研究者詳細 - 山崎　泰史

論文 - 山崎　泰史

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Taenia saginata Infection Diagnosed Based on the Number of Uterine Branches Observed During Capsule Endoscopy. 国際誌

Kenta Hamada, Koji Takemoto, Kensuke Takei, Yasushi Yamasaki, Yoshiro Fujiwara

The American journal of gastroenterology 113 ( 3 ) 327 - 327 2018年3月

Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas. 国際誌

Yasushi Yamasaki, Noriya Uedo, Yoji Takeuchi, Koji Higashino, Noboru Hanaoka, Tomofumi Akasaka, Minoru Kato, Kenta Hamada, Yusuke Tonai, Noriko Matsuura, Takashi Kanesaka, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Satoki Shichijo, Hiroko Nakahira, Ryu Ishihara, Hiroyasu Iishi

Endoscopy 50 ( 2 ) 154 - 158 2018年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND STUDY AIM: Underwater endoscopic mucosal resection (UEMR) was recently developed in a Western country. A prospective cohort study to investigate the effectiveness of UEMR was conducted in patients with small superficial nonampullary duodenal adenomas. PATIENTS AND METHODS: Patients with duodenal adenomas ≤ 20 mm were enrolled. After the duodenal lumen had been filled with physiological saline, UEMR was performed without submucosal injection. Endoclip closure was attempted for all mucosal defects after UEMR. Follow-up endoscopy with biopsy was performed 3 months later. The primary end point was the complete resection rate, defined as neither endoscopic nor histological residue of adenoma at the follow-up endoscopy. RESULTS: 30 patients with 31 lesions were enrolled. The mean (SD) tumor size was 12.0 mm (7.3). The complete resection rate was 97 % (90 % confidence interval, 87 % - 99 %). The en bloc resection rate was 87 %. All mucosal defects were successfully closed by endoclips. No adverse events occurred except for one case of mild aspiration pneumonia. CONCLUSIONS: UEMR is efficacious for the treatment of small duodenal adenomas, but further large-scale trials are warranted to confirm these results.

DOI： 10.1055/s-0043-119214

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Two cases of white globe appearance in non-cancerous stomach. 国際誌

Masaya Iwamuro, Takehiro Tanaka, Hiroyuki Sakae, Yasushi Yamasaki, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Ecancermedicalscience 12 856 - 856 2018年

記述言語：英語

In this report, we describe two patients with white globe appearance in the non-cancerous stomach. The patient in Case 1 was an 82-year-old Japanese man who had been taking vonoprazan, dimethicone, acotiamide, sitagliptin, candesartan, dutasteride, etizolam and zolpidem. The patient in Case 2 was a 74-year-old Japanese woman who had been taking esomeprazole, rebamipide, sitagliptin, candesartan, ezetimibe, mirabegron, levocetirizine, zolpidem and lactobacillus preparation. In both cases, endoscopy revealed multiple white spots in the stomach. Magnifying endoscopy and blue laser imaging revealed a slightly elevated, round, white substance. Biopsied specimens from the lesions contained parietal cell protrusions and fundic gland cysts. Intraglandular necrotic debris was absent. Consequently, microscopic features in these cases were different from those reported previously for white globe appearance observed in gastric cancer lesions. These results indicate that white globe appearance can be observed in non-cancerous stomach. Although the macroscopic features could be confusing or misleading, thorough endoscopic observation and pathological analysis of white globe appearance will aid oncologists and endoscopists in differentiating between cancer-related lesions and non-cancerous lesions.

DOI： 10.3332/ecancer.2018.856

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Current Status of Endoscopic Resection for Superficial Nonampullary Duodenal Epithelial Tumors. 国際誌

Yasushi Yamasaki, Noriya Uedo, Yoji Takeuchi, Ryu Ishihara, Hiroyuki Okada, Hiroyasu Iishi

