研究者詳細 - 垣内　慶彦

論文 - 垣内　慶彦

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An effective surgical educational system in the era of robotic surgery: "Double-Surgeon Technique" in robotic gastrectomy for minimally invasive surgery. 国際誌

Yoshihiko Kakiuchi, Shinji Kuroda, Yusuke Yoshida, Nobuhiko Kanaya, Hajime Kashima, Satoru Kikuchi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 410 ( 1 ) 20 - 20 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Gastric cancer (GC) remains a major malignancy. Robotic gastrectomy (RG) has gained popularity due to various advantages. Despite those advantages, many hospitals lack the necessary equipment for RG and are still performing laparoscopic gastrectomy (LG) due to its established minimal invasiveness and safety. METHODS: This study assessed the effectiveness of the "Double-Surgeon Technique" (DST) for improving surgical education and proficiency with LG. The DST involves both a console-side surgeon and a patient-side surgeon working actively in RG, enhancing the skill acquisition needed for LG and potentially reducing surgical time. Assessment of this method was performed by surgical time, and cases were divided into three groups: first half (Phase 1: P1) and second half (P2) before the introduction of DST, and after the introduction of DST (P3). RESULTS: Two surgical trainees were trained using the DST. The learning curve in both reached a plateau in P2, but descended again in P3. For one trainee, surgical time for P3 was significantly reduced compared to P1 (p = 0.001) and P2 (p = 0.0027) despite the intervals between laparoscopic distal gastrectomy as the main surgeon in P3 being significantly longer than in P2 (p = 0.0094). Other surgical results in both trainees did not differ significantly. Further, no difference in induction phase results of RG were evident between surgeons and trainees with or without DST experience. CONCLUSION: Surgical education using the DST could be effective in the current context of the need for RG and LG.

DOI： 10.1007/s00423-024-03593-5

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Optimization of workflow processes for sustainable paternal involvement: case study of an academic "daddy surgeon" in Japan.

Nobuhiko Kanaya, Shinji Kuroda, Yoshitaka Kondo, Yuko Takehara, Yoshihiko Kakiuchi, Hitoshi Minagi, Masaki Sakamoto, Shunsuke Kagawa, Hitomi Kataoka, Toshiyoshi Fujiwara

Surgery today 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Work-life balance is often discussed in Japan. Yet surgeons find it challenging to take paternity leave because of their demanding surgical duties and a strong sense of responsibility. One Japanese male surgeon had his first paternity experience as a research fellow in the US. When he returned to Japan, he resumed his surgical training and started a research project to become an academic surgeon. When he and his wife were expecting their second child, they discussed his paternity participation before the delivery and decided on a sustainable paternity participation plan. By coordinating his responsibilities with his co-workers, he limited his attendance at work to daytime hours only for 1 month to manage paternity duties. This adjustment did not affect the number of main and assistant operations conducted that month and effective optimization of workflow processes decreased the extra workload for other team members. His experience suggests that the optimization of workflow processes can enhance personal life, including paternity participation. (150/150).

DOI： 10.1007/s00595-024-02959-y

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Dendritic cell maturation is induced by p53-armed oncolytic adenovirus via tumor-derived exosomes enhancing systemic antitumor immunity. 国際誌

