Faculty Profiles - NAMBA Yuzaburo

MISC - NAMBA Yuzaburo

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Modified deep iliac circumflex osteocutaneous flapによる下腿再建の経験

渡邊敏之, 太田智之, 難波祐三郎, 木股敬裕

日本マイクロサージャリー学会学術集会プログラム・抄録集 44回 182 - 182 2017.12

Vaginoplasty with a Pudendal-groin Flap in Male-to-female Transsexuals

Yuko Mukai, Toshiyuki Watanabe, Morito Sugimoto, Yoshihiro Kimata, Yuzaburo Namba

ACTA MEDICA OKAYAMA 71 ( 5 ) 399 - 405 2017.10

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

Many vaginoplasty techniques have been introduced to improve the outcomes of sex reassignment surgery for male-to-female transsexuals. Some vaginoplasty patients still require additional skin grafts, making dilation mandatory to overcome shrinkage. We developed a new vaginoplasty method (called the "pudendal-groin flap") that uses pudendal-groin flaps. One of this procedure's advantages is that skin grafts are unnecessary, even for patients with small penises and scrotums. We introduce the procedure here and describe our evaluation of its utility. We retrospectively analyzed the cases of the 15 patients who underwent vaginoplasty using pudendal-groin flaps from May 2010 to January 2016 at our institution. We compared the complications as well as the functional and aesthetic outcomes with those of previous studies. The most common complication was bleeding, which occurred at the corpus spongiosum or while creating a new vaginal cavity. Bleeding can be reduced with more careful hemostasis and dissection. Aside from inadequate vaginal depth in one patient, the incidence of other complications, sexual intercourse, and aesthetic outcomes were acceptable. The pudendal-groin flap is thin and pliable and can create sufficient vaginal depth without skin grafts. The resulting scar is inconspicuous. Our findings suggest that vaginoplasty using the pudendal- groin flap method is feasible.

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Surgical treatment for gender identity disorder : Sex reassignment surgery

145 ( 3 ) 489 - 492 2016.6

塞栓術後、二期的に外科手術を施行したびまん性神経線維腫の1例

中桐僚子, 松本洋, 川井啓太, 小松星児, 山田潔, 長谷川健二郎, 難波祐三郎, 木股敬裕, 清家卓也

日本形成外科学会会誌 35 ( 4 ) 234 - 234 2015.4

巨大びまん性神経線維腫切除における2期分割手術法

中桐僚子, 松本洋, 小松星児, 山田潔, 長谷川健二郎, 難波祐三郎, 木股敬裕

日本形成外科学会会誌 34 ( 5 ) 425 - 425 2014.5

当院におけるジェンダー関連疾患に対する外科治療の経験

難波祐三郎

形成外科 57 ( 1 ) 57 - 62 2014

Vaginoplasty in Gender Identity Disorder Male-to-Female Transsexuals

Yuzaburo Namba

The Japanese journal of Plastic Surgery 57 ( 8 ) 867 - 873 2014

Surgical treatment for gender-associated diseases

Yuzaburo Namba

The Japanese journal of Plastic Surgery 57 ( 1 ) 57 - 62 2014

性同一性障害に対する外科治療（２）－造膣術

難波祐三郎

形成外科 57 ( 8 ) 867 - 873 2014

遊離広背筋皮弁を施行し知覚回復を認めた1例

光井俊人, 岩永紘征, 松本洋, 長谷川健二郎, 難波祐三郎, 木股敬裕

日本形成外科学会会誌 33 ( 2 ) 142 - 142 2013.2

当院における乳房再建術後合併症の検討

妹尾貴矢, 石川雅晴, 目谷雅恵, 渡部聡子, 徳山英二郎, 長谷川健二郎, 難波祐三郎, 木股敬裕

日本形成外科学会会誌 33 ( 2 ) 142 - 142 2013.2

operative treatment for gender identity disorder

Namba Yuzbauro

Obstetrical and Gynecological Practice 62 ( 13 ) 2129 - 2134 2013

性同一性障害の手術治療

難波祐三郎

産婦人科の実際 62 ( 13 ) 2129 - 2134 2013

Thumb Polydactyly with a Floating Ulnar Thumb

Hasegawa Kenjiro, Namba Yuzaburo, Kimata Yoshihiro

Acta Medica Okayama 67 ( 6 ) 391 - 395 2013

Negative Pressure Wound Therapy Incorporating Early Exercise Therapy in Hand Surgery:Bag-type Negative Pressure Wound Therapy

Hasegawa Kenjiro, Namba Yuzaburo, Kimata Yoshihiro

Acta Medica Okayama 67 ( 4 ) 271 - 276 2013

乳房再建における深下腹壁動脈穿通枝皮弁の術中静脈うっ血に対してバイパス手術を行った1例

中桐僚子, 渡部聡子, 長谷川健二郎, 難波祐三郎, 木股敬裕

日本マイクロサージャリー学会学術集会プログラム・抄録集 39回 237 - 237 2012.12

研修医のための岡山大学形成外科セミナー.

小野田聡, 安積昌吾, 片山裕子, 難波祐三郎, 木股敬裕

日形会誌 32 164 - 168 2012

Improvement of Therapeutic Environment : Effort to Establish the Medical Center for GID in a General Hospital

114 ( 6 ) 666 - 672 2012

性同一障害に対する乳房切除の経験第3報：術式選択におけるアルゴリズム.

難波祐三郎

形成外科 55 ( 4 ) 413 - 418 2012

性同一障害と手術療法：形成外科との連携.

難波祐三郎

日産婦誌 64 ( 9 ) 229 - 233 2012

性同一性障害に関する診断と治療のガイドライン

松本洋輔, 阿部輝夫, 池田官司, 織田裕行, 康純, 佐藤俊樹, 塚田攻, 針間克己, 松永千秋, 山内俊雄, 齋藤利和, 舛森直哉, 中塚幹也, 難波祐三郎, 木股敬裕

精神神経学雑誌 114 ( 11 ) 1250 - 1266 2012

The Utility of Multidetector-Row Computed Tomography Angiography for Evaluating Perforators of Fibular Osteocutaneous Flaps

Takashi Satoh, Yoshihiro Kimata, Kenjiro Hasegawa, Yuzaburo Namba

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 27 ( 1 ) 29 - 36 2011.1

Language：English Publisher：THIEME MEDICAL PUBL INC

Multidetector-row computed tomography angiography (MDCTA) can be used to visualize small vessels and has been used to search for perforators in deep inferior epigastric artery perforator flaps and anterolateral thigh flaps. Fibula osteocutaneous flaps are often used for mandibular reconstruction, but questions remain about the reliability of these flaps and the variety of their perforators. Eight patients who were candidates for mandibular or pedal reconstruction with a fibula osteocutaneous flap were prospectively evaluated with MDCTA and Doppler sonography. We evaluated the number, position, and course of perforators with MDCTA. The perforators were classified, and intraoperative findings were compared with those of Doppler sonography and MDCTA. MDCTA accurately identified the perforators and showed a satisfactory concordance with intraoperative findings. The high spatial resolution of MDCTA allows the perforators' origin, course, and type to be precisely described. Eighteen vessels were identified with MDCTA, and on average, 2.3 vessels were identified in the leg of each patient. The rate of concordance with operative findings was 87.5% for MDCTA. With MDCTA, flap perforators can be accurately evaluated before surgery in a manner not possible with traditional angiography or Doppler sonography. Reliable perforators can be chosen, and detailed operative plans can be made.

DOI： 10.1055/s-0030-1267380

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総合病院におけるGID医療センター化の取り組み.

難波祐三郎

精神医学 53 ( 9 ) 789 - 794 2011

性同一性障害(GID)に対する性別適合手術と半陰陽への応用.

難波祐三郎

産婦人科手術 22 115 - 122 2011

会陰部周囲の形成外科性同一性障害.

難波祐三郎

PEPARS 59 77 - 84 2011

下肢のリンパ浮腫に対するUntied Stay Suture 法によるリンパ管静脈吻合術.

長谷川健二郎, 山田潔, 難波祐三郎, 木股敬裕

PEPARS 57 ( 57 ) 83 - 89 2011

実験的精巣移植.

山下修二, 難波祐三郎, 木股敬裕

PEPARS 59 93 - 97 2011

Gender identity disorder after puberty and its comprehensive treatment

65 ( 12 ) 941 - 947 2011

岡山大学乳がん治療・再建センターの現況

渡部聡子, 片山裕子, 田中義人, 目谷雅恵, 徳山英二郎, 長谷川健二郎, 難波祐三郎, 木股敬裕

日本形成外科学会会誌 30 ( 10 ) 576 - 576 2010.10

Fluorescence Lymphography with Indocyanine Green for Intact Side of Unilateral Leg Lymphedema : Early Signs of Lymphedema Are Shown?

SENO Takaya, MORISADA Sunao, SUGIYAMA Narushi, YAMADA Kiyoshi, HASEGAWA Kenjiro, AO Masakazu, KIMATA Yoshihiro

23 ( 3 ) 295 - 302 2010.9

SEX REASSIGNMENT SURGERY IN FEMALE TO MALE TRANSSEXUALS

NAMBA Yuzaburo

Journal of Japan Surgical Society 111 ( 4 ) 241 - 245 2010.7

Vaginoplasty with a pudendal-thigh flap in intersexuals

Japanese journal of plastic surgery 53 ( 6 ) 685 - 690 2010.6

Lymphatic Revascularization or Lymphangiogenesis after Skin Flap Transplantation

SATOH Takashi, KIMATA Yoshihiro, SUGIYAMA Narushi, YAMADA Kiyoshi, TOKUYAMA Eijiro, HASEGAWA Kenjiro, NAMBA Yuzaburo, AO Masakazu

23 ( 1 ) 64 - 69 2010.3

Repositioning of the malpositioned ear with a new technique of fascia lata suspension

Takashi Satoh, Shuji Yamashita, Tomoyuki Yasuoka, Kenjiro Hasegawa, Yuzaburo Namba, Yoshihiro Kimata

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 63 ( 2 ) E161 - E163 2010.2

Management of local complications after head and neck reconstruction

ONODA Satoshi, OTUKI Yuki, HASEGAWA Kenjiro, NAMBA Yuzaburo, KIMATA Yoshihiro, SUGIYAMA Narushi, ONODA Tomoo, EGUCHI Motoharu, MIZUKAWA Nobuyoshi

Japanese jornal of Head and Neck Cancer 36 ( 3 ) 369 - 372 2010

Language：Japanese Publisher：Japan Society for Head and Neck Cancer

The goals of head and neck reconstruction after malignant tumor resection include obtaining good postoperative function and appearance and minimizing operative invasiveness. However, the most important goals are reducing local postoperative complications and discharging the patient early, because patients requiring head and neck reconstruction tend to have poorer prognoses. Local complications delay wound healing, postoperative treatment, and postoperative recovery of eating and speech functions. Thus, when shown to be necessary by clinical observation and imaging findings, we open the wound area promptly and attempt to diagnose the complication. In this way, we can discover cervical infections and minimize wound contamination before more serious complications, such as total flap necrosis, develop. We review measures for preventing local complications in patients undergoing head and neck reconstruction at our institution and divide them into preoperative, intraoperative, and postoperative measures.

DOI： 10.5981/jjhnc.36.369

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Other Link： http://search.jamas.or.jp/link/ui/2011048374

挫滅症候群を発症し透析治療を要した上肢切断の1例

佐藤卓士, 長谷川健二郎, 難波祐三郎, 木股敬裕

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 29 ( 10 ) 640 - 644 2009.10

Association study of gender identity disorder and sex hormone-related genes

Hiroshi Ujike, Kyohei Otani, Mikiya Nakatsuka, Kazushi Ishii, Aiko Sasaki, Tomoko Oishi, Toshiki Sato, Yuko Okahisa, Yosuke Matsumoto, Yuzaburo Namba, Yoshihiro Kimata, Shigetoshi Kuroda

PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY 33 ( 7 ) 1241 - 1244 2009.10

Language：English Publishing type：Book review, literature introduction, etc. Publisher：PERGAMON-ELSEVIER SCIENCE LTD

To investigate the biological mechanism of gender identity disorder (GID), five candidate sex hormone-related genes, encoding androgen receptor (AR), estrogen receptors alpha (ER alpha) and beta (ER beta), aromatase (CYP19), and progesterone receptor (PGR) were analyzed by a case-control association study. Subjects were 242 transsexuals (74 male-to-female patients (MTF) and 168 female-to-male patients (FTM)), and 275 healthy age- and geographical origin-matched controls (106 males and 169 females). The distributions of CAG repeat numbers in exon 1 of AR, TA repeat numbers in the promoter region of ER alpha CA repeat numbers in intron 5 of ER beta, TTTA repeat numbers in intron 4 of CYP19, and six polymorphisms (rs2008112, rs508653, V660L, H770H, rs572698 and PROGINS) of PGR were analyzed. No significant difference in allelic or genotypic distribution of any gene examined was found between MTFs and control males or between FTMs and control females. The present findings do not provide any evidence that genetic variants of sex hormone-related genes confer individual susceptibility to MTF or FTM transsexualism. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.pnpbp.2009.07.008

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Ophthalmic Artery Embolization as Pretreatment of Orbital Exenteration for Conjunctival Squamous Cell Carcinoma

Toshihiko Matsuo, Nobuya Ohara, Yuzaburo Namba, Isao Koshima, Kentaro Ida, Susumu Kanazawa

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 32 ( 3 ) 554 - 557 2009.5

Language：English Publisher：SPRINGER

The aim of this study is to describe the effect of transarterial embolization from the ophthalmic artery as a pretreatment for orbital exenteration. A 75-year-old Chinese man with a 7-year history of gradual increase of the left eye swelling showed a massive conjunctival tumor growing outwardly from the interpalpebral fissure and had no light perception in the left eye. Magnetic resonance imaging showed orbital invasion of the tumor around the left eyeglobe. The initial surgery for the planned orbital exenteration was discontinued after skin incision around the orbital margin due to massive hemorrhage. The patient underwent transarterial embolization with gelatin sponge (Spongel) of the feeding arteries from the left ophthalmic artery and, the next day, had orbital exenteration with well-controllable bleeding and reconstruction with free vascularized anterolateral thigh cutaneous flap transfer. Pathologically, well-differentiated squamous cell carcinoma proliferated in exophytic, papillary, and nested fashions, arising from the bulbar conjunctiva. Tumor cells were also found in the conjunctival stroma around the vessels. The sclera at the equator had a perforated site with tumor cell invasion, but no intraocular invasion was found. Hematoxylin-positive gelatin sponges were found inside the orbital vessels and large choroidal vessels. In conclusion, transarterial embolization of feeding arteries arising from the ophthalmic artery is a useful pretreatment to control bleeding at orbital exenteration for malignancy.

DOI： 10.1007/s00270-008-9413-6

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Mastectomy in Female-to male Transsexuals

Namba Y, Watanabe T, Kimata Y

Acta Medica Okayama 63 2009

性同一性障害に対する陰茎再建術の経験

難波祐三郎, 長谷川健二郎, 渡部敏之, 木股敬裕

形成外科 52 2009

Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals

Yuzaburo Namba, Narushi Sugiyama, Shuji Yamashita, Kenjiro Hasegawa, Yoshihiro Kimata, Mikiya Nakatsuka

ACTA MEDICA OKAYAMA 62 ( 6 ) 415 - 419 2008.12

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem.

DOI： 10.18926/AMO/30948

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A Novel Model for Supermicrosurgery Training: The Superficial Inferior Epigastric Artery Flap in Rats

Shuji Yamashita, Narushi Sugiyama, Kenjiro Hasegawa, Yuzaburo Namba, Yoshihiro Kimata

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 24 ( 8 ) 537 - 543 2008.11

Language：English Publisher：THIEME MEDICAL PUBL INC

The purpose of this study was to determine the usefulness of a new flap model, the superficial inferior epigastric artery (SIEA) flap for supermicrosurgical training. Experimental groups were randomly divided into three groups of 10 rats each. In each group REA flaps were elevated and then returned to their original locations with or without vascular anastomosis of the superficial inferior epigastric vessels. Group 1: free SIEA flap, group 2: free SIEA flap with 1 hour ischemia time, group 3: free SIEA flap with 4 hours ischemia time, group 4: SIEA flap without vascular anastomosis. The viability rate was 80% with group 1, 50% with group 2, and 40% with group 3. All nonvascularized flaps (group 4) underwent complete necrosis. These findings suggest that preservation of blood flow in a flap has a beneficial effect on the prevention of microthrombosis in the subcutaneous capillary network of the skin and increases the flap survival rate. The SIEA flap with preserved circulation is an ideal model for developing supermicrosurgical skills.

DOI： 10.1055/s-0028-1088226

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Phantom erectile penis after sex reassignment surgery

Yuzaburo Namba, Narushi Sugiyama, Shuji Yamashita, Eijiro Tokuyama, Kenjiro Hasegawa, Yoshihiro Kimata

ACTA MEDICA OKAYAMA 62 ( 3 ) 213 - 216 2008.6

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.

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United Stay Suture法によるリンパ管静脈吻合とリンパ管静脈吻合術の有効性

長谷川健二郎, 杉山成史, 難波祐三郎, 木股敬裕

PEPARES 22 60 - 65 2008

性同一性障害に対する造腟術の経験

難波祐三郎, 長谷川健二郎, 木股敬裕, 那須保友, 石井和史

形成外科 51 ( 10 ) 1197 - 1204 2008

1.陰圧閉鎖法による創傷治療2)早期運動療法を取り入れた袋型陰圧閉鎖療法

長谷川健二郎, 難波祐三郎, 木股敬裕

形成外科増刊号 51 250 - 254 2008

整形外科手術に役立つ皮弁とそのコツその他の穿通枝皮弁

難波祐三郎, 木股敬裕

MB Orthopaedics 21 ( 5 ) 122 - 128 2008

Mastectomy in female to male transsexuals (second report) Treatment for ptotic breast

Japanese journal of plastic surgery 51 ( 2 ) 203 - 209 2008

遊離皮弁、皮弁・中核皮弁、その他の穿通枝皮弁

難波祐三郎, 木股敬裕

Orthopaedics 122 - 133 2008

Vaginoplasty with an M-shaped perineo-scrotal flap in a male-to-female transsexual

Yuzaburo Namba, Narushi Sugiyama, Shuji Yamashita, Kenjiro Hasegawa, Yoshihiro Kimata, Kazushi Ishii, Yasutomo Nasu

ACTA MEDICA OKAYAMA 61 ( 6 ) 355 - 360 2007.12

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, a penile-scrotal flap and a reversed penile flap. However, none of these procedures is without its disadvantages. We developed a newly kind of flap for vaginoplasty, the M-shaped perineo-scrotal flap (M-shaped flap), using skin from both sides of the scrotum, shorn of hair by preoperative laser treatment. We applied this new type of flap in 7 MTFTS patients between January 2006 and January 2007. None of the flaps developed necrosis, and the patients could engage in sexual activity within 3 months of the operation. The M-shaped flap has numerous advantages: it can be elevated safely while retaining good vascularity, it provides for the construction of a sufficient deep vagina without a skin graft, the size of the flap is not influenced entirely by the length of the penis, and it utilizes skin from both sides of the scrotal area, which is usually excised.

DOI： 10.18926/AMO/32875

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鼠径部の軟部組織再建

木股敬裕, 難波祐三郎, 長谷川健二郎, 杉山成史, 尾崎敏文, 別府保男, 中馬広一, 川井章, 中谷文彦, 桜庭実

関節外科 26 108 - 114 2007

ラットを用いたマイクロサージャリーの経験

新田薫彬, 難波祐三郎, 筒井哲也, 杉山成史, 山下修, 松本洋, 小松星児, 小野田聡, 平川久美子, 木股敬裕

日本形成外科学会会誌 26 ( 12 ) 838 - 838 2006.12

大きな皮弁採取部の欠損に対する一期的縫縮の為のDivided flap technique(The Divided Flap Techinique for Primary Closure of Large Donor Site Defects)

小野田聡, 難波祐三郎, 筒井哲也, 杉山成史, 山下修二, 松本洋, 小松星児, 平川久美子, 木股敬裕

日本形成外科学会会誌 26 ( 12 ) 839 - 839 2006.12

下顎区域切除後の再建例における早期離床を目指した術後管理

平川久美子, 難波祐三郎, 筒井哲也, 杉山成史, 山下修二, 松本洋, 小松星児, 小野田聡, 木股敬裕

日本形成外科学会会誌 26 ( 12 ) 839 - 839 2006.12

性同一性障害患者に対する陰茎形成術の経験

平川久美子, 筒井哲也, 杉山成史, 山下修二, 小松星児, 中川彩, 松本洋, 小野田聡, 難波祐三郎, 木股敬裕, 毛山章, 岡博昭

日本形成外科学会会誌 26 ( 11 ) 778 - 778 2006.11

顔面神経麻痺の数次再建術

長尾聖子, 筒井哲也, 難波祐三郎, 山田潔, 藤津美佐子, 伊藤聖子, 石井直弘, 牛尾茂子, 杉山成史, 山下修二, 光嶋勲

日本形成外科学会会誌 26 ( 9 ) 614 - 614 2006.9

Free combined ALT+TFL flapを用いた頭頸部再建術

山田潔, 難波祐三郎, 筒井哲也, 藤津美佐子, 伊藤聖子, 石井直弘, 長尾聖子, 牛尾茂子, 杉山成史, 山下修二, 光嶋勲

日本形成外科学会会誌 26 ( 9 ) 616 - 616 2006.9

Fibular osteoadiposal flap for treatment of tibial adamantinoma: A case report

Yuzaburo Namba, Yoshihiro Kimata, Isao Koshima, Shinsuke Sugihara, Tohru Sato

ACTA MEDICA OKAYAMA 60 ( 4 ) 233 - 236 2006.8

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

We treated a case with left tibial adamantinoma by use of a contralateral. fibular osteoadiposal flap. The donor site of conventional fibular osteocutaneous flap must be covered with a skin graft because if we close the donor skin defect directly, compartment syndrome might occur. We were able to close the donor skin defect because this combined type flap included only a small monitoring skin paddle. We present herein the utility of the osteoadiposal flap and show the value of a skin-sparing approach with a minimal aesthetic defect.

DOI： 10.18926/AMO/30718

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Penile reconstruction with bilateral superficial circumflex iliac artery perforator (SCIP) flaps

Koshima, I, Y Nanba, A Nagai, M Nakatsuka, T Sato, S Kuroda

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 22 ( 3 ) 137 - 142 2006.4

Language：English Publisher：THIEME MEDICAL PUBL INC

The free radial forearm flap is a very common material for penile reconstruction. Its major problems are donor-site morbidity with large depressive scar after Skin grafting, urethra] fistula due to insufficiency of suture line for the urethra, and need for microvascular anastomosis. A new method using combined bilateral island SCIP flaps for the urethra and penis is developed for gender identity disorder (GID) patients. The advantages of this method are minimal donor-site morbidity with a concealed donor scar, and possible one-stage reconstruction for a longer urethra of 22 cm in length without insufficiency, even for GID female-to-male patients. A disadvantage is poor sensory recovery.

DOI： 10.1055/s-2006-939957

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口腔・中咽頭の再建

木股敬裕, 難波祐三郎, 杉山成史

ENTONI 67,,62-67. 2006

性同一性障害に対する乳房切除の経験

難波祐三郎, 筒井哲也, 木股敬裕, 光嶋勲

形成外科 2006

耳鼻科・頭頚部外科領域における皮弁の実際―要点とコツ―

木股敬裕, 難波祐三郎, 杉山成史

ENTONI 67,,62-67. 2006

性同一性障害における乳腺切除後二次修正の検討

小松星児, 難波祐三郎, 筒井哲也, 杉山成史, 松本洋, 小野田聡, 平川久美子, 木股敬裕

日本形成外科学会総会・学術集会プログラム・抄録集 49th 2006

ROLE OF RECONSTRUCTIVE SURGERY FOR HEAD AND NECK CANCER

KIMATA Yoshihiro, NAMBA Yuzaburo, TUTUI Tetuya, SUGIYAMA Narushi, TOKUYAMA Eijiro, SAKURABA Minoru, HAYASHI Ryuichi, EBIHARA Satoshi

頭頸部癌/ 日本頭頸部癌学会 31 ( 3 ) 313 - 318 2005.10

Sex reassignment surgery for male to female transsexuals: Initial experience at Okayama University hospital

A Nagai, E Tokuyama, Y Nanba, T Tsutsui, Y Kimata, M Nakatsuka, Koshima, I, T Saika, Y Nasu, H Kumon

ACTA MEDICA OKAYAMA 59 ( 5 ) 231 - 233 2005.10

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

The first case of sex reassignment surgery (SRS) in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

DOI： 10.18926/AMO/31976

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Functional reconstruction with free flaps following ablation of oropharyngeal cancer

Yoshihiro Kimata, Minoru Sakuraba, Yuzaburo Namba, Ryuichi Hayashi, Satoshi Ebihara

International Journal of Clinical Oncology 10 ( 4 ) 229 - 233 2005.8

Language：English Publishing type：Book review, literature introduction, etc.

With the development of various reconstructive procedures, most patients who have undergone ablative surgery for oropharyngeal cancer have obtained satisfactory functional results and good quality of life. However, many questions remain concerning methods of obtaining optimal postoperative oral and pharyngeal functions, especially after glossectomy. This review focuses on reconstructive methods after partial glossectomy, hemiglossectomy, and subtotal or total glossectomy and discusses current problems and the possibility of sensory and dynamic reconstruction. © The Japan Society of Clinical Oncology 2005.

DOI： 10.1007/s10147-005-0500-2

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小児マイクロサージャリー Flapの特長と欠点

権太浩一, 光嶋勲, 藤津美佐子, 筒井哲也, 難波裕三郎

日本マイクロサージャリー学会会誌 18 ( 2 ) 128 - 128 2005.6

摂食・会話機能を考慮した口腔再建 : より良い術後機能を求めて

木股敬裕, 難波祐三郎, 筒井哲也, 藤津美佐子, 杉山成史, 徳山英二郎, 桜庭実, 林隆一, 海老原敏

頭頸部癌/ 日本頭頸部癌学会 31 ( 2 ) 184 - 184 2005.5

Successful delayed venous drainage in 16 consecutive distal phalangeal replantations

Koshima, I, S Yamashita, N Sugiyama, S Ushio, T Tsutsui, Y Nanba

PLASTIC AND RECONSTRUCTIVE SURGERY 115 ( 1 ) 149 - 154 2005.1

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The authors describe, in the first report of this type of replantation surgery, a high success rate using delayed venous anastomosis in 16 consecutive distal phalangeal replantations under digital block. Among these replantations, seven fingers (43.8 percent) showed postoperative venous congestion and five fingers were reoperated on with delayed venous drainage under digital block. All the reoperated fingers were successfully drained by additional single or double venous drainage with a vein graft. As a result, 13 fingers survived (81.3 percent success rate). All operations were performed under a digital block.

DOI： 10.1097/01.PRS.0000146869.92997.F3

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耳鼻咽喉科・頭頚部外科学の最新医療

木股敬裕, 難波祐三郎, 杉山成史

先端医療シリーズ 2005

整容面に配慮した皮弁・頚部の再建

難波祐三郎, 青雅一, 木股敬裕

PEPARS 2005

患肢温存手術における形成外科的再建

光嶋勲, 難波祐三郎, 筒井哲也

New Mook整形外科 2005

Minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema - Is it effective for stage III and IV?

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, S Koh, M Fujitsu

ANNALS OF PLASTIC SURGERY 53 ( 3 ) 261 - 266 2004.9

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

This is the first report on the effectiveness of minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema. Fifty-two patients (age: 15 to 78 years old; 8 males, 44 females) were treated with lymphaticovenular anastomoses under local anesthesia and by postoperative compression using elastic stockings. The average duration of edema of these patients before treatment was 5.3 +/- 5.0 years. The average number of anastomosis in each patient was 2.1 +/- 1.2 (1-5). The patients were followed for an average of 14.5 +/- 10.2 months, and the result were considered effective (82.5%) even for the patients with stage III (progressive edema with acute lymphangitis) and IV (fibrolymphedema), but others showed no improvement. Among these cases, 17 patients showed reduction of over 4 cm in the circumference of the lower leg. The average decrease in the circumference excluding edema in bilateral legs was 41.8 +/- 31.2% of the preoperative excess length. These results indicate that minimal invasive lymphaticovenular anastomosis under a local anesthesia is valuable instead of general anesthesia.

DOI： 10.1097/01.sap.0000120319.89926.07

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穿通枝皮弁を用いた低侵襲乳房再建

牛尾茂子, 難波祐三郎, 筒井哲也, 山田潔, 伊藤聖子, 藤津美佐子, 石井直弘, 杉山成史, 山下修二, 長尾聖子, 光嶋勲

岡山医学会雑誌 116 ( 2 ) 209 - 209 2004.9

Application of Free Perforator Adiposal Flaps

NAMBA Yuzaburo, TSUTSUI Tetsuya, KOSHIMA Isao

17 ( 3 ) 285 - 289 2004.8

New one-stage nerve pedicle grafting technique using the great auricular nerve for reconstruction of facial nerve defects

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, S Itoh

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 20 ( 5 ) 357 - 361 2004.7

Language：English Publisher：THIEME MEDICAL PUBL INC

A new one-stage nerve pedicle grafting technique, employing a vascularized great auricular nerve graft, was used to repair a facial nerve defect. The facial nerve of a 39-year-old woman with facial schwannoma was resected, and an island vascularized great auricular nerve graft from the ipsilateral side was transferred to bridge a 4 cm long defect of the buccal branch. Postoperatively, rapid nerve sprouting through the vascularized nerve graft and excellent facial reamination were obtained within 6 months after surgery. This method in one-stage using a vascularized nerve graft is technically easy, requires a short operating time, has minimal donor-site morbidity, and leads to successful nerve regeneration postoperatively.