Digestion 97 ( 1 ) 45 - 51 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Endoscopic resection (ER) is becoming the first choice of treatment for treating superficial nonampullary duodenal epithelial tumors (SNADETs), but ER procedures for SNADETs remain challenging because of the difficulty experienced in maneuvering the endoscope toward the thin duodenal wall, which results in a high rate of adverse events. Although several ER methods were used to overcome these technical difficulties and complications, ER methods for SNADETs are not standardized. A new technique, underwater endoscopic mucosal resection (UEMR), was developed recently in a western country, and its usefulness was reported. Beginning in 2014, we were the first to use UEMR for SNADETs in Japan. Thus, in our experience, we would propose an indication of the various ER methods for SNADETs according to the lesion size. SUMMARY: Endoscopic mucosal resection (EMR) and UEMR were effective and safe for small lesions (≤20 mm), but for large lesions (>20 mm), piecemeal removal of lesion by EMR and UEMR had high incidence of recurrence and adverse events. Especially, piecemeal EMR could cause delayed perforation. Cold snare polypectomy was useful for small lesions (≤10 mm), but further study of its recurrence is warranted. Endoscopic submucosal dissection (ESD) achieved a high complete resection rate regardless of the lesion size, but its rate of adverse events, including morbid complications, was high. Thus, after ESD for large lesions, secure prevention method for adverse events, such as closure of the wound by laparoscopic-endoscopic cooperative surgery, should be required. Key Messages: ER methods for treating SNADETs were proposed based on the lesion size. For large lesions, prophylactic methods for adverse events should be implemented.

DOI： 10.1159/000484112

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Traction-assisted colorectal endoscopic submucosal dissection by use of clip and line for a neoplasm involving colonic diverticulum. 国際誌

Taro Iwatsubo, Noriya Uedo, Yasushi Yamasaki, Yoji Takeuchi, Yugo Ando

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 2 ( 12 ) 337 - 338 2017年12月

Traction-assisted colorectal endoscopic submucosal dissection using the Mucosectom2 device. 国際誌

Yasushi Yamasaki, Keita Harada, Hiroyuki Okada

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 29 ( 7 ) 815 - 816 2017年11月

Duodenal adenoma overlying a lipoma treated with laparoscopic endoscopic collaborative surgery. 国際誌

Taro Iwatsubo, Yoji Takeuchi, Yasushi Yamasaki

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 29 ( 7 ) 812 - 813 2017年11月

Case of colonic adenoma involving a diverticulum resected by a traction-assisted endoscopic submucosal dissection technique. 国際誌

Satoki Shichijo, Yasushi Yamasaki, Yoji Takeuchi

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 29 ( 6 ) 729 - 730 2017年9月

Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study. 国際誌

Kenta Hamada, Ryu Ishihara, Yasushi Yamasaki, Noboru Hanaoka, Sachiko Yamamoto, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Minoru Kato, Yusuke Tonai, Satoki Shichijo, Noriko Matsuura, Hiroko Nakahira, Takashi Kanesaka, Tomofumi Akasaka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Hiroyasu Iishi, Naoyuki Kanayama, Takero Hirata, Yoshifumi Kawaguchi, Koji Konishi, Teruki Teshima

Clinical and translational gastroenterology 8 ( 8 ) e110 2017年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: The reported 1- and 3-year overall survival rates after esophagectomy for stage I superficial esophageal squamous cell carcinoma (SESCC) are 95-97% and 86%, and those after definitive chemoradiotherapy (CRT) are 98% and 89%, respectively. This study was performed to elucidate the efficacy and safety of another treatment option for SESCC: endoscopic resection (ER) followed by CRT. METHODS: We retrospectively reviewed the overall survival, recurrence, and grade ≥3 adverse events of consecutive patients who refused esophagectomy and underwent ER followed by CRT for SESCC from 1 January 2006 to 31 December 2012. RESULTS: In total, 66 patients with SESCC underwent ER followed by CRT during the study period, and complete follow-up data were available for all patients. The median age was 67 (range, 45-82) years, and the median observation period was 51 (range, 7-103) months. Local and metastatic recurrences occurred in 2 (3%) and 6 (9%) patients, respectively, and 17 (26%) patients died. The 1-, 3-, and 5-year overall survival rates were 98%, 87%, and 75%, respectively. One of the 23 patients with mucosal cancer and 5 of 43 with submucosal cancer developed metastatic recurrences (P=0.65). Five of the 61 patients with negative vertical resection margin and 1 of 5 with positive vertical resection margin developed metastatic recurrences (P=0.39). None of the 30 patients without lymphovascular involvement developed metastatic recurrences; however, 6 of 36 patients with lymphovascular involvement developed metastatic recurrences (P=0.0098). Grade ≥3 adverse events occurred in 21 (32%) patients and all adverse events were associated with CRT, hematological adverse events in 13 (20%), and non-hematological adverse events in 9 (14%). CONCLUSIONS: ER followed by CRT provides survival comparable with that of esophagectomy or definitive CRT and has a low local recurrence rate. A particularly favorable outcome is expected for cancers without lymphovascular involvement.

