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2 results on '"Masashi Hirota"'

1. Esophageal submucosal dissection under steady pressure automatically controlled endoscopy (SPACE): a clinical feasibility study

Author

Motohiko Kato, Masashi Hirota, Kiyokazu Nakajima, Makoto Yamasaki, Yuichiro Doki, Masahiko Tsujii, Masaki Mori, Tetsuo Takehara, Takuya Yamada, Tsutomu Nishida, and Yasuaki Miyazaki

Subjects
Male, Insufflation, Chest Pain, medicine.medical_specialty, Esophageal Neoplasms, Partial Pressure, Vital signs, Pilot Projects, medicine, Clinical endpoint, Humans, Adverse effect, Aged, Mucous Membrane, medicine.diagnostic_test, business.industry, Dissection, Gastroenterology, Carbon Dioxide, Middle Aged, Abdominal distension, Endoscopy, Surgery, Clinical trial, Carcinoma, Squamous Cell, Feasibility Studies, Female, Esophagoscopy, medicine.symptom, Deglutition Disorders, business, Carcinoma in Situ
Abstract

Background and study aims: Steady pressure automatically controlled endoscopy (SPACE) is a new insufflation system that provides constant carbon dioxide (CO2) insufflation pressure during prolonged procedures. The system consists of an overtube, a surgical insufflator, and a newly developed leak-proof valve. The aims of this study were to validate the feasibility and safety of SPACE for esophageal endoscopic submucosal dissection (ESD). Patients and methods: This was a clinical phase I trial, involving 10 patients who underwent esophageal ESD. The primary end point was the rate of adverse events within 30 days (grade 0 to 4). Secondary end points were changes in partial pressure of carbon dioxide (PaCO2) and vital signs during ESD, completion rate of ESD, and degree of abdominal distension by patient assessment and radiographic grading. Results: All adverse events were Grade 2 or less. Mild PaCO2 elevation after ESD was noted; however, no associated symptoms were reported. The procedure was completed under SPACE alone in 8 of 10 patients. Minimal post-procedural bowel distension was observed. Conclusions: In this small pilot study, SPACE was feasible and appeared to be safe. Further study with larger case numbers is required to demonstrate efficacy and safety. Clinical trial registration: UMIN000005434

Published
2014

2. Simultaneous automatic insufflation and smoke-evacuation system in flexible gastrointestinal endoscopy.

Author

Hidekazu Takahashi, Masashi Hirota, Tsuyoshi Takahashi, Makoto Yamasaki, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Shuji Takiguchi, Masaki Mori, Yuichiro Doki, and Kiyokazu Nakajima

Subjects
*VENTILATION equipment, *ENDOSCOPIC gastrointestinal surgery, *GASTRIC mucosa, *ANIMAL experimentation, *ELECTROSURGERY, *SMOKE, *SWINE, *PRODUCT design, *INSUFFLATION, *SURGERY, *EQUIPMENT & supplies
Abstract

Background and Aims: Automatic smoke evacuation has not been feasible inside the gastrointestinal tract as evacuation collapses pneumoviscera. As previously reported, steady pressure automatically controlled endoscopy (SPACE) may resolve this problem. The aims of this study were to clarify the potential dangers of surgical smoke, and to evaluate the feasibility and potential usefulness of automatic smoke evacuation in flexible gastrointestinal endoscopy. Methods: Seven pigs were enrolled. SPACE was established by using a flexible endoscope, an overtube, and a surgical CO2 insufflator. Smoke was generated by gastric mucosal ablation for component analysis and was evacuated by a commercially available surgical-use smoke evacuator connected to an additional line attached to the endoscope. Endoscopic images with evacuation were evaluated subjectively in comparison to those from cases without evacuation. After each session, the residual intraluminal smoke was collected by a smoke testing device for objective evaluation. Results: Ten chemical compounds were detected. Smoke evacuation was achieved without collapse of the pneumostomach. Smoke was significantly reduced with the use of evacuation. Conclusions: Surgical smoke generated inside the gut lumen was potentially hazardous. Automatic evacuation was feasible and potentially useful in conjunction with SPACE technology. [ABSTRACT FROM AUTHOR]

Published
2016
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