DOI： 10.1055/s-2004-829998

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ウルトラマイクロ末節切断再接着術におけるdelayed venous drainageについて

牛尾茂子, 難波祐三郎, 筒井哲也, 山田潔, 藤津美佐子, 伊藤聖子, 石井直弘, 杉山成史, 山下修二, 光嶋勲

日本マイクロサージャリー学会会誌 17 ( 2 ) 161 - 161 2004.6

私の開発した再建法当科における陰茎再建術式の変遷

筒井哲也, 難波祐三郎, 藤津美佐子, 伊藤聖子, 長尾聖子, 牛尾茂子, 杉山成史, 山下修二, 山田潔, 石井直弘, 光嶋勲

日本マイクロサージャリー学会会誌 17 ( 2 ) 172 - 173 2004.6

深腓骨神経移行による足底の知覚再建

藤津美佐子, 難波祐三郎, 筒井哲也, 山田潔, 伊藤聖子, 石井直弘, 牛尾茂子, 杉山成史, 山下修二, 光嶋勲

日本マイクロサージャリー学会会誌 17 ( 2 ) 217 - 218 2004.6

チーム医療への提言 : 再建外科の立場から

筒井哲也, 難波祐三郎, 藤津美佐子, 光嶋勲

頭頚部腫瘍 30 ( 2 ) 146 - 146 2004.5

血管柄付きSIEA adiposal flapを用いた顔面陥凹の再建

牛尾茂子, 石井直弘, 難波祐三郎, 高橋義雄, 筒井哲也, 山田潔, 藤津美佐子, 杉山成史, 山下修二, 光嶋勲

日本頭蓋顎顔面外科学会誌 20 ( 1 ) 65 - 65 2004.4

頬部全層欠損の再建

石井直弘, 牛尾茂子, 筒井哲也, 高橋義雄, 難波祐三郎, 光嶋勲

日本頭蓋顎顔面外科学会誌 20 ( 1 ) 64 - 64 2004.4

Superficial circumflex iliac artery perforator flap for reconstruction of limb defects

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, K Urushibara, K Inagawa, T Hamasaki, T Moriguchi

PLASTIC AND RECONSTRUCTIVE SURGERY 113 ( 1 ) 233 - 240 2004.1

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The superficial circumflex iliac artery perforator (SCIP) flap differs from the established groin flap in that it is nourished by only a perforator of the superficial circumflex iliac system and has a short segment (3 to 4 cm in length) of this vascular system. Three cases in which free superficial circumflex iliac artery perforator flaps were successfully transferred for coverage of soft-tissue defects in the limb are described in this article. The advantages of this flap are as follows: no need for deeper and longer dissection for the pedicle vessel, a shorter flap elevation time, possible thinning of the flap with primary defatting, the possibility of an adiposal flap with customized thickness for tissue augmentation, a concealed donor site, minimal donor-site morbidity, and the availability of a large cutaneous vein as a venous drainage system. The disadvantages are the need for dissection for a smaller perforator and an anastomosing technique for small-caliber vessels of less than 1.0 mm.

DOI： 10.1097/01.PRS.0000095948.03605.20

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Sequential vascularized iliac bone graft and a superficial circumflex iliac artery perforator flap with a single source vessel for established mandibular defects

Koshima, I, Y Nanba, T Tsutsui, S Itoh

PLASTIC AND RECONSTRUCTIVE SURGERY 113 ( 1 ) 101 - 106 2004.1

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The major problems in dealing with established mandibular loss are severe soft-tissue contracture and a limited number of recipient vessels. The skin portion of the iliac osteocutaneous flap often necrotizes in cases without perforators of the deep circumflex iliac vessel. To overcome these problems, eight patients with established mandibular loss and no skin perforators of the deep circumflex iliac vessel were treated with a sequential vascularized iliac bone graft and a superficial circumflex iliac perforator flap with a single recipient vessel. Regarding the recipient vessels, the ipsilateral cervical vessels were used for four patients, and the contralateral facial and ipsilateral superficial temporal vessels were used for two cases each. The superficial circumflex iliac perforator flaps were 7 to 28 cm in length and 3 to 15 cm in width. The iliac bone grafts ranged from 7 to 13 cm in length, and three cases were repaired with the inner cortex of the iliac bone. There were no serious complications, such as flap necrosis or bone infection and resulting absorption. The advantages of this method are that both pedicles are very close to each other and of suitable diameter for anastomosis. Simultaneous flap elevation and preparation for the recipient site is possible. The skin flap and vascularized bone graft can be obtained from the same donor site. A single source vessel can nourish both the large skin area and bone sequentially. Longer dissection of the superficial circumflex iliac system to the proximal femoral division is unnecessary. A large flap can survive with a short segment of the superficial circumflex iliac system. Only the vascularized inner cortex of the iliac bone needs to be used, and the outer iliac cortex can be preserved, which results in less morbidity at the donor site.

DOI： 10.1097/01.PRS.0000090725.89401.DE

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マイクロサージャリーを用いた複合組織移植--超微小血管吻合術と低侵襲再建術の導入 (特集 21世紀の新しい外科治療) -- (新しい治療体系)

光嶋勲, 難波裕三郎, 藤津美佐子

現代医療 36 ( 1 ) 234 - 239 2004.1

糖尿病壊疽に対する患肢温存

石井直弘, 難波祐三郎, 筒井哲也, 山田潔, 藤津美佐子, 光嶋勲

岡山医学会雑誌 115 ( 3 ) 267 - 267 2004.1

穿通枝皮弁を用いた各種皮弁

青雅一, 松本洋, 伊藤聖子, 渡辺敏之, 徳山英二郎, 難波祐三郎

日本マイクロサージャリー学会会誌 2004

穿通枝皮弁

光嶋勲, 吉村浩太郎, 朝戸裕貴, 難波祐三郎

MB Orthop 2004

大殿筋皮弁を用いて再建を行った痔瘻癌の一例

森元芳典, 岩垣博巳, 森下紀夫, 笹浦先, 小林直哉, 松原長秀, 難波祐三郎, 光嶋勲, 田中紀章

岡山医学会雑誌 2004

AVMに対する外科的治療

光嶋勲, 難波祐三郎, 牛尾茂子, 杉山成史, 藤津美佐子, 三村秀文, 今井茂樹

血管腫・血管奇形の診断と治療のストラテジー 2004

穿通枝脂肪弁の応用

難波祐三郎, 筒井哲也, 光嶋勲

日本マイクロサージャリー学会会誌 17 ( 2 ) 128 - 128 2004

岡山大学医学部ジェンダークリニックにおける性同一性障害患者415名の解析

永井敦, 久住倫宏, 渡部昌実, 坪井啓, 公文裕巳, 中塚幹也, 平松祐司, 難波祐三郎, 木股敬裕, 佐藤俊樹, 黒田重利

日本小児泌尿器科学会雑誌 13 132 - 136 2004

Medial and lateral malleolar perforator flaps for repair of defects around the ankle

Koshima, I, S Itoh, Y Nanba, T Tsutsui, Y Takahashi

ANNALS OF PLASTIC SURGERY 51 ( 6 ) 579 - 583 2003.12

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Reconstruction for defects around the ankle continues to be challenging. Repairs have been effected with the dorsalis pedis flap, the medial plantar flap, and with reverse-flow island flaps using the anterior and posterior tibial systems and the peroneal system. However, sacrifice of the major vessels of the lower leg and wide and long seats at the donor site are disadvantages of these flaps. To overcome these disadvantages, the authors developed island lateral and medial malleolar flaps with the perforators located close to the ankle. These flaps are easy to elevate, involve a short operating time, require no sacrifice of major vessels or muscles of the lower legs, and the use of these adipofascial flaps makes donor scars more acceptable. Malleolar perforator flaps are suitable for the repair of small ankle defects.

DOI： 10.1097/01.sap.0000095654.07024.65

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Multiple vascular anastomoses with vein grafts for salvage of congestive flaps

Y Namba, Y Takahashi, S Ito, Koshima, I

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 19 ( 8 ) 531 - 535 2003.11

Language：English Publisher：THIEME MEDICAL PUBL INC

The authors present two cases in which the venous drainage of transferred flaps was compromised and the flaps were salvaged by vein grafts. Traditionally, once transferred free flaps had become congestive, surgeons would re-anastomose the thrombosed veins, and administer anticoagulants or carry out peripheral vessel dilation. These authors recommend not only re-anastomosis of veins, but also additional venous drainage, with or without vein grafts.

