的アプローチとは大きく異なり,その存在自体を認識できない症例が少なくない.今回,我々は死亡献体より腎臓と腎臓周囲臓器を一塊に摘出し,Gfに剥離操作を加えない状態で検体作成を行い,線維の走行,密度などについて組織学的検討を行った.その結果,Gfは筋上膜のような強固な膜とは構造が異なり,密度・配列など多様なコラーゲン線維のまばらな結合組織で構成されていることが分かった.すなわち,Gfが膜状構造物に観察されるのは,結合組織が剥離操作にて変化した結果の可能性があり,アプローチする方向の違いによりその形態が異なって見えることを念頭におく必要があるものと考えられる.(著者抄録)

転移性腎細胞がんに対する免疫チェックポイント阻害剤の有効性における転移部位腫瘍径の影響(The impact of metastatic tumor burden to the efficacy of immune checkpoint inhibitors for metastatic renal cell carcinoma)

岩田健宏, 片山聡, 吉永香澄, 丸山雄樹, 定平卓也, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 渡邉豊彦, 荒木元朗

日本泌尿器科学会総会 110回 OP25 - 05 2023.4

cT1腎癌におけるロボット支援腎部分切除(RAPN)と経皮的凍結療法(PCA)の傾向スコアマッチング解析を用いた周術期成績・術後腎機能の検討(Oncological outcomes and renal function in robot-assisted partial nephrectomy vs percutaneous cryoablation for cT1 RCC: A propensity score-matched analysis)

山野井友昭, 別宮謙介, 馬越紀行, 定平卓也, 片山聡, 岩田健宏, 宇賀麻由, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平木隆夫

日本泌尿器科学会総会 110回 PP75 - 01 2023.4

局所進行性膀胱癌に対する根治的膀胱全摘除術前化学療法としてのゲムシタビン、シスプラチン、パクリタキセル3剤併用化学療法の治療成績(Clinical Outcomes of Neoadjuvant Paclitaxel/Cisplatin/Gemcitabine compared with Gemcitabine/Cisplatin for Muscle-Invasive Bladder cancer)

河田達志, 別宮謙介, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 津川卓士, 坪井一馬, 定平卓也, 西村慎吾, 小林知子, 江原伸, 荒木元朗

日本泌尿器科学会総会 110回 OP36 - 02 2023.4

Tumor burdenはペムブロリズマブ療法を受けた転移性尿路上皮癌患者の予後因子となる多施設共同研究(Radiological tumor burden as prognostic biomarker in patients with metastatic urothelial carcinoma treated with immune checkpoint inhibitor)

片山聡, 岩田健宏, 小林泰之, 小林知子, 枝村康平, 坪井一馬, 高本篤, 坪井一朗, 久住倫宏, 中田哲也, 佐々木克己, 和田耕一郎, 荒木元朗

日本泌尿器科学会総会 110回 OP79 - 02 2023.4

The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing E. coli Strains from Urinary Tract Infections

Kazuma Sakaeda, Takuya Sadahira, Yuki Maruyama, Takehiro Iwata, Masami Watanabe, Koichiro Wada, Motoo Araki

Antibiotics 12 ( 3 ) 522 - 522 2023.3

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing E. coli strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing E. coli strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 E. coli strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing E. coli. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing E. coli, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or β-lactamase inhibitors and thus is an effective antimicrobial countermeasure.

DOI： 10.3390/antibiotics12030522

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 142 2023.3

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 O - 172 2023.3

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 168 2023.3

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 O - 172 2023.3

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 168 2023.3

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 142 2023.3

異所性腎患者に発生したmicropapillary variantを伴う筋層浸潤性膀胱癌に対して,ロボット支援下膀胱全摘除術を施行した一例

原惇也, 堀井聡, 岩田健宏, 鵜川聖也, 長崎直也, 松島萌希, 奥村美紗, 渡部智文, 関戸崇了, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 小林泰之

西日本泌尿器科 85 ( 増刊号1 ) 46 - 46 2023.1

転移性尿路上皮癌に対するペムブロリズマブの治療成績多施設共同研究

片山聡, 岩田健宏, 小林泰之, 長尾賢太郎, 小林知子, 別宮謙介, 枝村康平, 荒木元朗, 坪井一馬, 高本篤, 久住倫宏, 中田哲也, 佐々木克己, 山崎拓, 杭ノ瀬彩, 佐野雄芳, 川合裕也, 山本康雄, 竹中皇, 平田武志, 中塚浩一, 杉本盛人, 堀川雄平, 榮枝一磨, 白崎義範, 森分貴俊, 坪井一朗, 和田耕一郎

西日本泌尿器科 85 ( 増刊号1 ) 71 - 72 2023.1

Etiology of recurrent cystitis in postmenopausal women based on vaginal microbiota and the role of Lactobacillus vaginal suppository. International journal

Takanori Sekito, Koichiro Wada, Ayano Ishii, Takehiro Iwata, Takehiro Matsubara, Shuta Tomida, Masami Watanabe, Motoo Araki, Takuya Sadahira

Frontiers in microbiology 14 1187479 - 1187479 2023

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

BACKGROUND: The vaginal microbiota can be altered by uropathogenic bacteria associated with recurrent cystitis (RC), and the vaginal administration of Lactobacillus have suggested certain effects to prevent RC. The relationship between vaginal microbiota and the development of RC has not been elucidated. We aimed to clarify the etiology of RC from vaginal microbiota and importance of vaginal Lactobacillus. METHODS: Vaginal samples obtained from 39 postmenopausal women were classified into four groups: healthy controls; uncomplicated cystitis; RC; and prevention (prevented RC by Lactobacillus crispatus-containing vaginal suppositories). Principal coordinate analysis and beta-diversity analysis was used to assess 16S rRNA gene sequencing data from the vaginal microbiome. RESULTS: Cluster analysis divided the vaginal bacterial communities among 129 vaginal samples into three clusters (A, B, and C). Fourteen of 14 (100%) samples from the RC group and 51 of 53 (96%) samples from the prevention group were in clusters B and C, while 29 of 38 (76%) samples from the healthy group and 14 of 24 (58%) samples from the uncomplicated cystitis group were in cluster A. The principal coordinate analysis showed that plots in the uncomplicated cystitis group were similar to the healthy group, indicating a large separation between the RC group and the uncomplicated cystitis group. On beta-diversity analysis, there were significant differences between the healthy group and the uncomplicated cystitis group (p = 0.045), and between the RC group and the uncomplicated cystitis group or the healthy group (p = 0.001, p = 0.001, respectively). There were no significant differences between the RC group and the prevention group (p = 0.446). The top six taxa were as follows: Prevotella, Lactobacillus, Streptococcus, Enterobacteriaceae, Anaerococcus, and Bifidobacterium. Among patients with RC, Lactobacillus was undetectable before administration of suppositories, while the median relative abundance of Lactobacillus was 19% during administration of suppositories (p = 0.0211), reducing the average cystitis episodes per year (6.3 vs. 2.4, p = 0.0015). CONCLUSION: The vaginal microbiota of postmenopausal women with RC is differed from healthy controls and uncomplicated cystitis in terms of lack of Lactobacillus and relatively dominant of Enterobacteriaceae. Vaginal administration of Lactobacillus-containing suppositories can prevent RC by stabilizing vaginal dysbiosis and causing a loss of pathogenic bacteria virulence.

DOI： 10.3389/fmicb.2023.1187479

Bladder tuberculosis with ureteral strictures after bacillus Calmette‑Guérin therapy for urinary bladder cancer: A case report

Yusuke Tominaga, Masanori Fujii, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Katsuyuki Kiura, Yoshinobu Maeda, Koichiro Wada, Motoo Araki

Molecular and Clinical Oncology 18 ( 2 ) 2022.12

テストステロン補充療法による経時的身体変化の解析

富永悠介, 佐古智子, 松本裕子, 杉本盛人, 岩田健宏, 西村慎吾, 枝村康平, 小林泰之, 渡部昌実, 荒木元朗

GID(性同一性障害)学会雑誌 15 ( 1 ) 198 - 199 2022.12

Feasibility of robot‑assisted radical cystectomy in a patient with an ectopic kidney: A case report

Kohei Edamura, Takuya Sadahira, Junya Hara, Takehiro Iwata, Wataru Ando, Satoshi Horii, Kentaro Nagao, Asuyuki Kobayashi, Motoo Araki

Medicine International 3 ( 1 ) 2022.11

横隔膜、腸腰筋、左腎に接する後腹膜脱分化型脂肪肉腫に対して横隔膜合併切除を含めた外科的治療を行った一例

松島萌希, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 190 - 190 2022.11

当院におけるProteus mirabilisの薬剤感受性の推移とESBL産生株分離状況

丸山雄樹, 定平卓也, 岩田健宏, 荒木元朗, 片山聡, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡邉豊彦, 和田耕一郎

西日本泌尿器科学会総会抄録集 74回 216 - 216 2022.11

反復性膀胱炎の新しい予防法膀胱の外側から考える(A novel preventive approach for recurrent cystitis: thinking beyond the bladder)

関戸崇了, 定平卓也, 丸山雄樹, 岩田健宏, 石井亜矢乃, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 170 - 170 2022.11

再三の細胞診検査で骨盤内再発が判明した膀胱癌の一例

鵜川聖也, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 227 - 227 2022.11

当院におけるProteus mirabilisの薬剤感受性の推移とESBL産生株分離状況

丸山雄樹, 定平卓也, 岩田健宏, 荒木元朗, 片山聡, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 石井亜矢乃, 渡邉豊彦, 和田耕一郎

西日本泌尿器科学会総会抄録集 74回 216 - 216 2022.11

横隔膜、腸腰筋、左腎に接する後腹膜脱分化型脂肪肉腫に対して横隔膜合併切除を含めた外科的治療を行った一例

松島萌希, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 190 - 190 2022.11

反復性膀胱炎の新しい予防法膀胱の外側から考える(A novel preventive approach for recurrent cystitis: thinking beyond the bladder)

関戸崇了, 定平卓也, 丸山雄樹, 岩田健宏, 石井亜矢乃, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 170 - 170 2022.11

ロボット支援膀胱全摘除術(RARC)における体腔内(ICUD)・体腔外尿路変向(ECUD)の比較

山野井友昭, 小林泰之, 岩田健宏, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 渡邉豊彦, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 2 2022.11

仙骨腟固定術後の新規腹圧性尿失禁腹腔鏡下手術とロボット支援下手術での検討

小林知子, 佐古智子, 岩田健宏, 富永悠介, 別宮謙介, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 1 2022.11

ロボット支援膀胱全摘術における低分子ヘパリンによる予防的抗凝固療法の有用性

丸山雄樹, 岩田健宏, 吉永香澄, 片山聡, 小林智子, 別宮健介, 枝村康平, 小林泰之, 渡邉豊彦, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 O - 4 2022.11

腹腔鏡下手術でここまでできる～ロボット時代を生き抜く達人技～大きな腫瘍に対する腹腔鏡・後腹膜鏡併用による腫瘍摘出術の試み

吉永香澄, 小林泰之, 冨永悠介, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 WS - 4 2022.11

再三の細胞診検査で骨盤内再発が判明した膀胱癌の一例

鵜川聖也, 岩田健宏, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 渡部昌実, 渡邉豊彦, 荒木元朗

西日本泌尿器科学会総会抄録集 74回 227 - 227 2022.11

ロボット支援腹腔鏡下腎盂形成術(右側)

小林泰之, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 J - 1 2022.11

当院におけるMRI/TRUS融合画像ガイド下前立腺生検初期成績の臨床的検討

長尾賢太郎, 片山聡, 岩田健宏, 西村慎吾, 高本篤, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本泌尿器内視鏡・ロボティクス学会総会 36回 P - 1 2022.11

異所性腎患者の筋層浸潤性膀胱癌に対して、RARC+ICUDを施行した一例

堀井聡, 原惇也, 岩田健宏, 長尾賢太郎, 片山聡, 別宮謙介, 枝村康平, 小林知子, 荒木元朗, 小林泰之

日本泌尿器内視鏡・ロボティクス学会総会 36回 O - 2 2022.11

ステント付着結石により3本尿管ステント留置し2度のECIRSによりstone freeとなった1例

堀井聡, 奥村美紗, 渡部智文, 関戸崇了, 徳永素, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号2 ) 168 - 168 2022.6

尿から分離されたESBL産生大腸菌株の性状解析を踏まえたFMOXの使用法

榮枝一磨, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友, 和田耕一郎, 光畑律子

日本化学療法学会雑誌 70 ( Suppl.A ) 289 - 289 2022.5

ロボット支援下前立腺全摘除術中にモノポーラシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友, 小林泰之

Japanese Journal of Endourology and Robotics 35 ( 1 ) 168 - 172 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

我々が経験したロボット支援下前立腺全摘除術におけるインシデントを報告する.症例は70歳代男性.手術はda Vinci Xiで行われた.術中,1stポートのインストゥルメントを入れ替えた際に,モノポーラシザースよりチップカバーが外れ,紛失した.腹腔内や術野内外をX線透視も用いて探索するも見つからず,Computed tomographyを施行したところ,1stポート造設部の皮下に迷入していた.その後は手術を再開し,合併症なく終了.チップカバーは画像と同部位の皮下より摘出された.手術映像を見返したところ,チップカバーが適切に装着されておらず,インストゥルメント交換の際にトロッカーが皮下まで抜けていたことが判明した.本件のようなインシデントを予防するためには,チップカバーの適切な装着と,インストゥルメントの正しい手順での交換および交換時の確認が必要である.(著者抄録)

ロボット支援下前立腺全摘除術中にモノポーラシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友, 小林泰之

Japanese Journal of Endourology and Robotics 35 ( 1 ) 168 - 172 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

我々が経験したロボット支援下前立腺全摘除術におけるインシデントを報告する.症例は70歳代男性.手術はda Vinci Xiで行われた.術中,1stポートのインストゥルメントを入れ替えた際に,モノポーラシザースよりチップカバーが外れ,紛失した.腹腔内や術野内外をX線透視も用いて探索するも見つからず,Computed tomographyを施行したところ,1stポート造設部の皮下に迷入していた.その後は手術を再開し,合併症なく終了.チップカバーは画像と同部位の皮下より摘出された.手術映像を見返したところ,チップカバーが適切に装着されておらず,インストゥルメント交換の際にトロッカーが皮下まで抜けていたことが判明した.本件のようなインシデントを予防するためには,チップカバーの適切な装着と,インストゥルメントの正しい手順での交換および交換時の確認が必要である.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07650&link_issn=&doc_id=20220531400028&doc_link_id=%2Fcs5robot%2F2022%2F003501%2F032%2F0168-0172%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5robot%2F2022%2F003501%2F032%2F0168-0172%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

【初心にかえって、TURBTの手技徹底検証!】合併症を回避するTURBTの極意

西村慎吾, 小林泰之, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

Japanese Journal of Endourology and Robotics 35 ( 1 ) 45 - 50 2022.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

TURBTは泌尿器科医にとって必須な手技であり,その良し悪しが患者の予後を規定するといっても過言ではない.加えて,TURBTは個体差によるバリエーションに富んでおり,初心者のみならず熟練者であってもその難しさを痛感する手術である.そのため,それぞれの症例に応じた戦略(根治的・姑息的・診断的切除の判断,切除の手順・方法等)をたてることが重要であり,加えて合併症対策をしっかりと行うこと,システム化された指導法を確立することが重要である.今回,初心に立ち返り当院における『合併症を回避するためのポイント』を整理した.術中合併症には穿孔や出血が挙げられる.高齢者,複数回のTUR歴やBCG治療歴などによる膀胱壁菲薄化が術中穿孔リスクとなる.出血は,術中の不十分な止血操作だけでなく,抗血小板薬・抗凝固薬の内服もリスクとなる.これらの薬剤継続による出血のみならず,休薬に伴う血栓症リスクを術前に評価することも重要である.術後合併症には前立腺肥大症などによる尿道カテーテル抜去後尿閉による穿孔がある.これらの合併症対策として,1.術前に画像検査で筋層浸潤の有無を判断し,症例に応じた戦略作成をたてること,2.抗血小板・抗凝固薬の継続,中止の取り扱いを検討すること,3.システム化された指導を行うこと,が重要である.これらのポイントについて,当科で実践している手技,術前戦略が功を奏した症例などを提示しながら解説する.(著者抄録)

Post-prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview. International journal

Herik Acosta, Takuya Sadahira, Takanori Sekito, Yuki Maruyama, Takehiro Iwata, Motoo Araki, Kohei Ogawa, Ichiro Tsuboi, Koichiro Wada

International journal of urology : official journal of the Japanese Urological Association 29 ( 6 ) 486 - 493 2022.2

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

The development of several culture media and the availability to isolate and treat pathogens prior to a surgical procedure give us the ability to minimize treatment-related complications, and ultimately results in better outcomes for patients and avoidance of unwanted post-procedure inpatient admissions. In the last decade, an increasing incidence of multidrug-resistant Escherichia coli, especially extended-spectrum beta-lactamase-producing E. coli and fluoroquinolone-resistant pathogens, has been reported. These resistant species frequently colonize the rectal flora and gain access to the systemic circulation via the rectal plexus following a prostate biopsy. The bacteria can eventually lead to life-threatening complications, which is especially important in high-risk patients with multiple co-morbidities. Previously published studies have focused on the isolation of these pathogens with selective media before an invasive procedure and the potential benefits of incorporating the use of selective media as a mandatory pre-operative step. This preventive measure will allow us to offer a tailored prophylactic treatment that benefits patients and reduces the economic burden for the hospital.

