Faculty Profiles - Takagi Kosei

Papers - Takagi Kosei

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ロボット支援下膵頭十二指腸切除術は術後膵液瘻High risk症例のPOPFを減少させる

藤智和, 高木弘誠, 楳田祐三, 安井和也, 木村次郎, 永井康夫, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SF - 6 2024.4

Double-surgeon techniqueによるロボット支援下膵切除術

高木弘誠, 楳田祐三, 藤智和, 安井和也, 山田元彦, 木村次郎, 藤原俊義

日本外科学会定期学術集会抄録集 124回 SF - 2 2024.4

【消化器良性疾患に対する外科治療update】肝胆膵巨大肝嚢胞に対する外科治療update

藤智和, 楳田祐三, 高木弘誠, 安井和也, 木村次郎, 山田元彦, 永井康雄, 藤原俊義

外科 86 ( 4 ) 347 - 354 2024.4

Language：Japanese Publisher：(株)南江堂

＜文献概要＞単純性肝嚢胞のほとんどは治療を要しないが,巨大な嚢胞では周囲臓器の圧排による症状を認めることがあり治療介入が行われる.腹腔鏡下嚢胞開窓術は侵襲も少なく短期成績が良好で第一選択として広く行われている.開窓部の閉鎖による再発を防ぐためには十分な嚢胞壁切開が必要であり,インドシアニングリーン蛍光法を用いた術中ナビゲーションが胆道損傷回避に有用である.

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00393&link_issn=&doc_id=20240416110010&doc_link_id=10.15106%2Fj_geka86_347&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka86_347&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Role of robotic surgery as an element of Enhanced Recovery After Surgery protocol in patients undergoing pancreatoduodenectomy. Reviewed International journal

Kosei Takagi, Yuzo Umeda, Tomokazu Fuji, Kazuya Yasui, Motohiko Yamada, Jiro Kimura, Toshiyoshi Fujiwara

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 28 ( 3 ) 220 - 225 2024.3

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

BACKGROUND: Although the current trend in pancreatoduodenectomy (PD) has shifted from open surgery to minimally invasive surgery (MIS), evidence on the role of MIS as an element of Enhanced Recovery After Surgery (ERAS) in PD is limited. This study aimed to investigate the effect of robotic surgery using the ERAS protocol on the outcomes of patients undergoing PD. METHODS: This retrospective study included 252 patients who underwent open PD (OPD) or robotic PD (RPD) managed using the ERAS protocol between January 2017 and March 2023. Outcomes stratified by the surgical approach were compared. Multivariable analyses were performed to evaluate the effect of ERAS items, including robotic surgery, on outcomes after PD. RESULTS: Of 252 patients, 202 (80.2%) underwent OPD, and 50 (19.2%) underwent RPD. Multivariable analyses demonstrated that perioperative management center support (odds ratio [OR], 2.85; 95% CI, 1.14-7.72; P = .025), robotic surgery (OR, 6.40; 95% CI, 1.94-26.1; P = .002), early solid intake (OR, 2.84; 95% CI, 1.46-5.63; P = .002), and early drain removal (OR, 3.77; 95% CI, 2.04-7.06; P < .001) were significant ERAS items related to early discharge after PD. CONCLUSION: Our study demonstrated that employing the ERAS protocol for OPD and RPD is feasible and safe. Moreover, our results suggested the role of robotic surgery as an element of the ERAS protocol for PD. A combination of ERAS protocols and MIS may be safe and feasible for accelerating postoperative recovery after PD.

DOI： 10.1016/j.gassur.2023.12.017

PubMed

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Perioperative and Postoperative Continuous Nutritional Counseling Improves Quality of Life of Gastric Cancer Patient Undergoing Gastrectomy. Reviewed International journal

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

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

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

PubMed

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ASO Author Reflections: The Role of Robotic Surgery in Patients with Portal Annular Pancreas. Reviewed International journal

Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Yuzo Umeda, Toshiyoshi Fujiwara

Annals of surgical oncology 2023.12

Robotic Pancreatoduodenectomy in Portal Annular Pancreas Using a Hanging Maneuver with Indocyanine Green Fluorescence Imaging. Reviewed International journal

Kosei Takagi, Tomokazu Fuji, Motohiko Yamada, Jiro Kimura, Kazuya Yasui, Yuzo Umeda, Toshiyoshi Fujiwara

