55 results on '"KYOICHI KIHARA"'
Search Results
2. Two Cases of Rectal Cancer with Retzius Shunt Treated with Robot-Assisted Surgery
- Author
-
Kazushi Hara, Manabu Yamamoto, Shohei Sawata, Yusuke Kono, Kyoichi Kihara, Tomoyuki Matsunaga, Naruo Tokuyasu, Teruhisa Sakamoto, and Yoshiyuki Fujiwara
- Subjects
robot-assisted surgery ,General Medicine ,rectal cancer ,Retzius shunt ,venous malformation - Abstract
The retroperitoneal intestinal vein-general circulation anastomotic pathway is referred to as a Retzius shunt; however, it is not a well-recognized condition. Here, we describe two patients with a Retzius shunt who underwent robot-assisted surgery for rectal cancer. The first case was an 81-year-old woman who had tested positive for fecal occult blood. A type 0-Is tumor was found in the middle rectum, and we used robot-assisted surgery for resection. Intraoperative findings included a dilated vein between the inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV); further, computed tomography (CT) revealed flow into the inferior vena cava (IVC). We clipped the vein without major bleeding and the tumor-specific mesorectal excision was completed. Thereafter, we reviewed relevant literature and identified the structure to be a Retzius shunt. The second case was 77-year-old man with type 1 advanced cancer in the middle rectum who underwent robot-assisted surgery. In this case, we recognized the Retzius shunt on preoperative CT due to our experience with the first case and surgery was completed without any problems. Preoperative recognition of vascular malformations, such as the Retzius shunt by CT is critical to ensure the safety of robot-assisted surgery.
- Published
- 2022
3. Influence of the water jet system vs cavitron ultrasonic surgical aspirator for liver resection on the remnant liver
- Author
-
Takehiko Hanaki, Ayumi Tsuda, Teppei Sunaguchi, Keisuke Goto, Masaki Morimoto, Yuki Murakami, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, Teruhisa Sakamoto, Toshimichi Hasegawa, and Yoshiyuki Fujiwara
- Subjects
General Medicine - Published
- 2022
4. Impact of Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Short-Term Analysis
- Author
-
Tomoyuki Matsunaga, Yuji Shishido, Hiroaki Saito, Yu Sakano, Masahiro Makinoya, Wataru Miyauchi, Shota Shimizu, Kozo Miyatani, Yusuke Kono, Yuki Murakami, Takehiko Hanaki, Kyoichi Kihara, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Toshimichi Hasegawa, and Yoshiyuki Fujiwara
- Subjects
robotic esophagectomy ,Original Article ,General Medicine ,esophageal cancer - Abstract
Background: We compared short-term clinical outcomes between robotic-assisted minimally invasive esophagectomy (RAMIE) and video-assisted thoracic esophagectomy (VATS-E) using propensity score-matched analysis. Methods: We enrolled 114 patients with esophageal cancer who underwent esophagectomy at our institution from January 2013 to January 2022. Propensity score matching was performed to minimize selection bias between the RAMIE and VATS-E groups. Results: After propensity score matching, 72 patients (RAMIE group, n = 36; VATS-E group, n = 36) were selected for analysis. No significant differences in clinical variables were observed between the two groups. The RAMIE group had a significantly longer thoracic operation time (313 ± 40 vs. 295 ± 35 min, P = 0.048), a higher number of right recurrent laryngeal nerve lymph nodes (4.2 ± 2.7 vs. 2.9 ± 1.9, P = 0.039), and a shorter postoperative hospital stay (23.2 ± 12.8 vs. 30.4 ± 18.6 days, P = 0.018) than the VATS-E group. The RAMIE group tended to have a lower rate of anastomotic leakage (13.9% vs. 30.6%) than the VATS-E group, although the difference was not statistically significant (P = 0.089). No significant differences were found in recurrent laryngeal nerve paralysis (11.1% vs. 13.9%, P = 0.722) or pneumonia (13.9% vs. 13.9%, P = 1.000) between the RAMIE group and the VATS-E group. Conclusion: Although RAMIE for esophageal cancer requires a longer thoracic surgery time, it might be a feasible and safe alternative to VATS-E for treating esophageal cancer. Further analysis is needed to clarify the advantages of RAMIE over VATS-E, especially in terms of long-term surgical outcomes.
- Published
- 2023
5. A low cumulative perioperative prognostic nutritional index predicts poor long-term outcomes in patients with gastric cancer: A single-center retrospective study in Japan
- Author
-
Kozo Miyatani, Yu Sakano, Masahiro Makinoya, Wataru Miyauchi, Shota Shimizu, Yuji Shishido, Takehiko Hanaki, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Toshimichi Hasegawa, Hiroaki Saito, and Yoshiyuki Fujiwara
- Subjects
Surgery ,General Medicine - Published
- 2023
6. Estimation of the physiologic ability and surgical stress scoring system as a useful predictor of postoperative recurrence in patients with stage II colorectal cancer: a multicenter study
- Author
-
Akimitsu Tanio, Hiroaki Saito, Kazushi Hara, Ken Sugezawa, Chihiro Uejima, Kyoichi Kihara, Shigeru Tatebe, Yasuro Kurisu, Shunsuke Shibata, Toshio Yamamoto, Hiroshi Nishie, Setsujo Shiota, Takuji Naka, Kenji Sugamura, Kuniyuki Katano, Manabu Yamamoto, and Yoshiyuki Fujiwara
- Subjects
Surgery ,General Medicine - Published
- 2023
7. Evaluation of perioperative D-dimer concentration for predicting postoperative deep vein thrombosis following hepatobiliary-pancreatic surgery
- Author
-
Teruhisa Sakamoto, Yuki Murakami, Takehiko Hanaki, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Shuichi Takano, Naruo Tokuyasu, Toshimichi Hasegawa, and Yoshiyuki Fujiwara
- Subjects
Surgery ,General Medicine - Abstract
Purpose This study was performed to investigate the predictive value of the perioperative D-dimer concentration for the development of postoperative deep vein thrombosis (DVT) after hepatobiliary-pancreatic (HBP) surgery. Methods The subjects of this retrospective study were 178 patients who underwent HBP surgery in our hospital between January, 2017 and December, 2021. The D-dimer concentration was measured preoperatively and on postoperative days (POD) 1, 3, and 5. Postoperative DVT was diagnosed based on compression ultrasonography in both lower limbs on POD 6 or 7. Results Postoperative DVT developed in 21 (11.8%) of the 178 patients. The D-dimer concentration was significantly higher in the patients with than in those without postoperative DVT before surgery and on PODs 1, 3, and 5. The highest area under the curve of the D-dimer concentration for predicting DVT was 0.762 on POD 3. Multivariate analysis revealed that the D-dimer concentration on POD 3 was an independent predictive risk factor for postoperative DVT, along with the preoperative estimated glomerular filtration rate. Preoperative albumin and D-dimer concentrations were also identified as independent predictive factors of an increase in D-dimer concentration on POD 3. Conclusions The D-dimer concentration on POD 3 is a useful predictor of DVT after HBP surgery.
- Published
- 2023
8. Laparoscopic pelvic lymph node dissection in cadaver surgical training from the combined perspectives of urologists, gastroenterologists and gynecologists improves overall knowledge and technique: initial experience of multidisciplinary cadaver surgical training at a single institution in Japan
- Author
-
Shuichi Morizane, Masashi Honda, Kyoichi Kihara, Manabu Yamamoto, Hiroaki Komatsu, Shinya Sato, Katsuya Hikita, Shinji Tanishima, Hironobu Nakane, Masamichi Kurosaki, Toshiyuki Kaidoh, and Atsushi Takenaka
- Subjects
General Medicine ,Anatomy - Published
- 2022
9. Infiltration of CD204-overexpressing Macrophages Contributes to the Progression of Stage II and III Colorectal Cancer
- Author
-
Teruhisa Sakamoto, Yoichiro Tada, Shuichi Takano, Wataru Miyauchi, Kyoichi Kihara, Kazushi Hara, Toshimichi Hasegawa, Yoshiaki Matsumi, Ken Sugesawa, Manabu Yamamoto, Yoshiyuki Fujiwara, Yuji Nakayama, Akimitsu Tanio, and Chihiro Uejima
- Subjects
Male ,Cancer Research ,Colorectal cancer ,Antigens, Differentiation, Myelomonocytic ,Disease-Free Survival ,Flow cytometry ,Antigens, CD ,Cell Line, Tumor ,Tumor-Associated Macrophages ,Tumor Microenvironment ,medicine ,Humans ,Neoplasm Invasiveness ,Clinical significance ,neoplasms ,Aged ,Cell Proliferation ,Neoplasm Staging ,medicine.diagnostic_test ,business.industry ,CD68 ,Scavenger Receptors, Class A ,General Medicine ,Macrophage Activation ,Middle Aged ,Prognosis ,medicine.disease ,digestive system diseases ,In vitro ,Survival Rate ,Oncology ,Cell culture ,Cancer research ,Immunohistochemistry ,Female ,Colorectal Neoplasms ,business ,Infiltration (medical) - Abstract
Background/aim M1 macrophages have antitumour effects, while M2 macrophages promote tumour proliferation and invasion. The clinical significance of the M2-specific marker CD204 has not been elucidated in colorectal cancer (CRC). We investigated the prognostic significance of CD204- and CD68-positivity in specimens from patients with CRC and examined the effects of M2 polarized-macrophages on the proliferative and invasive potentials of CRC cell lines in vitro. Materials and methods Surgical tumour specimens from 206 patients with Stage II and III CRC were examined by immunohistochemistry. Proliferation and invasion assays and flow cytometry were used to investigate CD204 expression in macrophages co-cultured with three CRC cell lines. Results Infiltration of CD204-positive cells was significantly associated with shorter overall survival and relapse-free survival; no association was observed for CD68. M2-polarized macrophages significantly promoted proliferation and invasion of CRC cells. Conclusion Higher infiltration of CD204-positive macrophages into the tumour-microenvironment might be prognostically important in CRC.
- Published
- 2021
10. A rare case of sigmoid colon cancer in which the lower limbs received collateral blood flow from the inferior mesenteric artery owing to peripheral artery disease
- Author
-
Kyoichi Kihara, Hiromu Horie, Kozo Miyatani, Manabu Yamamoto, Masayuki Endo, Naruo Tokuyasu, Shinsaku Yata, Tomoyuki Matsunaga, Yoshiyuki Fujiwara, and Teruhisa Sakamoto
- Subjects
medicine.medical_specialty ,RD1-811 ,Population ,Ischemia ,Case Report ,Dissection (medical) ,Anastomosis ,Inferior mesenteric artery ,medicine.artery ,medicine ,education ,education.field_of_study ,Arteriosclerosis obliterans ,Lower extremity ,Multidisciplinary ,medicine.diagnostic_test ,Peripheral artery disease ,business.industry ,Angiography ,medicine.disease ,Colorectal cancer ,Surgery ,medicine.anatomical_structure ,Limb ischemia ,Collateral artery ,Indocyanine green fluorescence ,business ,Artery - Abstract
Background Colorectal cancer and peripheral artery disease are common conditions in older adults and may coexist in this population. Lymph node dissection along the inferior mesenteric artery is a vital procedure in cases of left-sided colorectal cancer. However, the inferior mesenteric artery may show a collateral blood pathway in rare cases of peripheral artery disease. We report a case of advanced sigmoid colon cancer in which the lower limbs received inferior mesenteric artery flow owing to asymptomatic peripheral artery disease. The possibility of catastrophic lower-limb ischemia because of complete mesenteric excision with ligation of the inferior mesenteric artery was a matter of concern in this case. Case presentation A 73-year-old man with asymptomatic peripheral artery disease was diagnosed with stage IIIB advanced sigmoid colon cancer. Angiography using a balloon-occlusion catheter revealed that his lower limbs received prominent inferior mesenteric artery blood flow through a collateral pathway. Therefore, interventional radiologists and cardiovascular surgeons evaluated the indications for endovascular stents or bypass grafts. The patient also had dilated cardiomyopathy, so the cardiovascular physicians evaluated his tolerance in the worst-case scenario of a colorectal anastomotic leak. The patient underwent axillofemoral artery bypass and two-stage laparoscopic sigmoid colectomy without anastomosis. The postoperative course was uneventful, and he resumed his job within a month after the resection. Conclusions Although collateral flow from the inferior mesenteric artery is rare in patients with peripheral artery disease, a few case reports have described fatal lower-limb ischemia following anterior resection. The perioperative multidisciplinary evaluation enabled us to understand the patient’s condition and risks, and allowed successful cancer treatment without ischemia of the lower limbs.