Tomoko Ohtani, Shinji Kuroda, Nobuhiko Kanaya, Yoshihiko Kakiuchi, Kento Kumon, Masashi Hashimoto, Chiaki Yagi, Ryoma Sugimoto, Satoru Kikuchi, Shunsuke Kagawa, Hiroshi Tazawa, Yasuo Urata, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 74 ( 1 ) 12 - 12 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Dendritic cells (DCs) are crucial in cancer immunity, because they activate cytotoxic T cells by presenting tumor antigens. Recently, oncolytic virus therapy has been recognized as a systemic immune stimulator. We previously developed a telomerase-specific oncolytic adenovirus (OBP-301) and a p53-armed OBP-301 (OBP-702), demonstrating that these viruses strongly activate systemic antitumor immunity. However, their effects on DCs remained unclear. In the present study, the aim was to elucidate the mechanisms of DC activation by OBP-702, focusing particularly on tumor-derived exosomes. Exosomes (Exo53, Exo301, or Exo702) were isolated from conditioned media of human or murine pancreatic cancer cell lines (Panc-1, MiaPaCa-2, and PAN02) after treatment with Ad-p53, OBP-301, or OBP-702. Exo702 derived from Panc-1 and MiaPaCa-2 cells significantly upregulated CD86, CD80, CD83 (markers of DC maturation), and IFN-γ in DCs in vitro. Similarly, Exo702 derived from PAN02 cells upregulated CD86 and IFN-γ in bone marrow-derived DCs in a bilateral PAN02 subcutaneous tumor model. This DC maturation was inhibited by GW4869, an inhibitor of exosome release, and anti-CD63, an antibody targeting the exosome marker. Intratumoral injection of OBP-702 into PAN02 subcutaneous tumors significantly increased the presence of mature DCs and CD8-positive T cells in draining lymph nodes, leading to long-lasting antitumor effects through the durable activation of systemic antitumor immunity. In conclusion, tumor-derived exosomes play a significant role in DC maturation following OBP-702 treatment and are critical for the systemic activation of antitumor immunity, leading to the abscopal effect.

DOI： 10.1007/s00262-024-03849-5

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Primary ileal myeloid sarcoma presenting with bowel obstruction: a case report. 国際誌

Hitoshi Minagi, Nobuhiko Kanaya, Yoshitaka Kondo, Yoshihiko Kakiuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Satoru Kikuchi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara

Surgical case reports 10 ( 1 ) 229 - 229 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Myeloid sarcoma (MS) is an extramedullary tumor constituted by myeloid blasts or immature myeloid cells. It frequently occurs in conjunction with acute myeloid leukemia (AML); however, it can exceptionally manifest in patients without leukemia. Here, we present a rare case of primary MS originating in the small bowel without evidence of bone marrow involvement. CASE REPRESENTATION: A 33 year-old female with no relevant medical history was admitted to our hospital with recurrent abdominal pain. Computed tomography (CT) revealed bowel obstruction due to thickening of the ileum wall, which was suspected to be an ileal tumor. Initially, ectopic endometriosis was suspected because of abdominal pain associated with the menstrual cycle and changes observed on a follow-up CT scan. The lesion could not be detected by double-balloon endoscopy. Despite conservative treatment, the obstruction persisted, and laparoscopic partial ileal resection was performed, which revealed extensive involvement of the ileum and mesentery. Additionally, the mesentery of the resected ileum was extremely thickened. Histopathological and immunohistochemical examinations of the surgical specimen indicated ileal MS. Bone marrow aspiration after discharge was negative for cytological findings of leukemia, leading to a final diagnosis of primary ileal MS. Her postoperative course was uneventful, and she is currently undergoing systemic chemotherapy tailored to AML at another hospital. CONCLUSIONS: Even though MS of the small bowel is rare and may not be considered preoperatively, similar surgical treatment to that of other small bowel malignancies can ensure proper postoperative diagnosis and appropriate chemotherapy. Given the potential need for chemotherapy, ensuring surgical safety that allows for its rapid initiation is critical.

DOI： 10.1186/s40792-024-02030-5

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発生部位からみた肉腫の適切な外科的切除縁とは?-領域横断的な認識の統合- 後腹膜脂肪肉腫に対する外科的切除縁の最適化

近藤喜太, 金谷信彦, 庄司良平, 松三雄騎, 垣内慶彦, 重安邦俊, 菊地覚次, 黒田新士, 田辺俊介, 野間和広, 寺石文則, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 OWS3 - 2 2024年10月

NTRK融合遺伝子とERBB2 amplificationが合併したマイクロサテライト安定型大腸癌

重安邦俊, 高橋利明, 山本英喜, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本癌治療学会学術集会抄録集 62回 ICCJ3 - 6 2024年10月

