研究者詳細 - 安井　和也

論文 - 安井　和也

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Usefulness of Middle Colic Artery Transposition Technique for Hepatic Arterial Reconstruction in Conversion Surgery for an Initially Unresectable, Locally Advanced Pancreatic Cancer. 査読

Ryuichi Yoshida, Takahito Yagi, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kosei Takagi, Kenjiro Kumano, Masashi Yoshimoto, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 4 ) 543 - 548 2021年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

The outcomes of pancreatectomy with resection and reconstruction of the involved arteries for locally advanced pancreatic cancer following chemotherapy have improved in recent years. In pancreatic head cancers in which there is contact with the common and proper hepatic arteries, margin-negative resection requires pancreati-coduodenectomy, with the resection of these arteries and the restoration of hepatic arterial flow. Here, we describe a middle colic artery transposition technique in hepatic arterial reconstruction during pancreatoduo-denectomy for an initially unresectable locally advanced pancreatic cancer. This technique was effective and may provide a new option for hepatic artery reconstruction in such cases.

DOI： 10.18926/AMO/62410

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高度なHCCの治療を目的とする粒子線治療を先行させた肝移植

八木孝仁, 吉田龍一, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 杭瀬崇, 高木弘誠, 藤原俊義

日本消化器外科学会総会 76回 P143 - 6 2021年7月

高齢者に対する肝臓外科治療高齢者に対する肝切除術前評価における5-Item Modified Frailty Indexの有用性

吉田一博, 楳田祐三, 吉田龍一, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 PD5 - 3 2021年7月

Pittsburgh styleによるロボット支援下膵頭十二指腸切除術術式の定型化と手技の工夫

高木弘誠, 楳田祐三, 吉田龍一, 吉田一博, 安井和也, 黒田新士, 野間和広, 寺石文則, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P147 - 4 2021年7月

肝細胞癌治療における肝移植の役割肝癌肝移植の長期予後に向けて肝移植適応の選別と再発時治療

楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 香川俊輔, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 WS20 - 6 2021年7月

進行膵癌集学的治療における術前血中KRAS遺伝子変異の新規バイオマーカーとしての有用性に関する検討

吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 佐藤博紀, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P167 - 3 2021年7月

切除可能大腸癌肝転移に対する治療戦略大腸癌肝転移における術前化学療法の適応選別 RAS/RAF変異による肝外進展リスク

岡林弘樹, 楳田祐三, 吉田龍一, 吉田一博, 高木弘誠, 安井和也, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 RS24 - 1 2021年7月

膵癌術後再発巣に対する局所療法の有用性の検討

佐藤博紀, 吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 3 2021年7月

切除後再発時期・生存期間に着目した膵癌治療成績の検討今後の治療方向性を探る

安井和也, 吉田龍一, 佐藤博紀, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 4 2021年7月

Gastroenteropancreatic neuroendocrine tumor of the accessory papilla of the duodenum: a case report. 査読国際誌

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Hiroki Sato, Takahito Yagi, Toshiyoshi Fujiwara

Surgical case reports 7 ( 1 ) 156 - 156 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Contrary to the increasing incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), GEP-NETs of the accessory papilla of the duodenum are extremely rare. Furthermore, there have been no recommendations regarding the treatment strategy for GEP-NETs of the accessory papilla of the duodenum. We present a case of GEP-NET of the accessory papilla of the duodenum successfully treated with robotic pancreatoduodenectomy. CASE PRESENTATION: A case of a 70-year-old complaining of no symptoms was diagnosed with GEP-NET of the accessory papilla of the duodenum. A 8-mm tumor was located at the submucosal layer with a biopsy demonstrating a neuroendocrine tumor grade 1. The patient underwent robotic pancreatoduodenectomy as curative resection for the tumor. The total operative time was 406 min with an estimated blood loss of 150 mL. The histological examination revealed a well-differentiated neuroendocrine tumor with low Ki-67 index (< 1%). In the posterior areas of the pancreas, the lymph node metastases were detected. The patient was followed up for 6 months with no recurrence postoperatively. CONCLUSIONS: Considering the potential risks of the lymph node metastases, the standard treatment strategy for GEP-NETs of the accessory papilla of the duodenum should be radical resection with pancreatoduodenectomy. Minimally invasive approach can be the alternative to the conventional open surgery.