DOI： 10.1038/ctg.2017.36

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Usefulness of the Valsalva maneuver without a mouthpiece to observe the hypopharynx using transoral endoscopy. 国際誌

Yasushi Yamasaki, Ryu Ishihara, Kenta Hamada

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 29 ( 5 ) 643 - 644 2017年7月

Comparing reduced-dose sodium phosphate tablets to 2 L of polyethylene glycol: A randomized study. 国際誌

Soichiro Ako, Koji Takemoto, Eriko Yasutomi, Chihiro Sakaguchi, Mayu Murakami, Tomoko Sunami, Shohei Oka, Hamada Kenta, Noriko Okazaki, Yuki Baba, Yasushi Yamasaki, Toshiyuki Asato, Daisuke Kawai, Ryuta Takenaka, Hirohumi Tsugeno, Sakiko Hiraoka, Jun Kato, Shigeatsu Fujiki

World journal of gastroenterology 23 ( 24 ) 4454 - 4461 2017年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To compare the tolerability and quality of bowel cleansing between 2 L polyethylene glycol (PEG) and reduced-dose sodium phosphate (NaP) tablets as a preparation for colonoscopy. METHODS: Two hundred patients were randomly assigned to the PEG or NaP groups at the same ratio. The NaP group patients took 30 tablets with 2 L of clear liquid, while the PEG group patients took 2L of PEG. Tolerability was assessed by a questionnaire about taste, volume, and the overall impression. The bowel cleansing quality was evaluated by colonoscopists. RESULTS: Although NaP showed better tolerability in terms of taste, volume and overall impression (P < 0.01, P < 0.01 and P = 0.02, respectively), the overall cleansing quality was better in the PEG group (P < 0.01). A subgroup analysis, stratified by sex and age, indicated that NaP was associated with better tolerability and equivalent bowel cleansing quality in females of < 50 years of age. CONCLUSION: Despite the better tolerability, the use of 30 NaP tablets with 2 L of clear liquid should be limited due to its lower cleansing quality; however, in certain cases the regimen may deserve consideration, particularly in cases involving young women.

DOI： 10.3748/wjg.v23.i24.4454

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New subtype of gastric adenocarcinoma: mixed fundic and pyloric mucosa-type adenocarcinoma.

Takashi Kanesaka, Noriya Uedo, Kenshi Yao, Hiroshi Tanabe, Yasushi Yamasaki, Yoji Takeuchi, Akinori Iwashita, Yasuhiko Tomita

Clinical journal of gastroenterology 10 ( 3 ) 224 - 228 2017年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 73-year-old woman underwent upper endoscopic screening that revealed a 30-mm superficial elevated lesion in the anterior wall of the upper gastric body. The lesion had a whitish color and coarse granular surface in conventional white light endoscopy. Magnifying narrow-band imaging indicated irregular microvascular and microsurface patterns within a demarcation line. The microvessels had a distorted polygonal shape within the area surrounded by the marginal crypt epithelium. The patient underwent endoscopic resection. Histological examination of the resected specimen showed a very well- to well-differentiated tubular adenocarcinoma with differentiation toward the mixed fundic and pyloric mucosa, without chief cells. The histological and serological findings indicated the absence of Helicobacter pylori infection. The present case demonstrates a new histological subtype of gastric adenocarcinoma, which has characteristic endoscopic findings.

DOI： 10.1007/s12328-017-0727-2

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Line-assisted complete closure of duodenal mucosal defects after underwater endoscopic mucosal resection. 国際誌

Yasushi Yamasaki, Yoji Takeuchi, Noriya Uedo, Noboru Hanaoka, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi

Endoscopy 49 ( S 01 ) E37-E38 2017年2月

Technical feasibility of line-assisted complete closure technique for large mucosal defects after colorectal endoscopic submucosal dissection. 国際誌

Minoru Kato, Yoji Takeuchi, Yasushi Yamasaki, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Kenta Hamada, Yusuke Tonai, Satoki Shichijo, Noriko Matsuura, Hiroko Nakahira, Takashi Kanesaka, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Noriya Uedo, Ryu Ishihara, Hiroyasu Iishi