Annals of surgical oncology 2023.12

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

BACKGROUND: Sufficient knowledge and surgical management of portal annular pancreas (PAP) are essential for pancreatic surgery. As PAP is a relatively rare pancreatic anomaly, few studies have described surgical techniques for patients with PAP undergoing robotic pancreatoduodenectomy (RPD). PATIENTS AND METHODS: An 82-year-old female patient who underwent RPD presented with distal cholangiocarcinoma and type III PAP (the fusion of the uncinate process with the anteportal main pancreatic duct). After the Kocher maneuver and stomach transection, the pancreas was transected into the neck of the anteportal portion. The retroportal portion was dissected, encircled with hanging tape, and compressed. Blood supply from the mesenteric vessels was confirmed using indocyanine green (ICG) fluorescence imaging. Subsequently, the retroportal portion was stapled. CONCLUSIONS: This study demonstrates a unique surgical technique for type III PAP using the hanging maneuver with ICG fluorescence imaging. Surgeons should decide on the surgical strategy on the basis of the fusion and ductal anatomy of the pancreas.

DOI： 10.1245/s10434-023-14685-9

PubMed

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Fontan手術後の肝腺腫に対してロボット支援下肝切除術を施行した2例

山田元彦, 高木弘誠, 楳田祐三, 藤智和, 安井和也, 木村裕司, 木村次郎, 萱野真史, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1281 - 1281 2023.12

鼠径ヘルニア術後、膀胱上窩ヘルニアに対して腹腔鏡下根治術を施行した1例

萱野真史, 高木弘誠, 山田元彦, 近藤喜太, 木村次郎, 木村裕司, 安井和也, 藤智和, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1932 - 1932 2023.12

Double-surgeon techniqueによるロボット支援下肝切除術

高木弘誠, 楳田祐三, 藤智和, 安井和也, 木村裕司, 山田元彦, 木村次郎, 萱野真史, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 2336 - 2336 2023.12

鼠径ヘルニア術後、膀胱上窩ヘルニアに対して腹腔鏡下根治術を施行した1例

萱野真史, 高木弘誠, 山田元彦, 近藤喜太, 木村次郎, 木村裕司, 安井和也, 藤智和, 楳田祐三, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1932 - 1932 2023.12

Fontan手術後の肝腺腫に対してロボット支援下肝切除術を施行した2例

山田元彦, 高木弘誠, 楳田祐三, 藤智和, 安井和也, 木村裕司, 木村次郎, 萱野真史, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1281 - 1281 2023.12

【胆道癌・膵臓癌の集学的治療におけるsupportive careの有用性について】胆道癌集学的治療における栄養指標の有用性

楳田祐三, 日置勝義, 吉田一博, 松田達雄, 児島亨, 佐藤太祐, 遠藤芳克, 藤智和, 高木弘誠, 安井和也, 木村真士, 石堂展宏, 大石正博, 稲垣優, 藤原俊義

胆と膵 44 ( 12 ) 1631 - 1637 2023.12

Language：Japanese Publisher：医学図書出版(株)

癌患者は,蛋白質の同化障害や異化亢進を特徴とする栄養不良に陥りやすく,筋肉量も減少しやすい。こうした担癌状態に伴う栄養不良,筋肉量低下・筋肉の質の低下といった二次性サルコペニアは,胆道癌において予後不良因子となることが報告されている。また手術後の感染性合併症の危険因子ともなるため,とくに胆道再建を伴う肝切除や膵頭十二指腸切除を要する胆道癌では注意を要する。胆道癌のさらなる治療予後向上には,腫瘍進行度のみならず,栄養状態を正確に評価し,リハビリ栄養療法を積極的に介入していくことが必要である。今回,肝内胆管癌切除例における栄養指標についての解析結果を踏まえ,胆道癌集学的治療における栄養評価と術前リハビリ栄養療法介入の意義について概説する。(著者抄録)

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ロボット支援下vs.腹腔鏡下膵体尾部切除術 100例の経験から

安井和也, 高木弘誠, 楳田祐三, 藤智和, 吉田龍一, 木村裕司, 山田元彦, 木村次郎, 藤原俊義

日本内視鏡外科学会雑誌 28 ( 7 ) 1941 - 1941 2023.12