DOI： 10.1186/s40792-021-01241-4

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Clinical and epigenetic features of colorectal cancer patients with somatic POLE proofreading mutations. 査読国際誌

Takashi Kawai, Akihiro Nyuya, Yoshiko Mori, Takehiro Tanaka, Hiroaki Tanioka, Kazuya Yasui, Toshiaki Toshima, Fumitaka Taniguchi, Kunitoshi Shigeyasu, Yuzo Umeda, Toshiyoshi Fujiwara, Makoto Okawaki, Yoshiyuki Yamaguchi, Ajay Goel, Takeshi Nagasaka

Clinical epigenetics 13 ( 1 ) 117 - 117 2021年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Mutations in the POLE gene result in an ultra-hypermutated phenotype in colorectal cancer (CRC); however, the molecular characterisation of epigenetic alterations remains unclear. We examined the genetic and epigenetic profiles of POLE-mutant CRC to elucidate the clinicopathological features of the associated genetic and epigenetic alterations. RESULTS: Tumour tissues (1,013) obtained from a cohort of patients with CRC were analysed to determine associations between the proofreading domain mutations of POLE with various clinicopathological variables, microsatellite instability (MSI) status, BRAF and KRAS mutations, and the methylation status of key regions of MLH1, MGMT, and SFRP2 promoters by calculating the methylation scores (range 0-6). Only four cases (0.4%) exhibited pathogenic POLE hotspot mutations (two p.P286R [c.857C > G], one p.V411L [c.1231G > C], and p.S459F [c.1376C > T] each), which were mutually exclusive to BRAF and KRAS mutations and MSI. CRC patients were divided into four subgroups: patients with POLE mutations (POLE, 0.4%, n = 4), patients with both MSI and extensive methylation in MLH1 (MSI-M, 2.9%, n = 29), patients with MSI but no extensive methylation in MLH1 (MSI-U, 3.6%, n = 36), and patients without MSI (non-MSI, 93.2%, n = 944). The POLE group was younger at diagnosis (median 52 years, P < 0.0001), with frequent right-sided tumour localisation (frequency of tumours located in the right colon was 100%, 93.1%, 36.1%, and 29.9% in POLE, MSI-M, MSI-U, and non-MSI, respectively; P < 0.0001), and was diagnosed at an earlier stage (frequency of stages I-II was 100%, 72.4%, 77.8%, and 46.6% in POLE, MSI-M, MSI-U, and non-MSI, respectively, P < 0.0001). The mean methylation score in POLE was not different from that in MSI-U and non-MSI, but the methylation signature was distinct from that of the other subgroups. Additionally, although the examined number of POLE-mutant tumours was small, the number of CD8-positive cells increased in tumours with partial methylation in the MLH1 gene. CONCLUSIONS: CRC patients with POLE proofreading mutations are rare. Such mutations are observed in younger individuals, and tumours are primarily located in the right colon. Diagnosis occurs at an earlier stage, and distinct epigenetic alterations may be associated with CD8 cell infiltration.

DOI： 10.1186/s13148-021-01104-7

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外科マネージメントセンターによる情熱のある外科医教育・育成システム

菊地覚次, 吉田龍一, 黒田新士, 野間和広, 安井和也, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会定期学術集会抄録集 121回 SP - 6 2021年4月

外科における多施設臨床試験の意義と方向性消化器外科における多施設共同研究の意義地方からのevidence発信を目指して

楳田祐三, 黒田新士, 香川俊輔, 吉田龍一, 菊池覚次, 杭瀬崇, 吉田一博, 高木弘誠, 安井和也, 西崎正彦, 八木孝仁, 藤原俊義

日本外科学会定期学術集会抄録集 121回 NES - 4 2021年4月

外科系新専門医制度のあるべきグランドデザイン地域枠医師に対する外科専門研修のあり方充実した地域医療の実現を目指して査読

黒田新士, 吉田龍一, 池田宏国, 岡崎幹生, 大澤晋, 小谷恭弘, 山根正修, 杉本誠一郎, 菊地覚次, 安井和也, 野田卓男, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会雑誌 122 ( 1 ) 83 - 85 2021年1月

Hemobilia after bile duct resection: perforation of pseudoaneurysm into intra-pancreatic remnant bile duct: a case report. 査読国際誌

Kazuhiro Yoshida, Yuzo Umeda, Masaya Iwamuro, Kazuyuki Matsumoto, Hironari Kato, Mayu Uka, Yusuke Matsui, Ryuichi Yoshida, Takashi Kuise, Kazuya Yasui, Kosei Takagi, Hiroyuki Araki, Takahito Yagi, Toshiyoshi Fujiwara