DOI： 10.1111/iju.14824

テキストマイニングによる腎移植に関する症例報告論文の考察

関戸崇了, 荒木元朗, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 渡部昌実, 渡邉豊彦, 田邊克幸, 竹内英実, 喜多村真治, 杉山斉, 和田淳, 那須保友

日本臨床腎移植学会プログラム・抄録集 55回 227 - 227 2022.2

Medical uses for silver nitrate in the urinary tract (Review)

Takanori Sekito, Takuya Sadahira, Toyohiko Watanabe, Yuki Maruyama, Tomofumi Watanabe, Takehiro Iwata, Koichiro Wada, Kohei Edamura, Motoo Araki, Masami Watanabe

World Academy of Sciences Journal 4 ( 1 ) 2022.1

待機日数56日で先行的脳死下献腎移植を行った17歳女性の1例

奥村美紗, 吉永香澄, 西村慎吾, 和田耕一郎, 荒木元朗, 渡部智文, 近藤崇弘, 関戸崇了, 堀井聡, 竹丸紘史, 和田里章悟, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 50 - 51 2022.1

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検

高本篤, 河田達志, 長尾賢太郎, 富永悠介, 渡部智文, 三宅修司, 林あずさ, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 定平卓也, 岩田健宏, 西村慎吾, 和田耕一郎, 枝村康平, 佐古智子, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 48 2022.1

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検

高本篤, 河田達志, 長尾賢太郎, 富永悠介, 渡部智文, 三宅修司, 林あずさ, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 定平卓也, 岩田健宏, 西村慎吾, 和田耕一郎, 枝村康平, 佐古智子, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 48 2022.1

岡山大学におけるUTUCに対するURSの成績と課題

和田耕一郎, 丸山雄樹, 荒木元朗, 関戸崇了, 枝村康平, 定平卓也, 林あずさ, 三宅修司, 渡部智文, 吉永香澄, 和田里章悟, 長尾賢太郎, 河田達志, 富永悠介, 大岩裕子, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 49 2022.1

待機日数56日で先行的脳死下献腎移植を行った17歳女性の1例

奥村美紗, 吉永香澄, 西村慎吾, 和田耕一郎, 荒木元朗, 渡部智文, 近藤崇弘, 関戸崇了, 堀井聡, 竹丸紘史, 和田里章悟, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 50 - 51 2022.1

全身転移を来たした成人発症の胎児型前立腺横紋筋肉腫の1例

近藤崇弘, 関戸崇了, 定平卓也, 富永悠介, 高本篤, 奥村美紗, 渡部智文, 堀井聡, 竹丸絋史, 和田里章悟, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友, 田端雅弘, 柳井広之

西日本泌尿器科 84 ( 増刊号1 ) 53 - 53 2022.1

後腹膜リンパ節郭清術後の射精障害の検討

富永悠介, 佐古智子, 奥村美紗, 渡部智文, 近藤崇弘, 関戸崇了, 竹丸紘史, 堀井聡, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 片山聡, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友, 松本裕子, 杉本盛人, 和田耕一郎

西日本泌尿器科 84 ( 増刊号1 ) 84 - 84 2022.1

後腹膜リンパ節郭清術後の射精障害の検討

富永悠介, 佐古智子, 奥村美紗, 渡部智文, 近藤崇弘, 関戸崇了, 竹丸紘史, 堀井聡, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 片山聡, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友, 松本裕子, 杉本盛人, 和田耕一郎

西日本泌尿器科 84 ( 増刊号1 ) 84 - 84 2022.1

全身転移を来たした成人発症の胎児型前立腺横紋筋肉腫の1例

近藤崇弘, 関戸崇了, 定平卓也, 富永悠介, 高本篤, 奥村美紗, 渡部智文, 堀井聡, 竹丸絋史, 和田里章悟, 吉永香澄, 丸山雄樹, 山野井友昭, 長尾賢太郎, 河田達志, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友, 田端雅弘, 柳井広之

西日本泌尿器科 84 ( 増刊号1 ) 53 - 53 2022.1

岡山大学におけるUTUCに対するURSの成績と課題

和田耕一郎, 丸山雄樹, 荒木元朗, 関戸崇了, 枝村康平, 定平卓也, 林あずさ, 三宅修司, 渡部智文, 吉永香澄, 和田里章悟, 長尾賢太郎, 河田達志, 富永悠介, 大岩裕子, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 小林泰之, 石井亜矢乃, 渡部昌実, 渡辺豊彦, 那須保友

西日本泌尿器科 84 ( 増刊号1 ) 48 - 49 2022.1

A Novel Technique Using Fluorescent Ureteral Catheter and Flexible Ureteroscope for Safe Laparoscopic Fenestration of Lymphocele after Kidney Transplantation. International journal

Takanori Sekito, Motoo Araki, Koichiro Wada, Kasumi Yoshinaga, Yuki Maruyama, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Toyohiko Watanabe

Case reports in transplantation 2022 9948425 - 9948425 2022

Language：English

Laparoscopic fenestration of a postrenal transplant lymphocele is associated with a risk of renal hilar vessel and ureteral injury. Consequently, determination of the incision line is difficult. We describe a case of a 73-year-old man with postrenal transplant lymphocele who underwent a laparoscopic fenestration. We report a surgical video containing a new technique of laparoscopic fenestration using a fluorescent ureteral catheter in combination with a flexible ureteroscope. The combination of a fluorescent ureteral catheter and flexible ureteroscope during surgery enabled us to determine the incision line safely and accurately. Intraoperative real-time visualization of the lymphocele and ureter using a fluorescent ureteral catheter and a flexible ureteroscope is safer than conventional methods for laparoscopic fenestration. To the best of our knowledge, this is the first report of this novel technique.

DOI： 10.1155/2022/9948425

Testosterone Recovery after Neoadjuvant Gonadotropin-Releasing Hormone Antagonist versus Agonist on Permanent Iodine-125 Seed Brachytherapy in Prostate Cancer Patients: A Propensity Score Analysis.

Takehiro Iwata, Yuki Maruyama, Tatsushi Kawada, Takuya Sadahira, Satoshi Katayama, Atsushi Takamoto, Tomoko Sako, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Acta medica Okayama 75 ( 6 ) 705 - 711 2021.12

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

Optimal neoadjuvant hormone therapy (NHT) for reducing prostate cancer (PC) patients' prostate volume pre-brachytherapy is controversial. We evaluated the differential impact of neoadjuvant gonadotropin-releasing hormone (GnRH) antagonist versus agonist on post-brachytherapy testosterone recovery in 112 patients treated pre-brachytherapy with NHT (GnRH antagonist, n=32; GnRH agonists, n=80) (Jan. 2007-June 2019). We assessed the effects of patient characteristics and a GnRH analogue on testosterone recovery with logistic regression and a propensity score analysis (PSA). There was no significant difference in the rate of testosterone recovery to normal levels (> 300 ng/dL) between the GnRH antagonist and agonists (p=0.07). The GnRH agonists induced a significantly more rapid testosterone recovery rate at 3 months post-brachytherapy versus the GnRH antagonist (p<0.0001); there was no difference in testosterone recovery at 12 months between the GnRH antagonist/agonists (p=0.8). In the multivariate analysis, no actor was associated with testosterone recovery. In the PSA, older age and higher body mass index (BMI) were significantly associated with longer testosterone recovery. Post-brachytherapy testosterone recovery was quicker with the neoadjuvant GnRH agonists than the antagonist, and the testosterone recovery rate was significantly associated with older age and higher BMI. Long-term follow-ups are needed to determine any differential effects of GnRH analogues on the quality of life of brachytherapy-treated PC patients.

DOI： 10.18926/AMO/62810

浸潤性膀胱癌に対する開腹膀胱全摘除術(ORC)と比較した腹腔鏡下膀胱全摘除術(LRC)の長期治療成績に関する後方視的検討

和田里章悟, 小林泰之, 河田達志, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 2 ) 146 - 153 2021.12

Language：Japanese Publisher：(一社)西日本泌尿器科学会

【目的】腹腔鏡下膀胱全摘除術(LRC)と開腹膀胱全摘除術(ORC)の長期制癌性を検討した本邦からの報告は少数である。当院におけるLRCとORCの周術期成績と長期治療成績を後方視的に比較検討した。【対象】2012年5月から2018年6月までに施行した膀胱全摘症例のうち78例(LRC48例,ORC30例)とした。【結果】観察期間中央値はLRC群30ヵ月,ORC群43.5ヵ月であった。LRC群で男性が多く,回腸導管の割合が高かった。手術時間はLRC群で長く(p=0.038),推定出血量と輸血症例が少なかった(ともにp<0.001)。術後病理結果はLRC群でG2症例が少なかった(p=0.008)が,断端陽性率を含む他の結果に差はなかった。リンパ節郭清領域はORCで内外腸骨動脈分岐部以下,LRCで総腸骨動脈分岐部以下を基本としたが,郭清リンパ節の数とリンパ節陽性症例の割合に差はなかった。LRC群とORC群の5年全生存率,癌特異生存率,無再発生存率は72.2%と54.4%(p=0.249),77.7%と63.4%(p=0.376),71.4%と55.0%(p=0.115)であった。【結語】当院におけるLRC群の周術期成績は出血量,輸血頻度においてORC群より優れていた。制癌性についてもORC群に比しLRC群が優れている傾向を認め,リンパ節郭清領域が制癌性に影響する報告を裏付ける結果となった。(著者抄録)

APCCC JAPAN:今こそ日本人泌尿器科医の常識を問う! M0CRPC診療 M0CRPCに対する新規ホルモン剤はどのような症例に有効か?

枝村康平, 河田達志, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友

日本泌尿器科学会総会 109回 SY31 - 3 2021.12

Clinical Efficacy and Safety of Sitafloxacin 200 mg Once Daily for Refractory Genitourinary Tract Infections.

Takehiro Iwata, Takuya Sadahira, Yuki Maruyama, Takanori Sekito, Kasumi Yoshinaga, Shogo Watari, Kentaro Nagao, Tatsushi Kawada, Yusuke Tominaga, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Ayano Ishii, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 6 ) 763 - 766 2021.12

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

The aim of this ongoing trial is to evaluate the clinical efficacy and safety of sitafloxacin (STFX) 200 mg once daily (QD) for 7 days in patients with refractory genitourinary tract infections, which include recurrent or complicated cystitis, complicated pyelonephritis, bacterial prostatitis, and epididymitis. The primary endpoint is the microbiological efficacy at 5-9 days after the last administration of STFX. Recruitment began in February 2021, and the target total sample size is 92 participants.

DOI： 10.18926/AMO/62820

TVT手術19年後に発症したテープ感染の一例

渡部智文, 富永悠介, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器科学会総会 109回 PP16 - 07 2021.12

反復性膀胱炎に対する乳酸菌腟坐剤の予防効果を評価する第II相試験

定平卓也, 和田耕一郎, 石井亜矢乃, 丸山雄樹, 岩田健宏, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器科学会総会 109回 AOP09 - 02 2021.12

腸骨下腹神経ブロックが鼠径部痛の緩和に有効であった、再発性鼠径ヘルニアを合併したミュラー管遺残症候群の1例

関戸崇了, 丸山雄樹, 定平卓也, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡辺豊彦, 那須保友

日本泌尿器科学会総会 109回 OP05 - 06 2021.12

限局性上部尿路上皮癌診断における、tumor grade、tumor stageによる予測モデルの臨床的有用性の検討

片山聡, 荒木元朗, 森啓一郎, 岩田健宏, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 渡部昌実, 渡邉豊彦, Shariat Shahrokh F., 那須保友

日本泌尿器科学会総会 109回 OP19 - 01 2021.12

筋層浸潤性膀胱癌に対する肝細胞増殖因子の予後的価値(Prognostic value of hepatocyte growth factor for muscle-invasive bladder cancer)

片山聡, 森啓一郎, 岩田健宏, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, Shariat Shahrokh F., 那須保友

日本泌尿器科学会総会 109回 ISA03 - 08 2021.12

尿路変向術:私の工夫 RARC ICUD失敗から学んだこと

小林泰之, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 84 ( 2 ) 122 - 127 2021.12

Language：Japanese Publisher：(一社)西日本泌尿器科学会

ロボット支援膀胱全摘除術(以下:RARC)は,本邦において2019年4月に保険適応され,導入する施設も右肩上がりに増えている。当院においても,腹腔鏡下膀胱全摘除,RARC,体腔外尿路変向(以下:ECUD)を経て2019年6月より体腔内尿路変向(以下:ICUD)を開始した。ICUDは腸管という非常に長い対象物を鏡視下の拡大視野にて扱うため,全容が見えていない状態で手術を行うこととなる。その為に初期症例においては,誰も陥りやすいpit fallがあると考えている。この度,我々が経験した失敗とその対策を提示することで,同様のトラブルが回避できれば幸いと考えている。(著者抄録)

Tumor suppressor REIC/Dkk-3 and its co-chaperone SGTA: Two aspects of a GR inhibitor and AR activator as a modifier of the steroid signaling(和訳中)

岩田健宏, 定平卓也, 片山聡, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科学会総会抄録集 73回 175 - 175 2021.11

癌抑制因子REIC/Dkk-3とそのコシャペロンSGTA ステロイドシグナル伝達の調節因子としてのGR阻害剤とAR活性化剤の二つの側面(Tumor suppressor REIC/Dkk-3 and its co-chaperone SGTA: Two aspects of a GR inhibitor and AR activator as a modifier of the steroid signaling)