Endoscopy international open 5 ( 1 ) E11-E16 2017年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background and study aims Complete closure of large mucosal defects after colorectal endoscopic submucosal dissection (C-ESD) is considered impossible in most cases because of the limited width of the open clip. We therefore invented a simple closure technique using clip-and-line, named "line-assisted complete closure (LACC)", and assessed its technical feasibility. Patients and methods Between January and February 2016, we performed LACC in 11 patients after C-ESD and included them in this retrospective feasibility study. Outcome measures were procedural success rate, procedure time, and post-procedural complications. Results The median size of the resected specimen was 36 mm (range 30 - 72 mm). Procedural success was achieved in 10 of 11 cases (91 %). Those 10 cases required a median of 9 endoclips (range 6 - 12) for complete closure. Median procedure time for LACC was 14 minutes (range 6 - 22). No complications were observed in any of the cases after the procedure. Conclusion LACC is a simple and feasible technique for complete closure of large mucosal defects after C-ESD.

DOI： 10.1055/s-0042-121002

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Pethidine hydrochloride is a better sedation method for pharyngeal observation by transoral endoscopy compared with no sedation and midazolam. 国際誌

Yasushi Yamasaki, Ryu Ishihara, Noboru Hanaoka, Noriko Matsuura, Takashi Kanesaka, Tomofumi Akasaka, Minoru Kato, Kenta Hamada, Yusuke Tonai, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yuri Ito, Masahiko Yano, Hiroyasu Iishi

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 29 ( 1 ) 39 - 48 2017年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIM: Standard surveillance methods for pharyngeal cancer have not been established. We conducted a randomized controlled trial to investigate the best sedation method for pharyngeal observation using transoral endoscopy. METHODS: In total, 120 patients who underwent surveillance or diagnostic examinations for esophageal cancer were enrolled and divided equally into three groups (no sedation, midazolam, or pethidine hydrochloride). In the midazolam group, midazolam was given i.v. maintaining a Ramsay score of 3. In the pethidine group, pethidine hydrochloride (35 mg) given i.v. Seven sites in five pharyngeal regions were observed on insertion of the endoscope, and graded (0 = poor, 1 = good). After examination, the five pharyngeal regions were scored using a seven-point scale. Primary endpoint was the total score from the five pharyngeal regions. Secondary endpoints were the proportion of the perfect score using the seven-point scale, discomfort score, and adverse events. RESULTS: Mean total scores for the no sedation group, the midazolam group and the pethidine group were 5.7, 5.5, and 6.8, respectively (P < 0.0001). Proportion of patients with a perfect score for the no sedation group, the midazolam group and the pethidine group were 53%, 35%, and 89%, respectively (P < 0.0001). The pethidine group had better results than the other two groups. Discomfort score and adverse events were low in the pethidine group. CONCLUSION: Pethidine hydrochloride is a feasible and safe sedation method, and was superior to no sedation and midazolam regarding pharyngeal observation of esophageal cancer patients.

DOI： 10.1111/den.12746

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Investigation of mucosal pattern of gastric antrum using magnifying narrow-band imaging in patients with chronic atrophic fundic gastritis. 国際誌

Yasushi Yamasaki, Noriya Uedo, Hiromitsu Kanzaki, Minoru Kato, Kenta Hamada, Kenji Aoi, Yusuke Tonai, Noriko Matsuura, Takashi Kanesaka, Takeshi Yamashina, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Yasuhiko Tomita, Hiroyasu Iishi

Annals of gastroenterology 30 ( 3 ) 302 - 308 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Magnifying narrow-band imaging (M-NBI) can reportedly help predict the presence and distribution of atrophy and intestinal metaplasia in the gastric corpus. However, the micro-mucosal pattern of the antrum shown by M-NBI differs from that of the corpus. We studied the distribution and histology of the micro-mucosal pattern in the antrum based on magnifying endoscopy. METHODS: Endoscopic images of the greater curvature of the antrum were evaluated in 50 patients with chronic atrophic fundic gastritis (CAFG). The extent of CAFG was evaluated by autofluorescence imaging. The micro-mucosal pattern was evaluated by M-NBI and classified into groove and white villiform types. The localization of white villiform type mucosa was classified into three types in relation to the areae gastricae: null, central, and segmental types. Biopsies were taken from regions showing different micro-mucosal patterns. Associations among the extent of CAFG, micro-mucosal pattern, and histology were examined. RESULTS: As the extent of CAFG increased, the proportion of white villiform type mucosa increased, whereas that of groove type mucosa decreased (P=0.022). In patients with extensive CAFG, most of the areae gastricae was composed of the segmental or central type of white villiform type mucosa (P=0.044). The white villiform type mucosa had significantly higher grades of atrophy (P=0.002) and intestinal metaplasia (P<0.001) than did the groove type mucosa. CONCLUSION: White villiform type mucosa is indicative of atrophy and intestinal metaplasia in the gastric antrum. It extends to the whole or central part of the areae gastricae as CAFG becomes more extensive.