BMC surgery 20 ( 1 ) 307 - 307 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Hemobilia occurs mainly due to iatrogenic factors such as impairment of the right hepatic or cystic artery, and/or common bile duct in hepatobiliary-pancreatic surgery. However, little or no cases with hemobilia from the intra-pancreatic remnant bile duct after bile duct resection (BDR) has been reported. Here, we report a case of massive hemobilia due to the perforation of psuedoaneurysm of the gastroduodenal artery (GDA) to the intra-pancreatic remnant bile duct after hepatectomy with BDR. CASE PRESENTATION: A 68-year-old male underwent extended right hepatectomy with BDR for gallbladder carcinoma. He presented with upper gastrointestinal bleeding 2 months after the initial surgery. Upper endoscopy identified a blood clot from the ampulla of Vater and simultaneous endoscopic balloon tamponade contributed to temporary hemostasis. Abdominal CT and angiography revealed a perforation of the psuedoaneurysm of the GDA to the intra-pancreatic remnant bile duct resulting in massive hemobilia. Subsequent selective embolization of the pseudoaneurysm with micro-coils could achieve complete hemostasis. He survived without any recurrence of cancer and bleeding. CONCLUSION: Hemobilia could occur in a patient with BDR due to perforation of the pseudoaneurysm derived from the GDA to the intra-pancreatic remnant bile duct. Endoscopic balloon tamponade was useful for a temporal hemostasis and a subsequent radiologic interventional approach.

DOI： 10.1186/s12893-020-00981-8

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Short-term and long-term outcomes in living donors for liver transplantation: Cohort study. 査読国際誌

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Nobuyuki Watanabe, Takashi Kuise, Kazuhiro Yoshida, Kazuya Yasui, Tatsuo Matsuda, Toshiyoshi Fujiwara, Takahito Yagi

International journal of surgery (London, England) 84 147 - 153 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Although perioperative outcomes following donor hepatectomy (DH) have been reported, little is known about the long-term outcomes in living donors of liver transplantation. The aim of this study was to investigate the short-term and long-term outcomes following DH. METHODS: A total of 408 living donors who underwent DH between 1996 and 2019 were analyzed in this retrospective study, focusing on short-term outcomes with respect to the operation period (era) and the graft type, as well as long-term outcomes. RESULTS: The overall incidence of postoperative complications was 40.4%. These included minor (30.4%), major (10.0%), and biliary (14.0%) complications. Short-term outcomes after DH slightly improved over time, and outcomes did not differ significantly between the graft types. With regards to long-term outcomes, the incidence of surgery-related complications such as keloids, incisional hernias, and mechanical bowel obstructions was 6.6% over a median follow-up of 7.2 years. In addition, some donors developed comorbidities such as lifestyle diseases and cancers during the follow-up period. CONCLUSIONS: Our study confirmed an improvement of perioperative outcomes in living donors. There was no significant association between the graft type and postoperative outcomes. Donors could develop various morbidities during long-term follow-up. Therefore, a careful perioperative management and long-term follow-up should be provided to living donors.

DOI： 10.1016/j.ijsu.2020.11.013

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A novel modified hanging maneuver in laparoscopic left hemihepatectomy. 査読国際誌

Kosei Takagi, Yuzo Umeda, Takashi Kuise, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Yuma Tani, Takahito Yagi, Toshiyoshi Fujiwara

International journal of surgery case reports 76 251 - 253 2020年

記述言語：英語

INTRODUCTION: The liver hanging maneuver is an essential technique for controlling bleeding in hepatectomy, however it is often difficult in laparoscopic major hepatectomy. The present study describes a novel modified hanging maneuver in laparoscopic left hemihepatectomy. PRESENTATION OF CASE: A 29-year-old female underwent laparoscopic left hemihepatectomy for mucinous cystic neoplasm. After mobilizing the left lobe, the liver parenchyma was dissected along the demarcation line. For the hanging technique, the upper edge of the hanging tape was placed on the lateral side of the left hepatic vein, and fixed with the Falciform ligament. The lower edge of the tape was extracted outside the abdomen. Accordingly the hanging tape can be controlled extraperitoneally during the liver parenchyma dissection. DISCUSSION: This technique includes several advantages including no need of assistance using forceps, easy control of the hanging tape extraperitoneally, outflow control, better exposure of surgical field, and helpful guide of the liver dissection line toward the root of the left hepatic vein. CONCLUSION: Our novel modified hanging maneuver is easy and reproducible to use in laparoscopic left hemihepatectomy. Moreover, this technique can be applied to other laparoscopic hepatectomy.

