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1. Long-term activation of anti-tumor immunity in pancreatic cancer by a p53-expressing telomerase-specific oncolytic adenovirus

Author

Hashimoto, Masashi, Kuroda, Shinji, Kanaya, Nobuhiko, Kadowaki, Daisuke, Yoshida, Yusuke, Sakamoto, Masaki, Hamada, Yuki, Sugimoto, Ryoma, Yagi, Chiaki, Ohtani, Tomoko, Kumon, