Faculty Profiles - EDAMURA Kohei

Papers - EDAMURA Kohei

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糖尿病患者は腎部分切除術後一年で腎機能が低下する Propensity Score-Matched Analysis

河村香澄, 荒木元朗, 丸山雄樹, 光井洋介, 定平卓也, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 渡辺豊彦, 那須保友

西日本泌尿器科 81 ( 増刊 ) 177 - 177 2019.10

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)

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サルコペニアが前立腺全摘除後の排尿関連QoLに与える影響 Expanded Prostate Cancer Index Compositeを用いた経時的変化

光井洋介, 渡邉豊彦, 定平卓也, 丸山雄樹, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 那須保友

日本排尿機能学会誌 30 ( 1 ) 255 - 255 2019.9

Comparison of the predictive value among inflammation-based scoring systems for bleomycin pulmonary toxicity in patients with germ cell tumors. International journal

Yuki Maruyama, Takuya Sadahira, Motoo Araki, Yosuke Mitsui, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

International journal of urology : official journal of the Japanese Urological Association 26 ( 8 ) 813 - 819 2019.8

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

OBJECTIVE: To compare the predictive value of pretreatment inflammation-based scoring systems in patients with germ cell tumors receiving first-line bleomycin-based chemotherapy. METHODS: Retrospectively, we evaluated 57 patients with germ cell tumors. Bleomycin pulmonary toxicity was defined as the presence of asymptomatic decline in pulmonary function tests, pulmonary symptoms or interstitial pneumonia on computed tomography in the absence of infection. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, albumin-to-globulin ratio, Prognostic Nutritional Index, Glasgow Prognostic Score and C-reactive protein were measured in all patients. To assess the predictive ability of each scoring system, the area under the receiver operating characteristic curve was calculated, and multivariate analysis was carried out to identify the predictive scores associated with bleomycin pulmonary toxicity. RESULTS: Of the 57 patients, 15 patients developed bleomycin pulmonary toxicity. The neutrophil-to-lymphocyte ratio had the highest area under the curve value (0.763) of all inflammation-based scoring systems, followed by the Prognostic Nutritional Index (0.749). In multivariate analysis, the neutrophil-to-lymphocyte ratio (odds ratio 11.5; P = 0.009) and Prognostic Nutritional Index (odds ratio 9.07; P = 0.013) were independently associated with development of bleomycin pulmonary toxicity. As these two independent markers were combined, the area under the curve achieved the highest value (0.822). CONCLUSIONS: The present study shows that the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index are independent risk factors for development of bleomycin pulmonary toxicity. The combination of the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index seems to have superior predictive value compared with other inflammation-based scoring systems.

DOI： 10.1111/iju.14017

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ロボット支援腹腔鏡下腎部分切除術後の腎癌尿管再発の1例

角南亮輔, 大岩裕子, 高本篤, 関戸崇了, 佐久間貴文, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 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, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 4 ) 482 - 482 2019.8

当院におけるニボルマブ+イピリムマブの初期経験

片山聡, 高本篤, 関戸崇了, 角南亮輔, 佐久間貴文, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 窪田理沙, 大岩裕子, 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, 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 ( 4 ) 483 - 484 2019.8

局所進行性前立腺癌に対するRALP(拡大リンパ節郭清、拡大摘除)の予後因子の検討

柳原豊, 芳賀俊介, 渡辺隆太, 沢田雄一郎, 野田輝乙, 浅井聖史, 福本哲也, 三浦徳宣, 宮内勇貴, 菊川忠彦, 雑賀隆史, 中島宏親, 枝村康平, 江原伸

泌尿器外科 32 ( 8 ) 1023 - 1024 2019.8

Language：Japanese Publisher：医学図書出版(株)

局所進行性前立腺癌に対する一次治療としてのロボット支援下前立腺全摘術(RALP)の成績は、限られた報告しかない。そこでわれわれは、extended RALP(拡大摘除+拡大骨盤内リンパ節郭清)を行った局所進行性前立腺癌の症例(ネオアジュバントならびにアジュバント治療を施行していない約100例)を後方視的に、手術成績、周術期合併症、術後PSA再発、予後因子などを検討し報告する。(著者抄録)

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ロボット支援腹腔鏡下腎部分切除術後に再発した3症例の検討

小林泰之, 荒木元朗, 枝村康平, 西村慎吾, 高本篤, 渡辺豊彦, 那須保友

腎癌研究会会報 ( 49 ) 40 - 40 2019.7

Robotic renal auto transplantation

Motoo Araki, Koichiro Wada, Shingo Nishimura, Risa Kubota, Kasumi Kawamura, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Atsushi Takamoto, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Ayano Ishii, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 81 ( 3 ) 314 - 320 2019.6

Language：Japanese Publishing type：Research paper (international conference proceedings) Publisher：The West Japan Urological Association

Renal autotransplantation (RAT) is a great surgical procedure for renal preservation, however it is underutilized due to its invasiveness. Robotic RATx has been in use since 2014. We conducted robotic RATx following a feasibility study using a porcine model. A 38-year-old woman with left ureteral stenosis was referred to us for urinary tract reconstruction. She had undergone an emergency Caesarean section for intraperitoneal bleeding secondary to left ovarian rupture four years earlier. After the surgery, she developed hypovolemic shock and disseminated intravascular coagulation (DIC) due to postoperative bleeding. Left internal iliac artery embolization saved her life. However, it resulted in a left ureteral stenosis measuring 2.7 cm that was located 5 cm from the left ureteral orifice, which required chronic ureteral stent exchange. Neither balloon dilation nor laser incision was successful. In addition, retrograde pyelography showed a possible left ureteropelvic junction obstruction. The patient was hesitant about the surgery because of its invasiveness. However, four years later, the patient elected to undergo robotic RATx. To date, only four cases of robotic RATx have been reported, including the current case. The indication of all four cases was extensive ureteral stenosis. Ileal ureter is frequently used for the treatment of extensive ureteral stenosis, but it can entail many problems including urine reabsorption resulting in metabolic acidosis. Ileal ureter is contraindicated for patients with a serum creatinine (sCr) level greater than 2 mg/dl. Even if sCr is less than 2 mg/dl, it is questionable whether sCr will remain less than 2 mg/ dl for the remainder of someone's life. Boari flap can give rise to vesicoureteral reflux causing urinary tract infection. RATx does not have those problems. Robotic RATx is a new, minimally invasive approach to renal preservation.

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ROBOTIC RENAL AUTOTRANSPLANTATION

荒木元朗, 和田耕一郎, 西村慎吾, 窪田理沙, 河村香澄, 丸山雄樹, 光井洋介, 定平卓也, 高本篤, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 渡部昌美, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 3 ) 314 - 320 2019.6

BCG膀胱内注入療法後に発症した感染性胸部大動脈瘤の1例

高村剛輔, 三宅修司, 小倉一真, 花本昌紀, 河田達志, 平田武志, 枝村康平, 江原伸, 甲斐誠二

泌尿器科紀要 65 ( 6 ) 229 - 229 2019.6

Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot-assisted radical prostatectomy. International journal

Takuya Sadahira, Yosuke Mitsui, Motoo Araki, Yuki Maruyama, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Lower urinary tract symptoms 11 ( 3 ) 122 - 126 2019.5

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

OBJECTIVE: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. METHODS: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. RESULTS: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. CONCLUSIONS: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.

DOI： 10.1111/luts.12245

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Experience of robot-assisted radical cystectomy in Okayama University Hospital

Yasuyuki Kobayashi, Masao Mitsui, Shingo Nishimura, Atsushi Takamoto, Tomoko Sako, Koichiro Wada, Kohei Edamura, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 81 ( 2 ) 122 - 127 2019.4

Language：Japanese Publisher：The West Japan Urological Association

Robot-assisted radical cystectomy became listed as being covered by insurance in 2018 and accordingly, it is expected to become a popular surgical method in Japan in the future. In this study, we examined the findings of 102 patients who underwent total cystectomy (ORC, 35 cases), laparoscopic radical cystectomy (LRC, 52 cases), and robot-assisted radical cystectomy (RARC, 15 cases). The examined items were operative time, bleeding volume, postoperative complications, length of hospital stay, postoperative walking start date, postoperative pain and postoperative fever. Operative time was the shortest for RARC and bleeding volume was the lowest for RARC. Postoperative complications comprised approximately 33% (all grades) in any group. LRC and RARC were superior to ORC regarding both the period until walking start day and the period of postoperative persistent fever. Compared to ORC, patients undergoing RARC can expect an earlier recovery after surgery. In addition, patients undergoing RARC can expect stable surgical results with little difference in the postoperative course of each case.