DOI： 10.1016/j.ijscr.2020.10.002

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Heterogeneity of Epigenetic and Epithelial Mesenchymal Transition Marks in Hepatocellular Carcinoma with Keratin 19 Proficiency. 査読国際誌

Naosuke Yokomichi, Naoshi Nishida, Yuzo Umeda, Fumitaka Taniguchi, Kazuya Yasui, Toshiaki Toshima, Yoshiko Mori, Akihiro Nyuya, Takehiro Tanaka, Takeshi Yamada, Takahito Yagi, Toshiyoshi Fujiwara, Yoshiyuki Yamaguchi, Ajay Goel, Masatoshi Kudo, Takeshi Nagasaka

Liver cancer 8 ( 4 ) 239 - 254 2019年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

Objective: Keratin 19 (K19) expression is a potential predictor of poor prognosis in patients with hepatocellular carcinoma (HCC). To clarify the feature of K19-proficient HCC, we traced epigenetic footprints in cultured cells and clinical materials. Patients and Methods: In vitro, KRT19 promoter methylation was analyzed and 5-aza-2'-deoxycytidine with trichostatin A (TSA) treatment was performed. Among 564 surgically resected HCCs, the clinicopathological relevance of K19-proficent HCCs was performed in comparison with hepatocytic (HepPar-1 and arginase-1), epithelial-mesenchymal transition (E-cadherin and vimentin), biliary differentiation-associated (K7 and NOTCH-1) markers, and epigenetic markers (KRT19 promoter/long interspersed nucleotide element-1 [LINE-1] methylation status). Results: KRT19 promoter methylation was clearly associated with K19 deficiency and 5-aza-2'-deoxycytidine with TSA treatment-stimulated K19 re-expression, implicating DNA methylation as a potential epigenetic process for K19 expression. After excluding HCCs with recurrence, TNM stage as IIIB or greater, preoperative therapy, transplantation, and combined hepatocellular cholangiocarcinoma, we assessed 125 of 564 HCC cases. In this cohort, K19 expression was found in 29 HCCs (23.2%) and corresponded with poor survival following surgery (p = 0.025) and extrahepatic recurrence-free survival (p = 0.017). Compared with K19-deficient HCCs, lower KRT19 promoter methylation level was observed in K19-proficient HCCs (p < 0.0001). Conversely, HCC with genome-wide LINE-1 hypermethylation was frequently observed in K19-proficient HCCs (p = 0.0079). Additionally, K19 proficiency was associated with K7 proficiency (p = 0.043), and reduced E-cadherin and HepPar-1 expression (p = 0.043 and p < 0.0001, respectively). Conclusions: K19-proficient HCC exhibited poor prognosis owing to extrahepatic recurrence, with molecular signatures differing from those in conventional cancer stem cells, providing novel insights of the heterogeneity underlying tumor development.

DOI： 10.1159/000490806

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Detection of circulating microRNAs with Ago2 complexes to monitor the tumor dynamics of colorectal cancer patients during chemotherapy. 査読国際誌

Tomokazu Fuji, Yuzo Umeda, Akihiro Nyuya, Fumitaka Taniguchi, Takashi Kawai, Kazuya Yasui, Toshiaki Toshima, Kazuhiro Yoshida, Toshiyoshi Fujiwara, Ajay Goel, Takeshi Nagasaka

International journal of cancer 144 ( 9 ) 2169 - 2180 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Because of the different forms of circulating miRNAs in plasma, Argonaute2 (Ago2)-miRNAs and extracellular vesicles (EV-miRNAs), we examined the two forms of extracellular miRNAs in vitro and developed a unique methodology to detect circulating Ago2-miRNAs in small volumes of plasma. We demonstrated that Ago2-miR-21 could be released into the extracellular fluid by active export from viable cancer cells and cytolysis in vitro. As miR-21 and miR-200c were abundantly expressed in both metastatic liver sites and primary lesions, we evaluated Ago2-miR-21 as a candidate biomarker of both active export and cytolysis while Ago2-miR-200c as a biomarker of cytolysis in plasma obtained from colorectal cancer (CRC) patients before treatment and in a series of plasma obtained from CRC patients with liver metastasis who received systemic chemotherapy. The measurement of Ago2-miR-21 allowed us to distinguish CRC patients from subjects without CRC. The trend in ΔCt values for Ago2-miR-21 and -200c during chemotherapy could predict tumor response to ongoing treatment. Thus, capturing circulating Ago2-miRNAs from active export can screen patients with tumor burdens, while capturing them from passive release by cytolysis can monitor tumor dynamics during chemotherapy treatment.

DOI： 10.1002/ijc.31960

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膵腫瘍におけるゲノム解析-病態解明と臨床的意義包括的アプローチによる浸潤性膵管癌の非侵襲的診断技術の構築

吉田一博, 楳田祐三, 吉田龍一, 信岡大輔, 杭瀬崇, 藤智和, 安井和也, Goel Ajay, 八木孝仁, 藤原俊義

膵臓 33 ( 3 ) 360 - 360 2018年5月

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