DOI： 10.1055/s-2004-815639

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島状後脛骨動脈穿通枝脂肪弁によるアキレス腱の再建例

寺戸道久, 難波祐三郎, 筒井哲也, 伊藤聖子, 松本洋, 大西文夫, 光嶋勲, 尾崎敏文, 井上一

日本形成外科学会会誌 23 ( 11 ) 705 - 705 2003.11

短茎ALT perforator flapを用いた四肢の再建

大西文夫, 難波祐三郎, 筒井哲也, 伊藤聖子, 松本洋, 寺戸道久, 光嶋勲

日本形成外科学会会誌 23 ( 11 ) 706 - 706 2003.11

Deep peroneal nerve transfer for established plantar sensory loss

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 19 ( 7 ) 451 - 454 2003.10

Language：English Publisher：THIEME MEDICAL PUBL INC

Patients with established or irreversible plantar sensory loss often have normal sensation on the dorsal aspect of the foot, due to an intact deep peroneal nerve. A new method of deep peroneal nerve transfer is proposed for repair of plantar sensory loss caused by extensive nerve gaps or high-level lesions of the posterior tibial nerve. Two cases in which this technique was used are described. The surgical technique is relatively easy, with a short operating time, rapid nerve regeneration after surgery, accurate sensory recovery, and minimal donor-site morbidity with sensory loss only on the first web space of the foot.

DOI： 10.1055/s-2003-44632

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スーパーマイクロ手技を用いた切断指再接着末節挫滅切断60症例の検討

松本洋, 難波祐三郎, 筒井哲也, 伊藤聖子, 大西文夫, 光嶋勲

岡山医学会雑誌 115 ( 2 ) 181 - 181 2003.9

超微小外科を用いた再建

難波祐三郎, 筒井哲也, 伊藤聖子, 中後貴江, 藤津美佐子, 石井直弘, 山下修二, 杉山成史, 牛尾茂子, 光嶋勲

岡山医学会雑誌 115 ( 2 ) 178 - 178 2003.9

Free gluteal artery perforator flap with a short, small perforator

Koshima, I, T Tsutsui, Y Takahashi, Y Nanba

ANNALS OF PLASTIC SURGERY 51 ( 2 ) 200 - 204 2003.8

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The introduction of supermicrosurgery has led to the development of a new gluteal perforator flap nourished only by a musculocutaneous perforator of the superficial gluteal artery system. This flap has a perforator that is short (3-4 cm in length) and small (less than 1 mm). The successful transference of a free gluteal perforator flap for the coverage of soft-tissue defects in the foot and face in two patients is described in this article. With this flap, deeper and longer dissection for a pedicle vessel is unnecessary, flap elevation time is shorter, thinning of the flap with primary defatting and creation of an adiposal flap with customized thickness for tissue augmentation are possible, the donor site is in a concealed area with minimal donor site morbidity, and application of the flap as a scarred flap for previous operations in the gluteal region is possible. The disadvantages of this flap are necessity of dissection for a smaller perforator and of anastomosis of small-caliber vessels of less than 1.0 mm.

DOI： 10.1097/01.SAP.0000044139.78441.53

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Free perforator flap for the treatment of defects after resection of huge arteriovenous malformations in the head and neck regions

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, A Watanabe, R Ishii

ANNALS OF PLASTIC SURGERY 51 ( 2 ) 194 - 199 2003.8

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The authors report two cases of huge arteriovenous malformations in the head and neck regions treated successfully with preoperative superselective transarterial embolization and resection followed by a free perforator flap transfer. Based on the authors, previous cases, en block mass resection of the malformation was possible with bleeding of less than 150 ml. The massive defects could be repaired with free perforator flaps using an anterolateral thigh flap and a deep inferior epigastric artery perforator flap. One patient who lost facial muscle underwent reconstruction by simultaneous muscle transfer, and both patients regained accept- able cosmetic appearance and dynamic facial function. Now, more than 4 to 7 years after surgery, the patients have shown no reexpansion of the malformation. The important points of this treatment are complete embolization to accomplish total resection with minimal bleeding, free flap transfer to prevent postoperative reexpansion or recurrence of arteriovenous malformations, and the selection of recipient vessels because of arterial embolization in part of the lesion.

DOI： 10.1097/01.SAP.0000044706.58478.73

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New anterolateral thigh perforator flap with a short pedicle for reconstruction of defects in the upper extremities

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi

ANNALS OF PLASTIC SURGERY 51 ( 1 ) 30 - 36 2003.7

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Three cases of successful transfer of a new free anterolateral thigh (ALT) perforator flap for coverage of soft-tissue defects in the hand and upper arm are described. This new flap has a thin superficial fatty layer, no fascial component, and is vascularized with a perforator of the descending branch of the lateral circumflex femoral system. The free flap is nourished by anastomosing of the perforator or the proximal small segment of the descending branch. The advantages of this flap are no need for deep dissection, minimal time for flap elevation, minimal donor site morbidity, preservation of the main trunk of the lateral circumflex femoral system, possible thinning of the flap with primary defatting, possible application as a flow-through flap, and a concealed donor scar. This flap is suitable for coverage of defects in the fingers, hands, and arms.

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Vascularized femoral nerve graft with anterolateral thigh true perforator flap for massive defects after cancer ablation in the upper arm

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, A Kawai

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 19 ( 5 ) 299 - 302 2003.7

Language：English Publisher：THIEME MEDICAL PUBL INC

Massive resection of soft-tissue sarcoma in the elbow region often results in loss of long segments of the brachial artery and median nerve, as well as a wide soft-tissue defect. With conventional nerve grafts and revascularization of the arm, forearm and hand function is poor because nerves cannot be regenerated over the long nerve gap in the high elbow region. The authors used a long vascularized nerve graft and found it effective for reconstruction of upper arm function. This paper describes the first application of a free vascularized femoral nerve graft and a free anterolateral thigh true perforator flap based on the lateral circumflex femoral system, to repair elbow and forearm function. Long vascularized femoral nerve grafts of over 12 cm can be obtained, and an anterolateral thigh flap can be harvested from the same donor area.

DOI： 10.1055/s-2003-42498

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Medial plantar perforator flaps with supermicrosurgery

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi

CLINICS IN PLASTIC SURGERY 30 ( 3 ) 447 - + 2003.7

Language：English Publisher：W B SAUNDERS CO

Since the 1980s, the concept of the perforator flap has been modified to include new perforator flaps. A medial plantar perforator flap, which has no fascial component and is nourished only with perforators of the medial plantar vessel and a cutaneous vein, or with a small segment of the medial plantar vessel, was developed. A free medial plantar perforator flap was successfully transferred for coverage of a soft-tissue defect in the finger. The advantages of this flap are minimum donor site morbidity, minimum damage to the posterior tibial and medial plantar systems, no need for deep dissection, possible thinning of the flap with primary defatting, a short time for flap elevation, use of a large cutaneous vein as a venous drainage system, a good color and texture match for finger pulp repair, a concealed donor scar, and possible application as a flow-through flap as a free flap and an island perforator flap for plantar weight-bearing defects.