DOI： 10.20524/aog.2017.0134

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The Very First Changes in the Tongue with the Development of Cancer. 国際誌

Kenta Hamada, Ryu Ishihara, Yasushi Yamasaki

European journal of case reports in internal medicine 4 ( 4 ) 000577 - 000577 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）

We describe the case of an elderly man with a 3-month history of pain at the tip of his tongue due to a lingual cancer. The lesion appeared slightly depressed and reddish. Our images show the very first changes in the tongue with the development of cancer. Patients with tongue pain often visit the internal medicine department first, so highlighting this case will help physicians detect lingual cancer quickly. LEARNING POINTS: Surgical treatment of lingual cancer may affect several tongue functions and remarkably decrease quality of life, so early detection is important to both improve prognosis and maintain quality of life after surgery.Lingual cancer first appears as a slightly depressed reddish lesion as lingual papillae disappear.Since patients with tongue pain often visit the internal medicine department first, early detection of lingual cancer depends on physicians.

DOI： 10.12890/2017_000577

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Advanced Oropharyngeal Cancer Can Be Easily Missed During Esophagogastroduodenoscopy. 国際誌

Kenta Hamada, Tomofumi Akasaka, Yasushi Yamasaki, Ryu Ishihara

European journal of case reports in internal medicine 4 ( 4 ) 000597 - 000597 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）

The case of an elderly man with an advanced oropharyngeal cancer that was missed during esophagogastroduodenoscopy is described. He was referred for endoscopic resection of superficial esophageal squamous cell neoplasms. He died a month after referral due to an advanced oropharyngeal cancer with a metastatic lesion to the brain. Patients with esophageal squamous cell carcinoma are high risk for head and neck cancer. The pharynx is the most common site for cancer in the head and neck region. Consequently, the pharynx should be observed carefully when patients with esophageal squamous cell carcinoma undergo esophagogastroduodenoscopy. LEARNING POINTS: Head and neck cancer develops in approximately 10% of patients with esophageal squamous cell carcinoma.The pharynx should be observed carefully when patients with esophageal squamous cell carcinoma undergo esophagogastroduodenoscopy because the pharynx is the most common site for cancer in the head and neck region.Sedation using narcotic drugs can reduce the gag reflex but still allow patients to vocalize and offer adequate conditions for pharyngeal observation during esophagogastroduodenoscopy.

DOI： 10.12890/2017_000597

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Clinical Outcomes of Endoscopic Hemostasis in Marginal Ulcer Bleeding.

Yasushi Yamasaki, Ryuta Takenaka, Keisuke Hori, Koji Takemoto, Seiji Kawano, Yoshiro Kawahara, Shigeatsu Fujiki, Hiroyuki Okada

Acta medica Okayama 70 ( 6 ) 469 - 475 2016年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding. Sixteen patients had active bleeding. Initial hemostasis was achieved in all patients. There were no procedure-related adverse events. Rebleeding occurred in one patient within the first month and in 7 patients thereafter. There was a significant difference in the rebleeding rate between the patients who received a PPI and those who did not. In a multivariate analysis, the non-use of PPIs was a risk factor for rebleeding (hazard ratio, 6.22). Therapeutic endoscopy is effective in achieving hemostasis from marginal ulcer bleeding. PPIs may prevent rebleeding from marginal ulcers.

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Line-assisted complete closure of large gastric mucosal defects by use of multiple clip-and-line technique. 国際誌

Yasushi Yamasaki, Yoji Takeuchi, Minoru Kato, Noriya Uedo, Ryu Ishihara

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 1 ( 3 ) 49 - 50 2016年11月

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