- Published
- 2021
11. GPX4 Regulates Tumor Cell Proliferation
- Author
-
Ken, Sugezawa, Masaki, Morimoto, Manabu, Yamamoto, Yoshiaki, Matsumi, Yuji, Nakayama, Kazushi, Hara, Chihiro, Uejima, Kyoichi, Kihara, Tomoyuki, Matsunaga, Naruo, Tokuyasu, Teruhisa, Sakamoto, Yoshihisa, Umekita, and Yoshiyuki, Fujiwara
- Subjects
Stomach Neoplasms ,Humans ,Ferroptosis ,Prognosis ,Reactive Oxygen Species ,Cell Proliferation - Abstract
Gastric cancer (GC) is the fourth leading cause of cancer-related death worldwide. Glutathione peroxidase 4 (GPX4) is a glutathione-dependent antioxidant enzyme known to regulate ferroptosis, which is a non-apoptotic form of cell death accompanied by iron-dependent accumulation of reactive oxygen species (ROS). This study evaluated the expression and function of GPX4 in GC.The expression of GPX4 was examined in five human GC cell lines (KATO-III, MKN-1, MKN-28, MKN-45, and MKN-74) using real-time quantitative PCR and western blotting. The role of GPX4 in GC was examined using small interference RNA and cell proliferation and ROS assays. Finally, we analyzed GPX4 expression in tumor tissues from 106 patients who underwent GC surgery using immunohistochemistry and evaluated the relationship between GPX4 levels and clinical outcomes of GC.GPX4 was expressed in all GC cell lines at various levels. GPX4 silencing and inhibition significantly reduced cell proliferation and increased ROS generation. Furthermore, the mRNA levels of prostaglandin-endoperoxide synthase 2, a known biomarker of ferroptosis, were increased after GPX4 silencing. GPX4 expression was found to be an independent prognostic factor for overall and disease-specific survival in GC patients.GPX4 can regulate cancer cell death via ferroptosis in GC cell lines and represents a significant risk factor for survival in patients with GC.
- Published
- 2022
12. Impact of skeletal muscle mass in patients with recurrent gastric cancer
- Author
-
Tomoyuki Matsunaga, Kyoichi Kihara, Teruhisa Sakamoto, Shuichi Takano, Yuki Murakami, Takehiko Hanaki, Toshimichi Hasegawa, Kozo Miyatani, Manabu Yamamoto, Naruo Tokuyasu, Hiroaki Satio, Wataru Miyauchi, Yoshiyuki Fujiwara, and Yuji Shishido
- Subjects
Male ,Sarcopenia ,medicine.medical_specialty ,RD1-811 ,medicine.medical_treatment ,Neutropenia ,Gastroenterology ,Skeletal muscle mass ,Stomach Neoplasms ,Internal medicine ,medicine ,Humans ,Chemotherapy ,Muscle, Skeletal ,RC254-282 ,Retrospective Studies ,Univariate analysis ,business.industry ,Research ,Incidence (epidemiology) ,Cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,medicine.disease ,Cross-Sectional Studies ,Oncology ,Vomiting ,Female ,Surgery ,medicine.symptom ,business ,Gastric cancer ,Body mass index ,Febrile neutropenia - Abstract
Background We retrospectively examined the relationship among skeletal muscle mass index (SMI), prognosis, and chemotherapy side effects in patients with recurrent gastric cancer (RGC). Methods Sixty-seven patients who developed recurrence after undergoing curative gastrectomy for gastric cancer at Tottori University Hospital and received palliative chemotherapy were included in this study. Pretreatment computed tomography was performed to measure the skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra. We focused on haematologic toxicity (neutropenia, thrombocytopenia, and anaemia), febrile neutropenia, and gastrointestinal toxicity (diarrhoea, vomiting, and stomatitis) as the side effects of chemotherapy. Results Median SMIs for males and females (43.9 and 34.7 cm2/m2, respectively) were used as cutoff values. The patients were classified into high (SMIHigh; n = 34) and low SMI groups (SMILow; n = 33). The SMILow group included more patients treated with monotherapy (P = 0.016) compared with the SMIHigh group, had a significantly lower number of chemotherapy lines (P = 0.049), and had a significantly higher incidence of grade 3 or 4 side effects (P = 0.010). The median survival rate was significantly higher in the SMIHigh group (17.8 vs 15.8 months; P = 0.034). In the univariate analysis, body mass index, SMI, histological type, and prognostic nutritional index were identified as prognostic indicators. The multivariate analysis identified SMI (P = 0.037) and histological type (P = 0.028) as independent prognostic factors. Conclusion The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow RGC. SMI was a useful prognostic marker of RGC.
- Published
- 2021
13. Robot-assisted total pelvic exenteration for rectal cancer after neoadjuvant chemoradiotherapy: a case report
- Author
-
Kyoichi Kihara, Yuri Koyama, Takehiko Hanaki, Kozo Miyatani, Tomoyuki Matsunaga, Manabu Yamamoto, Shuichi Morizane, Naruo Tokuyasu, Teruhisa Sakamoto, and Yoshiyuki Fujiwara
- Abstract
Background There are numerous indications for minimally invasive surgery. However, the laparoscopic approach for extended pelvic surgery is currently provided by only a few institutions specializing in cancer treatment, primarily because of technical difficulties that arise in cases involving a narrow pelvis and rigid forceps. We report a case of robot-assisted total pelvic exenteration for rectal cancer involving the prostate. We assessed the feasibility of robot-assisted total pelvic exenteration and compared the short-term outcomes of other conventional and minimally invasive approaches. Case presentation A 67-year-old man was referred to our hospital after positive fecal blood test results. The initial diagnosis was clinical T4bN2aM0, Stage IIIC rectal cancer involving the prostate. The patient underwent neoadjuvant chemoradiotherapy. Consequently, robot-assisted total pelvic exenteration with an ileal conduit and end colostomy creation were performed. The total operative duration was 9 h and 20 min. The durations of robot console usage by the colorectal and urological teams were 2 h 9 min and 2 h 23 min, respectively. The patient was discharged on postoperative day 21. The pathological diagnosis was T4b (prostate) N0M0, Stage IIC. The resection margin was 2.5 mm. During reassessment at 2 years after resection, no evidence of recurrence was observed. Conclusions Robot-assisted total pelvic exenteration was performed for a patient with advanced rectal cancer without serious complications. Robot-assisted total pelvic exenteration may provide the advantages of minimally invasive surgery, particularly in the enclosed space of the pelvis.
- Published
- 2022
14. Circular stapling anastomosis with indocyanine green fluorescence imaging for cervical esophagogastric anastomosis after thoracoscopic esophagectomy: a propensity score-matched analysis
- Author
-
Yuji Shishido, Tomoyuki Matsunaga, Masahiro Makinoya, Wataru Miyauchi, Shota Shimizu, Kozo Miyatani, Chihiro Uejima, Masaki Morimoto, Yuki Murakami, Takehiko Hanaki, Kyoichi Kihara, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Hiroaki Saito, Toshimichi Hasegawa, and Yoshiyuki Fujiwara
- Subjects
Esophagectomy ,Indocyanine Green ,Esophageal Neoplasms ,Anastomosis, Surgical ,Optical Imaging ,Humans ,Anastomotic Leak ,Surgery ,Constriction, Pathologic ,General Medicine ,Propensity Score - Abstract
Background Thoracoscopic esophagectomy has been extensively used worldwide as a curative surgery for patients with esophageal cancer; however, complications such as anastomotic leakage and stenosis remain a major concern. Therefore, the objective of this study was to evaluate the efficacy of circular stapling anastomosis with indocyanine green (ICG) fluorescence imaging, which was standardized for cervical esophagogastric anastomosis after thoracoscopic esophagectomy. Methods Altogether, 121 patients with esophageal cancer who underwent thoracoscopic esophagectomy with radical lymph node dissection and cervical esophagogastric anastomosis from November 2009 to December 2020 at Tottori University Hospital were enrolled in this study. Patients who underwent surgery before the anastomotic method was standardized were included in the classical group (n = 82) and patients who underwent surgery after the anastomotic method was standardized were included in the ICG circular group (n = 39). The short-term postoperative outcomes, including anastomotic complications, were compared between the two groups using propensity-matched analysis and the risk factors for anastomotic leakage were evaluated using logistic regression analyses. Results Of the 121 patients, 33 were included in each group after propensity score matching. The clinicopathological characteristics of patients did not differ between the two groups after propensity score matching. In terms of perioperative outcomes, a significantly higher proportion of patients who underwent surgery using the laparoscopic approach (P P = 0.003), as well as those who had a lower volume of blood loss (P = 0.009) in the ICG circular group were observed after matching. Moreover, the ICG circular group had a significantly lower incidence of anastomotic leakage (39% vs. 9%, P = 0.004) and anastomotic stenosis (46% vs. 21%, P = 0.037) and a shorter postoperative hospital stay (30 vs. 20 days, P P = 0.013). Conclusions Circular stapling anastomosis with ICG fluorescence imaging is effective in reducing complications such as anastomotic leakage and stenosis.
- Published
- 2022
15. Risk factors for recurrence in elderly patients with stage II colorectal cancer: a multicenter retrospective study
- Author
-
Takuki Yagyu, Manabu Yamamoto, Akimitsu Tanio, Kazushi Hara, Ken Sugezawa, Chihiro Uejima, Kyoichi Kihara, Shigeru Tatebe, Yasuro Kurisu, Shunsuke Shibata, Toshio Yamamoto, Hiroshi Nishie, Setsujo Shiota, Hiroaki Saito, Takuji Naka, Kenji Sugamura, Kuniyuki Katano, and Yoshiyuki Fujiwara
- Subjects
Cancer Research ,Nutrition Assessment ,Oncology ,Risk Factors ,Genetics ,Humans ,Nutritional Status ,Neoplasm Recurrence, Local ,Colorectal Neoplasms ,Prognosis ,Geriatric Assessment ,Aged ,Retrospective Studies - Abstract
Background Adjuvant chemotherapy for stage II colorectal cancer (CRC) is considered appropriate for patients with risk factors for recurrence, rather than for all patients uniformly. However, the risk factors for recurrence remain controversial, and there is limited information, especially for elderly patients. The Geriatric Nutritional Risk Index (GNRI) is widely used as a simple nutritional screening tool in the elderly and is associated with cancer prognosis and recurrence. This study aimed to investigate the risk factors for recurrence in the elderly with stage II CRC, focusing on the GNRI. Methods We enrolled 348 elderly patients (≥ 75 years) with stage II CRC who underwent curative resection at the Department of Surgery, Tottori University and our 10 affiliated institutions. The patients were divided into GNRIhigh (≥ 93.465) and GNRIlow ( Results The GNRIlow group showed a significantly worse overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) (P P P low (hazard ratio [HR]: 2.244, P P = 0.014), and moderate to severe lymphatic or venous invasion (HR: 1.460, P = 0.033) were independent factors affecting RFS. By using these three factors to score the risk of recurrence from 0 to 3 points, the prognosis was significantly stratified in terms of OS, CSS, and RFS (P P P Conclusions GNRIlow, pathologic T4 stage, and moderate to severe lymphatic or venous invasion are high-risk factors for recurrence in the elderly with stage II CRC. The scoring system using these three factors appropriately predicted their recurrence and outcome.