DOI： 10.1016/S0094-1298(03)00044-0

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小児マイクロサージャリー患者91例の検討

難波祐三郎, 高橋義雄, 伊藤聖子, 筒井哲也, 月野暁彦, 大西文夫, 寺戸通久, 松本洋, 光嶋勲

日本マイクロサージャリー学会会誌 16 ( 2 ) 98 - 98 2003.6

当科における陰茎再建術特に虫垂を用いた尿道再建について

筒井哲也, 難波祐三郎, 伊藤聖子, 松本洋, 月野暁彦, 寺戸通久, 大西文夫, 光嶋勲

日本マイクロサージャリー学会会誌 16 ( 2 ) 124 - 124 2003.6

頭頸部再建外科における穿通枝皮弁の応用

光嶋勲, 藤津美佐子, 筒井哲也, 高橋義雄, 難波裕三郎

頭頚部腫瘍 29 ( 2 ) 258 - 258 2003.5

Long-term follow-up after lymphaticovenular anastomosis for lymphedema in the leg

Koshima, I, Y Nanba, T Tsutsui, Y Takahashi, S Itoh

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 19 ( 4 ) 209 - 215 2003.5

Language：English Publisher：THIEME MEDICAL PUBL INC

Over the last 9 years, the authors analyzed lymphedema of the lower extremity in a total of 25 patients, comparing the use of supermicrosurgical lymphaticovenular anastomosis and/or conservative treatment. The most common cause of edema was hysterectomy, with or without subsequent radiation therapy for uterine cancer. Among 12 cases that underwent only conservative treatment, only one case showed a decrease of over 4 cm in the circumference of the lower leg. The average period for conservative treatment was 1.5 years,and the average decreased circumference was 0.6 cm (8 percent of the preoperative excess). Thirteen patients were followed after lymphaticovenular anastomoses, as well as pre- and postoperative conservative treatment. The average follow-up after surgery was 3.3 years, and eight patients showed a reduction of over 4 cm in the circumference of the lower leg. The average decrease in the circumference, excluding edema in the bilateral leg, was 4.7 cm (55.6 percent of the preoperative excess). These results indicate that supermicrosurgical lymphaticovenular anastomosis has a valuable place in the treatment of lymphedema.

DOI： 10.1055/s-2003-40575

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Dynamic reconstruction of large abdominal defects using a free rectus femoris musculocutaneous flap with normal motor function

Koshima, I, Y Nanba, T Tutsui, Y Takahashi, S Itoh, R Kobayashi

ANNALS OF PLASTIC SURGERY 50 ( 4 ) 420 - 424 2003.4

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Reconstruction of large abdominal wall defects with conventional reconstruction including the component separation technique is difficult because of strong transverse tension and loss or weakness of the rectus abdominis muscle. To overcome this problem, dynamic reconstruction of the abdominal wall using a free innervated rectus femoris musculocutaneous flap was performed for large defects with separation of the bilateral rectus abdominis muscles. The intact motor nerve of the rectus femoris muscle was transferred without transection, and only the pedicle vessels were anastomosed to the omental vessels. Four and one-half years after surgery, the rectus femoris muscle had voluntary strong muscle contraction and there was no abdominal protrusion, herniation, or donor morbidity. This new method with dynamic function can replace conventional techniques for large abdominal defects without rectus muscle function.

DOI： 10.1097/01.SAP.0000032304.45784.F6

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副神経麻痺に対する遊離神経移植による再建

筒井哲也, 難波祐三郎, 伊藤聖子, 松本洋, 月野暁彦, 寺戸通久, 大西文夫, 柳林聡, 光嶋勲

日本形成外科学会会誌 23 ( 4 ) 285 - 286 2003.4

腫瘍切除後の顔面神経機能即時再建の治療経験

筒井哲也, 難波祐三郎, 伊藤聖子, 松本洋, 月野暁彦, 寺戸通久, 大西文夫, 光嶋勲

日本頭蓋顎顔面外科学会誌 19 ( 1 ) 61 - 62 2003.4

血管柄付き遊離脂肪移植による再建術

松本洋, 難波祐三郎, 筒井哲也, 伊藤聖子, 月野暁彦, 大西文夫, 柳林聡, 寺戸通久, 光嶋勲

日本形成外科学会会誌 23 ( 4 ) 286 - 286 2003.4

Treatment of meralgia paresthetica with a deep inferior epigastric perforator adiposal flap: Case report

Y Namba, S Ito, T Tsutsui, Koshima, I

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 19 ( 2 ) 69 - 71 2003.2

Language：English Publisher：THIEME MEDICAL PUBL INC

A case of a 40-year-old female with meralgia paresthetica after malignant tumor resection in the right inguinal. region is reported. Traditionally, meralgia paresthetica is treated with neurotransection or neurolysis. The therapeutic strategy using neurolysis, and the use of a deep inferior epigastric perforator adiposal flap wrapping as a prophylactic procedure against reentrapment is discussed.

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副神経損傷に対する遊離神経移植による再建

大西文夫, 難波祐三郎, 筒井哲也, 伊藤聖子, 松本洋, 月野暁彦, 寺戸通久, 柳林聡, 光嶋勲

岡山医学会雑誌 114 ( 3 ) 340 - 340 2003.1

切り落とした指はつなげられるか．

難波祐三郎, 光嶋勲

治療 2003

特集，子宮頚癌治療のcontroversy, 下肢リンパ浮腫の予防と治療．

光嶋勲, 伊藤聖子, 筒井哲也, 高橋義雄, 難波裕三郎

産科と婦人科 5,629-633 2003

下肢リンパ浮腫の予防と治療．

光嶋勲, 伊藤聖子, 筒井哲也, 高橋義雄, 難波祐三郎

産科と婦人科 2003

小児における遊離皮弁．

難波裕三郎, 筒井哲也, 光嶋勲

日本マイクロ会誌 16,231-237 2003

リンパ浮腫の治療．特にリンパ管細静脈吻合に関して．

光嶋勲, 藤津美佐子, 高橋義雄, 筒井哲也, 難波裕三郎

手術 57,1189-1192 2003

先端外科医療の最前線．超微小血管吻合術と低侵襲再建術-キメラ型組織移植術の開発-．

光嶋勲, 難波裕三郎

医学のあゆみ 205,728-832 2003

切り落とした指はつなげられるかについて教えてください．特集：プライマリケア医のための創傷治療ガイド．

難波裕三郎, 光嶋勲

治療 85,162-164 2003

小児における遊離皮弁．

難波祐三郎, 筒井哲也, 光嶋勲

日本マイクロ会誌 2003

外側大腿皮神経絞扼症候群の1例

筒井哲也, 難波祐三郎, 高橋義雄, 伊藤聖子, 月野暁彦, 柳林聡, 平野信夫, 大西文夫, 寺戸通久, 松本洋, 光嶋勲

岡山医学会雑誌 114 ( 2 ) 236 - 236 2002.9

ウルトラマイクロサージャリーの現況--超微小血管吻合術を用いた新しい再建術 (ウルトラマイクロサージャリーの現況)

光嶋勲, 難波裕三郎

医学のあゆみ 202 ( 2 ) 115 - 118 2002.7

Perforator flaps in lower extremity reconstruction

Isao Koshima, Y. Nanba, T. Tsutsui, Y. Takahashi, S. Itoh

Handchirurgie Mikrochirurgie Plastische Chirurgie 34 ( 4 ) 251 - 256 2002.7

Language：English

Perforator flaps are defined as skin flap without fascia or muscle and they are nourished by one or more perforating vessels perforating the fascia, muscle, or intermuscular septum. As early as 1985 in Japan, we proposed this concept over that of the fasciocutaneous flap, which was believed to be nourished by fascial plexus. The pedicle perforators are classified as septocutaneous, musclular (intermuscular), periosteal, and intertendinous perforators. As useful perforator flaps in the lower extremity, posterior tibial perforator island flaps, saphenous island flaps, peroneal island flaps, malleolar island perforator flaps, deep inferior epigastric perforator free flap (DIEP flap), anterolateral thigh free flap (ALT flap), and latissimus dorsi muscle free perforator flap (thoracodorsal artery perforator flap, T-DAP or TAP flap) were described. These flaps have the advantage of minimal donor-site morbidity, relatively rapid dissection and flap elevation, and reliable skin territory.

