研究者詳細 - 垣内　慶彦

論文 - 垣内　慶彦

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高齢者に対する薬物治療術前化学療法を要する高齢胃癌患者に対する治療戦略

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

日本胃癌学会総会記事 96回 203 - 203 2024年2月

上部胃癌に対する脾摘と脾門郭清の手技と成績脾門郭清における脾摘の有無によらない脾門アプローチの定型化

黒田新士, 垣内慶彦, 皆木仁志, 庄司良平, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 184 - 184 2024年2月

Minimum invasive surgeryでの胃切除術時における手ブレ軽減の工夫

皆木仁志, 垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 369 - 369 2024年2月

高齢者/ハイリスク患者の低侵襲手術肥満症合併胃癌患者に対するロボット支援下胃切除のリンパ節郭清効果

賀島肇, 皆木仁志, 金谷信彦, 垣内慶彦, 菊地覚次, 黒田新士, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 215 - 215 2024年2月

術後障害の評価と対策術後継続的な栄養指導による胃切除術後障害の軽減効果

菊地覚次, 半澤俊哉, 賀島肇, 庄司良平, 松三雄騎, 垣内慶彦, 黒田新士, 田辺俊介, 野間和広, 香川俊輔, 藤原俊義

日本胃癌学会総会記事 96回 175 - 175 2024年2月

Epidural versus patient-controlled intravenous analgesia on pain relief and recovery after laparoscopic gastrectomy for gastric cancer: randomized clinical trial. 査読国際誌

Satoru Kikuchi, Takashi Matsusaki, Toshiharu Mitsuhashi, Shinji Kuroda, Hajime Kashima, Nobuo Takata, Ema Mitsui, Yoshihiko Kakiuchi, Kazuhiro Noma, Yuzo Umeda, Hiroshi Morimatsu, Toshiyoshi Fujiwara

BJS open 8 ( 1 ) 2024年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Epidural analgesia (EDA) is a main modality for postoperative pain relief in major open abdominal surgery within the Enhanced Recovery After Surgery protocol. However, it remains unclear whether EDA is an imperative modality in laparoscopic gastrectomy (LG). This study examined non-inferiority of patient-controlled intravenous analgesia (PCIA) to EDA in terms of postoperative pain and recovery in patients who underwent LG. METHODS: In this open-label, non-inferiority, parallel, individually randomized clinical trial, patients who underwent elective LG for gastric cancer were randomized 1:1 to receive either EDA or PCIA after surgery. The primary endpoint was pain score using the Numerical Rating Scale at rest 24 h after surgery, analysed both according to the intention-to-treat (ITT) principle and per protocol. The non-inferiority margin for pain score was set at 1. Secondary outcomes were postoperative parameters related to recovery and adverse events related to analgesia. RESULTS: Between 3 July 2017 and 29 September 2020, 132 patients were randomized to receive either EDA (n = 66) or PCIA (n = 66). After exclusions, 64 patients were included in the EDA group and 65 patients in the PCIA group for the ITT analysis. Pain score at rest 24 h after surgery was 1.94 (s.d. 2.07) in the EDA group and 2.63 (s.d. 1.76) in the PCIA group (P = 0.043). PCIA was not non-inferior to EDA for the primary endpoint (difference 0.69, one side 95% c.i. 1.25, P = 0.184) in ITT analysis. Postoperative parameters related to recovery were similar between groups. More EDA patients (21 (32.8%) versus 1 (1.5%), P < 0.001) developed postoperative hypotension as an adverse event. CONCLUSIONS: PCIA was not non-inferior to EDA in terms of early-phase pain relief after LG.Registration number: UMIN000027643 (https://www.umin.ac.jp/ctr/index-j.htm).

DOI： 10.1093/bjsopen/zrad161

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Perioperative and Postoperative Continuous Nutritional Counseling Improves Quality of Life of Gastric Cancer Patient Undergoing Gastrectomy. 査読国際誌

Shunya Hanzawa, Satoru Kikuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Ayako Takahashi, Yoshihiko Kakiuchi, Kosei Takagi, Shunsuke Tanabe, Kazuhiro Noma, Shunsuke Kagawa, Kenichi Shikata, Toshiyoshi Fujiwara