- Published
- 2022
16. Initial Experience in Rectal Cancer Surgery for the Next Generation of Robotic Surgeons Trained in a Dual Console System
- Author
-
Kozo Miyatani, Keigo Ashida, Akimitsu Tanio, Teruhisa Sakamoto, Tomoyuki Matsunaga, Chihiro Uejima, Yoshiyuki Fujiwara, Takehiko Hanaki, Ken Sugezawa, Manabu Yamamoto, Kyoichi Kihara, Yuji Shishido, Naruo Tokuyasu, and Kazushi Hara
- Subjects
medicine.medical_specialty ,Colorectal cancer ,business.industry ,Incidence (epidemiology) ,General Medicine ,medicine.disease ,Surgery ,dual console ,Blood loss ,robotic surgery ,Rectal cancer surgery ,medicine ,Operative time ,Original Article ,Robotic surgery ,Rectal surgery ,rectal cancer ,Early phase ,business - Abstract
[Background]?Robotic surgery for rectal cancer is used worldwide, with an increasing incidence of robotic surgeons. Therefore, the most appropriate educational system for next-generation robotic surgeons should be urgently established. [Methods]?We analyzed 39 patients who underwent robotic rectal surgery performed by a next-generation surgeon with limited experienced in laparoscopic rectal cancer surgery. The dual console system was used in the initial 15 cases, and we assessed short-term outcomes and the learning curve on operative time using the cumulative sum method. [Results]?The patients were divided into two groups: 15 cases in the early phase, and 24 cases in the late phase. The operative time and surgeon console time were significantly shorter in the late phase than the early phase (P?< 0.001). Postoperative complications were more frequently observed in the early phase (P?= 0.049); however, the estimated blood loss and length of hospital stay were not significantly different. In the initial 15 cases that using the dual console, the average operative time changing to the expert surgeon was 82 minutes in the first 5 cases, 19 minutes on average in the next 5 cases, and no change occurred in the last 5 cases. The learning curve peaked after 14 cases, plateaued from case number 15 to 23, and decreased in a linear fashion until the final case. [Conclusion]?Education of a next generation surgeon using a dual console system for robotic rectal cancer surgery was performed safely.
- Published
- 2021
17. Correlation of Operative Mortality and Morbidity With Preoperative C-Reactive Protein/Albumin Ratio, Neutrophil/Lymphocyte Ratio, and Prognostic Nutritional Index in Patients Undergoing Emergent Operations Due to Strangulation Ileus
- Author
-
Takashi Sawada, Kazunori Suzuki, Kyoichi Kihara, Masahide Ikeguchi, Kanenori Endo, Takehiko Hanaki, Seiichi Nakamura, and Tetsu Shimizu
- Subjects
medicine.medical_specialty ,biology ,Ileus ,business.industry ,Lymphocyte ,C-reactive protein ,Operative mortality ,Albumin ,medicine.disease ,Gastroenterology ,medicine.anatomical_structure ,Internal medicine ,biology.protein ,medicine ,Surgery ,In patient ,business - Abstract
Emergent surgery is necessary in patients with strangulation ileus. However, such procedures are associated with high morbidity and mortality. A retrospective analysis was performed to determine whether the preoperative C-reactive protein/albumin ratio (CAR); neutrophil/lymphocyte ratio (NLR); and prognostic nutritional index (PNI) are good indicators of mortality or morbidity in patients undergoing emergent operations for treatment of strangulation ileus. Emergent surgery was performed for 1698 patients at Tottori Prefectural Central Hospital from 2012 and 2015. Among them, 45 patients (2.7%) were preoperatively diagnosed with strangulation ileus. We evaluated the clinical importance of the preoperative CAR, NLR, and PNI in these patients. We excluded pediatric patients from this study. Postoperative complications developed in 14 of 45 (31.1%) patients. The mean postoperative hospital stay among the 14 patients with postoperative complications was significantly longer than that of the 31 patients without postoperative complications (44.0 versus 11.3 days, respectively; P = 0.006). Three patients died of postoperative complications. The overall operative mortality and morbidity rates were 6.7% and 31.1%, respectively. We found strong correlations of postoperative complications with older age, a longer operation time, and an abnormal preoperative CAR, NLR, and PNI. Not only inflammation, but also a patients' nutritional and immune status appear to be strongly correlated with mortality or morbidity after emergent operations for strangulation ileus. Patients with a high CAR and NLR and low PNI preoperatively must be closely monitored for the occurrence of postoperative complications such as surgical site infections or pulmonary complications.
- Published
- 2021
18. Platelet-to-Lymphocyte Ratio Multiplied by the Cytokeratin-19 Fragment Level as a Predictor of Pathological Response to Neoadjuvant Chemotherapy in Esophageal Squamous Cell Carcinoma
- Author
-
Shuichi Takano, Hiroaki Saito, Yuki Murakami, Manabu Yamamoto, Kozo Miyatani, Tomoyuki Matsunaga, Chihiro Uejima, Yoshiyuki Fujiwara, Masahiro Makinoya, Wataru Miyauchi, Teruhisa Sakamoto, Kyoichi Kihara, Toshimichi Hasegawa, Naruo Tokuyasu, Shohei Sawata, Yuji Shishido, Takehiko Hanaki, and Masaki Morimoto
- Subjects
platelet ,medicine.medical_specialty ,Chemotherapy ,Receiver operating characteristic ,business.industry ,medicine.medical_treatment ,Standard treatment ,Area under the curve ,General Medicine ,lymphocyte ,Esophageal cancer ,medicine.disease ,Gastroenterology ,Cytokeratin ,Esophagectomy ,Internal medicine ,Medicine ,Original Article ,esophageal cancer ,business ,cytokeratin ,Pathological ,neoadjuvant chemotherapy - Abstract
BACKGROUND: The standard treatment for resectable advanced esophageal squamous cell carcinoma in Japan is surgery followed by neoadjuvant chemotherapy, and it is important to predict the effect of neoadjuvant chemotherapy before treatment. Therefore, this study aims to extract conventional blood examination data, such as tumor markers and/or inflammatory/nutritional index levels, that can predict the pathological response of patients with esophageal squamous cell carcinoma to neoadjuvant chemotherapy. METHODS: We retrospectively analyzed the medical records of 66 patients with thoracic esophageal squamous cell carcinoma who received neoadjuvant chemotherapy, followed by curative esophagectomy at Tottori University Hospital between June 2009 and December 2019. RESULTS: We demonstrated that the product of the platelet-to-lymphocyte ratio (PLR) multiplied by the cytokeratin-19 fragment (CYFRA) level, which was termed “PLR-CYFRA,” is the most accurate indicator that predicts the pathological response to neoadjuvant chemotherapy, with the highest area under the curve [0.795 (95% confidence interval: 0.665–0.925), P < 0.001] in receiver operating characteristic analyses. Therefore, we divided patients into the PLR-CYFRA(Low) (< 237.6, n = 21) and PLR-CYFRA(High) (≥ 237.6, n = 45) groups and found that the percentage of PLR-CYFRA(Low) was significantly higher in patients with a better pathological response (P < 0.001). Furthermore, patients with good pathological response had significantly better prognoses in terms of disease-specific survival (P = 0.014), recurrence-free survival (P = 0.014), and overall survival (P = 0.032). In the multivariate analysis, PLR-CYFRA was an independent predictor of the pathological response of patients with esophageal squamous cell carcinoma to neoadjuvant chemotherapy (P = 0.002). CONCLUSION: Pretreatment PLR-CYFRA might be a useful and simple tool that predicts the pathological effect of neoadjuvant chemotherapy in esophageal squamous cell carcinoma.
- Published
- 2021
19. Antitumor Effect of 5-Aminolevulinic Acid Through Ferroptosis in Esophageal Squamous Cell Carcinoma
- Author
-
Yuji Shishido, Yuji Nakayama, Shuichi Takano, Tomoyuki Matsunaga, Yoshiyuki Fujiwara, Manabu Yamamoto, Masataka Amisaki, Toshimichi Hasegawa, Teruhisa Sakamoto, Haruna Yakura, Kozo Miyatani, Yoshiaki Matsumi, Naruo Tokuyasu, Takehiko Hanaki, Soichiro Honjo, Kyoichi Kihara, and Wataru Miyauchi
- Subjects
HMOX1 ,Esophageal Neoplasms ,GPX4 ,Lipid peroxidation ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Downregulation and upregulation ,Animals ,Ferroptosis ,Humans ,Medicine ,Phospholipid-hydroperoxide glutathione peroxidase ,Microarray analysis techniques ,business.industry ,Aminolevulinic Acid ,Phospholipid Hydroperoxide Glutathione Peroxidase ,Heme oxygenase ,Blot ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Cancer research ,030211 gastroenterology & hepatology ,Surgery ,Esophageal Squamous Cell Carcinoma ,business - Abstract
Due to its tumor-specific metabolic pathway characteristics, 5-aminolevulinic acid (5-ALA) is a natural amino acid widely used in cancer treatment. The current study, demonstrated that 5-ALA induced ferroptosis via glutathione peroxidase 4 (GPX4) and heme oxygenase 1 (HMOX1) and had an antitumor effect in esophageal squamous cell carcinoma (ESCC). Expression of GPX4 and HMOX1 in pathologic specimens of 97 ESCC patients was examined, and prognostic analyses were performed. Real-time polymerase chain reaction (RT-PCR), RNA microarray, and Western blotting analyses were used to evaluate the role of 5-ALA in ferroptosis in vitro. In addition, this study used ferrostatin-1, a ferroptosis inhibitor, and a lipid peroxidation reagent against cell lines treated with 5-ALA. Finally, the role of 5-ALA was confirmed by its effect on an ESCC subcutaneous xenograft mouse model. The study showed that upregulation of GPX4 and downregulation of HMOX1 were poor prognostic factors in ESCC. In an RNA microarray analysis of KYSE30, ferroptosis was one of the most frequently induced pathways, with GPX4 suppressed and HMOX1 overexpressed by 5-ALA treatment. These findings were verified by RT-PCR and Western blotting. Furthermore, 5-ALA led to an increase in lipid peroxidation and exerted an antitumor effect in various cancer cell lines, which was inhibited by ferrostatin-1. In vivo, 5-ALA suppressed GPX4 and overexpressed HMOX1 in tumor tissues and led to a reduction in tumor size. Modulation of GPX4 and HMOX1 by 5-ALA induced ferroptosis in ESCC. Thus, 5-ALA could be a promising new therapeutic agent for ESCC.