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経尿道的砕石術(TUL)を施行した小児腎結石症の1例

佐久間貴文, 和田耕一郎, 本郷智拡, 前原貴典, 高本篤, 坪井一朗, 松尾聡子, 三井將雄, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 窪田理沙, 大岩裕子, 定平卓也, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 石井亜矢乃, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

西日本泌尿器科 81 ( 2 ) 243 - 244 2019.4

持続勃起症に対してT-shunt術を施行した1例

三宅修司, 小倉一真, 花本昌紀, 河田達志, 高村剛輔, 平田武志, 別宮謙介, 江原伸, 枝村康平

西日本泌尿器科 81 ( 2 ) 244 - 244 2019.4

難治性過活動膀胱(OAB)に対する仙骨神経刺激療法(SNM)の初期経験と今後の治療戦略について

渡邉豊彦, 大岩裕子, 佐久間貴文, 定平卓也, 石井亜矢乃, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 那須保友, 横山光彦, 井上雅, 小林知子

西日本泌尿器科 81 ( 2 ) 245 - 245 2019.4

【腹腔鏡手術〜初心者に何をどう教えるべきか〜】ロボット支援腹腔鏡下手術時代における腹腔鏡教育

小林泰之, 和田耕一郎, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 32 ( 1 ) 28 - 31 2019.4

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

ロボット手術導入後より、腹腔鏡手術の手術件数は減少し、全盛期の半分となっている。これからの腹腔鏡教育はこのことを念頭に考えていかなければならない。"手術教育の根幹となる手術"は腹腔鏡手術の普及に伴い開腹手術から腹腔鏡に移行したが、近年ロボット手術に移行しつつある。しかしながら、ロボット手術は腹腔鏡手術の一種であり、開腹手術から腹腔鏡手術へといった大きなシフトではなく、ロボット手術と腹腔鏡手術は並列なものと捉え、相補的な教育を行っていくことが大切だと考える。(著者抄録)

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QOL向上をめざした泌尿器がん治療岡山大学病院におけるロボット支援腹腔鏡下膀胱全摘除術の経験

小林泰之, 三井将雄, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

西日本泌尿器科 81 ( 2 ) 122 - 127 2019.4

Language：Japanese Publisher：西日本泌尿器科学会

2018年にロボット支援腹腔鏡下膀胱全摘除術が保険収載され、今後本邦においても普及していくことが予想される。今回、当院にて膀胱全摘除術を行った102例(ORC35例、LRC52例、RARC15例)を対象に後方視的に検討を行った。検討項目は、手術時間、出血量、術後合併症、入院日数、術後の歩行開始日、術後疼痛、術後発熱とした。手術時間はRARCが最も短く、出血量はRARCが最も少なかった。術後の合併症はいずれの群においても約33%(全グレード)認めた。術後の歩行開始日、発熱が持続した期間は鏡視下手術群がORCと比して優れた結果であった。入院日数においては3群に有意な差はなかった。RARCはORCに比べ術後早期に回復が期待できるだけでなく、症例ごとの術後経過に差が少なく安定した手術成績が期待できる。(著者抄録)

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超細径HDIGスコープを用いた直視下腎杯穿刺とPCNLの初期成績

和田耕一郎, 公文裕巳, 谷本竜太, 荒木元朗, 本郷智拡, 三井將雄, 松尾聡子, 坪井一朗, 佐久間貴文, 和田里章悟, 河村香澄, 丸山雄樹, 光井洋介, 前原貴典, 窪田理沙, 大岩裕子, 定平卓也, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 杉本盛人, 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 80 ( 12 ) 700 - 700 2018.12

The Combination of Gemcitabine, Cisplatin, and Paclitaxel as Salvage Chemotherapy for Advanced Urothelial Carcinoma.

Takeshi Hirata, Masanori Hanamoto, Kazuma Ogura, Nobuki Hayashi, Kosuke Takamura, Kohei Edamura, Shin Ebara, Takashi Saika

Acta medica Okayama 72 ( 2 ) 175 - 179 2018.4

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

There is no standard second-line or salvage treatment for advanced urothelial carcinoma (UC). Here we investigated the efficacy and safety of gemcitabine, cisplatin, and paclitaxel (GCP) combination chemotherapy as salvage chemotherapy for advanced UC. We retrospectively analyzed the cases of 23 patients with advanced UC who showed progression or recurrence after cisplatin-based chemotherapy. Gemcitabine (1000 mg/m2), and paclitaxel (80 mg/m2) were administered on days 1 and 8. Cisplatin (70 mg/m2) was administered on day 1. The 3-week cycle regimen was repeated until disease progression if it had no intolerable toxicity. The overall response rate was 61% (95%CI, 41-78%). The median overall survival and progression-free survival times were 14 months and 5.5 months, respectively. Of the already known risk factors of chemotherapy for advanced UC, only the performance status was a prognostic factor for OS. Overall, 16 of the 23 patients (70%) experienced grade 3/4 toxicities, and no fatal adverse events were observed. GCP therapy was a promising option as second-line or salvage therapy for advanced UC.

DOI： 10.18926/AMO/55858

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