Nutrition and cancer 76 ( 6 ) 476 - 485 2024年

記述言語：英語掲載種別：研究論文（学術雑誌）

Post-gastrectomy syndrome (PGS) and body weight loss (BWL) decrease quality of life (QOL) and survival of the patient undergoing gastrectomy. We have introduced perioperative and post-discharge continuous nutritional counseling (CNC) to prevent BWL and improve QOL after gastrectomy. In the present study, we evaluated the effect of CNC on QOL using the Post-gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Eighty-three patients with gastric cancer (GC) who underwent curative gastrectomy between March 2018 and July 2019 were retrospectively analyzed. Patients received either pre-discharge nutritional counseling alone (control group, n = 45) or CNC (CNC group, n = 38) after gastrectomy. QOL at 12 months after gastrectomy was compared between the two groups. In QOL assessment, change in body weight (-7.98% vs. -12.77%, p = 0.0057), ingested amount of food per meal (7.00 vs. 6.07, p = 0.042) and ability for working (1.89 vs. 2.36, p = 0.049) were significantly better in CNC group than control group. Multiple regression analysis showed that CNC was a significantly beneficial factor for abdominal pain subscale (p = 0.028), diarrhea subscale (p = 0.047), ingested amount of food per meal (p = 0.012), Ability for working (p = 0.031) and dissatisfaction at the meal (p = 0.047). Perioperative and postoperative CNC could improve QOL in the patient undergoing gastrectomy in addition to preventing postoperative BWL.

DOI： 10.1080/01635581.2024.2340782

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胃癌術後1年目に局所リンパ節再発との鑑別を要した腹腔内デスモイド腫瘍の1例

片山哲也, 垣内慶彦, 黒田新士, 近藤喜太, 菊地覚次, 重安邦俊, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会雑誌 56 ( 12 ) 677 - 684 2023年12月

記述言語：日本語出版者・発行元：(一社)日本消化器外科学会

症例は44歳の男性で,胃癌に対して腹腔鏡下幽門側胃切除術,D2リンパ節郭清,Billroth-I法再建を施行し,病理組織診断はpT2N0M0 Stage IBであった.術後1年目のCTおよびPET-CTにて,#6リンパ節郭清領域にリンパ節再発を示唆する所見を認めたため腹腔鏡下腫瘤摘出術を施行し,病理組織診断でデスモイド腫瘍であった.デスモイド腫瘍は術前診断が困難であり,その発生機序の一因として手術による機械刺激が挙げられるため,胃癌術後に発生した際は再発との鑑別が困難である.再発リスクの低い症例では化学療法などを施行する前に,診断的治療を目的とした手術を行うことは有用であり,術中迅速検査などで再発が否定できるのであれば,他臓器合併切除は極力避けるべきである.胃癌術後にリンパ節再発との鑑別を要したデスモイド腫瘍の1例を経験した.(著者抄録)

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炎症性腸疾患に対する低侵襲手術の新しい工夫瘻孔形成を伴うクローン病低侵襲手術の効果とバイオ製剤導入時期の腸管機能温存への影響

近藤喜太, 金谷信彦, 庄司良平, 垣内慶彦, 菊地覚次, 重安邦俊, 田辺俊介, 黒田新士, 野間和広, 寺石文則, 楳田祐三, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2246 - 2246 2023年12月

減量・代謝改善手術を安全かつ有効に行うためのちょっとした工夫腹腔鏡下スリーブ状胃切除における縫合補強材を用いた大彎側切離の安全性と手術時間短縮効果

賀島肇, 菊地覚次, 香川俊輔, 皆木仁志, 庄司良平, 金谷信彦, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 408 - 408 2023年12月

Omental Abscess after Laparoscopic Proximal Gastrectomy Successfully Treated with Percutaneous Drainage. 査読

Atsunobu Sakurai, Mayu Uka, Toshihiro Iguchi, Koji Tomita, Yusuke Matsui, Yoshihiko Kakiuchi, Shinji Kuroda, Toshiyoshi Fujiwara, Takao Hiraki

Acta medica Okayama 77 ( 6 ) 665 - 669 2023年12月

記述言語：英語

We report the case details of a 65-year-old Japanese man with an omental abscess that was discovered 43 days after he underwent a laparoscopic proximal gastrectomy for gastric cancer. His chief complaint was mild abdominal pain that had persisted for several days. The abscess was diagnosed as a rare postoperative complication. We hesitated to perform a reoperation given the invasiveness of general anesthesia and surgery, plus the possibility of postoperative adhesions and because the patient's general condition was stable and he had only mild abdominal pain. Percutaneous drainage using a 10.2-F catheter was performed with the patient under conscious sedation and computed tomography-fluoroscopy guidance, with no complications. After the procedure, the size of the abscess cavity was remarkably reduced, and 23 days later the catheter was withdrawn.