- Published
- 2020
20. The Significance of Surgical Intervention for Metasynchronous Liver Metastasis in Gastric Cancer: A Single-centre Analysis
- Author
-
TAKEHIKO HANAKI, TEPPEI SUNAGUCHI, KEISUKE GOTO, MASAKI MORIMOTO, YUKI MURAKAMI, YUJI SHISHIDO, KOZO MIYATANI, KYOICHI KIHARA, TOMOYUKI MATSUNAGA, MANABU YAMAMOTO, NARUO TOKUYASU, TERUHISA SAKAMOTO, TOSHIMICHI HASEGAWA, and YOSHIYUKI FUJIWARA
- Subjects
Male ,Cancer Research ,Oncology ,Gastrectomy ,Stomach Neoplasms ,Liver Neoplasms ,Hepatectomy ,Humans ,Female ,General Medicine ,Aged ,Retrospective Studies - Abstract
This study investigated the influence of surgery for metasynchronous liver metastasis in gastric cancer on prognosis.A retrospective study was conducted involving 21 consecutive patients with gastric cancer with metasynchronous distant metastasis only in the liver after curative gastrectomy. The patients were divided into two groups: those who underwent hepatic resection and those who did not. The clinicopathological characteristics, recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were analysed.Among 981 gastrectomies performed in Tottori University Hospital between 2005 and 2019, 930 were curative. Among 153 cases of recurrence during the follow-up, 21 consecutive cases involving the liver only and metasynchronous recurrent metastasis on imaging were included in this study. The study included 16 males and five females with a median age of 70 years. No statistical difference in RFS (237 vs. 201 days; p=0.788) was observed between the hepatectomy and non-hepatectomy groups; however, OS (1,564 vs. 608 days, p=0.008) and DSS (1,597 vs. 608 days, p=0.006) were significantly prolonged in the hepatectomy group. Univariate and multivariate analyses revealed that hepatectomy was the only independent prognostic factor (hazard ratio=0.33; p=0.042).Hepatic resection of heterogeneous liver metastases in gastric cancer seems to be a useful option that can be expected to cure the disease, which cannot be achieved by chemotherapy alone.
- Published
- 2022
21. Modified Geriatric Nutritional Risk Index in Patients with Pancreatic Cancer
- Author
-
Teruhisa Sakamoto, Teppei Sunaguchi, Keisuke Goto, Masaki Morimoto, Yuki Murakami, Kozo Miyatani, Takehiko Hanaki, Yuji Shishido, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, and Yoshiyuki Fujiwara
- Abstract
Background: The geriatric nutritional risk index (GNRI) was recently reported not as a nutritional assessment tool but as a useful index for predicting prognosis in various diseases including malignancies. The modified nutritional geriatric risk index (mGNRI), incorporating C-reactive protein instead of albumin, was developed as a novel index and provides a more appropriate prognostic index than the original GNRI. This study aimed to establish the prognostic significance of the mGNRI compared with the GNRI in patients with pancreatic cancer.Methods: This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI (< 85.3), and high GNRI (≥ 92) or low GNRI (< 92) for prognostic analysis based on cutoff values.Results: The 5-year overall survival and recurrence-free survival of patients in the high mGNRI group were significantly longer than those in the low mGNRI group. Similarly, the 5-year overall survival and recurrence-free survival of patients in the high GNRI group were significantly longer than those in the low GNRI group. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.004).Conclusions: The mGNRI might be a useful prognostic factor for patients with pancreatic cancer and might predict prognostic outcomes more accurately than the GNRI.
- Published
- 2022
22. Modified geriatric nutritional risk index in patients with pancreatic cancer: a propensity score-matched analysis
- Author
-
Teruhisa Sakamoto, Teppei Sunaguchi, Keisuke Goto, Masaki Morimoto, Yuki Murakami, Kozo Miyatani, Takehiko Hanaki, Yuji Shishido, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, and Yoshiyuki Fujiwara
- Subjects
Pancreatic Neoplasms ,Cancer Research ,Nutrition Assessment ,Oncology ,Genetics ,Humans ,Nutritional Status ,Propensity Score ,Geriatric Assessment ,Aged ,Retrospective Studies - Abstract
Background The modified nutritional geriatric risk index (mGNRI) was developed as a novel index and provides a more appropriate prognostic index than the original GNRI, which was reported to be a useful index for predicting prognoses for various malignancies. This study investigated the prognostic significance of the mGNRI compared with that of the GNRI in patients with pancreatic cancer and the association with psoas muscle volume (PMV) for survival outcomes. Methods This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI ( Results The 5-year overall survival of patients in the high mGNRI group or high GNRI group was significantly longer than those in the low mGNRI group or low GNRI group. Statistically significant differences for the 5-year OS were observed in the three groups with respect to the combination of mGNRI and PMV. Patients with low mGNRI/low PMV had a worse 5-year OS rate compared with patients with high GNRI/high PMV or those with high GNRI or high PMV, but not both. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI or the combination of the GNRI and PMV, but lower than that of the combination of the mGNRI and PMV. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.005). Conclusions The mGNRI might be a more useful prognostic factor than the GNRI for patients with pancreatic cancer, and might predict prognostic outcomes more accurately when combined with PMV.
- Published
- 2022
23. [A Case of Cervical Esophageal Cancer with Lymph Node Recurrence Three Times after Definitive Chemoradiotherapy]
- Author
-
Shohei, Sawata, Tomoyuki, Matsunaga, Wataru, Miyauchi, Yuki, Murakami, Yuji, Shishido, Kozo, Miyatani, Takehiko, Hanaki, Kyoichi, Kihara, Manabu, Yamamoto, Naruo, Tokuyasu, Shuichi, Takano, Teruhisa, Sakamoto, Toshimichi, Hasegawa, and Yoshiyuki, Fujiwara
- Subjects
Male ,Esophageal Neoplasms ,Lymphatic Metastasis ,Humans ,Lymph Node Excision ,Chemoradiotherapy ,Lymph Nodes ,Middle Aged - Abstract
A 56-years old man was diagnosed with cervical esophageal cancer with lymph node metastasis. After definitive chemoradiotherapy as the first-line therapy, complete response(CR)was obtained. One year and 3 months after the therapy, lymph node dissection and postoperative chemotherapy was performed for the lymph node metastases of the left neck and axillary lymph node. After 3 years and 10 months from the first-line therapy, follow-up CT revealed left axillary lymph node swelling and diagnosed with lymph node recurrence. Chemoradiotherapy was performed for the recurrence of the lymph node and CR was achieved for the lymph node. However, left axillary lymph node swelling were detected again 6 years after the first-line therapy. After 6 months of chemotherapy with S-1, CR was achieved for the lymph node again. He is now alive without recurrence for 10 years after the first-line therapy.
- Published
- 2022
24. Prognostic Significance of TYRO3 Receptor Tyrosine Kinase Expression in Gastric Cancer
- Author
-
Yoichiro Tada, Manabu Yamamoto, Teruhisa Sakamoto, Masaki Morimoto, Yoshihisa Umekita, Ken Sugezawa, Wataru Miyauchi, Naruo Tokuyasu, Akimitsu Tanio, Tomoyuki Matsunaga, Kyoichi Kihara, Yoshiyuki Fujiwara, Kazushi Hara, Soichiro Honjo, and Chihiro Uejima
- Subjects
Cancer Research ,Carcinogenesis ,Receptor tyrosine kinase ,chemistry.chemical_compound ,Cell Movement ,Stomach Neoplasms ,Cell Line, Tumor ,Biomarkers, Tumor ,Humans ,Medicine ,Neoplasm Invasiveness ,Aged ,Cell Proliferation ,Gene knockdown ,biology ,business.industry ,Receptor Protein-Tyrosine Kinases ,Cancer ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Gene Expression Regulation, Neoplastic ,Blot ,Oncology ,chemistry ,Tumor progression ,Disease Progression ,biology.protein ,Cancer research ,Immunohistochemistry ,Female ,business ,Proto-Oncogene Proteins c-akt ,Bromodeoxyuridine ,TYRO3 - Abstract
Background Despite improved treatment for gastric cancer (GC), the prognosis of advanced disease remains poor. Further investigation of the oncogenic sequence for GC is needed. Materials and methods The expression of TYRO3 protein tyrosine kinase in five GC cell lines was confirmed using western blotting. TYRO3 knockdown in GC cells, and bromodeoxyuridine and Transwell assays were used to examine the functions of TYRO3 in tumor proliferation and invasion. Finally, TYRO3 expression in 138 patients who underwent curative gastric resection for advanced GC (Union for International Cancer Control stage II/III) was tested by immunohistochemistry, and the association between prognosis and TYRO3 expression was analyzed. Results TYRO3 was detected at various levels in all the tested GC cell lines. Deleting TYRO3 significantly suppressed proliferation and invasion. Immunohistochemistry revealed TYRO3 expression was an independent prognostic factor for overall survival in patients with GC. Conclusion TYRO3 appears to mediate tumor progression and predict prognosis of patients with GC.
- Published
- 2020
25. The Advantages of Robotic Gastrectomy over Laparoscopic Surgery for Gastric Cancer
- Author
-
Teruhisa Sakamoto, Yusuke Kono, Joji Watanabe, Naruo Tokuyasu, Kozo Miyatani, Yoji Fukumoto, Manabu Yamamoto, Takehiko Hanaki, Wataru Miyauchi, Shuichi Takano, Yuji Shishido, Soichiro Honjo, Kyoichi Kihara, Tomoyuki Matsunaga, Yoshiyuki Fujiwara, and Hiroaki Saito
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,gastric cancer ,robotic gastrectomy ,Laparoscopic gastrectomy ,Cancer ,General Medicine ,medicine.disease ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Gastrectomy ,Original Article ,Pancreatic injury ,business ,Survival rate - Abstract
Background We compared short- and long-term clinical outcomes including inflammatory marker levels between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) to define the advantages of RG over LG. Methods We enrolled 209 patients with gastric cancer who underwent curative distal gastrectomy. We compared short- and long-term clinical outcomes including inflammatory marker levels between RG and LG to define the advantages of RG over LG. C-reactive protein (CRP) levels; the CRP-to-albumin, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios; and the prognostic nutritional index were compared as systemic inflammatory markers. Results RG was associated with a longer operative time. The incidence of postoperative infectious complications of grade II or higher according to the Clavien-Dindo classification was not significantly different between the two groups. Amylase levels in drainage fluid on postoperative days 1 and 3 were significantly lower in the RG group than in the LG group. The incidence of pancreatic fistula in the RG group (4.3%) was lower than that in the LG group (7.5%), albeit without significance. There were no significant differences in inflammatory marker levels either before or after surgery between the two groups. The 3-year overall survival rate did not significantly differ between the RG and LG groups (91.1% vs. 91.1%). Similar results were observed regarding the 3-year disease-specific survival rate (100% vs. 97.1%). Conclusion RG might be feasible and safe for treating gastric cancer from both surgical and oncological perspectives. The use of robotic assistance is associated with decreased amylase levels in drainage fluid, which may reduce the risk of pancreatic fistula and prevent pancreatic injury.