岩田健宏, 定平卓也, 片山聡, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科学会総会抄録集 73回 175 - 175 2021.11

鏡視下手術後の深部静脈血栓症早期発見を目的としたD-dimer測定の有用性

丸山雄樹, 岩田健宏, 吉永香澄, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 AP - 6 2021.11

左単腎不完全重複腎盂尿管の合流部狭窄に対するロボット支援下腎盂形成術

小林泰之, 枝村康平, 和田耕一郎, 佐古智子, 西村慎吾, 岩田健宏, 荒木元朗, 渡辺豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 AV - 2 2021.11

当院における転移性腎細胞癌患者の免疫チェックポイント阻害剤とVEGFR-TKI併用療法の初期経験

堀井聡, 河田達志, 高本篤, 枝村康平, 小林泰之, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保知

西日本泌尿器科学会総会抄録集 73回 235 - 235 2021.11

限局性上部尿路上皮癌における腫瘍グレードと病期を中心とした予測モデルの精度と臨床的有用性(Accuracy and clinical utility of the tumor grade and stage-centered predictive model in localized upper tract urothelial carcinoma)

片山聡, 荒木元朗, 岩田健宏, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 渡部昌実, 渡邉豊彦, Shariat Shahrokh F., 那須保友

西日本泌尿器科学会総会抄録集 73回 173 - 173 2021.11

当科で施行した腹腔鏡下仙骨腟固定術とロボット支援下仙骨腟固定術の比較

佐古智子, 岩田健宏, 西村慎吾, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 P - 1 2021.11

ロボット支援膀胱全摘除術(RARC)における体腔内・体腔外尿路変更の検討

長尾賢太郎, 岩田健宏, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 P - 1 2021.11

腎盂尿管鏡検査における生検組織診断率向上のためのPilot study

岩田健宏, 和田耕一郎, 長尾賢太郎, 富永悠介, 片山聡, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 35回 P - 9 2021.11

Impact of paclitaxel, cisplatin, and gemcitabine as first-line chemotherapy in cisplatin-fit and -unfit patients with advanced/metastatic urothelial carcinoma. International journal

Satoshi Katayama, Yasuyuki Kobayashi, Atsushi Takamoto, Kohei Edamura, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Koichiro Wada, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Urologic oncology 39 ( 10 ) 731.e25-731.e32 2021.10

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

PURPOSE: This study aimed to clarify the efficacy and toxicity of first-line combination treatment with paclitaxel, cisplatin, and gemcitabine (PCG) for advanced/metastatic urothelial carcinoma (UC) in cisplatin-unfit patients compared with cisplatin-fit patients. METHODS: We conducted a retrospective study of patients who received first-line PCG. Using international consensus criteria, patients were classified into cisplatin-fit and -unfit groups. Cisplatin-unfit patients received PCG with adjustment of the cisplatin dose after assessing 24-hour urinary creatinine clearance, without modifying the administration interval. RESULTS: From 2008 to 2017, 50 patients received first-line PCG, of whom 30 and 20 were classified into the cisplatin-fit and -unfit groups. After a median follow-up of 15.0 months, the median overall survival (OS) and progression-free survival (PFS) were 15.0 and 9.8 months in all patients, 15.0 and 10.0 months in the cisplatin-fit group, and 13.2 and 9.3 months in the cisplatin-unfit group, respectively. There was no significant difference in OS (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 0.69-2.54) or PFS (HR: 1.38, 95% CI: 0.74-2.55) between the groups. The overall response rate and complete response rate were 58% (95% CI: 43.2-71.8) and 32% (95% CI: 19.5-46.7) in all patients, and 55% (95% CI: 31.5-76.9) and 35% (95% CI: 15.4-59.2) in the cisplatin-unfit group, respectively. The common grade 3 of 4 adverse events experienced were neutropenia (78%), followed by thrombocytopenia (56%), anemia (46%), and febrile neutropenia (16%). The 24-hour urinary creatinine clearance did not differ significantly between the groups after one, two, or three courses of PCG. CONCLUSIONS: We found no significant difference regarding OS and PFS between the cisplatin-fit patients with a full dose of cisplatin and -unfit patients with cisplatin-dose-adjusted chemotherapy. In select cisplatin-unfit patients, PCG with dose adjustment of cisplatin may be useful for treating advanced/metastatic UC without any significant adverse events or impaired renal function compared with cisplatin-fit patients with a full dose of cisplatin.

DOI： 10.1016/j.urolonc.2021.02.029

Efficacy of Lactobacillus vaginal suppositories for the prevention of recurrent cystitis: A phase II clinical trial. International journal

Takuya Sadahira, Koichiro Wada, Motoo Araki, Ritsuko Mitsuhata, Masumi Yamamoto, Yuki Maruyama, Takehiro Iwata, Masami Watanabe, Toyohiko Watanabe, Reiko Kariyama, Yasutomo Nasu, Ayano Ishii

International journal of urology : official journal of the Japanese Urological Association 28 ( 10 ) 1026 - 1031 2021.10

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

OBJECTIVES: To prospectively assess the efficacy and safety of Lactobacillus vaginal suppositories for the prevention of recurrent cystitis. METHODS: In this single-arm, open-label, phase II clinical trial, participants used vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus for 1 year either every 2 days or three times per week. The primary end-point was the response rate, as assessed by the number of episodes of recurrent cystitis during the year of administration. The secondary end-points were the response rate, as assessed by episodes of recurrent cystitis during the 1 year after completion of the administration period; the total number of episodes of recurrent cystitis before, during and after administration; adverse events; and changes in urine bacteria and the vaginal microbiome. RESULTS: A total of 28 women were enrolled, and 21 completed the study. A total of 18 patients achieved an effective response (86%) during administration. The suppressive effects of Lactobacillus vaginal suppositories on episodes of cystitis continued up to 1 year after the last suppository was administered. There was a significant reduction in the mean number of episodes of cystitis, both during and after administration of Lactobacillus vaginal suppositories. No treatment-related adverse events were observed. Amplicon sequencing analysis of the vaginal microbiome showed that Lactobacillus species colonized the vagina during the periods when episodes of cystitis were absent. CONCLUSIONS: Vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus effectively prevent episodes of recurrent cystitis, both during administration and for at least 1 year after administration.

DOI： 10.1111/iju.14636

Comparison of intracorporeal versus extracorporeal urinary diversion after robot-assisted radical cystectomy at a medium-sized facility.

Takehiro Iwata, Yasuyuki Kobayashi, Yuki Maruyama, Tatsushi Kawada, Takuya Sadahira, Yuko Oiwa, Satoshi Katayama, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Koichiro Wada, Kohei Edamura, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

International journal of clinical oncology 26 ( 9 ) 1714 - 1721 2021.9

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

BACKGROUND: The aim of this study is to compare the perioperative outcomes and learning curves between intracorporeal and extracorporeal urinary diversion at our medium-sized institution. METHODS: Between January 2018 and September 2020, a single surgeon at our institution performed 46 consecutive robot-assisted radical cystectomies with ileal conduit. We compared the perioperative outcomes between patients who underwent intracorporeal versus extracorporeal urinary diversion. We also investigated learning curves for the first and last 10 patients in each group. RESULTS: The extracorporeal group had shorter overall operative time (P = 0.003) and urinary diversion time (P < 0.0001) than the intracorporeal group. The intracorporeal group had shorter length of hospital stay (P = 0.02). There was no difference in complication and readmission rates. The extracorporeal group demonstrated no difference between the first and last 10 patients for overall operative time or time for cystectomy, lymph node dissection, or urinary diversion. However, the intracorporeal group had shorter urinary diversion time for the last 10 patients compared with the first 10 patients. The first 10 patients in the extracorporeal group had shorter overall operative time than the first 10 in the intracorporeal group, but there was no difference for the last 10 patients. CONCLUSIONS: Intracorporeal urinary diversion requires longer overall operative time than extracorporeal diversion for the first 10 patients, due to longer urinary diversion time. However, there is no difference in overall operative time for the last 10 patients. The benefit of intracorporeal over extracorporeal urinary diversion was not confirmed at our medium-sized institution.

DOI： 10.1007/s10147-021-01957-1

Kidney cyst infection through a fistula between bladder and retroperitoneal abscess in a polycystic kidney disease patient. International journal

Takato Nakadoi, Kenji Tsuji, Takehiro Iwata, Eriko Eto, Hisashi Masuyama, Koji Tomita, Takao Hiraki, Shinji Kitamura, Hitoshi Sugiyama, Jun Wada

Nephrology (Carlton, Vic.) 27 ( 4 ) 383 - 384 2021.8

ハイリスク腎移植 game changers DSA陽性ハイリスク腎移植

西村慎吾, 荒木元朗, 関戸崇了, 坪井一朗, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 83 ( 3 ) 152 - 160 2021.8

Language：Japanese Publisher：(一社)西日本泌尿器科学会

腎移植は末期腎不全に対する腎代替療法として理想的な治療である。生体で約94%,献腎で約88%という高い5年生着率が得られており,抗ドナー抗体(Donor-Specific Antibody:DSA)陽性のハイリスク症例に対する移植も積極的に行われつつある。2019年12月にDSA陽性腎移植における術前脱感作として免疫グロブリン大量静注療法(Intravenous Immunoglobulins:IVIG)が保険適応となった。IVIGは海外ではその有効性について多くの報告があり,日本でもGame changerとなりうる。今回,当科でDSA陽性に対し術前IVIGを行った2例を含めその有用性について文献的に検討する。症例1は69歳,3次移植の男性。原疾患不明の腎不全に対し,外国にて献腎移植を施行するも,術中に超急性拒絶反応を認め即座に移植腎を摘出,2つ目の腎が移植された。移植後約12年で当科に紹介受診。移植後約20年でgraft lossに至り,妻をドナーとしたA型(Rh+)→AB型(Rh+)の血液型不一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-DQ強陽性であった(nMFI=23,230)。TAC,PSLに加え術前6週前より中止していたMMFを再開し,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。症例2は71歳,女性。IgA腎症を原疾患とする腎不全に対して,HD導入前に当科受診。妊娠・出産歴3回,夫をドナーとしたAB型(Rh+)→AB型(Rh+)の血液型一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-C,DR,DQ陽性であった(nMFI=〜5,000)。術前脱感作はTAC,MMF,PSL,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。2症例とも術後現在まで一度も拒絶反応を起こすことなく良好な腎機能で経過している。(著者抄録)

ハイリスク腎移植 game changers DSA陽性ハイリスク腎移植

西村慎吾, 荒木元朗, 関戸崇了, 坪井一朗, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 83 ( 3 ) 152 - 160 2021.8

Language：Japanese Publisher：(一社)西日本泌尿器科学会

腎移植は末期腎不全に対する腎代替療法として理想的な治療である。生体で約94%,献腎で約88%という高い5年生着率が得られており,抗ドナー抗体(Donor-Specific Antibody:DSA)陽性のハイリスク症例に対する移植も積極的に行われつつある。2019年12月にDSA陽性腎移植における術前脱感作として免疫グロブリン大量静注療法(Intravenous Immunoglobulins:IVIG)が保険適応となった。IVIGは海外ではその有効性について多くの報告があり,日本でもGame changerとなりうる。今回,当科でDSA陽性に対し術前IVIGを行った2例を含めその有用性について文献的に検討する。症例1は69歳,3次移植の男性。原疾患不明の腎不全に対し,外国にて献腎移植を施行するも,術中に超急性拒絶反応を認め即座に移植腎を摘出,2つ目の腎が移植された。移植後約12年で当科に紹介受診。移植後約20年でgraft lossに至り,妻をドナーとしたA型(Rh+)→AB型(Rh+)の血液型不一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-DQ強陽性であった(nMFI=23,230)。TAC,PSLに加え術前6週前より中止していたMMFを再開し,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。症例2は71歳,女性。IgA腎症を原疾患とする腎不全に対して,HD導入前に当科受診。妊娠・出産歴3回,夫をドナーとしたAB型(Rh+)→AB型(Rh+)の血液型一致生体腎移植が検討された。CDCXMはT,B cell共に(-),FCXMはT cell(-),B cell(+),FlowPRA Single antigenでHLA-C,DR,DQ陽性であった(nMFI=〜5,000)。術前脱感作はTAC,MMF,PSL,計500mgのrituximabを3及び1週前に投与,血漿交換はDFPP3回とPEX1回,術前16日前より計5回,計140gのIVIGを行い,移植を施行した。2症例とも術後現在まで一度も拒絶反応を起こすことなく良好な腎機能で経過している。(著者抄録)

A Case of Metastatic Fumarate Hydratase-Deficient-like Renal Cell Carcinoma Successfully Managed by Ipilimumab plus Nivolumab.

Takanori Sekito, Atsushi Takamoto, Yasuyuki Kobayashi, Masao Mitsui, Shogo Watari, Risa Kubota, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Sako, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Rei Shibata, Daisuke Ennishi, Yasutomo Nasu

Acta medica Okayama 75 ( 3 ) 397 - 402 2021.6

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

We report a 62-year-old male with metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) without fumarate hydratase (FH) mutation (FH-deficient-like RCC). The International Metastatic RCC Database Consortium risk score was intermediate, and immunotherapy with nivolumab and ipilimumab (Ipi/ Nivo) was initiated. Four cycles of Ipi/Nivo and 5 cycles of nivolumab resulted in a complete response of the metastases. Hypophysitis occurred as an immune-related adverse event after four cycles of Ipi/Nivo. The prognosis of patients with FH-deficient RCC is generally poor. Few reports of FH-deficient RCC successfully treated with Ipi/Nivo have been published. Ipi/Nivo can be effective for treating FH-deficient RCC.

DOI： 10.18926/AMO/62237

腎門部に発生した粘液嚢胞腺癌の1例

三宅修司, 岩田健宏, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 久保寿夫, 柳井広之, 那須保友

西日本泌尿器科 83 ( 1 ) 14 - 14 2021.6

腎門部に発生した粘液嚢胞腺癌の1例

三宅修司, 岩田健宏, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 久保寿夫, 柳井広之, 那須保友

西日本泌尿器科 83 ( 2 ) 100 - 105 2021.6

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は79歳,男性。2年前に検診にて左腎嚢胞と診断され近医で経過観察となっていたが,増大傾向であったため当科紹介となった。造影CT検査でBosniak分類category IVの左嚢胞性腎癌を疑い,腹腔鏡下左腎摘除術を施行した。術後病理結果から,粘液嚢胞腺癌(Mucinous cystadenocarcinoma)と診断した。術後補助化学療法は行わずに経過観察としていたが,術後3ヵ月後に多発肺転移が出現し,化学療法(カルボプラチン+パクリタキセル)を開始した。5コース投与後の肺転移はSDであったため,一旦化学療法中止で経過観察の方針としたが,5ヵ月後に肺転移は増大傾向を認めたため術後14ヵ月目よりニボルマブの投与を開始した。ニボルマブ2コース投与後のCTで肺転移は縮小し,5コース投与後もPRを維持しているため現在も投与継続中である。(著者抄録)

Photodynamic diagnostic ureteroscopy using the VISERA ELITE video system for diagnosis of upper-urinary tract urothelial carcinoma: a prospective cohort pilot study. International journal

Koichiro Wada, Motoo Araki, Ryuta Tanimoto, Takuya Sadahira, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Hirochika Nakajima, Herik Acosta, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

BMC urology 21 ( 1 ) 45 - 45 2021.3

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

BACKGROUND: The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system. METHODS: We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated. RESULTS: A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS). CONCLUSIONS: Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system. TRIAL REGISTRATION: The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803-002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205).