術前治療後の局所進行直腸癌に対するロボット支援手術の短期～中期治療成績

寺石文則, 庄司良平, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 2317 - 2317 2024年7月

下部消化管大腸癌集学的治療について高齢化社会における大腸癌患者の長期生存を目指した遠隔転移制御戦略

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 596 - 596 2024年7月

下部消化管大腸癌集学的治療について高齢化社会における大腸癌患者の長期生存を目指した遠隔転移制御戦略

重安邦俊, 高橋利明, 楳田祐三, 垣内慶彦, 松三雄騎, 近藤喜太, 寺石文則, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 596 - 596 2024年7月

術前治療後の局所進行直腸癌に対するロボット支援手術の短期～中期治療成績

寺石文則, 庄司良平, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 2317 - 2317 2024年7月

下部消化管新規内科治療が台頭する時代の炎症性腸疾患に対する外科治療の意義手術適応クローン病患者において術前の栄養学的・免疫学的指標の改善が術後合併症を軽減する

Moriwake Kazuya, Kondo Yoshitaka, Sakamoto Masaki, Kanaya Nobuhiko, Kakiuchi Yoshihiko, Shigeyasu Kunitoshi, Kuroda Shinji, Teraishi Fuminori, Kagawa Shunsuke, Fujiwara Toshiyoshi

日本消化器外科学会総会 79回 345 - 345 2024年7月

私が目指すScientific Surgeonとその現状と未来

金谷信彦, 黒田新士, 近藤喜太, 坂本真樹, 垣内慶彦, 菊地覚次, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 668 - 668 2024年7月

上部消化管上部消化管癌に対する更なる低侵襲・機能温存治療観音開き法再建後の吻合部狭窄および狭窄症状のリスク因子分析から見えた再建手技の理想型

黒田新士, 垣内慶彦, 菊地覚次, 賀島肇, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 79回 573 - 573 2024年7月

A multi-center, prospective, clinical study to evaluate the anti-reflux efficacy of laparoscopic double-flap technique (lD-FLAP Study). 査読

Shinji Kuroda, Michihiro Ishida, Yasuhiro Choda, Atsushi Muraoka, Shinji Hato, Tetsuya Kagawa, Norimitsu Tanaka, Toshiharu Mitsuhashi, Yoshihiko Kakiuchi, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Annals of gastroenterological surgery 8 ( 3 ) 374 - 382 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Double-flap technique (DFT) is a reconstruction procedure after proximal gastrectomy (PG). We previously reported a multi-center, retrospective study in which the incidence of reflux esophagitis (RE) (Los Angeles Classification ≥Grade B [LA-B]) 1 year after surgery was 6.0%. There have been many reports, but all of them were retrospective. Thus, a multi-center, prospective study was conducted. METHODS: Laparoscopic PG + DFT was performed for cT1N0 upper gastric cancer patients. The primary endpoint was the incidence of RE (≥LA-B) 1 year after surgery. The planned sample size was 40, based on an estimated incidence of 6.0% and an upper threshold of 20%. RESULTS: Forty patients were recruited, and 39, excluding one with conversion to total gastrectomy, received protocol treatment. Anastomotic leakage (Clavien-Dindo ≥Grade III) was observed in one patient (2.6%). In 38 patients, excluding one case of postoperative mortality, RE (≥LA-B) was observed in two patients (5.3%) 1 year after surgery, and the upper limit of the 95% confidence interval was 17.3%, lower than the 20% threshold. Anastomotic stricture requiring dilatation was observed in two patients (5.3%). One year after surgery, body weight change was 88.9 ± 7.0%, and PNI <40 and CONUT ≥5, indicating malnutrition, were observed in only one patient (2.6%) each. In the quality of life survey using the PGSAS-45 questionnaire, the esophageal reflux subscale score was 1.4 ± 0.6, significantly better than the public data (2.0 ± 1.0; p = 0.001). CONCLUSION: Laparoscopic DFT showed anti-reflux efficacy. Taken together with the acceptable incidence of anastomotic stricture, DFT can be an option for reconstruction procedure after PG.