- Published
- 2020
26. A Novel Noninvasive Method for Predicting Liver Fibrosis by Quantifying the Estrangement of Indocyanine Green Retention Rate and Tc-99m-diethylenetriamine-penta-acetic Acid-galactosyl Human Serum Albumin Scintigraphy
- Author
-
Manabu Yamamoto, Yoji Fukumoto, Takuki Yagyu, Kyoichi Kihara, Toshimichi Hasegawa, Teruhisa Sakamoto, Yoshiyuki Fujiwara, Shuichi Takano, Naruo Tokuyasu, Soichiro Honjo, Ei Uchinaka, Joji Watanabe, Takehiko Hanaki, Tomoyuki Matsunaga, Kozo Miyatani, and Masaki Morimoto
- Subjects
Adult ,Indocyanine Green ,Liver Cirrhosis ,Male ,Cancer Research ,medicine.medical_specialty ,Cirrhosis ,medicine.medical_treatment ,Scintigraphy ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,chemistry.chemical_compound ,Liver Function Tests ,Internal medicine ,medicine ,Humans ,Radionuclide Imaging ,Technetium Tc 99m Aggregated Albumin ,Aged ,Aged, 80 and over ,Pharmacology ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Retention rate ,Prognosis ,Human serum albumin ,medicine.disease ,ROC Curve ,chemistry ,Female ,Liver function ,Hepatectomy ,Liver function tests ,business ,Indocyanine green ,Biomarkers ,Research Article ,medicine.drug - Abstract
Background/Aim: Indocyanine green (ICG) clearance test is one of the most popular dynamic methods for evaluating preoperative liver function to avoid posthepatectomy liver failure (PHLF). Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin scintigraphy (GSA) also facilitates the direct estimation of functional hepatocytes and can estimate the ICG retention rate (R15); however, in some cases, there is a discrepancy between results of a preoperative examination of ICG-R15 and the estimated ICG-R15 obtained by 99mTc-GSA (GSA-R15). This study evaluated the gap between ICG-R15 and GSA-R15 (ΔICG) for predicting background liver fibrosis in patients who underwent hepatectomy. Patients and Methods: Sixty-four consecutive patients who underwent hepatectomy and preoperative ICG-R15 and GSA-R15 examinations from 2016 to 2019 were retrospectively evaluated. The gap between GSA-R15 and ICG-R15 was defined as ΔICG and the factors predicting liver fibrosis were investigated. Results: In the pathologically-proven cirrhotic group, platelet counts were significantly lower and ΔICG values were significantly larger than those in the non-/early-cirrhotic group. A multivariate analysis identified a higher total bilirubin level, a higher AST level, and a larger ΔICG level as significant predictive factors for liver cirrhosis. Conclusion: Larger ΔICG was found to be an independent preoperative predictor of liver fibrosis and may positively contribute to decision-making before hepatectomy to avoid PHLF.
- Published
- 2020
27. Repeated Perforation of the Sigmoid Colon where Participation of Polystyrene Sulfonate was Suspected
- Author
-
Kyoichi Kihara, Tomohiro Takahashi, Kazushi Hara, Akimitsu Tanio, Manabu Yamamoto, and Yoshiyuki Fujiwara
- Subjects
Polystyrene sulfonate ,chemistry.chemical_compound ,medicine.medical_specialty ,medicine.anatomical_structure ,chemistry ,business.industry ,Perforation (oil well) ,Medicine ,Sigmoid colon ,business ,Surgery - Published
- 2020
28. Surgical Outcomes Following Early Drain Removal After Distal Pancreatectomy in Elderly Patients
- Author
-
Teruhisa Sakamoto, Yoshiyuki Fujiwara, Tomoyuki Matsunaga, Yakuki Yagyu, Kozo Miyatani, Manabu Yamamoto, Takehiko Hanaki, Ei Uchinaka, Naruo Tokuyasu, Kyoichi Kihara, and Soichiro Honjo
- Subjects
Cancer Research ,medicine.medical_specialty ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Pancreatectomy ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Pharmacology ,Perioperative management ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Independent factor ,Surgery ,Pancreatic Neoplasms ,Treatment Outcome ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Amylases ,Drainage ,Drain removal ,Distal pancreatectomy ,business ,Research Article - Abstract
Background/aim The efficacy and safety of early drain removal following distal pancreatectomy in elderly patients are unclear. We aimed to investigate the short-term surgical outcomes following early drain removal after distal pancreatectomy in elderly patients. Patients and methods Fifty-seven patients aged ≥70 years who underwent distal pancreatectomy at our Hospital were enrolled in the study. Data were retrospectively analyzed to evaluate the short-term surgical outcomes following early drain removal after distal pancreatectomy in elderly patients. Results The incidence of pancreatic fistula following distal pancreatectomy in the early-removal group was significantly lower vs. the conventional group (p=0.022). Multivariate analysis revealed that early drain removal was an independent factor for reducing the risk of pancreatic fistula after distal pancreatectomy in elderly patients (p=0.042). Conclusion Early drain removal following distal pancreatectomy is an effective and safe surgical perioperative management procedure to prevent pancreatic fistula in elderly patients.
- Published
- 2020
29. Combination of C-reactive Protein and Monocyte Count Is a Useful Prognostic Indicator for Patients With Colorectal Cancer
- Author
-
Chihiro Uejima, Manabu Yamamoto, Yoshiyuki Fujiwara, Kyoichi Kihara, Soichiro Honjo, Kazushi Hara, Akimitsu Tanio, Teruhisa Sakamoto, Ken Sugezawa, Hiroaki Saito, and Yoichiro Tada
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Neutrophils ,Colorectal cancer ,Lymphocyte ,Gastroenterology ,Monocytes ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Preoperative Care ,Biomarkers, Tumor ,medicine ,Humans ,Lymphocytes ,Aged ,Retrospective Studies ,Cause of death ,Pharmacology ,biology ,medicine.diagnostic_test ,business.industry ,Monocyte ,C-reactive protein ,Area under the curve ,Complete blood count ,Prognosis ,medicine.disease ,C-Reactive Protein ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Colorectal Neoplasms ,business ,Follow-Up Studies ,Research Article - Abstract
Background/Aim: Several studies have demonstrated the usefulness of C-reactive protein (CRP) or cellular components obtained from complete blood count as prognostic indicators in colorectal cancer (CRC) patients. The aim of this study was to investigate the prognostic significance of the combination of CRP and blood cellular components in CRC patients. Patients and Methods: A total of 463 patients who underwent curative surgery for CRC were enrolled in this study. Results: ROC analysis revealed that the values of area under the curve of neutrophil, lymphocyte, platelet, and monocyte counts (MC) for overall survival (OS) were 0.594, 0.513, 0.553, and 0.625, respectively. Using cut-off values derived from ROC analysis, patients were divided into the following groups, CRP(High), CRP(Low), MC(High), and MC(Low). The 5-year OS rates of CRP(High) and MC(High), CRP(High) and MC(Low), CRP(Low) and MC(High), and CRP(Low) and MC(Low) patients were 60.2%, 75.7%, 82.1%, and 88.3%, respectively (p
- Published
- 2019
30. Influence of the water jet system
- Author
-
Takehiko, Hanaki, Ayumi, Tsuda, Teppei, Sunaguchi, Keisuke, Goto, Masaki, Morimoto, Yuki, Murakami, Kyoichi, Kihara, Tomoyuki, Matsunaga, Manabu, Yamamoto, Naruo, Tokuyasu, Teruhisa, Sakamoto, Toshimichi, Hasegawa, and Yoshiyuki, Fujiwara
- Abstract
Several methods, such as finger fracture, Pean crush, cavitron ultrasonic surgical aspirator (CUSA), and water jet (WJ), are used for hepatic parenchymal dissection in liver surgery. CUSA is the conventional method in Japan. WJ is a relatively novel method for parenchymal dissection. Although it has several advantages, such as lower volume of blood loss and shorter operative time, the effect of the WJ system for hepatic dissection on the remnant liver has not yet been investigated.To investigate and compare the effect of the WJ methodThis observational study compared the two types of parenchymal transection methods (WJOn CT scan, the median areas of denaturation in the liver dissection planes were 522 (range: 109.5-1242) mmThe WJ group had significantly thinner contrast-enhanced areas in the post hepatectomy detached section than the CUSA group.
- Published
- 2021
31. Human chromosome 3p21.3 carries TERT transcriptional regulators in pancreatic cancer
- Author
-
Yoshiyuki Fujiwara, Takuki Yagyu, Teruhisa Sakamoto, Yuki Murakami, Naruo Tokuyasu, Ryutaro Shimizu, Hiroyuki Kugoh, Manabu Yamamoto, Kyoichi Kihara, Takehiko Hanaki, Tomoyuki Matsunaga, Masaki Morimoto, and Takahito Ohira
- Subjects
0301 basic medicine ,Transcription, Genetic ,Carcinogenesis ,Science ,Chromosome Transfer ,Loss of Heterozygosity ,Biology ,Article ,Loss of heterozygosity ,03 medical and health sciences ,Gastrointestinal cancer ,Mice ,0302 clinical medicine ,Cell Line, Tumor ,Animals ,Humans ,Telomerase reverse transcriptase ,Neoplasm Invasiveness ,Promoter Regions, Genetic ,Gene ,Telomerase ,Cancer ,Cell Proliferation ,Multidisciplinary ,Cell growth ,Chimera ,Chromosome ,Molecular biology ,Gene Expression Regulation, Neoplastic ,Pancreatic Neoplasms ,030104 developmental biology ,Chromosome 4 ,Chromosome 3 ,030220 oncology & carcinogenesis ,Medicine ,Chromosomes, Human, Pair 3 - Abstract
Frequent loss of heterozygosity (LOH) on the short arm of human chromosome 3 (3p) region has been found in pancreatic cancer (PC), which suggests the likely presence of tumor suppressor genes in this region. However, the functional significance of LOH in this region in the development of PC has not been clearly defined. The human telomerase reverse transcriptase gene (hTERT) contributes to unlimited proliferative and tumorigenicity of malignant tumors. We previously demonstrated that hTERT expression was suppressed by the introduction of human chromosome 3 in several cancer cell lines. To examine the functional role of putative TERT suppressor genes on chromosome 3 in PC, we introduced an intact human chromosome 3 into the human PK9 and murine LTPA PC cell lines using microcell-mediated chromosome transfer. PK9 microcell hybrids with an introduced human chromosome 3 showed significant morphological changes and rapid growth arrest. Intriguingly, microcell hybrid clones of LTPA cells with an introduced human chromosome 3 (LTPA#3) showed suppression of mTert transcription, cell proliferation, and invasion compared with LTPA#4 cells containing human chromosome 4 and parental LTPA cells. Additionally, the promoter activity of mTert was downregulated in LTPA#3. Furthermore, we confirmed that TERT regulatory gene(s) are present in the 3p21.3 region by transfer of truncated chromosomes at arbitrary regions. These results provide important information on the functional significance of the LOH at 3p for development and progression of PC.
- Published
- 2021
32. Geriatric nutritional risk index as a prognostic factor in patients with recurrent pancreatic cancer
- Author
-
Teruhisa Sakamoto, Masahiro Makinoya, Teppei Sunaguchi, Keisuke Goto, Masaki Morimoto, Yuki Murakami, Kozo Miyatani, Takehiko Hanaki, Yuji Shishido, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, and Yoshiyuki Fujiwara
- Subjects
Pancreatic Neoplasms ,Nutrition Assessment ,Multidisciplinary ,Recurrence ,Risk Factors ,Humans ,Nutritional Status ,Prognosis ,Geriatric Assessment ,Aged ,Retrospective Studies - Abstract
The aim of this study is to investigate the prognostic significance of geriatric nutritional risk index (GNRI) at the time of recurrence in patients with recurrent pancreatic cancer, and the relationship between GNRI and skeletal muscle mass for survival outcomes after recurrence. This study enrolled 77 patients who developed postoperative recurrence. The skeletal muscle mass index (SMI) was used in this study. The patients were divided into a high-GNRI group (n = 36) and a low-GNRI group (n = 41) for the GNRI, and were divided into a high-SMI group (n = 38) and a low-SMI group (n = 39) for SMI. The 2-year post-recurrence overall survival of patients in the high-GNRI group was significantly longer than that of patients in the low-GNRI group (P = 0.001). No significant difference for the 2-year post-recurrence OS curves between the high-SMI group and the low-SMI group was observed (P = 0.125). Upon stratifying the patients with high GNRI or low GNRI according to SMI, There was no significant difference in the 2-year post-recurrence OS curves between the patients with both high GNRI and high SMI and the patients with high GNRI and low SMI (P = 0.399). Similarly, There was no significant difference in the 2-year post-recurrence OS curves between the patients with low GNRI and high SMI and the patients with both low GNRI and low SMI (P = 0.256). Multivariate analysis revealed that the GNRI at the time of recurrence was an independent prognostic risk factor in patients with recurrent pancreatic cancer (P = 0.019). The GNRI at the time of recurrence is useful for predicting the prognosis in patients with recurrence pancreatic cancer. Skeletal muscle mass at the time of recurrence is not contributed to predict post-recurrence survival of patients with recurrent pancreatic cancer.