DOI： 10.1186/s12894-021-00819-2

神経線維腫症1型に合併した後腹膜悪性末梢神経鞘腫瘍の1例

宗田大二郎, 岩田健宏, 定平卓也, 富永悠介, 片山聡, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友, 中田英二, 柳井広之

西日本泌尿器科 82 ( 6 ) 596 - 600 2021.2

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は30代,女性。過去に左腋窩皮膚生検で神経線維腫と診断され,特徴的な皮膚所見や家族歴などから神経線維腫症1型(NF-1;von Recklinghausen病)を疑われていたが放置していた。20XX年2月に右大腿部痛,背部痛を主訴に近医を受診しMRI,造影CTで約13cm大の後腹膜腫瘤を指摘され,L2神経根からの発生と脊柱管内の浸潤も疑われ,神経線維腫の疑いとして手術目的に当科紹介された。合同での手術が必要と考えられたため,整形外科に紹介しMRIガイド下生検で悪性末梢神経鞘腫瘍の可能性を示唆された。同年6月に腫瘍の動脈塞栓術施行後に右後腹膜腫瘍摘出術を施行し,病理結果から悪性末梢神経鞘腫瘍と診断された。術後10ヵ月現在再発認めず,外来通院中である。後腹膜原発腫瘍において悪性末梢神経鞘腫瘍は極めて稀な症例であり,有効な治療法は確立されていない。今回,後腹膜原発の悪性末梢神経鞘腫瘍の1例を経験したので,若干の文献的考察を加えて報告する。(著者抄録)

Comparison of inflammation-based prognostic scores as predictors of survival outcomes in patients with germ cell tumors. International journal

Kasumi Yoshinaga, Takuya Sadahira, Yuki Maruyama, Yosuke Mitsui, Takehiro Iwata, Koichiro Wada, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Investigative and clinical urology 62 ( 1 ) 47 - 55 2021.1

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

PURPOSE: The aim of this study was to compare the prognostic value of pretreatment inflammation-based scoring systems in terms of overall survival (OS) and progression-free survival (PFS) in patients with germ cell tumors (GCTs) receiving bleomycin, etoposide, and cisplatin (BEP) chemotherapy. MATERIALS AND METHODS: We evaluated 63 patients with GCTs retrospectively. The Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio, prognostic index, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index, and albumin-to-globulin ratio (AGR) were measured in all patients before chemotherapy. To assess the predictive ability of each scoring system, areas under the receiver operating characteristic curve were calculated, and multivariate analysis was performed to identify associations between the predictive scores and OS. RESULTS: Of all the inflammation-based scoring systems, the GPS had the greatest area under the curve (0.847) for predicting OS, followed by the PNI (0.829) and AGR (0.810). Kaplan-Meier analyses revealed that the GPS, PNI, and AGR were significantly associated with OS, whereas the GPS, PLR, and PNI were significantly associated with PFS. In the multivariate analysis, the GPS was an independent predictor of OS and PFS. CONCLUSIONS: We demonstrated that the GPS was the most valuable biomarker of OS and PFS in patients with GCTs.

DOI： 10.4111/icu.20200103

Differential Impact of Gonadotropin-releasing Hormone Antagonist Versus Agonist on Clinical Safety and Oncologic Outcomes on Patients with Metastatic Prostate Cancer: A Meta-analysis of Randomized Controlled Trials. International journal

Mohammad Abufaraj, Takehiro Iwata, Shoji Kimura, Anoud Haddad, Hashim Al-Ani, Lana Abusubaih, Marco Moschini, Alberto Briganti, Pierre I Karakiewicz, Shahrokh F Shariat

European urology 79 ( 1 ) 44 - 53 2021.1

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

CONTEXT: Androgen deprivation therapy is the mainstay treatment of metastatic prostate cancer, achieved mainly by gonadotropin-releasing hormone (GnRH) agonists or antagonists. OBJECTIVE: To investigate the differential impact of GnRH agonists and antagonists on clinical safety and oncologic outcomes. EVIDENCE ACQUISITION: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search using the electronic databases (MEDLINE, Web of Science, Cochrane Library, and Scopus) included randomized controlled trials comparing the clinical safety and oncologic outcomes of GnRH agonists and antagonists. The endpoints of interest were the following: (1) treatment-related adverse effects (AEs), (2) prostate-specific antigen (PSA) progression, and (3) overall mortality. The relative risk (RR) was used as the summary statistic, and results were reported with 95% confidence intervals (CIs). EVIDENCE SYNTHESIS: Eight clinical trials (20 published studies) comprising 2632 men met our inclusion criteria; of them, 1646 received GnRH antagonist and 986 had GnRH agonist. Treatment-emerging AEs occurred in 73% patients in the GnRH antagonist group and 68% in the GnRH agonist group (RR: 1.10, 95% CI: 1.04-1.15). Serious AEs occurred in 9.8% of the GnRH antagonist and 11% of the GnRH agonist group (RR: 0.92, 95% CI: 0.73-1.17). Antagonists were associated with higher injection site reaction rates (38%) than agonists (4.8%). GnRH antagonist was associated with fewer cardiovascular events (RR: 0.52, 95% CI: 0.34-0.80). There was no significant difference in PSA progression, but GnRH antagonist was associated with lower overall mortality rates than GnRH agonists (RR: 0.48, 95% CI: 0.26-0.90, p = 0.02). CONCLUSIONS: Existing data indicate that GnRH antagonist use is associated with significantly lower overall mortality and cardiovascular events as compared with agonists. These findings should be interpreted with caution owing to the short follow-up duration and assessment of cardiovascular events as secondary endpoints in the included trials. Further studies are needed to validate or refute these observations. Injection site reactions were significantly higher in the GnRH antagonist group. PATIENT SUMMARY: Gonadotropin-releasing hormone (GnRH) antagonist is associated with lower death rates and cardiovascular events than GnRH agonists, based on the data from trials with short follow-up duration. GnRH agonists are associated with lower adverse events, such as decreased libido, hot flushes, erectile dysfunction, back pain, weight gain, constipation, and injection site reactions. There were no significant differences in prostate-specific antigen progression or fatigue.

DOI： 10.1016/j.eururo.2020.06.002

A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial.

Takuya Sadahira, Yuki Maruyama, Yoshiki Hiyama, Hiroyuki Kitano, Hiroki Yamada, Takayuki Goto, Tsubasa Kondo, Katsumi Shigemura, Yosuke Mitsui, Takehiro Iwata, Kohei Edamura, Motoo Araki, Masami Watanabe, Tadasu Takenaka, Jun Teishima, Yasuyoshi Miyata, Kiyohito Ishikawa, Ei-Ichiro Takaoka, Jun Miyazaki, Satoshi Takahashi, Naoya Masumori, Hiroshi Kiyota, Masato Fujisawa, Shingo Yamamoto, Takafumi Sakuma, Norihiro Kusumi, Takaharu Ichikawa, Toyohiko Watanabe, Yoshitsugu Nasu, Masaya Tsugawa, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 5 ) 663 - 667 2021

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

The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants.

DOI： 10.18926/AMO/62782

ロボット支援下仙骨膣固定術の導入に向けて

佐古智子, 岩田健宏, 西村慎吾, 高本篤, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友

Japanese Journal of Endourology 34 ( 2 ) 221 - 225 2021

Language：Japanese Publisher：日本泌尿器内視鏡学会

骨盤臓器脱に対する治療として, 2010年に経腟メッシュ手術が, 2014年に腹腔鏡下仙骨膣固定術が保険収載され, 泌尿器科医が骨盤臓器脱に対する治療を行うことも一般的になってきている.

2020年4月の診療報酬改定により, 新たにロボット支援腹腔鏡下仙骨膣固定術が保険収載された. 腹腔鏡下仙骨膣固定術は, 正確な剥離操作を要し, 深部での縫合結紮操作を多用する手術であることなど, 良性疾患に対する手術でありながら手技の難易度が比較的高い術式であると考えられる. これに対して手術支援ロボットを用いることで, 手術の難易度が低減されること, 手術成績が向上することが期待される.

当院でも2020年8月よりロボット支援下仙骨膣固定術を導入した. ロボット支援下仙骨膣固定術のメリットやデメリット, 導入の意義などについて, 手術導入に向けた取り組みについて述べる.

DOI： 10.11302/jsejje.34.221

【地方の腎移植の継続と継承-組織・指導医の取り組みと今後の展望-】岡山大学における腎移植継承の取り組み

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科 33 ( 2 ) 67 - 71 2021

【地方の腎移植の継続と継承-組織・指導医の取り組みと今後の展望-】岡山大学における腎移植継承の取り組み

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科 33 ( 2 ) 67 - 71 2021

Language：Japanese Publisher：腎移植・血管外科研究会

1.岡山大学の腎移植の背景・歴史岡山大学泌尿器科は2009年に新しい腎移植プログラムを立ち上げ総計144例となった.成績も1年生存・生着率100%を維持している.2.人材確保医局員の確保から始まる.3.育成腎移植は幅広いテクニックが要求される.血管縫合糸は若手医師でも縫いやすく結紮もし易いGore-tex sutureを用いている.いい雰囲気でやることを心がけている.4.腎臓内科との連携術前術後連携を取るため腎移植カンファレンスを月一回行い情報共有している.5.教室内での他の領域の医師との関係腎移植チームのメンバーも腫瘍の手術やロボット手術を担当することによって腎移植のみに偏らない配慮をしている.6.働き方改革移植前後の管理の簡略化に努めている.(著者抄録)

RARCにおけるECUDとICUD (回腸導管) の比較検討

小林泰之, 枝村康平, 岩田健宏, 西村慎吾, 和田耕一郎, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 34 ( 2 ) 182 - 185 2021

Language：Japanese Publisher：日本泌尿器内視鏡学会

岡山大学病院にて2018年1月より2020年9月までの期間に単一術者にて連続的に行われたロボット支援膀胱全摘 (以下 : RARC) 46症例体腔外尿路変更 (以下 : ECUD) (23例), 体腔内尿路変更 (以下 : ICUD) (23例) の比較検討を行った. 検討項目は手術時間, 推定出血量, 輸血率, リンパ節郭清個数, 入院日数, 血液生化学データ, 術後合併症とした. 尿路変更に要した時間はICUD群の方が有意に長かったが, 入院期間はICUD群が有意に短かった. 他の周術期成績はECUDと同等であった. 術者の視点では良好な拡大視野, 尿管導管吻合の精緻性, 同一視野で手術の流れが途切れることなく継続できることがICUDのメリットではないかと考える.

DOI： 10.11302/jsejje.34.182

【ロボット手術の教育方法-それぞれの施設での試み-】岡山大学病院泌尿器科におけるロボット手術教育の現状

小林泰之, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 定平卓也, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 33 ( 2 ) 221 - 224 2020.12

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

2009年にダビンチSが薬事承認、2012年にロボット支援下腹腔鏡下前立腺全摘除術が保険収載されて以来、ロボット手術は急激に普及している。岡山大学病院関連施設においても、この数年間でダビンチが急速に普及し、13台(岡山大学病院を含む)のダビンチが稼働し45名の術者が執刀を行っている。しかしながら、各々施設での手術方法、指導方法は全く同じではない。関連施設内での人事異動にともない、岡山大学病院においても、様々な背景を有する術者が在籍するようになり、同一施設内にも関わらず複数の手術方法が乱立した。この状態に当施設のロボット手術教育はうまく対応できず、2015年頃より周術期成績も悪化の傾向を示した。この問題を解決するために、腹腔鏡手術教育にて培った"手術内容を統一し手術内容の再現性を高め、短いラーニングカーブを目指す"というコンセプトを応用し、この状況を乗り越えようと試みている。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J05817&link_issn=&doc_id=20201215380007&doc_link_id=%2Fcs5jjend%2F2020%2F003302%2F009%2F0221-0224%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5jjend%2F2020%2F003302%2F009%2F0221-0224%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検の初期

高本篤, 河田達志, 小林泰之, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 1 2020.11

RALP術中にモノポーラーシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 宗田大二郎, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 2 2020.11

これから始めるロボット支援下仙骨腟固定術ロボット支援腹腔鏡下仙骨腟固定術の導入に向けて

佐古智子, 岩田健宏, 西村慎吾, 高本篤, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

腹腔鏡技術認定医実際の教育現場を紹介します! 岡山大学泌尿器科における腹腔鏡教育

小林泰之, 富永悠介, 枝村康平, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 荒木元朗, 渡辺豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

初心者向けの新術式一筆書きHoLEPの提案と教育効果について

富永悠介, 宗田大二郎, 坪井一馬, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 4 2020.11

Expression of urokinase-type plasminogen activator system in non-metastatic prostate cancer. International journal

Shoji Kimura, David D'Andrea, Takehiro Iwata, Beat Foerster, Florian Janisch, Mehdi Kardoust Parizi, Marco Moschini, Alberto Briganti, Marko Babjuk, Piotr Chlosta, Pierre I Karakiewicz, Dmitry Enikeev, Leonid M Rapoport, Veronica Seebacher, Shin Egawa, Mohammad Abufaraj, Shahrokh F Shariat

World journal of urology 38 ( 10 ) 2501 - 2511 2020.10

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

PURPOSE: To investigate the prognostic role of expression of urokinase-type plasminogen activator system members, such as urokinase-type activator (uPA), uPA-receptor (uPAR), and plasminogen activator inhibitor-1 (PAI-1), in patients treated with radical prostatectomy (RP) for prostate cancer (PCa). METHODS: Immunohistochemical staining for uPA system was performed on a tissue microarray of specimens from 3121 patients who underwent RP. Cox regression analyses were performed to investigate the association of overexpression of these markers alone or in combination with biochemical recurrence (BCR). Decision curve analysis was used to assess the clinical impact of these markers. RESULTS: uPA, uPAR, and PAI-1 were overexpressed in 1012 (32.4%), 1271 (40.7%), and 1311 (42%) patients, respectively. uPA overexpression was associated with all clinicopathologic characteristics of biologically aggressive PCa. On multivariable analysis, uPA, uPAR, and PAI-1 overexpression were all three associated with BCR (HR: 1.75, p < 0.01, HR: 1.22, p = 0.01 and HR: 1.20, p = 0.03, respectively). Moreover, the probability of BCR increased incrementally with increasing cumulative number of overexpressed markers. Decision curve analysis showed that addition of uPA, uPAR, and PAI-1 resulted in a net benefit compared to a base model comparing standard clinicopathologic features across the entire threshold probability range. In subgroup analyses, overexpression of all three markers remained associated with BCR in patients with favorable pathologic characteristics. CONCLUSION: Overexpression of uPA, uPAR, and PAI-1 in PCa tissue were each associated with worse BCR. Additionally, overexpression of all three markers is informative even in patients with favorable pathologic characteristics potentially helping clinical decision-making regarding adjuvant therapy and/or intensified follow-up.