DOI： 10.18926/AMO/66160

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低侵襲胃癌手術における脾門リンパ節郭清-脾摘か脾温存か、適応とアプローチの実際- 低侵襲アプローチによる脾温存脾門リンパ節郭清手技の定型化とその標準術式としての可能性

黒田新士, 菊地覚次, 垣内慶彦, 賀島肇, 金谷信彦, 庄司良平, 皆木仁志, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2681 - 2681 2023年12月

腹腔鏡下胃切除術の際の12mmポート挿入方向の工夫による手ブレ軽減効果

皆木仁志, 垣内慶彦, 黒田新士, 金谷信彦, 賀島肇, 菊地覚次, 香川俊輔, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 570 - 570 2023年12月

病理組織学的に膵浸潤を認めた壁外発育型胃GISTの1例

新田薫, 垣内慶彦, 庄司良平, 重安邦俊, 菊地覚次, 近藤喜太, 黒田新士, 寺石文則, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 11 ) 1829 - 1829 2023年11月

Prognostic nutritional index is a prognostic factor for patients with gastric cancer and esophagogastric junction cancer undergoing proximal gastrectomy with esophagogastrostomy by the double-flap technique: A secondary analysis of the rD-FLAP study. 査読国際誌

Yoshihiko Kakiuchi, Shinji Kuroda, Yasuhiro Choda, Shinya Otsuka, Satoshi Ueyama, Norimitsu Tanaka, Atsushi Muraoka, Shinji Hato, Yasuaki Kamikawa, Toshiyoshi Fujiwara

Surgical oncology 50 101990 - 101990 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Although proximal gastrectomy (PG) is commonly used in patients with upper gastric cancer (GC) and esophagogastric junction (EGJ) cancer, long-term prognostic factors in these patients are poorly understood. The double-flap technique (DFT) is an esophagogastrostomy with anti-reflux mechanism after PG; we previously conducted a multicenter retrospective study (rD-FLAP) to evaluate the short-term outcomes of DFT reconstruction. Here, we evaluated the long-term prognostic factors in patients with upper GC and EGJ cancer. METHODS: The study was conducted as a secondary analysis of the rD-FLAP Study, which enrolled patients who underwent PG with DFT reconstruction, irrespective of disease type, between January 1996 and December 2015. RESULTS: A total of 509 GC and EGJ cancer patients were enrolled. Univariate and multivariate analyses of overall survival demonstrated that a preoperative prognostic nutritional index (PNI) < 45 (p < 0.001, hazard ratio [HR]: 3.59, 95% confidential interval [CI]: 1.93-6.67) was an independent poor prognostic factor alongside pathological T factor ([pT] ≥2) (p = 0.010, HR: 2.29, 95% CI: 1.22-4.30) and pathological N factor ([pN] ≥1) (p = 0.001, HR: 3.27, 95% CI: 1.66-6.46). In patients with preoperative PNI ≥45, PNI change (<90%) at 1-year follow-up (p = 0.019, HR: 2.54, 95%CI: 1.16-5.54) was an independent poor prognostic factor, for which operation time (≥300 min) and blood loss (≥200 mL) were independent risk factors. No independent prognostic factors were identified in patients with preoperative PNI <45. CONCLUSIONS: PNI is a prognostic factor in upper GC and EGJ cancer patients. Preoperative nutritional enhancement and postoperative nutritional maintenance are important for prognostic improvement in these patients.

DOI： 10.1016/j.suronc.2023.101990

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米国留学中に経験した出産育児と共稼ぎから見えた外科医のワークライフバランスへの提言

金谷信彦, 黒田新士, 竹原裕子, 皆木仁志, 垣内慶彦, 近藤喜太, 香川俊輔, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S65 - S65 2023年10月

肥満手術の現状と展望減量代謝改善手術(Bariatric Metabolic Surgery:BMS)チームの介入による術前減量効果と腹腔鏡下スリーブ状胃切除手術(Laparoscopic sleeve gastrectomy:LSG)による減量効果の関係

日本臨床外科学会雑誌 84 ( 増刊 ) S184 - S184 2023年10月

胃憩室を合併した高度肥満症に対して腹腔鏡下スリーブ状胃切除を施行した1例

廣砂賢祐, 賀島肇, 菊地覚次, 香川俊輔, 庄司良平, 金谷信彦, 垣内慶彦, 松三雄騎, 重安邦俊, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 寺石文則, 藤原俊義

日本臨床外科学会雑誌 84 ( 増刊 ) S332 - S332 2023年10月

胃憩室を合併した高度肥満症に対して腹腔鏡下スリーブ状胃切除を施行した1例

日本臨床外科学会雑誌 84 ( 増刊 ) S332 - S332 2023年10月

日本臨床外科学会雑誌 84 ( 増刊 ) S184 - S184 2023年10月

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