- Published
- 2022
33. Human Chromosome 3p21.3 Carries TERT Transcriptional Regulators in Pancreatic Cancer
- Author
-
Takuki Yagyu, Takahito Ohira, Ryutaro Shimizu, Masaki Morimoto, Yuki Murakami, Takehiko Hanaki, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshiyuki Fujiwara, and Hiroyuki Kugoh
- Abstract
Frequent loss of heterozygosity (LOH) on the short arm of human chromosome 3 (3p) region has been found in pancreatic cancer (PC), which suggests the likely presence of tumor suppressor genes in this region. However, the functional significance of LOH in this region in the development of PC has not been clearly defined. The human telomerase reverse transcriptase gene (hTERT) contributes to unlimited proliferative and tumorigenicity of malignant tumors. We previously demonstrated that hTERT expression was suppressed by the introduction of human chromosome 3 in several cancer cell lines. To examine the functional role of putative TERT suppressor genes on chromosome 3 in PC, we introduced an intact human chromosome 3 into the human PK9 and murine LTPA PC cell lines using microcell-mediated chromosome transfer. PK9 microcell hybrids with an introduced human chromosome 3 showed significant morphological changes and rapid growth arrest. Intriguingly, microcell hybrid clones of LTPA cells with an introduced human chromosome 3 (LTPA#3) showed suppression of mTert transcription, cell proliferation, and invasion compared with LTPA#4 cells containing human chromosome 4 and parental LTPA cells. Additionally, the promoter activity of mTert was downregulated in LTPA#3. Furthermore, we confirmed that TERT regulatory gene(s) are present in the 3p21.3 region by transfer of truncated chromosomes at arbitrary regions. These results provide important information on the functional significance of the LOH at 3p for development and progression of PC.
- Published
- 2021
34. The prognostic significance of combined geriatric nutritional risk index and psoas muscle volume in older patients with pancreatic cancer
- Author
-
Kyoichi Kihara, Manabu Yamamoto, Takehiko Hanaki, Takuki Yagyu, Naruo Tokuyasu, Tomoyuki Matsunaga, Kozo Miyatani, Ei Uchinaka, Soichiro Honjo, Yoshiyuki Fujiwara, and Teruhisa Sakamoto
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Muscle volume ,lcsh:RC254-282 ,Risk Factors ,GNRI ,Surgical oncology ,Internal medicine ,Pancreatic cancer ,Nutritional risk index ,Genetics ,medicine ,Humans ,Psoas muscle volume ,Geriatric Assessment ,Aged ,Psoas Muscles ,business.industry ,Cancer ,Retrospective cohort study ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,medicine.disease ,Pancreatic Neoplasms ,Survival Rate ,Older ,Nutrition Assessment ,Oncology ,Pancreatectomy ,Female ,business ,Research Article - Abstract
Background The geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. Body composition is also an important consideration when predicting the prognosis of patients with cancer. This study aimed to investigate the relationship between the GNRI and psoas muscle volume (PMV) for survival outcomes in patients with pancreatic cancer. Methods This retrospective study evaluated the prognostic significance of the GNRI and PMV in 105 consecutive patients aged ≥65 years who underwent pancreatectomy for histologically confirmed pancreatic cancer. The patients were divided into high (GNRI > 98) and low GNRI groups (GNRI ≤98), and into high (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) and low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) groups. Results Both the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly greater among patients in the high GNRI group than among patients in the low GNRI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high PMV group than among patients in the low PMV group. Patients were stratified into three groups: those with both high GNRI and high PMV; those with either high GNRI or high PMV (but not both); and those with both low GNRI and low PMV. Patients with both low GNRI and low PMV had a worse 5-year OS rate, compared with patients in other groups (P P = 0.003). Conclusions The combination of the GNRI and PMV might be useful to predict prognosis in patients aged ≥65 years with pancreatic cancer.
- Published
- 2021
35. Ruptured Small Intestinal Stromal Tumor Causing Concurrent Gastrointestinal and Intra-Abdominal Hemorrhage: A Case Report
- Author
-
Ken Sugesawa, Soichiro Honjo, Manabu Yamamoto, Chihiro Ueshima, Teruhisa Sakamoto, Kyoichi Kihara, Toshimichi Hasegawa, Shuichi Takano, Akimitsu Tanio, Shohei Sawata, Yoshiyuki Fujiwara, Kazushi Hara, Naruo Tokuyasu, Yoichiro Tada, and Tomoyuki Matsunaga
- Subjects
medicine.medical_specialty ,Intra-Abdominal Hemorrhage ,gastrointestinal hemorrhage ,Gastroenterology ,Patient Report ,gastrointestinal stromal tumor ,03 medical and health sciences ,0302 clinical medicine ,Melena ,Internal medicine ,medicine ,Stromal tumor ,Gastrointestinal tract ,GiST ,business.industry ,General Medicine ,Pelvic cavity ,Partial Small Intestine Resection ,Small intestine ,intra-abdominal hemorrhage ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,rupture ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,small intestine - Abstract
Gastrointestinal stromal tumors (GISTs) originate from mesenchymal cells throughout the gastrointestinal tract. A common symptom is gastrointestinal hemorrhage; intra-abdominal hemorrhage is relatively rare. There are few reports of GIST presenting with both types of hemorrhage concurrently. A 77-year-old man was admitted to our hospital because of melena and anemia (Hb: 4.7 g/dL). Computed tomography revealed a small bowel tumor and high-density fluid in both the small intestine and the pelvic floor. We diagnosed a small intestinal tumor with concurrent gastrointestinal and intra-abdominal hemorrhage, and performed emergency surgery. The tumor arose from the small intestine and was ruptured. We found hemorrhage in the pelvic cavity and performed partial small intestine resection. Pathological findings revealed that the tumor was positive for c-Kit protein and was diagnosed as GIST. The patient was discharged from the hospital on postoperative day 9 and received imatinib 1 month postoperatively. We experienced a very rare case of ruptured GIST originating from the small intestine associated with both gastrointestinal and intra-abdominal hemorrhage. We also reviewed the relevant literature.
- Published
- 2021
36. Prognostic Significance of the Number of Teeth in Patients with Colorectal Cancer
- Author
-
Yoichiro Tada, Akimitsu Tanio, Yoshiyuki Fujiwara, Kazushi Hara, Soichiro Honjo, Hisashi Noma, Teruhisa Sakamoto, Kyoichi Kihara, Naruro Tokuyasu, Chihiro Uejima, Manabu Yamamoto, and Ken Sugezawa
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Colorectal cancer ,tooth number ,colorectal cancer ,RC799-869 ,stomatognathic system ,Interquartile range ,Internal medicine ,medicine ,Original Research Article ,Risk factor ,prognostic factor ,periodontitis ,Periodontitis ,biology ,Fusobacterium nucleatum ,business.industry ,Perioperative ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,biology.organism_classification ,Chronic periodontitis ,stomatognathic diseases ,business - Abstract
Objectives: Fusobacterium nucleatum, which is the predominant subgingival microbial species found in chronic periodontitis, has been recently proposed as a risk factor for both the initiation and progression of colorectal cancer. We evaluated whether the number of teeth, which represents oral health, is a marker for the prognosis of patients with colorectal cancer. Methods: This retrospective single-center study recruited 179 patients who underwent primary colorectal cancer resection with curative intent between 2015 and 2017. The baseline characteristics and survival were analyzed according to the number of teeth observed in dental panoramic radiographs taken before surgical resection as a part of the perioperative surveillance for oral function and hygiene. Results: The median number of teeth was 20 (interquartile range: 6-25), including 28 patients with no teeth. Patients with 20 or more teeth had better overall survival (p = 0.002) and colorectal cancer-specific survival (p = 0.032) than those with less than 20 teeth. Multivariate analyses confirmed that the number of teeth was a significant prognostic factor for overall survival (p = 0.045) but not for colorectal cancer-specific survival (p = 0.258). We also took a propensity score-weighting approach using inverse probability weighting, and the p-values of the number of teeth were 0.032 for overall survival and 0.180 for colorectal cancer-specific survival. Conclusions: A low number of teeth, which can be easily and noninvasively assessed, has been a poor prognostic factor for overall survival in colorectal cancer patients who underwent surgery with curative intent.
- Published
- 2020
37. Comparisons of Postoperative Complications and Nutritional Status After Proximal Laparoscopic Gastrectomy with Esophagogastrostomy and Double-Tract Reconstruction
- Author
-
Soichiro Honjo, Yuji Shishido, Manabu Yamamoto, Yoshiyuki Fujiwara, Hiroaki Saito, Naruo Tokuyasu, Takehiko Hanaki, Teruhisa Sakamoto, Kyoichi Kihara, Wataru Miyauchi, Tomoyuki Matsunaga, Kozo Miyatani, and Shuichi Takano
- Subjects
medicine.medical_specialty ,business.industry ,Stomach ,gastric cancer ,Reflux ,Nutritional status ,General Medicine ,Anastomosis ,medicine.disease ,Surgery ,laparoscopic proximal gastrectomy ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,medicine.anatomical_structure ,Pancreatic fistula ,esophagogastrostomy ,030220 oncology & carcinogenesis ,medicine ,Adenocarcinoma ,030211 gastroenterology & hepatology ,Original Article ,business ,Laparoscopic proximal gastrectomy - Abstract
[Background] The purpose of this study was to compare postoperative complications and nutritional status between esophagogastrostomy and double-tract reconstruction in patients who underwent laparoscopic proximal gastrectomy, and assess the advantages of both surgical procedures. [Methods] Between 2010 and 2018, 47 cases underwent proximal gastrectomy with esophagogastrostomy (n = 23) or double-tract reconstruction (n = 24) at our institution for the treatment of clinical T1N0 adenocarcinoma located in the upper third of the stomach. Patient clinical characteristics, short-term outcomes, nutrition status, and skeletal muscle index were compared among the two groups. [Results] There was no significant difference between esophagogastrostomy and double-tract reconstruction in terms of operation time, blood loss, and length of postoperative hospital stay. Reflux symptoms and anastomotic stenosis were significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group (P < 0.001 and P = 0.004, respectively). There was no significant difference in anastomotic leakage, surgical site infection, and pancreatic fistula. For the nutritional status, the decrease rate of cholinesterase was significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group at 6 months (P = 0.008) There was no significant difference in the decrease rate of skeletal muscle mass index at 1 year after surgery. [Conclusion] Compared with esophagogastrostomy, double-tract reconstruction tends to have better short-term nutritional status and postoperative outcomes in terms of preventing the occurrence of gastroesophageal reflux and anastomosis stenosis. These findings suggest that double-tract reconstruction may be a useful method in laparoscopic proximal gastrectomy.