DOI： 10.1007/s00345-019-03038-5

ハイリスク腎移植game changers DSA陽性ハイリスク腎移植

西村慎吾, 荒木元朗, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 90 - 90 2020.10

尿路変向術:私の工夫 RARC ICUD失敗から学んだこと

小林泰之, 枝村康平, 西村慎吾, 岩田健宏, 定平卓也, 高本篤, 佐古智子, 荒木元朗, 渡邊豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 111 - 111 2020.10

腎摘除術を要した多房性気腫性腎盂腎炎の1例

小林宏州, 高本篤, 定平卓也, 和田耕一郎, 前原貴典, 大岩裕子, 岩田健宏, 西村慎吾, 杉本盛人, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 4 ) 465 - 469 2020.10

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は55歳、女性。右腰背部痛を主訴に近医受診した。CTでClass 3Bの気腫性腎盂腎炎を認め、当院緊急搬送となった。未治療の2型糖尿病を有しており、HbA1cは13.4%であった。抗菌薬投与、血糖コントロール、ガンマグロブリン療法による保存的加療を開始したが、改善を認めなかった。CTガイド下経皮的ドレナージによる腎温存治療を最大限に検討したものの、広範で多房性にガス像を呈していたため穿刺部位を特定できず断念した。そのため入院4日後に経腰式右腎摘除術を施行した。術後の経過は良好で、入院30日後に退院となった。気腫性腎盂腎炎は腎実質やその周囲組織にガスの集簇を認める重篤な急性壊死性感染症である。適切に加療しなければ致死的となり得る疾患であるが、近年では保存的加療や経皮的ドレナージを中心とする腎温存を図る治療が多数ある。腎温存は施行できなかったが、腎摘除術を行うことで良好な経過を得られた症例を経験したので報告する。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01004&link_issn=&doc_id=20201022210008&doc_link_id=%2Fer9niuro%2F2020%2F008204%2F008%2F0465-0469%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2020%2F008204%2F008%2F0465-0469%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

後腹膜SFT(Solitary fibrous tumor)の一例

坪井一馬, 高本篤, 関戸崇了, 富永悠介, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 荒木元朗, 渡部昌美, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 191 - 191 2020.10

Tumor suppressor REIC/Dkk-3 and its interacting protein SGTA inhibit glucocorticoid receptor to nuclear transport. International journal

Takehiro Iwata, Takuya Sadahira, Kazuhiko Ochiai, Hideo Ueki, Takanori Sasaki, Peng Haung, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu, Masami Watanabe

Experimental and therapeutic medicine 20 ( 2 ) 1739 - 1745 2020.8

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

REIC/Dkk-3 is a tumor suppressor, and its expression is significantly downregulated in a variety of human cancer types. A previous study performed yeast two-hybrid screening and identified the small glutamine-rich tetratricopeptide repeat-containing protein α (SGTA), known as a negative modulator of cytoplasmic androgen receptor (AR) signaling, which is a novel interacting partner of REIC/Dkk-3. The previous study also indicated that the REIC/Dkk-3 protein interferes with the dimerization of SGTA and then upregulates the AR transport and signaling in human prostate cancer PC3 cells. Since the transport of some steroid receptors to nucleus is conducted similarly by dynein motor-dependent way, the current study aimed to investigate the role of SGTA and REIC/Dkk-3 in the transport of other glucocorticoid receptors (GR). In vitro reporter assays for the cytoplasmic GR transport were performed in human prostate cancer PC3 cells and 293T cells. As for the SGTA protein, a suppressive effect on the GR transport to the nucleus was observed in the cells. As for the REIC/Dkk-3 protein, an inhibitory effect was observed for the GR transport in PC3 cells. Under the depleted condition of SGTA by short-hairpin (sh)RNA, the downregulation of GR transport by REIC/Dkk-3 was significantly enhanced compared with the non-depleted condition in PC3 cells, suggesting a compensatory role of REIC/Dkk-3 in the SGTA mediated inhibition of GR transport. The current study therefore demonstrated that SGTA inhibited the cytoplasmic transport of GR in 293T and PC3 cells, and REIC/Dkk-3 also inhibited the cytoplasmic transport of GR in PC3 cells. These results may be used to gain novel insight into the GR transport and signaling in normal and cancer cells.

DOI： 10.3892/etm.2020.8819

Efficacy of Preoperative Chemotherapy for High Risk Upper Tract Urothelial Carcinoma. International journal

Beat Foerster, Mohammad Abufaraj, Firas Petros, Mounsif Azizi, Mohit Gupta, Donald Schweitzer, Vitaly Margulis, Takehiro Iwata, Shoji Kimura, Ahmad Shabsigh, Alberto Briganti, Ja H Ku, Tim Muilwijk, Wassim Kassouf, Surena F Matin, Philippe E Spiess, Phillip M Pierorazio, Kees Hendricksen, Shahrokh F Shariat

The Journal of urology 203 ( 6 ) 1101 - 1108 2020.6

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

PURPOSE: The impact of preoperative chemotherapy in patients with upper urinary tract urothelial carcinoma remains poorly investigated. We assessed the rates of pathological complete response (pT0N0/X) and downstaging (pT1N0/X or less) at radical nephroureterectomy after preoperative chemotherapy and evaluated their impact on survival. MATERIALS AND METHODS: This was an international observational study of patients who underwent preoperative chemotherapy and radical nephroureterectomy for high risk upper tract urothelial carcinoma between 2005 and 2017. Multiple imputation of chained equations was applied to account for missing values. Logistic regression analyses were performed to identify predictors of pathological response. Cox proportional hazard regression models were used to estimate recurrence-free survival, cancer specific survival and overall survival. RESULTS: A total of 267 patients met our inclusion criteria. Among included patients 82 (31%) received methotrexate, vinblastine, doxorubicin and cisplatin; 123 (46%) gemcitabine and cisplatin; 25 (9%) gemcitabine and carboplatin; and 32 (12%) other regimens. The overall rates of pathological complete response and pathological downstaging were 10.1% and 44.9%, respectively. On multivariable analysis the use of gemcitabine and cisplatin, and gemcitabine and carboplatin was not statistically different from methotrexate, vinblastine, doxorubicin and cisplatin in achieving pathological complete response and pathological downstaging, respectively. The number of administered cycles did not appear to have an effect on pathological responses. Pathological downstaging was the strongest prognostic factor for recurrence-free survival (HR 0.2, p <0.001), cancer specific survival (HR 0.19, p <0.001) and overall survival (HR 0.40, p <0.001). CONCLUSIONS: Pathological downstaging after preoperative chemotherapy is a robust prognostic factor at radical nephroureterectomy and is associated with improved survival outcomes. Although preoperative chemotherapy appears to be effective, well designed prospective studies are still needed.

DOI： 10.1097/JU.0000000000000737

Inflammatory bowel disease and prostate cancer risk: A systematic review. International journal

Anoud Haddad, Mohammed Qussay Al-Sabbagh, Hashim Al-Ani, Abdel Muez Siyam, Emad Aborajooh, Takehiro Iwata, Shoji Kimura, Shahrokh F Shariat, Mohammad Abufaraj

Arab journal of urology 18 ( 4 ) 207 - 212 2020.5

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

Objective: To evaluate the risk of prostate cancer (PCa) in patients with inflammatory bowel disease (IBD), focussing on ulcerative colitis (UC) and Crohn's disease (CD) separately. Methods: A systemic search was carried out using PubMed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We retrieved a total of 349 articles. All the articles were in the English language and investigated the incidence of PCa in patients with IBD. Results: Nine studies met our inclusion criteria, with a total of 205 037 men. Two studies reported an increase in the risk of PCa in men with IBD in general. Five other studies reported an increased risk of PCa in men with UC or with CD specifically. On the other hand, two studies reported a decreased risk of PCa in patients with UC and patients with IBD treated with aminosalicylates. Conclusions: While men with UC appear to have higher risk of developing PCa, data on patients with CD are inconclusive. Therefore, patients with UC may benefit from earlier PCa screening. Our findings confirm a complex interplay between IBD and PCa, including factors such as genetic predisposition, systemic inflammation and treatment effects. The modulatory effect of treatment strategies for IBD on the development and progression of PCa might be of clinical significance. Abbreviations: CD: Crohn's disease; CRP: C- reactive protein; FOLH1: folate hydrolase 1; GIT: gastrointestinal tract; IBD: inflammatory bowel disease; IL-6: interleukin 6; NOS: Newcastle-Ottawa Scale; PCa: prostate cancer; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PSMA: prostate-specific membrane antigen; UC: ulcerative colitis.

DOI： 10.1080/2090598X.2020.1761674

Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis. International journal

Florian Janisch, Shahrokh F Shariat, Pascal Baltzer, Harun Fajkovic, Shoji Kimura, Takehiro Iwata, Philipp Korn, Lin Yang, Petr V Glybochko, Michael Rink, Mohammad Abufaraj

World journal of urology 38 ( 5 ) 1165 - 1175 2020.5

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

PURPOSE: To systematically review the literature evaluating the performance of MDCTU for the diagnosis of UTUC and meta-analyse available data. We also compared the diagnostic accuracy of MDCTU to other radiologic modalities. METHODS: This systematic review and meta-analysis was conducted according to the PRISMA statement. A systematic research using Pubmed, Scopus, Cochrane, and Web of Science libraries was performed on November 1st, 2018. We included all original articles investigating the performance of MDCTU for the diagnosis of UTUC using histopathology as the reference standard for true positives and an unsuspicious clinical follow-up of at least 1 year for true negatives. RESULTS: Overall, 13 studies comprising 1233 patients were eligible and included in this systematic review and meta-analysis. In patient-based analyses, the pooled sensitivity and specificity were 92% (CI 0.85-0.96) and 95% (CI 0.88-0.98), respectively. The reported sensitivity in the per-lesion analysis ranged between 91 and 97%. All studies reporting segment-based analysis demonstrated high diagnostic accuracy (> 90%). While one study reported higher accuracy of retrograde ureteropyelography than MDCTU (97% vs. 94%), another study demonstrated an inferior accuracy of intravenous pyelogram compared to MDCTU. Findings on the accuracy of diffusion-weighted magnetic resonance imaging compared to MDCTU were inconsistent. CONCLUSION: MDCTU has excellent diagnostic performance in detecting UTUC and ruling-out suspicious upper urinary tract lesions in per-patient and per-lesion-based analyses. We confirm the choice of MDCTU as the radiologic diagnostic modality of choice for work-up of suspicious upper urinary tract lesions providing valuable information in patient counseling, decision-making, and treatment planning.

DOI： 10.1007/s00345-019-02875-8

The prognostic value of the urokinase-plasminogen activator system (uPA) in bladder cancer patients treated with radical cystectomy (RC). International journal

Florian Janisch, David D'Andrea, Takehiro Iwata, Shoji Kimura, Mohammad Abufaraj, Dmitry Enikeev, Petr V Glybochko, Pierre I Karakiewicz, Peter Nyirady, Harun Fajkovic, Andrea Haitel, Veronika Seebacher, Michael Rink, Shahrokh F Shariat

Urologic oncology 38 ( 5 ) 423 - 432 2020.5

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

PURPOSE: Urokinase-plasminogen activator (uPA), its receptor (uPAR), and the plasmin-activator inhibitor type 1 (PAI-1) have been associated with oncologic outcomes in various malignancies and could help identify bladder cancer (BC) patients treated with radical cystectomy (RC) who are likely to benefit from intensification of therapy to prevent disease progression. Our aim was to assess the value of uPA, uPAR, and PAI-1 for prognosticating survival outcomes of patients treated with RC for BC. MATERIALS AND METHODS: Tumor specimens from 272 consecutive patients treated with RC for advanced BC were assessed with immunohistochemical staining for uPA, uPAR, and PAI-1. Overexpression was assessed by pathological image analysis. Kaplan-Meier estimates and multivariable Cox-regression were used to analyze survival. Harrell's C-index was used to assess for clinical impact of the uPA system. RESULTS: uPA, uPAR, and PAI-1 were overexpressed in 48.2%, 51.1%, and 52.2% of patients, respectively. uPA overexpression was associated with lymphovascular invasion (P = 0.034) and nodal status (P = 0.013); PAI-1 overexpression was associated with primary muscle-invasive BC (P = 0.015) and lymphovascular invasion (P = 0.024). uPA, uPAR, and the number of overexpressed markers were all 3 significantly associated with shorter overall recurrence-free-, distant recurrence-free-, and cancer-specific survival. In multivariable analyses, uPA overexpression remained associated with shorter recurrence-free survival (hazard ratio [HR] = 1.79; P = 0.036) in the entire cohort, in patients without lymph node metastasis (HR = 1.98; P = 0.018) and those with nonorgan-confined disease (HR = 1.98; P = 0.022). uPAR overexpression was associated with shorter recurrence-free survival in patients without lymph node metastasis (HR = 2.01; P = 0.021) and those with organ-confined disease (HR = 4.11; P = 0.037). CONCLUSION: Members of the uPA system are associated with features of biologically aggressive BC and oncologic outcomes. However, their value beyond currently available information remains limited.

DOI： 10.1016/j.urolonc.2020.02.002

【腎盂・尿管癌の治療を考える】腎盂・尿管癌における腹腔鏡下腎尿管全摘除術の適応

吉永香澄, 荒木元朗, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 和田耕一郎, 佐古智子, 枝村康平, 小林泰之, 渡部昌実, 渡辺豊彦, 那須保友

泌尿器外科 33 ( 5 ) 455 - 461 2020.5

Language：Japanese Publisher：医学図書出版(株)

切除可能な腎盂・尿管癌において、外科的治療の標準術式は腎尿管全摘除術・膀胱部分切除術である。腹腔鏡手術は開放手術と比較して低侵襲であり、低リスク症例では前者が選択される傾向にあるが、pT3以上やリンパ節転移が疑われる症例では開放手術が推奨されている。また、腎機能に問題がある場合などに腎温存療法や化学療法が選択されることもある。本稿では腎盂・尿管癌における腹腔鏡手術の適応について考察する。(著者抄録)

Clinical experience with pembrolizumab in the treatment of advanced urothelial cancer

Yusuke Tominaga, Atsushi Takamoto, Takanori Sekito, Syogo Watari, Yuko Oiwa, Risa Kubota, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 82 ( 1 ) 106 - 110 2020.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The West Japan Urological Association

[Introduction and objective) Pembrolizumab, a programmed death one checkpoint inhibitor, was approved as second-line treatment of advanced urothelial cancer (UC). We performed a pilot study to investigate the effect of pembrolizumab. [Methods and patients) 19 patients who were treated with pembrolizumab from April 2018 to July 2019 were retrospectively reviewed and analyzed to evaluate efficacy and safety. Pembrolizumab was administered after platinum-based chemotherapy. [Results) The median age was 68 years old
male-to-female ratio was 14:5
primary lesions were upper urinary tract, bladder and others (10, 7 and 2, respectively)
recurrence lesions were lymph nodes, lung, bone and liver (14, 9, 4 and 2, respectively). The median number of cycles was three courses (range, 1-16). The objective response rate, median progression-free survival period (PFS), and median overall survival period (OS) were 24%, 2.7 months and 9.1 months, respectively. Pembrolizumab showed a long-term effect for all responsive cases until the end of the follow-up period. Immune-related adverse events (irAE) were observed in four patients. Neutrophil-to-lymphocyte ratio was negatively correlated with PFS, but not significantly correlated with OS. [Conclusion) Pembrolizumab demonstrated a comparable efficacy and safety profile in the treatment of advanced UC. In particular, responsive cases showed a durable response. Further investigation is required to identify predictive markers that can be routinely used in clinical practice.