DOI： 10.1055/s-2002-36291

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Trapezius Perforator Flapによる頸部再建

金福泰, 難波祐三郎, 高橋義雄, 岸本晃司, 月野暁彦, 伊藤聖子, 佐久間恒, 牛尾茂子, 杉本直子, 杉山成史

日本形成外科学会会誌 22 ( 6 ) 481 - 482 2002.6

マイクロサージャリー領域におけるエステティックマインド足趾移植による手指再建におけるエステティックマインド

難波祐三郎, 高橋義雄, 伊藤聖子, 金福泰, 岸本晃司, 長谷川健二郎, 佐久間恒, 牛尾茂子, 徳山英二郎, 杉山成史

日本マイクロサージャリー学会会誌 15 ( 2 ) 78 - 78 2002.6

四肢の形成術、６リンパ浮腫

難波祐三郎, 高橋義, 光嶋勲

形成外科 2002

ウルトラマイクロサージャリーの現況

光嶋勲, 難波祐三郎

医学の歩み 202,115-118 2002

Future of supramicrosurgery as it relates to breast reconstruction:Free paraumbilical perforator adiposal flap.

Koshima I, Namba Y, Takahashi Y, Tsukino A, Kishimoto K

Seminors in Plast Surg 16,93-99 2002

患肢温存手術における形成外科的手技の応用特集：患肢温存手術の限界と臨床成績

光嶋勲, 難波祐三郎, 筒井哲也, 高橋義雄, 伊藤聖子

関節外科 105-110 2002

リンパ浮腫．四肢の形成手術

難波祐三郎, 高橋義雄, 光嶋勲

形成外科増刊号 45,211-215 2002

低侵襲の頭頸部再建術，-遊離穿通枝皮弁による頭頸部再建-

光嶋勲, 難波祐三郎, 筒井哲也, 高橋義雄, 伊藤聖子, 菅原利男, 松村智弘, 細田超

頭頸部腫瘍 2002

Free vascularized nail graft under digital block

Koshima, I, S Itoh, Y Takahashi, Y Nanba, K Kishimoto

JOURNAL OF RECONSTRUCTIVE MICROSURGERY 17 ( 8 ) 599 - 601 2001.11

Language：English Publisher：THIEME MEDICAL PUBL INC

Vascularized toenail grafts with long vascular pedicles have usually been transferred under general anesthesia. In this paper, a minimally invasive vascularized nail graft with a short pedicle and small cutaneous flap, which was successfully transferred under digital block of the finger and toe, is described.

DOI： 10.1055/s-2001-18813

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障害者スポーツにおける難治性潰瘍, 褥瘡の治療

光嶋勲, 難波祐三郎, 高橋義雄

臨床スポーツ医学 = The journal of clinical sports medicine 18 ( 6 ) 661 - 667 2001.6

指尖および爪再建の経験.

難波祐三郎, 高橋義雄, 岸本晃司, 光嶋勲

日本マイクロサージャリー学会会誌 2001

The treatment of port wine stains with a dye laser: A study of 644 patients

Y. Namba, O. Mae, M. Ao

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 35 ( 2 ) 197 - 202 2001

Language：English

Between June 1989 and December 1996, the flashlamp pumped pulsed dye laser was used to treat port wine stains (PWS) in 644 patients, age, range 3 months-93 years (mean 21). The efficacy of the treatment was assessed after more than one year of follow-up. Each factor that might affect the efficacy was then evaluated statistically. Broad lesions required more laser treatments than narrow lesions and clearing tended to start from the periphery of the lesion, indicating the three-dimensional depth of the broader PWS. Patients who had been given previous treatments such as argon laser required about two more laser treatments than those who had not, but there were no clear differences in the efficacy of dye laser treatment between the two groups.

DOI： 10.1080/028443101300165345

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動静脈奇形の部位別治療.

光嶋勲, 高橋義雄, 難波祐三郎, 稲川喜一, 岡博昭, 森口隆彦, 今井茂樹

形成外科 44,7,665-673 2001

Latissimus Dorsi Perforator Flaps for the Repairing of Soft-tissue Defects in the Thoracic wall

TAKAHASHI Yoshio, NAMBA Yuuzaburou, KOSHIMA Isao, ANDOU Akio, SHIMIZU Nobuyoshi

Skin Cancer 16 ( 3 ) 305 - 309 2001

Language：Japanese Publisher：The Japanese Skin Cancer Society

A-68-year-old man had a tumor on the thoracic wall for two years. It had a diameter of 10cm, and was elastically hard. Histopathological findings showed fibrous tissue made of compact and mature fibroblasts and collagen fibers. Fbbroblasts are small, slender nuclei with rare mitotic figures. We diagnosed that tumor as a desmoid tumor. Tumor resection was performed; a large defect (20×20cm) in the trunk had to be reconstructed. We showed a new strategy of repairing soft-tissue defects in the thoracic wall. We utilized two flaps, which are both pedicled latissimus dorsi muscle perforator flaps. One is perforated from the circumflex scapular artery, which we call a scapular flap, and the other is perforated from the intercostal artery. We propose these flaps latissimus dorsi perforator flaps and demonstrated some points of technique for the repairing of soft-tissue defects in the thoracic wall and rising musculocutaneous flaps. [Skin Cancer (Japan) 2001; 16: 305-309]

DOI： 10.5227/skincancer.16.305

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Other Link： http://search.jamas.or.jp/link/ui/2002156268

爪再建ー部分足趾移植による爪再建ー.

難波祐三郎, 高橋義雄, 光嶋勲

形成外科 2001

リンパ浮腫の治療保存＆外科併用療法.

光嶋勲, 高橋義雄, 難波祐三郎

JIM 11,4,332-335 2001

動静脈奇形の部位別治療.

光嶋勲, 高橋義雄, 難波祐三郎, 稲川喜一, 岡博昭, 森口隆彦, 今井茂樹

形成外科 2001

障害者スポーツにおける母指再建.

光嶋勲, 難波祐三郎, 高橋義雄

臨床スポーツ医学 18,6,661-667 2001

境界領域の最新技術，穿通枝皮弁：前外側大腿皮弁.

光嶋勲, 高橋義雄, 難波祐三郎, 岸本晃司

新OS NOW Orthopaedic Surgery 12,97-105 2001

穿通枝皮弁前外側大腿皮弁.

光嶋勲, 高橋義雄, 難波祐三郎, 岸本晃司

OS NOW 12,97-105 2001

性同一性障害に対する包括的医療の実践.

高橋義雄, 難波祐三郎, 岸本晃司, 光嶋勲

岡山医学会雑誌 113,279-284 2001

Perforator-based flap for coverage of lumbosacral defects

Masakazu Ao, Okiharu Mae, Yuuzaburou Namba, Kenji Asagoe

Plastic and Reconstructive Surgery 101 ( 4 ) 987 - 991 1998.4

Language：English

Lumbosacral defects on 20 patients were covered with a perforator-based flap. Cutaneous perforators derived from the 9th and loth intercostal arteries, the 4th lumbar artery, and multiple gluteal perforators that penetrate the gluteus maximus muscle were used as vascular pedicles. Minor complications occurred in five cases. Using this method, minimal morbidity of the donor site is expected because the gluteus maximus need not be sacrificed. Accordingly, perforator-based flaps are especially indicated for ambulatory patients, but for paraplegic patients as well. Even in the event of recurrence, another perforator-based or musculocutaneous flap can be elevated from the ipsilateral side because of the presence of multiple perforators in the lumbosacral and gluteal regions.

DOI： 10.1097/00006534-199804040-00015

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Perforator-based flap for coverage of lumbosacral defects

Masakazu Ao, Okiharu Mae, Yuuzaburou Namba, Kenji Asagoe

Plastic and Reconstructive Surgery 101 ( 4 ) 987 - 991 1998.4

Language：English

DOI： 10.1097/00006534-199804040-00015

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Tissue Expanderを用いた治療経験

難波祐三郎

岡山済生会総合病院雑誌 24 11 - 17 1992

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