- Published
- 2020
38. Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study
- Author
-
Tomoyuki Matsunaga, Kozo Miyatani, Takuki Yagyu, Takehiko Hanaki, Naruo Tokuyasu, Teruhisa Sakamoto, Manabu Yamamoto, Yoshiyuki Fujiwara, Kyoichi Kihara, Soichiro Honjo, and Ei Uchinaka
- Subjects
Male ,medicine.medical_specialty ,Sarcopenia ,Multivariate analysis ,medicine.medical_treatment ,lcsh:Surgery ,Gastroenterology ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Pancreatic cancer ,medicine ,Humans ,Survival analysis ,Psoas Muscles ,Retrospective Studies ,Chemotherapy ,business.industry ,Research ,Area under the curve ,Retrospective cohort study ,lcsh:RD1-811 ,medicine.disease ,Prognosis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,musculoskeletal system ,Recurrent pancreatic cancer ,Pancreatic Neoplasms ,body regions ,Oncology ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Surgery ,business ,human activities - Abstract
Background Sarcopenia is a prognostic factor in various cancers. However, the impact of sarcopenia in patients with recurrent pancreatic cancer remains unclear. This study evaluated the prognostic significance of sarcopenia in patients with recurrent pancreatic cancer. Methods Seventy-four patients who developed postoperative recurrence of pancreatic cancer after undergoing pancreatectomies were enrolled. Sarcopenia in these patients was defined according to the psoas muscle index (PMI) measured via computed tomography at the third vertebra. Results The mean PMIs at the time of recurrence were 4.47 ± 1.27 cm2/m2 for men and 3.26 ± 0.70 cm2/m2 for women. Of the 74 patients, 65 (87.8%) were diagnosed with sarcopenia with low PMI. The 2-year post-recurrence survival curve in the sarcopenia group was significantly worse than that in the non-sarcopenia group (P = 0.034). Multivariate analysis revealed that sarcopenia at the time of recurrence was an independent prognostic factor (P = 0.043) along with a high neutrophil-to-lymphocyte ratio (P = 0.004), early recurrence (P = 0.001), and chemotherapy after recurrence (P = 0.005) in patients with recurrent pancreatic cancer. Furthermore, the area under the curve (AUC) of the combination of sarcopenia and time to recurrence for predicting 2-year survival was 0.763, which was much higher than that of sarcopenia alone (AUC = 0.622). Conclusions Sarcopenia is a useful prognostic factor in patients with recurrent pancreatic cancer. The combination of sarcopenia and time of recurrence may more accurately predict post-recurrence survival than can sarcopenia alone.
- Published
- 2020
39. Disinfection with single or double usage of new antiseptic olanexidine gluconate in general surgery: a randomized study
- Author
-
Yoichiro Tada, Chihiro Uejima, Akimitsu Tanio, Kozo Miyatani, Teruhisa Sakamoto, Shuichi Takano, Tomoyuki Matsunaga, Naruo Tokuyasu, Manabu Yamamoto, Takehiko Hanaki, Soichiro Honjo, Kyoichi Kihara, Yuji Shishido, Kazushi Hara, Yoshiyuki Fujiwara, and Ken Sugezawa
- Subjects
medicine.medical_specialty ,medicine.drug_class ,Biguanides ,Glucuronates ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Antiseptic ,law ,medicine ,Clinical endpoint ,Humans ,Surgical Wound Infection ,Adverse effect ,Povidone-Iodine ,business.industry ,General surgery ,Vascular surgery ,Cardiac surgery ,Disinfection ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Anti-Infective Agents, Local ,030211 gastroenterology & hepatology ,Surgery ,business ,Abdominal surgery - Abstract
Olanexidine gluconate is a newly developed solution for skin disinfection that was recently approved in Japan. We aimed to compare single and double application of the solution in preventing surgical site infection (SSI) in patients undergoing general surgery. This randomized study was conducted at the Tottori University Hospital. Patients scheduled to undergo gastrointestinal or hernia surgery were randomly assigned to one of two groups using either one or two Olanedine applicators for skin disinfection. The primary endpoint was the difference in SSI incidence between the two groups. The secondary endpoint was all adverse events related to olanexidine gluconate. A total of 393 patients qualified for the study protocol: 193 received a single application, and 200 received a double application of Olanedine. SSI occurred in 10 patients (2.5%) overall; nine were superficial incisional SSIs, and one patient had a deep incisional SSI. Of the 10 patients who developed SSI, six (3.1%) were in the group receiving a single application, and four (2.0%) were in the group receiving a double application; there was no statistically significant difference between the two groups (P = 0.537). Allergic reactions or skin disorders related to olanexidine gluconate were not observed. There was no difference in the SSI incidence between the use of one or two Olanedine applicators for skin preparation in elective general surgery. Therefore, a single application of Olanedine is sufficient and is recommended for general surgery as a standard disinfection precaution. UMIN000027319; 5/12/2017.
- Published
- 2020
40. Small bowel stenosis after blunt abdominal trauma: a case report
- Author
-
Joji Watanabe, Kazushi Hara, Teruhisa Sakamoto, Yoshiyuki Fujiwara, Soichiro Honjo, Naruo Tokuyasu, Takehiko Hanaki, Chihiro Uejima, Kyoichi Kihara, Akimitsu Tanio, Yoichiro Tada, Kozo Miyatani, Manabu Yamamoto, Ken Sugezawa, and Shuichi Takano
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,Ileus ,medicine.medical_treatment ,Blunt abdominal trauma ,lcsh:Surgery ,Case Report ,Abdominal cavity ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Blunt ,medicine ,business.industry ,Small bowel stenosis ,digestive, oral, and skin physiology ,lcsh:RD1-811 ,medicine.disease ,digestive system diseases ,Abdominal aortic aneurysm ,Surgery ,Stenosis ,medicine.anatomical_structure ,Abdominal trauma ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
Background Small bowel stenosis after blunt abdominal trauma is relatively rare, and progression from trauma to bowel stenosis might sometimes be delayed. Herein, we report the case of a patient who was diagnosed with small bowel stenosis relatively early and received laparoscopic surgery. Case presentation An 18-year-old Japanese male was in a traffic accident and was urgently transported to our hospital. On arrival, he was admitted with right kidney and right adrenal injury and abdominal aortic aneurysm. On hospital day 13, he vomited during conservative treatment without surgery, and computed tomography revealed small bowel stenosis and dilatation of the oral-side small bowel. No improvement with the ileus tube occurred, and he received laparoscopic surgery on hospital day 21. Briefly, the abdominal cavity was observed with a laparoscope. The mesentery was congested, scarring around the stenotic small bowel regions was present, and three stenotic regions were observed 40–50 cm from the Treitz ligament. The patient received partial resection and anastomosis of the small bowel. The postoperative course was stable, and he was discharged on postoperative day eight. Conclusions Most cases of bowel stenosis after abdominal trauma are irreversible and usually require surgical treatment. Therefore, small bowel stenosis should be considered in patients with abdominal symptoms after blunt abdominal trauma.
- Published
- 2020
41. [A Case of Solitary Metastasis to the Small Intestine with Lymph Node Metastasis after Surgery in Rectal Cancer]
- Author
-
Chihiro, Uejima, Manabu, Yamamoto, Kazushi, Hara, Ken, Sugezawa, Yoichiro, Tada, Akimitsu, Tanio, Kyoichi, Kihara, Yoji, Fukumoto, Naruo, Tokuyasu, Shuichi, Takano, Teruhisa, Sakamoto, Soichiro, Honjo, and Yoshiyuki, Fujiwara
- Subjects
Male ,Rectal Neoplasms ,Lymphatic Metastasis ,Intestine, Small ,Humans ,Lymph Nodes ,Middle Aged ,Neoplasm Recurrence, Local - Abstract
The patient was a 63-year-old man. He underwent laparoscopic anterior resection of a rectal cancer when he was 60 years. The tumor was diagnosed as T3N0M0, Stage Ⅱ, and he was followed up without adjuvant chemotherapy. Two years and 9 months after surgery, anemia and increased levels of tumor markers were observed. CT scan revealed a mass in the mesentery. We suspected rectal cancer recurrence and performed partial resection of the jejunum with regional lymph node dissection. As the tumor appearance and histological findings were similar to those of the previous rectal cancer, the tumor was diagnosed as hematogenous metastasis of rectal cancer with lymph nodes metastasis. The hematogenous metastasis of rectal cancer to the small intestine is rare; however, it may cause metastasis to regional lymph nodes. Therefore, lymph node dissection may be necessaryin surgical interventions for metastatic tumors of the small intestine.
- Published
- 2020
42. Successful treatment of peritoneal recurrence after gastric cancer surgery with intravenous and intraperitoneal paclitaxel combined with S-1 chemotherapy: a case report
- Author
-
Manabu Yamamoto, Joji Watanabe, Yoshiyuki Fujiwara, Kyoichi Kihara, Toshimichi Hasegawa, Shuichi Takano, Yoji Fukumoto, Takehiko Hanaki, Yuji Shishido, Tomoyuki Matsunaga, Naruo Tokuyasu, Kozo Miyatani, Wataru Miyauchi, Yusuke Kono, Soichiro Honjo, and Teruhisa Sakamoto
- Subjects
medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,lcsh:Surgery ,Metachronous peritoneal metastasis ,Case Report ,Malignancy ,Intraperitoneal chemotherapy ,03 medical and health sciences ,0302 clinical medicine ,Ascites ,Medicine ,030212 general & internal medicine ,Tumor marker ,Chemotherapy ,business.industry ,Cancer ,Combination chemotherapy ,lcsh:RD1-811 ,S-1 ,medicine.disease ,Surgery ,Regimen ,Peritoneal recurrence ,030220 oncology & carcinogenesis ,Peritoneal metastasis ,Gastrectomy ,medicine.symptom ,business ,Gastric cancer - Abstract
Background Despite recent advances in systemic chemotherapy, the prognosis of patients with peritoneal metastases from gastric cancer still remains poor. Nonetheless, several efficacious intraperitoneal chemotherapy regimens have recently been developed for patients with peritoneal metastases. However, no study has investigated the effectiveness of intraperitoneal chemotherapy for metachronous peritoneal metastases from gastric cancer after curative surgery. Case presentation We herein report a case of a 65-year-old man who had metachronous peritoneal metastases from gastric cancer after curative total gastrectomy who had been successfully treated with intraperitoneal chemotherapy. One month after surgery, adjuvant chemotherapy with S-1 was initiated given a final pathological stage of IIIB (pT4aN2M0). However, during adjuvant chemotherapy 12 months after surgery, tumor marker levels, which had been within normal range before surgery, increased with abdominal contrast-enhanced computed tomography (CT) revealing pelvic ascites. Thereafter, staging laparoscopy was performed, and the patient was diagnosed with peritoneal recurrence of gastric cancer. Following staging laparoscopy, an intraperitoneal access port was subcutaneously implanted for subsequent intraperitoneal chemotherapy. Combined chemotherapy with intraperitoneal and intravenous administration of paclitaxel and oral S-1 was then provided. After one course of combined chemotherapy, peritoneal lavage cytology was negative for malignancy. CT showed gradually decreasing ascites, whereas tumor marker levels returned to normal. The patient continued chemotherapy without major side effects and remained progression-free for 33 months with 36 chemotherapy cycles. Conclusions A combination regimen including intraperitoneal chemotherapy could be a promising option for patients with peritoneal recurrence after gastric cancer surgery.