Impact of Gender on Chemotherapeutic Response and Oncologic Outcomes in Patients Treated With Radical Cystectomy and Perioperative Chemotherapy for Bladder Cancer: A Systematic Review and Meta-Analysis. International journal

Shoji Kimura, Takehiro Iwata, Mohammad Abufaraj, Florian Janisch, David D'Andrea, Marco Moschini, Baeth Al-Rawashdeh, Harun Fajkovic, Veronika Seebacher, Shin Egawa, Shahrokh F Shariat

Clinical genitourinary cancer 18 ( 2 ) 78 - 87 2020.4

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

Female patients with bladder cancer (BCa) have had more advanced disease than their male counterparts at diagnosis and have experienced worse oncologic outcomes. However, the effect of gender on the chemotherapeutic response and oncologic outcomes after radical cystectomy (RC) and perioperative chemotherapy remains to be elucidated. We performed a systematic literature search to identify eligible studies that had investigated the effect of gender on the chemotherapeutic response and oncologic outcomes after RC and perioperative chemotherapy. We identified 15 studies reported from 2008 to 2019. For the patients who had received neoadjuvant chemotherapy (NAC), female gender was not associated with a complete response (pooled odds ratio [OR], 0.94; 95% confidence interval [CI], 0.69-1.26) nor a complete or partial response (pooled OR, 0.96; 95% CI, 0.73-1.27). In addition, women experienced had less upstaging (pooled OR, 0.3; 95% CI, 0.14-0.68) at RC compared with their male counterparts. Moreover, female patients who had undergone RC and NAC were likely to have better disease recurrence and cancer-specific mortality rates than were the male patients (pooled hazard ratio [HR], 0.66 and 95% CI, 0.44-0.98; and pooled HR, 0.49 and 95% CI, 0.29-0.81, respectively). For the patients who had undergone adjuvant chemotherapy, female gender was not associated with overall mortality (pooled HR, 1.15; 95% CI, 0.7-1.89), disease recurrence (pooled HR, 0.95; 95% CI, 0.74-1.23), or cancer-specific mortality (pooled HR, 1.07; 95% CI, 0.81-1.43). Female patients with BCa seem to benefit more from NAC than do their male counterparts. This potential differential sensitivity of female BCa to cisplatin-based combination chemotherapy might help close the gender gap in BCa, suggesting that gender could be a biomarker to help select the best systemic therapy for patients with advanced BCa.

DOI： 10.1016/j.clgc.2019.11.007

岡山大学病院における進行性尿路上皮癌に対するpembrolizumabの治療経験 Reviewed

富永悠介, 高本篤, 関戸崇了, 和田里章悟, 大岩裕子, 窪田理沙, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 1 ) 106 - 110 2020.4

Language：Japanese Publisher：西日本泌尿器科学会

【目的】当科におけるpembrolizumabの治療成績について報告する。【対象と方法】2018年4月から2019年7月までの間に、当院で進行性尿路上皮癌に対してpembrolizumabを使用した19例を対象とした。後方視的に有効性と安全性について検討した。【結果】年齢中央値は68歳(39〜81歳)、性別は男性14例(74%)、女性5例(26%)であった。上部尿路腫瘍10例(53%)、膀胱腫瘍7例(37%)、その他2例(11%)であり、転移部位はリンパ節14例(74%)、肺9例(47%)、骨4例(21%)、肝2例(11%)であった。投与回数の中央値は3回(1〜16回)、観察期間の中央値は4ヵ月(1〜12ヵ月)であった。奏効率は24%、progression-free survival(PFS)の中央値は2.7ヵ月、overall survival(OS)の中央値は9.1ヵ月であった。PRを得られた症例(4例)では観察期間終了時点においても全例で継続可能であった。免疫関連有害事象は4例で経験した。好中球・リンパ球比とPFSは負の相関を認めた。【結論】当院におけるpembrolizumabの治療成績は他の報告と同等であった。奏効例についてはdurable responseを得られた。今後、臨床的に応用可能な効果予測因子のさらなる検討が必要である。(著者抄録)

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後腹膜悪性末梢神経鞘腫の1例

宗田大二郎, 高本篤, 荒木元朗, 角南亮輔, 関戸崇了, 佐久間貴文, 和田里章悟, 吉永香澄, 丸山雄樹, 光井洋介, 富永悠介, 大岩裕子, 窪田理沙, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 1 ) 173 - 173 2020.4

Performance of [68Ga] Ga-PSMA 11 PET for detecting prostate cancer in the lymph nodes before salvage lymph node dissection: a systematic review and meta-analysis. International journal

Shoji Kimura, Mohammad Abufaraj, Florian Janisch, Takehiro Iwata, Mehdi Kardoust Parizi, Beat Foerster, Nicola Fossati, Alberto Briganti, Shin Egawa, Markus Hartenbach, Shahrokh F Shariat

Prostate cancer and prostatic diseases 23 ( 1 ) 1 - 10 2020.3

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

BACKGROUND: Salvage lymph node dissection (sLND) for nodal recurrence in prostate cancer (PCa) patients with biochemical recurrence (BCR) is still not recommended in current guidelines, because of the diagnostic inaccuracy of current conventional imaging. To assess the performance of [68Ga] Ga-prostate-specific membrane antigen conjugate 11 positron emission tomography (PSMA-PET) in detecting PCa lymph node metastasis using pathologic confirmation through sLND. METHODS: Literature search was conducted using the MEDLINE, SCOPUS, Web of Science, and Cochrane Library on November 11th, 2018 to identify the eligible studies. Studies were eligible if they investigated the diagnostic performance of PSMA-PET before sLND in PCa patients with BCR and reported the number of true positive, false positive, false negative, and true negative on a lesion-based and/or field-based analyses to compare with histopathologic findings in sLND specimens. RESULTS: Fourteen studies published between 2015 and 2018 comprising 462 patients were selected in this systematic review and meta-analysis. The positive predictive value of PSMA-PET before sLND on a patient-based analysis ranged between 0.70 and 0.93. The pooled sensitivity using lesion-based and field-based analyses were 0.84 (95%CI: 0.61-0.95) and 0.82 (95%CI: 0.72-0.89), respectively. The pooled specificity using lesion-based and field-based analyses were 0.97 (95%CI: 0.95-0.99) and 0.95 (95%CI: 0.70-0.99), respectively. The diagnostic odds ratio using lesion-based and field-based analyses were 189 (95%CI: 39-920) and 82 (95%CI: 8-832), respectively. CONCLUSIONS: PSMA-PET before sLND provided highly accurate performance with clinically relevant high positive and negative predictive values for detecting lymph node disease in patients with BCR after local treatment with curative intent for PCa. PSMA-PET can identify the patients who are likely to benefit from sLND and possibly direct to lesion or region-based dissection.

DOI： 10.1038/s41391-019-0156-z

Robotic Renal Autotransplantation: A Feasibility Study in a Porcine Model.

Risa Kubota, Motoo Araki, Koichiro Wada, Kasumi Kawamura, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Yuichi Ariyoshi, Takehiro Iwata, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Yuzuki Kano, Masashi Kitagawa, Katsuyuki Tanabe, Hitoshi Sugiyama, Jun Wada, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Acta medica Okayama 74 ( 1 ) 53 - 58 2020.2

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

We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci® robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort® and irrigated on ice with Ringer's solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery.

DOI： 10.18926/AMO/57953

Preventive efficacy and safety of lactobacillus vaginal suppositories in women with recurrent cystitis: A phase 2 study Reviewed

Sadahira T, Wada K, Ishii A, Maruyama Y, Iwata T, Araki M, Watanabe M, Watanabe T, Nasu Y

Eur Urol Open Sci 19 ( 2 ) 2036 - 2037 2020

岡山大学病院における進行性尿路上皮癌に対するpembrolizumabの治療経験

富永悠介, 高本篤, 角南亮輔, 関戸崇了, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 大岩裕子, 窪田理沙, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 6 ) 656 - 656 2019.12

Impact of alcohol consumption on the risk of developing bladder cancer: a systematic review and meta-analysis. International journal

Mihai Dorin Vartolomei, Takehiro Iwata, Beat Roth, Shoji Kimura, Romain Mathieu, Matteo Ferro, Shahrokh F Shariat, Christian Seitz

World journal of urology 37 ( 11 ) 2313 - 2324 2019.11

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

BACKGROUND: Epidemiologic studies that investigated alcohol consumption in relation to the risk of bladder cancer (BCa) have demonstrated inconsistent results. We conducted a systematic review and meta-analysis of the literature to investigate the association of alcohol including different types of alcoholic beverages consumption with the risk of BCa. MATERIALS AND METHODS: A systematic search of Web of Science, Medline/PubMed and Cochrane library was performed in May 2018. Studies were considered eligible if they assessed the risk of BCa due to alcohol consumption (moderate or heavy dose) and different types of alcoholic beverages (moderate or heavy dose) in multivariable analysis in the general population (all genders, males or females) or compared with a control group of individuals without BCa. STUDY DESIGN: observational cohorts or case-control. RESULTS: Sixteen studies were included in this meta-analysis. Moderate and heavy alcohol consumption did not increase the risk of BCa in the entire population. Sub-group and sensitivity analyses revealed that heavy alcohol consumption increased significantly the risk of BCa in the Japanese population, RR 1.31 (95% CI 1.08-1.58, P < 0.01) in the multivariable analysis, and in males RR of 1.50 (95% CI 1.18-1.92, P < 0.01), with no significant statistical heterogeneity. Moreover, heavy consumption of spirits drinks increased the risk of BCa in males, RR 1.42 (95% CI 1.15-1.75, P < 0.01). CONCLUSION: In this meta-analysis, moderate and heavy alcohol consumption did not increase the risk of bladder cancer significantly. However, heavy consumption of alcohol might increase the risk of BCa in males and in some specific populations.

DOI： 10.1007/s00345-019-02825-4

The role of adjuvant radiotherapy after surgery for upper and lower urinary tract urothelial carcinoma: A systematic review. International journal

Takehiro Iwata, Shoji Kimura, Mohammad Abufaraj, Florian Janisch, Pierre I Karakiewicz, Veronika Seebacher, Morgan Rouprêt, Yasutomo Nasu, Shahrokh F Shariat

Urologic oncology 37 ( 10 ) 659 - 671 2019.10

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

OBJECTIVES: The role of adjuvant radiotherapy (ART) in patients with bladder cancer (BCa) and upper tract urothelial carcinoma (UTUC) is controversial. We systematically evaluated the oncologic efficacy of ART and its associated toxicity in patients treated with surgery and ART for BCa and UTUC. MATERIALS AND METHOD: We performed a literature search on December 2018 using MEDLINE, Web of Science, Cochrane databases and Scopus according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Fourteen BCa studies and 14 UTUC studies were included in this systematic review. The data were too scarce and heterogeneous for meta-analytical analysis. RESULTS: The quality and quantity of the data on ART in BCa and UTUC patients are limited. The combination of ART and chemotherapy appears to be beneficial in patients with locally advanced BCa or UTUC. The early and late adverse effects of ART are decreasing reflecting the progress in radiation technology. CONCLUSIONS: According to the currently available literature, there is no clear benefit of ART after radical surgery in BCa and UTUC. Future efforts should focus on evaluating multimodal approach using ART with chemotherapy. Until that time comes, ART should be used carefully in patients with BCa and UTUC on a case-by-case basis.

DOI： 10.1016/j.urolonc.2019.05.021

Oncological safety of testosterone replacement therapy in prostate cancer survivors after definitive local therapy: A systematic literature review and meta-analysis. International journal

Mehdi Kardoust Parizi, Mohammad Abufaraj, Harun Fajkovic, Shoji Kimura, Takehiro Iwata, David D'Andrea, Pierre I Karakiewicz, Shahrokh F Shariat

Urologic oncology 37 ( 10 ) 637 - 646 2019.10

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

AIM: To evaluate the association between testosterone replacement therapy (TRT) in prostate cancer (CaP) patients who underwent definitive local therapy with curative intent with biochemical recurrence (BCR). MATERIALS AND METHODS: A literature search using PubMed, Scopus, Web of Science, and Cochrane Library was conducted on November 2018 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis guidelines. The pooled BCR rate in CaP men treated with TRT after definitive local therapy with curative intent was calculated using a random effects model. RESULTS: Twenty-one studies were eligible. The overall pooled BCR rate was 0.01 (95%CI 0.00-0.02) suggesting a lack of association between TRT and BCR; there was no heterogeneity among included studies (I2 = 24.34%, P = 0.15). In subgroup analyses, pooled BCR rates were 0.00 (95%CI 0.00-0.02) in patients treated with radical prostatectomy and 0.02 (95%CI 0.00-0.04) in patients treated with external beam radiation therapy, brachytherapy, cryotherapy, or high intensity focused ultrasound; there was no heterogeneity in the subgroup analyses (I2 = 19.88%, P = 0.18). CONCLUSIONS: In this systematic review and meta-analysis, we did not observe higher rate of BCR after TRT for nonmetastatic CaP patients after definitive local therapy. Based on these data, others and we have outlined a phase I/II trial assessing the safety and benefits of TRT in select men with secondary symptomatic hypogonadism who have no active disease after definitive local CaP therapy with curative intent.

DOI： 10.1016/j.urolonc.2019.06.007

Prognostic role of the urokinase plasminogen activator (uPA) system in patients with nonmuscle invasive bladder cancer. International journal

Takehiro Iwata, Shoji Kimura, Mohammad Abufaraj, Florian Janisch, Mehdi Kardoust Parizi, Andrea Haitel, Micheal Rink, Morgan Rouprêt, Harun Fajkovic, Veronica Seebacher, Peter Nyirady, Pierre I Karakiewicz, Dmitry Enikeev, Leonid M Rapoport, Yasutomo Nasu, Shahrokh F Shariat

Urologic oncology 37 ( 10 ) 774 - 783 2019.10

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

OBJECTIVES: To assess the role of the urokinase plasminogen activator (uPA) system as a prognostic biomarker in patients with nonmuscle invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB) with or without adjuvant intravesical therapy. MATERIAL AND METHODS: We stained TURB tissue from 827 NMIBC patients with uPA, its receptor (uPAR) and its inhibitor (PAI-1). The status of these markers was categorized as normal vs. overexpressed using the cutoffs of 30% for uPA, 50% for uPAR, and 30% for PAI-1. Multivariable Cox regression analyses were performed to evaluate the prognostic value of these markers. RESULTS: uPA was overexpressed in 37.7% of patients, uPAR in 44.7% and PAI-1 in 44.6%. Overexpression of these markers was associated with high tumor grade. Within a median follow-up was 60 months (interquartile range: 22-109), uPA (hazard ratio [HR]: 1.40; P = 0.006), uPAR (HR: 1.70; P < 0.001), PAI-1 (HR: 1.35; P = 0.014), and the combination of all 3 markers (HR: 3.38; P < 0.001) were associated with recurrence-free survival (RFS); uPA (HR: 1.68; P = 0.035) and the combination of all 3 markers (HR: 8.79; P = 0.005) were associated with progression-free survival (PFS). The addition of the uPA system to a base model improved the discrimination by 1.3% for RFS and 2.1% for PFS. In subgroup analyses, uPA (HR: 2.19; P = 0.018) was associated with PFS in T1G3 patients and its addition to a base model improved the discrimination by 2.5%. uPA (HR: 1.44; P = 0.019), uPAR (HR: 1.54; P = 0.006), PAI-1 (HR: 1.46; P = 0.013) and the combination of all 3 markers (HR: 3.48; P < 0.001) were associated with RFS in TaG1-2 patients and their addition to a base model improved the discrimination by 2.1%. CONCLUSION: uPA, uPAR, and PAI-1 are overexpressed in one-third to half of patients with NMIBC. Their overexpression is an independent prognosticator of RFS and PFS which improved the predictive accuracy of current clinicopathological characteristics. Biomarkers that capture the biological and clinical behavior of individual tumors may help personalize clinical decision-making in patients with NMIBC.