DOI： 10.1002/ags3.12783

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「多様な外科医が活躍する社会」の実現に向けて Academic daddy surgeonを目指した一外科医の試み

金谷信彦, 黒田新士, 坂本真樹, 垣内慶彦, 近藤喜太, 竹原裕子, 香川俊輔, 藤原俊義

日本外科系連合学会誌 49 ( 3 ) 276 - 276 2024年5月

「多様な外科医が活躍する社会」の実現に向けて Academic daddy surgeonを目指した一外科医の試み

金谷信彦, 黒田新士, 坂本真樹, 垣内慶彦, 近藤喜太, 竹原裕子, 香川俊輔, 藤原俊義

日本外科系連合学会誌 49 ( 3 ) 276 - 276 2024年5月

Long-term activation of anti-tumor immunity in pancreatic cancer by a p53-expressing telomerase-specific oncolytic adenovirus. 査読国際誌

Masashi Hashimoto, Shinji Kuroda, Nobuhiko Kanaya, Daisuke Kadowaki, Yusuke Yoshida, Masaki Sakamoto, Yuki Hamada, Ryoma Sugimoto, Chiaki Yagi, Tomoko Ohtani, Kento Kumon, Yoshihiko Kakiuchi, Kazuya Yasui, Satoru Kikuchi, Ryuichi Yoshida, Hiroshi Tazawa, Shunsuke Kagawa, Takahito Yagi, Yasuo Urata, Toshiyoshi Fujiwara

British journal of cancer 130 ( 7 ) 1187 - 1195 2024年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Pancreatic cancer is an aggressive, immunologically "cold" tumor. Oncolytic virotherapy is a promising treatment to overcome this problem. We developed a telomerase-specific oncolytic adenovirus armed with p53 gene (OBP-702). METHODS: We investigated the efficacy of OBP-702 for pancreatic cancer, focusing on its long-term effects via long-lived memory CD8 + T cells including tissue-resident memory T cells (TRMs) and effector memory T cells (TEMs) differentiated from effector memory precursor cells (TEMps). RESULTS: First, in vitro, OBP-702 significantly induced adenosine triphosphate (ATP), which is important for memory T cell establishment. Next, in vivo, OBP-702 local treatment to murine pancreatic PAN02 tumors increased TEMps via ATP induction from tumors and IL-15Rα induction from macrophages, leading to TRM and TEM induction. Activation of these memory T cells by OBP-702 was also maintained in combination with gemcitabine+nab-paclitaxel (GN) in a PAN02 bilateral tumor model, and GN + OBP-702 showed significant anti-tumor effects and increased TRMs in OBP-702-uninjected tumors. Finally, in a neoadjuvant model, in which PAN02 cells were re-inoculated after resection of treated-PAN02 tumors, GN + OBP-702 provided long-term anti-tumor effects even after tumor resection. CONCLUSION: OBP-702 can be a long-term immunostimulant with sustained anti-tumor effects on immunologically cold pancreatic cancer.

DOI： 10.1038/s41416-024-02583-0

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薬物療法と手術を組み合わせた直腸癌遠隔転移症例の長期生存への取り組み

重安邦俊, 香川俊輔, 高橋利明, 梅田響, 松三雄騎, 菊地覚次, 垣内慶彦, 庄司良平, 近藤喜太, 黒田新士, 楳田祐三, 藤原俊義

日本大腸肛門病学会雑誌 77 ( 4 ) 238 - 238 2024年4月

高齢者,併存疾患を有する症例などハイリスク症例の胃癌に対するconversion手術の現況と成績年齢と全身状態から考えるStageIV胃癌に対するConversion手術の是非

垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 重安邦俊, 香川俊輔, 藤原俊義

日本外科学会定期学術集会抄録集 124回 WS - 3 2024年4月

大臀筋に浸潤した局所進行直腸癌に対してtotal neoadjuvant therapyが奏効した一例

坂本真樹, 寺石文則, 庄司良平, 金谷信彦, 賀島肇, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 85 ( 3 ) 461 - 461 2024年3月

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