- Published
- 2020
43. Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report
- Author
-
Teruhisa Sakamoto, Tomoyuki Matsunaga, Kazushi Hara, Joji Watanabe, Shuichi Takano, Kozo Miyatani, Yusuke Kono, Kyoichi Kihara, Soichiro Honjo, Manabu Yamamoto, Yuji Shishido, Yoji Fukumoto, Naruo Tokuyasu, Takehiko Hanaki, Wataru Miyauchi, and Yoshiyuki Fujiwara
- Subjects
Intraoperative ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Esophageal cancer ,lcsh:Surgery ,Cancer ,Case Report ,lcsh:RD1-811 ,Blood flow ,Anastomosis ,medicine.disease ,Indocyanine green ,Surgery ,chemistry.chemical_compound ,chemistry ,Esophagectomy ,medicine ,Adenocarcinoma ,Gastrectomy ,Gastric tube cancer ,business - Abstract
Background There have been two reports on preserving the proximal gastric tube by using intraoperative indocyanine green (ICG)-based photodynamic detection to evaluate blood flow through the anastomosis for gastric tube cancer after esophagectomy. However, in those cases, the period since the first operation was > 3 years 11 months, and there have been no reports of cases with < 1-year periods after the first operation. Case presentation A 59-year-old man underwent video-assisted thoracic subtotal esophagectomy and gastric tube reconstruction after two courses of preoperative chemotherapy for middle thoracic esophageal cancer. After half a year, follow-up upper gastrointestinal endoscopy showed a submucosal tumor in the posterior wall of the pre-pyloric region. We performed a biopsy, and the results led to a diagnosis of gastric cancer (moderately differentiated adenocarcinoma: tub2). Clinically, the patient was described as having stage IB (cT2N0M0) gastric cancer of the reconstructed gastric tube. To avoid total gastrectomy, we tried to evaluate the blood flow of the proximal part of the gastric tube by intraoperative ICG-based photodynamic detection. Intraoperative findings confirmed neo-vascularization from the remnant cervical esophagus to the upper region of the gastric tube approximately 7 cm through the esophagogastric anastomosis. Therefore, we dissected the distal part of the gastric tube approximately 4 cm from the esophagogastric anastomosis and then performed Roux-en-Y gastro-jejunostomy via the ante-sternum route. The postoperative course was stable, and the patient was discharged on the 14th postoperative day. Conclusions ICG-based photodynamic diagnosis was found to be simple and less invasive. Therefore, even if the postoperative period is short, this method should be considered for evaluation of blood flow prior to performing less invasive surgery.
- Published
- 2020
44. AMIGO2 as a novel indicator of liver metastasis in patients with colorectal cancer
- Author
-
Hiroaki Saito, Mitsuhiko Osaki, Ken Sugezawa, Chihiro Uejima, Yoichiro Tada, Kazushi Hara, Manabu Yamamoto, Kanae Nosaka, Ryo Sasaki, Yoshiyuki Fujiwara, Akimitsu Tanio, Masataka Amisaki, Futoshi Okada, and Kyoichi Kihara
- Subjects
Cancer Research ,recurrence ,Oncogene ,business.industry ,Colorectal cancer ,Cell growth ,Cell ,Cancer ,Articles ,Cell cycle ,medicine.disease ,Molecular medicine ,Metastasis ,CRC ,liver metastasis ,medicine.anatomical_structure ,Oncology ,Cancer research ,AMIGO2 ,Medicine ,business - Abstract
Our previous study showed that adhesion molecule with immunoglobulin like domain 2 (AMIGO2) is a pivotal driver gene of liver metastasis via regulating tumor cell adhesion to liver endothelial cells in mouse models. The aim of the present study was to clarify the role of AMIGO2 in liver metastasis in patients the colorectal cancer (CRC). Two human CRC cell lines, Caco-2 (AMIGO2-low) and HCT116 (AMIGO2-high), were used in this study. AMIGO2-overexpressing Caco-2 and AMIGO2-knockdown HCT116 cells were generated by transfection with an AMIGO2 expression vector or AMIGO2 small interfering RNA, respectively. Cell proliferation, invasion and adhesion to human liver endothelial cells were examined in in vitro studies. Immunohistochemical analysis was also performed to evaluate the association between AMIGO2 expression and liver metastasis in patients with CRC. In vitro studies revealed that cell proliferation, invasion and adhesion to liver endothelial cells were accelerated by upregulation of AMIGO2 expression, but suppressed by downregulation of AMIGO2 expression in human CRC cells. Immunohistochemical analysis using clinical CRC specimens revealed that AMIGO2 expression was associated with the frequency of liver metastasis (P
- Published
- 2020
45. Evaluation of prognostic markers for patients with curatively resected thoracic esophageal squamous cell carcinomas
- Author
-
Tetsu Shimizu, Kyoichi Kihara, Masahide Ikeguchi, Hiroaki Saito, Takashi Sawada, Kazunori Suzuki, Yusuke Kouno, Kanenori Endo, Tomoyuki Matsunaga, Seiichi Nakamura, and Yoji Fukumoto
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Cancer ,Postoperative complication ,Retrospective cohort study ,Articles ,Anastomosis ,medicine.disease ,Gastroenterology ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Esophagus ,Stage (cooking) ,business ,Lymph node ,Survival rate - Abstract
The Glasgow Prognostic Score (GPS), neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI) are prognostic parameters for malignancies. Additionally, serum squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragments (CYFRA 21-1) are tumor markers for squamous cell carcinoma. In the present study, the prognostic importance of these markers in patients with resectable thoracic esophageal cancer was investigated. In this retrospective study, 84 enrolled patients diagnosed with resectable clinical stage I-III thoracic esophageal squamous cell carcinomas (ESCCs) underwent thoracic esophageal resection and three-field lymph node dissection at Tottori University Hospital between January 2007 and December 2013. The correlations among preoperative patient markers (GPS, NLR, PNI, SCC-Ag and CYFRA 21-1) and the occurrence of postoperative complications and patient survival were analyzed. The operative mortality was 2.4%, and morbidity was 42.9%. Strong correlations between occurrence of postoperative complications and open thoracotomy (P=0.083) and high-serum CYFRA 21-1 (P=0.007) were observed. In 15 patients with high-serum CYFRA 21-1, postoperative complications were detected in 11 of them (73.3%); on the other hand, complications occurred in 25 of 69 (36.2%) with low-serum CYFRA 21-1. The 5-year disease-free survival rate and 5-year overall survival rate of all the patients were 52.2 and 50.8%, respectively. Among the prognostic parameters, preoperative high NLR was determined to be a poor prognostic factor, independent of the tumor stage in the multivariate analysis. These results may indicate that, in patients with preoperative high-serum CYFRA 21-1, more attention should be paid to the occurrence of postoperative complications. Therefore, in such cases, anastomosis between blood vessels of the substitute esophagus and cervical vessels would be recommended. Furthermore, in patients with high preoperative NLR, effective adjuvant chemoradiotherapy should be considered to prolong the patients' survival, even of stage I or II patients.
- Published
- 2016
46. Modified FOLFOX6 Induced Hyperammonemic Encephalopathy in a Case of Metastatic Sigmoid Colon Cancer Successfully Rechallenged with CapeOX
- Author
-
Tetsu Simizu, Kazunori Suzuki, Takashi Sawata, Kyoichi Kihara, Yusuke Kono, and Seiichi Nakamura
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Sigmoid colon cancer ,business.industry ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Hyperammonemic encephalopathy ,business ,Gastroenterology ,030217 neurology & neurosurgery ,Surgery - Published
- 2016
47. Isolated port-site metastasis of hepatocellular carcinoma after laparoscopic liver resection
- Author
-
Tetsu Shimizu, Masahide Ikeguchi, Kanenori Endo, Takashi Sawata, Shu Nakamoto, Kyoichi Kihara, Kazunori Suzuki, Yusuke Tokuyasu, and Seiichi Nakamura
- Subjects
medicine.medical_specialty ,Radiofrequency ablation ,business.industry ,General Medicine ,030230 surgery ,medicine.disease ,digestive system diseases ,Resection ,law.invention ,Surgery ,Metastasis ,Abdominal wall ,03 medical and health sciences ,0302 clinical medicine ,Port (medical) ,medicine.anatomical_structure ,law ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,medicine ,Laparoscopic Port ,Port site metastasis ,business - Abstract
Port-site metastasis of hepatocellular carcinoma (HCC) is extremely rare, and only one case has been reported in the English-language literature. Contamination with malignant cells along the needle tract during percutaneous biopsy or radiofrequency ablation is a well-recognized cause of HCC recurrence. Here, we describe a case of port-site metastasis after laparoscopic liver resection of HCC. The patient, who had undergone laparoscopic partial resection of the left lateral segment of the liver 18 months earlier, was diagnosed with HCC. CT showed a nodule in the abdominal wall where the laparoscopic port had been inserted during resection. Local excision was performed, and histological examination revealed HCC consistent with recurrence after laparoscopic resection. The experience described in this report highlights the risk of port-site metastasis of HCC. Imaging for oncologic surveillance after laparoscopic resection must include all port sites.
- Published
- 2016
48. A Case of Peliosis Hepatis Diagnosed by Laparoscopic Liver Biopsy with Fatal Course
- Author
-
Masataka Amisaki, Kyoichi Kihara, Seiichi Nakamura, Takashi Sawata, Tetsu Shimizu, and Kazunori Suzuki
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Peliosis hepatis ,Laparoscopic liver biopsy ,Radiology ,medicine.disease ,business - Published
- 2015
49. Spontaneous regression of colon cancer
- Author
-
Kyoichi Kihara, Shigeki Sekine, Taihei Ohshiro, Seiichiro Yamamoto, and Shin Fujita
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,Remission, Spontaneous ,Colonoscopy ,Adenocarcinoma ,Gastroenterology ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Colectomy ,medicine.diagnostic_test ,business.industry ,Transverse colon ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Tumor site ,Oncology ,Colonic Neoplasms ,business ,Transverse colon cancer ,Right hemicolectomy - Abstract
A case of spontaneous regression of transverse colon cancer is reported. A 64-year-old man was diagnosed as having cancer of the transverse colon at a local hospital. Initial and second colonoscopy examinations revealed a typical cancer of the transverse colon, which was diagnosed as moderately differentiated adenocarcinoma. The patient underwent right hemicolectomy 6 weeks after the initial colonoscopy. The resected specimen showed only a scar at the tumor site, and no cancerous tissue was proven histologically. The patient is alive with no evidence of recurrence 1 year after surgery. Although an antitumor immune response is the most likely explanation, the exact nature of the phenomenon was unclear. We describe this rare case and review the literature pertaining to spontaneous regression of colorectal cancer.
- Published
- 2014
50. Isolated port-site metastasis of hepatocellular carcinoma after laparoscopic liver resection
- Author
-
Kyoichi, Kihara, Kanenori, Endo, Kazunori, Suzuki, Seiichi, Nakamura, Takashi, Sawata, Tetsu, Shimizu, Masahide, Ikeguchi, Yusuke, Tokuyasu, and Shu, Nakamoto
- Subjects
Male ,Carcinoma, Hepatocellular ,Neoplasm Seeding ,Abdominal Neoplasms ,Abdominal Wall ,Liver Neoplasms ,Hepatectomy ,Humans ,Laparoscopy ,Aged - Abstract
Port-site metastasis of hepatocellular carcinoma (HCC) is extremely rare, and only one case has been reported in the English-language literature. Contamination with malignant cells along the needle tract during percutaneous biopsy or radiofrequency ablation is a well-recognized cause of HCC recurrence. Here, we describe a case of port-site metastasis after laparoscopic liver resection of HCC. The patient, who had undergone laparoscopic partial resection of the left lateral segment of the liver 18 months earlier, was diagnosed with HCC. CT showed a nodule in the abdominal wall where the laparoscopic port had been inserted during resection. Local excision was performed, and histological examination revealed HCC consistent with recurrence after laparoscopic resection. The experience described in this report highlights the risk of port-site metastasis of HCC. Imaging for oncologic surveillance after laparoscopic resection must include all port sites.
- Published
- 2016
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.