DOI： 10.1016/j.urolonc.2019.05.019

症例から学ぶ治療変遷から読み解く腎癌治療何を、どこまで、どのように? 下大静脈腫瘍塞栓を伴う腎腫瘍の新しい手術アプローチ

荒木元朗, 小林泰之, 枝村康平, 角南亮輔, 関戸崇了, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 大岩裕子, 窪田理沙, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 渡辺豊彦, 渡部昌実, 那須保友, 楳田佑三, 八木孝仁

西日本泌尿器科 81 ( 増刊 ) 113 - 113 2019.10

Current Disease Management of Primary Urethral Carcinoma. International journal

Florian Janisch, Mohammad Abufaraj, Harun Fajkovic, Shoji Kimura, Takehiro Iwata, Peter Nyirady, Michael Rink, Shahrokh F Shariat

European urology focus 5 ( 5 ) 722 - 734 2019.9

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

CONTEXT: Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidence-based management recommendations difficult. OBJECTIVE: To review reported disease management strategies of PUC and their impact on oncological outcomes. EVIDENCE ACQUISITION: A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10yr including ≥20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma. EVIDENCE SYNTHESIS: In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst(oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT. CONCLUSIONS: PUC is a rare malignancy with an often poor natural course, requiring a stage- and gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important. PATIENT SUMMARY: In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes.

DOI： 10.1016/j.euf.2019.07.001

岡山大学病院泌尿器科における腹腔鏡教育プログラムの有用性腹腔鏡下副腎摘除術

和田里章悟, 小林泰之, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 荒木元朗, 渡邉豊彦, 那須保友

Japanese Journal of Endourology 32 ( 2 ) 225 - 229 2019.9

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

当院泌尿器科では2006年から独自の腹腔鏡手術教育プログラムを作成し手術教育を行っている。2009年3月から2017年11月までに当院で腹腔鏡技術認定医トレーニング中の泌尿器科医師が執刀した腹腔鏡下副腎摘除術76症例と、当院の腹腔鏡技術認定医が行った43症例との周術期成績の比較検討を行った。プログラム対象者は合計18人(卒後6-11年目)で、1人あたりの執刀症例数は中央値4例(range:1-9)、認定医の術者は9名で中央値2例(range:1-26)であった。患者背景には大きな差は認めなかった。手術時間は認定医群で有意に短かった(p=0.0122)ものの、両群において輸血や開腹移行症例、重篤な合併症はなかった。手術時間・出血量に急激なラーニングカーブは認めなかった。系統的な手術教育により腹腔鏡手術経験の未熟な術者の初期症例においても、安定した周術期成績を残すことが出来た。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J05817&link_issn=&doc_id=20191106410020&doc_link_id=%2Fcs5jjend%2F2019%2F003202%2F023%2F0225-0229%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5jjend%2F2019%2F003202%2F023%2F0225-0229%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Comparison of perioperative complications and health-related quality of life between robot-assisted and open radical cystectomy: A systematic review and meta-analysis. International journal

Shoji Kimura, Takehiro Iwata, Beat Foerster, Nicola Fossati, Alberto Briganti, Yasutomo Nasu, Shin Egawa, Mohammad Abufaraj, Shahrokh F Shariat

International journal of urology : official journal of the Japanese Urological Association 26 ( 8 ) 760 - 774 2019.8

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

To compare postoperative complications and health-related quality of life of patients undergoing robot-assisted radical cystectomy with those of patients undergoing open radical cystectomy. A systematic search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A pooled meta-analysis was carried out to assess the differences between robot-assisted radical cystectomy and open radical cystectomy according to randomized and non-randomized comparative studies, respectively. We identified six randomized comparative studies and 31 non-randomized comparative studies. Most robot-assisted radical cystectomy patients were treated with extracorporeal urinary diversion. Robot-assisted radical cystectomy was associated with longer operative times, and lower blood loss and transfusion rates compared with open radical cystectomy in both randomized comparative studies and non-randomized comparative studies. There was no significant difference between robot-assisted radical cystectomy and open radical cystectomy in the rate of patients with any or major complications within 90 days both in randomized comparative studies and non-randomized comparative studies. Non-randomized comparative studies reported a lower rate of complications at 30 days, mortality at 90 days and length of stay for patients treated with robot-assisted radical cystectomy, which were not confirmed in randomized comparative studies. Additionally, there were no differences in postoperative quality of life score assessment at 3 and 6 months between robot-assisted radical cystectomy and open radical cystectomy. Robot-assisted radical cystectomy is associated with less blood loss and lower transfusion rates. There is no difference in complications, length of stay, mortality, and quality of life between robot-assisted radical cystectomy and open radical cystectomy. Data from non-randomized comparative studies favor perioperative outcomes in robot-assisted radical cystectomy patients, the failure to confirm in randomized comparative studies, likely due to bias in study design and reporting. Further randomized comparative studies comparing postoperative complications and quality of life between robot-assisted radical cystectomy with intracorporeal urinary diversion and open radical cystectomy are required to assess potential differences between these two surgical approaches.

DOI： 10.1111/iju.14005

Oncologic outcomes after robot-assisted versus open radical cystectomy: a systematic review and meta-analysis. International journal

Takehiro Iwata, Shoji Kimura, Beat Foerster, Nicola Fossati, Alberto Briganti, Pierre I Karakiewicz, Kilian M Gust, Shin Egawa, Yasutomo Nasu, Mohammad Abufaraj, Shahrokh F Shariat

World journal of urology 37 ( 8 ) 1557 - 1570 2019.8

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

PURPOSE: The efficacy of RARC in oncologic outcomes compared ORC is controversial. We assess potential differences in oncologic outcomes between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). METHODS: We performed the literature search systematically according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A pooled meta-analysis was performed to assess the difference in oncologic outcomes between RARC and ORC, separately in randomized controlled trials (RCTs) and non-randomized studies (NRCTs). RESULTS: Five RCTs and 28 NRCTs were included in this systematic review and meta-analysis. There was no difference in the rate of overall positive surgical margin (PSM) in RCTs, while NRCTs showed a lower rate for RARC. There was no difference in the soft tissue PSM rate between RARC and ORC in both RCTs and NRCTs. There was no difference in the lymph node yield by standard and extended lymph node dissection between RARC and ORC in both RCTs and NRCTs. There was no significant difference in survival outcomes between RARC and ORC in both RCTs and NRCTs. CONCLUSIONS: Based on the current evidence, there is no difference in the rate of PSMs, lymph node yield, recurrence rate and location as well as short-term survival outcomes between RARC and ORC in RCTs. In NRCTs, only PSM rates were better for RARC compared to ORC, but this was likely due to selection and reporting bias which are inherent to retrospective study designs.

DOI： 10.1007/s00345-019-02708-8

Perioperative blood transfusion affects oncologic outcomes after nephrectomy for renal cell carcinoma: A systematic review and meta-analysis. International journal

Takehiro Iwata, Shoji Kimura, Beat Foerster, Mohammad Abufaraj, Pierre I Karakiewicz, Felix Preisser, Yasutomo Nasu, Shahrokh F Shariat

Urologic oncology 37 ( 4 ) 273 - 281 2019.4

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

AIM: To investigate the association of perioperative blood transfusion (PBT) with oncologic outcomes in patients with renal cell carcinoma (RCC), we conducted a systematic review and meta-analysis of the literature to clarify the long-term oncologic effect of PBT in patients undergoing nephrectomy for RCC. MATERIALS AND METHODS: We searched the MEDLINE, Web of Science, Cochrane Library and Scopus on 15th April 2018 to identify studies that compared patients who received PBT undergoing radical or partial nephrectomy for RCC to patients who did not with the aim of evaluating its impact on overall mortality (OM), cancer-specific mortality (CSM) and disease recurrence using multivariable cox regression analysis. RESULTS: A total of 19,681 patients in 7 studies matched the selection criteria for the systematic review and meta-analysis. All 7 studies were retrospective design and published between 1994 and 2018. Our study included low quality of eligible studies due to their retrospective design and showed a significant heterogeneity. PBT was associated with OM (pooled hazard ratio [HR], 1.49, 1.24-1.78), CSM (pooled HR, 1.46, 1.20-1.77), and disease recurrence (pooled HR, 1.80, 1.03-3.12). In a subgroup analysis of 3,664 patients with nonmetastatic RCC, PBT was remained associated with OM (pooled HR, 1.91; 1.06-3.41), but not anymore with CSM (pooled HR, 1.92, 0.94-3.91) or disease recurrence (pooled HR, 2.18, 0.86-5.55). CONCLUSIONS: PBT in patients undergoing nephrectomy for RCC is associated with worse overall survival. While PBT may be reflective of the underlying aggressiveness of the disease, it could be that its detrimental effect on outcomes is caused by its negative effect on the host's resilience.

DOI： 10.1016/j.urolonc.2019.01.018

Focal Neuroendocrine Differentiation of Conventional Prostate Adenocarcinoma as a Prognostic Factor after Radical Prostatectomy: A Systematic Review and Meta-Analysis. International journal

Mehdi Kardoust Parizi, Takehiro Iwata, Shoji Kimura, Florian Janisch, Mohammad Abufaraj, Pierre I Karakiewicz, Dmitry Enikeev, Leonid M Rapoport, Georg Hutterer, Shahrokh F Shariat

International journal of molecular sciences 20 ( 6 ) 2019.3

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

The biologic and prognostic value of focal neuroendocrine differentiation (NED) in conventional prostate adenocarcinoma (PC) patients who undergo radical prostatectomy (RP) remains controversial. In this systematic review and meta-analysis, we assessed the association of focal NED in conventional PC with oncological outcomes after RP. A literature search using PubMed, Scopus, Web of Science, and Cochrane Library was conducted on December 2018 to find relevant studies according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We used a fixed-effect model to analyze the impact of focal NED in RP specimen on progression-free survival defined by biochemical recurrence (BCR). A total of 16 studies with the outcomes of disease progression and survival were eligible. No patient in these studies received androgen deprivation therapy prior to RP. Eleven studies found no significant correlation between focal NED and outcomes of interest, while five studies reported a significant association of focal NED assessed by immunohistochemical chromogranin A or serotonin staining with BCR or survival. Focal NED was associated with higher BCR rates after RP with a pooled HR of 1.39 (95% CI 1.07‒1.81) in five studies. No heterogeneity was reported in this analysis (I² = 21.7%, p = 0.276). In conclusion, focal NED in conventional PC is associated with worse prognosis after RP. Its presence should be reported in pathologic reports and its true clinical impact should be assessed in well-designed prospective controlled studies.

DOI： 10.3390/ijms20061374

Prognostic value of modified Glasgow Prognostic Score in non-muscle-invasive bladder cancer. International journal

Shoji Kimura, David D' Andrea, Francesco Soria, Beat Foerster, Mohammad Abufaraj, Mihai D Vartolomei, Takehiro Iwata, Pierre I Karakiewicz, Michael Rink, Kilian M Gust, Shin Egawa, Shahrokh F Shariat

Urologic oncology 37 ( 3 ) 179.e19-179.e28 2019.3

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

PURPOSE: To investigate the prognostic value of preoperative modified Glasgow Prognostic Score (mGPS) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of bladder with or without intravesical therapy. MATERIAL AND METHODS: We retrospectively reviewed our medical records to identify 1,096 consecutive patients with NMIBC treated with transurethral resection of bladder. The mGPS of each patient was calculated on the basis of preoperative serum C-reactive protein and albumin. Univariable and multivariable Cox regression analyses were performed to investigate the association of mGPS with recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: The mGPS of 0, 1, and 2 was observed in 764 (69.7%), 299 (27.3%), and 33 (3.0%) patients, respectively. On univariable analysis, mGPS 2 was associated with worse RFS (Hazard Ratio [HR]: 1.60, 95%; CI: 1.01-2.54). However, on multivariable analyses, which adjusted for the effects of established clinicopathologic features, mGPS 2 did not maintain its independent association with RFS (HR: 1.41, 95% CI: 0.88-2.26). On multivariable analysis, mGPS 1 and 2 were both independently associated with worse PFS compared to mGPS 0 (HR: 2.06, 95% CI: 1.37-3.12 and HR: 3.31, 95% CI: 1.40-7.87, respectively). The inclusion of mGPS improved the discrimination of a standard prognostic model for PFS from 71.6% to 73.8%. In subgroup analyses, mGPS 1 was associated with PFS (HR 2.09, 95% CI: 1.24-3.52) on multivariable analysis in patients with the European Association of Urology high-risk group. Additionally, in patients treated with bacillus Calmette-Guérin, mGPS 2 was associated with disease PFS (HR10.1, 95% CI: 2.61-38.8). CONCLUSIONS: The mGPS independently predicts PFS in patients with NMIBC. Inclusion of mGPS in prognostic models might help identify patients who are more likely to fail standard therapy and experience disease progression and, therefore, may benefit from intensified therapy such as radical cystectomy or inclusion in clinical trials of novel immunotherapeutics.

DOI： 10.1016/j.urolonc.2018.11.005

当院で経験した前立腺炎症性偽腫瘍の1例

佐久間貴文, 高本篤, 河村香澄, 岩田健宏, 和田耕一郎, 谷本竜太, 杉本盛人, 小林泰之, 荒木元朗, 渡邊豊彦, 柳井広之, 那須保友

西日本泌尿器科 80 ( 増刊 ) 176 - 176 2018.10

前立腺全摘後の持続する発熱とLDH高値を契機に診断に至った血管内リンパ腫の1例

中森宏親, 平田武志, 小倉一真, 花本昌紀, 林信希, 岩田健宏, 甲斐誠二, 枝村康平, 江原伸, 三好夏季, 市村浩一

西日本泌尿器科 79 ( 6 ) 198 - 199 2017.6

当科における抗がん剤の取扱い

江原伸, 中島宏親, 林信希, 岩田健宏, 甲斐誠二, 平田武志, 枝村康平

西日本泌尿器科 79 ( 5 ) 162 - 162 2017.5

根治的前立腺全摘除術症例をもとにしたActive surveillanceのリスク検討

中島宏親, 枝村康平, 林信希, 岩田健宏, 平田武志, 甲斐誠二, 江原伸

日本泌尿器科学会総会 105回 PP54 - 03 2017.4

膀胱癌に対するneoadjuvant化学療法の有用性の検討

林信希, 中島宏親, 岩田健宏, 甲斐誠二, 平田武志, 枝村康平, 江原伸

日本泌尿器科学会総会 105回 PP45 - 04 2017.4

Efficacy and safety of 3 day versus 7 day cefditoren pivoxil regimens for acute uncomplicated cystitis: Multicentre, randomized, open-label trial Reviewed

Takuya Sadahira, Okayama Urological Research Group (OURG), Koichiro Wada, Motoo Araki, Ayano Ishii, Atsushi Takamoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Hiromi Kumon, Teruaki Akaeda, Nobuyuki Akazawa, Naoki Akebi, Daiji Araki, Tohru Araki, Ryoji Arata, Yuichi Ariyoshi, Eiichi Ando, Nobuyoshi Ando, Kazushi Ishii, Tsutomu Ishikawa, Noritaka Ishito, Takaharu Ichikawa, Takaaki Inoue, Miyabi Inoue, Yosuke Inoue, Shin Irie, Takehiro Iwata, Tatsuya Uesugi, Shinya Uehara, Katsutoshi Uematsu, Satoshi Uno, Kohei Edamura, Shin Ebara, Yuko Oiwa, Tadashi Oeda, Teruhisa Ohashi, Yozo Ohashi, Hideo Ozawa, Junzo Ochi, Noriaki Ono, Seiji Kai, Haruki Kaku, Satoshi Katayama, Yasuhiro Katayama, Tetuzo Kaneshige, Keiichiro Kawauchi, Masashi Kawaguchi, Tatsushi Kawada, Taiki Kanbara, Mikio Kishi, Ryo Kishimoto, Nobuyuki Kusaka, Norihiro Kusumi, Kimito Kunitomi, Risa Kubota, Hiroaki Kurahashi, Hironori Kojima, Tomoko Kobayashi, Makoto Kobuke, Katsuyoshi Kondo, Takashi Saika, Kazuma Sakaeda, Koji Sakuramoto, Shinichi Sako, Tomoko Sako, Taketo Sasaoka, Katsumi Sasaki, Yoshimasa Jo, Morito Sugimoto, Yuko Seno, Akira Takao, Kosuke Takamura, Kousuke Takamura, Hitoshi Takamoto, Katsuji Takeda, Tadasu Takenaka, Daisuke Tanaka, Ryuta Tanimoto, Masaya Tsugawa, Tomoyasu Tsushima, Hiromu Tsuboi, Syunji Tojo, Kenji Tokinaga, Yusuke Tominaga, Keisuke Doi, Atsushi Nagai, Hirochika Nakajima, Tetsuya Nakada, Hirokazu Nakatsuka, Aya Nakamura, Yasuki Nakayama, Yoshitsugu Nasu, Daisuke Nishikawa, Jun Nishiguchi, Yoshio Nishitani, Shingo Nishimura, Motoichi Nishimura, Yasuhiro Nishiyama, Hajime Nibuno, Kunihiro Nozaki, Hiroyuki Nose, Gaku Noda, Hideaki Hashimoto, Kazuhiro Hata, Toshihide Hayashi, Nobuki Hayashi, Syunji Hayata, Ryoei Hara, Takeshi Hirata, Tomohiro Fujii, Kei Fujio, Ryuji Fujita, Kensuke Bekku, Takanori Maehara, Yoshio Maki, Yuko Matsumoto, Daisuke Manabe, Yusuke Mayumi, Yuki Maruyama, Yosuke Mitsui, Sadayuki Miyaji, Syuhei Munemasa, Wataru Murao, Takanori Murakami, Tadashi Murata, Akihiro Mori, Akira Morita, Koichi Monden, Tomoya Yamasaki, Masahiro Yamashita, Daiduke Yamada, Toyoko Yamato, Toru Yamane, Tomoaki Yamanoi, Yasuo Yamamoto, Kazuaki Yukari, Teruhiko Yokoyama, Takashi Yoshioka, Yuichi Watanabe

Journal of Antimicrobial Chemotherapy 72 ( 2 ) 529 - 534 2017

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press

Background: Fluoroquinolone-non-susceptible Escherichia coli isolated from patients with acute uncomplicated cystitis are a matter of increasing concern. Cefditoren pivoxil is an oral, β-lactamase-stable, extended-spectrum cephalosporin that is effective against fluoroquinolone-non-susceptible bacteria. Objectives: To evaluate the clinical and microbiological efficacies of cefditoren pivoxil against acute uncomplicated cystitis and to determine the optimal duration of cefditoren pivoxil treatment. Methods: We compared 3 and 7 day regimens of cefditoren pivoxil in a multicentre, randomized, open-label study. Results: A total of 104 female patients with acute uncomplicated cystitis were enrolled and randomized into 3 day (n=51) or 7 day (n=53) treatment groups. At first visit, 94 bacterial strains were isolated from the 104 participants of which 81.7% (85/104) were E. coli. Clinical and microbiological efficacies were evaluated 5-9 days following administration of the final dose of cefditoren pivoxil. The clinical efficacies of the 3 and 7 day groups were 90.9% (40/44) and 93.2% (41/44), respectively (P=1.000). The microbiological efficacies of the 3 and 7 day groups were 82.5% (33/40) and 90.2% (37/41), respectively (P=0.349). There were no adverse events due to cefditoren pivoxil treatment, with the exception of a mild allergic reaction in one patient, after which the cefditoren pivoxil was exchanged for another antimicrobial. Conclusions: Cefditoren pivoxil is safe and effective for uncomplicated cystitis, with no significant differences in clinical and microbiological efficacies between 3 and 7 day regimens.

DOI： 10.1093/jac/dkw424

ロボット支援下前立腺全摘除術(RALP)における術後鼠径ヘルニアの検討

甲斐誠二, 中島宏親, 林信希, 岩田健宏, 平田武志, 枝村康平, 江原伸, 弓狩一晃, 雑賀隆史

Japanese Journal of Endourology 29 ( 3 ) 260 - 260 2016.11

希少部位子宮内膜症の1例

小倉一真, 岩田健宏, 中島宏親, 林信希, 甲斐誠二, 枝村康平, 江原伸, 植田麻衣子

西日本泌尿器科 78 ( 増刊 ) 159 - 159 2016.10

当院における転移性腎癌に対してのfirst lineとしてのスニチニブとバゾパニブの検討

岩田健宏, 中島宏親, 林信希, 甲斐誠二, 平田武志, 枝村康平, 江原伸

西日本泌尿器科 78 ( 増刊 ) 169 - 169 2016.10

経尿道的膀胱腫瘍一塊切除術(TUR-BO)にて切除し得た、膀胱異所性褐色細胞腫の1例

岩田健宏, 中島宏親, 林信希, 山野井友昭, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史

西日本泌尿器科 78 ( 9 ) 481 - 481 2016.9

当院におけるCRPCに対する新規抗アンドロゲン剤Enzalutamide、Abirateroneの使用経験

林信希, 中島宏親, 岩田健宏, 甲斐誠二, 弓狩一晃, 枝村康平, 雑賀隆史

西日本泌尿器科 78 ( 5 ) 259 - 259 2016.5

ロボット支援腹腔鏡下腎部分切除術の初期経験

枝村康平, 中島宏親, 林信希, 岩田健宏, 甲斐誠二, 弓狩一晃, 雑賀隆史

西日本泌尿器科 78 ( 4 ) 195 - 195 2016.4

ロボット支援下腎部分切除術の初期経験

河内啓一郎, 岩田健宏, 弓狩一晃, 枝村康平, 小泉文人, 雑賀隆史

泌尿器科紀要 62 ( 3 ) 158 - 158 2016.3

集学的治療が奏効したStage IV尿管癌の1例

山野井友昭, 枝村康平, 林信希, 中島宏親, 岩田健宏, 弓狩一晃, 小泉文人, 雑賀隆史

西日本泌尿器科 78 ( 3 ) 133 - 133 2016.3

Feasibility of robot-assisted radical prostatectomy in elderly patients: Comparative analysis of the peri-surgical/oncological outcomes with younger patients. Reviewed

Takehiro Iwata, Takashi Saika, Kohei Edamura

JOURNAL OF CLINICAL ONCOLOGY 34 ( 2 ) 2016.1

腹腔鏡/ロボット支援手術における骨盤内リンパ節郭清の要点 Special High-risk前立腺癌に対するロボット支援腹腔鏡下骨盤内リンパ節郭清

雑賀隆史, 枝村康平, 弓狩一晃, 岩田健宏, 甲斐誠二, 林信希, 中島宏親

日本内視鏡外科学会雑誌 20 ( 7 ) PD18 - 2 2015.12

腹膜外アプローチによるロボット支援腹腔鏡下前立腺全摘除の経験

枝村康平, 中島宏親, 林信希, 山野井友昭, 岩田健宏, 弓狩一晃, 小泉文人, 雑賀隆史

Japanese Journal of Endourology 28 ( 3 ) 195 - 195 2015.11

ロボット支援腹腔鏡下前立腺全摘除における、症例に即したアプローチの工夫について

雑賀隆史, 枝村康平, 弓狩一晃, 岩田健宏, 甲斐誠二, 林信希, 中島宏親

Japanese Journal of Endourology 28 ( 3 ) 167 - 167 2015.11

Special High-risk前立腺癌に対するロボット支援腹腔鏡下骨盤内リンパ節郭清

岩田健宏, 中島宏親, 林信希, 山野井友昭, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史

Japanese Journal of Endourology 28 ( 3 ) 238 - 238 2015.11

高齢前立腺癌症例に対するロボット支援下前立腺全摘除術の臨床的検討

雑賀隆史, 中島宏親, 林信希, 岩田健宏, 甲斐誠二, 弓狩一晃, 枝村康平

Japanese Journal of Endourology 28 ( 3 ) 218 - 218 2015.11

原発性前立腺扁平上皮癌の1例

山野井友昭, 岩田健宏, 中島宏親, 林信希, 河内啓一郎, 弓狩一晃, 枝村康平, 小泉文人, 雑賀隆史, 井谷史嗣, 荒木宏之, 高橋一剛

西日本泌尿器科 77 ( 増刊 ) 125 - 125 2015.10

前立腺前立腺がんのリスク予測前立腺癌のステージングにおけるFDG-PET/CTの有用性 200例の全摘所見との対比

岩田健宏, 中島宏親, 林信希, 山野井友昭, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史

日本癌治療学会誌 50 ( 3 ) 138 - 138 2015.9

広島市立広島市民病院におけるロボット支援腹腔鏡下前立腺全摘除術(RALP)280例の経験

林信希, 中島宏親, 岩田健宏, 弓狩一晃, 枝村康平, 小泉文人, 雑賀隆史

日本癌治療学会誌 50 ( 3 ) 754 - 754 2015.9

根治的前立腺全摘除術症例をもとにしたActive surveillanceの有用性について

中島宏親, 枝村康平, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 小泉文人, 雑賀隆史

日本癌治療学会誌 50 ( 3 ) 719 - 719 2015.9

前立腺癌のステージングにおけるFDG-PET/CTの有用性

岩田健宏, 宗政修平, 山崎智也, 河内啓一郎, 弓狩一晃, 小泉文人, 枝村康平, 黒瀬恭平, 日下信行, 雑賀隆史

泌尿器外科 28 ( 臨増 ) 884 - 884 2015.5

ロボット支援下腎部分切除術の初期経験

河内啓一郎, 岩田健宏, 弓狩一晃, 枝村康平, 小泉文人, 雑賀隆史

日本泌尿器科学会総会 103回 762 - 762 2015.4

前立腺癌のステージングにおけるFDG-PET/CTの有用性

岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 枝村康平, 黒瀬恭平, 日下信行, 雑賀隆史

日本泌尿器科学会総会 103回 576 - 576 2015.4

当院における体腔鏡下膀胱全摘除術と開腹膀胱全摘除術との比較検討

弓狩一晃, 中島宏親, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 枝村康平, 小泉文人, 雑賀隆史

日本泌尿器科学会総会 103回 571 - 571 2015.4

広島市民病院における腎部分切除の検討

河内啓一郎, 岩田健宏, 弓狩一晃, 枝村康平, 小泉文人, 雑賀隆史

西日本泌尿器科 77 ( 4 ) 151 - 151 2015.4

広島市民病院におけるロボット支援下前立腺全摘除術(RALP)の治療成績

山野井友昭, 中島宏親, 林信希, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史

日本泌尿器科学会総会 103回 749 - 749 2015.4

当院で施行した根治的前立腺全摘除術症例をもとにしたActive surveillanceの有用性について

中島宏親, 枝村康平, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 雑賀隆史

日本泌尿器科学会総会 103回 716 - 716 2015.4

当院における副腎悪性腫瘍の経験

林信希, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史

日本泌尿器科学会総会 103回 633 - 633 2015.4

腎腫瘍に対するロボット支援腹腔鏡下腎部分切除術の初期経験

枝村康平, 中島宏親, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 雑賀隆史

広島市立広島市民病院医誌 31 ( 1 ) 101 - 104 2015.3

Language：Japanese Publisher：広島市立広島市民病院

2014年6月からロボット支援腹腔鏡下腎部分切除術(Robot Assisted Partial Nephrectomy:RAPN)を導入し現在まで8例を経験した。年齢52～76(中央値:62)歳、男性5例、女性3例、腫瘍径15～48(同:19)mm、右2例、左6例、経腹膜アプローチ4例、後腹膜アプローチ4例であった。全例開腹に移行することなく術式を完遂した。手術時間は113～168(中央値:137)分、温阻血時間は16～44(同:22)分であり、出血量はいずれも少量のみで輸血例は無かった。術中、術後に特筆すべき合併症はなく、全例病理組織学的に断端陰性であった。ダヴィンチシステムの導入により、腹腔鏡手術の難点である操作制限が改善され、手術手技が安定した。RAPNは低侵襲性を維持したまま合併症を低下させ、術後の腎機能維持やQOL改善に有効と考えられた。(著者抄録)

腹膜外アプローチによるロボット支援腹腔鏡下前立腺全摘除術の経験

枝村康平, 中島宏親, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 雑賀隆史

Japanese Journal of Endourology 27 ( 3 ) 244 - 244 2014.11

ロボット支援下前立腺全摘除術(RALP)導入後200例の治療成績

山野井友昭, 雑賀隆史, 枝村康平, 日下信行, 黒瀬恭平, 小泉文人, 弓狩一晃, 岩田健宏, 中島宏親, 林信希

Japanese Journal of Endourology 27 ( 3 ) 175 - 175 2014.11

リンパ節郭清術 Super High-risk前立腺癌に対するロボット支援腹腔鏡下骨盤内リンパ節郭清

雑賀隆史, 枝村康平, 小泉文人, 弓狩一晃, 河内啓一郎, 岩田健宏, 日下信行, 中島宏親, 林信希, 山野井友昭

Japanese Journal of Endourology 27 ( 3 ) 132 - 132 2014.11

ロボット支援前立腺全摘除術(RALP)における課題症例における対策

雑賀隆史, 枝村康平, 小泉文人, 弓狩一晃, 河内啓一郎, 岩田健宏

日本内視鏡外科学会雑誌 19 ( 7 ) 859 - 859 2014.10

腹膜外アプローチによるロボット支援腹腔鏡下前立腺全摘除の経験

枝村康平, 中島宏親, 林信希, 山野井友昭, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 雑賀隆史

日本内視鏡外科学会雑誌 19 ( 7 ) 859 - 859 2014.10

泌尿器科領域での腹腔鏡下・ロボット支援手術拡大リンパ節郭清の適応と手技 High Risk前立腺癌に対する拡大リンパ節郭清の検討

雑賀隆史, 枝村康平, 小泉文人, 弓狩一晃, 河内啓一郎, 岩田健宏

日本内視鏡外科学会雑誌 19 ( 7 ) 403 - 403 2014.10

各診療科の迅速な連携により救命しえたフルニエ壊疽の1例

中島宏親, 岩田健宏, 河内啓一郎, 弓狩一晃, 小泉文人, 枝村康平, 雑賀隆史, 宗政修平, 日下信行

西日本泌尿器科 76 ( 10 ) 378 - 378 2014.10

広島市立広島市民病院における腎部分切除の検討

小泉文人, 河内啓一郎, 弓狩一晃, 岩田健宏, 枝村康平, 日下信行, 雑賀隆史

日本癌治療学会誌 49 ( 3 ) 2201 - 2201 2014.6

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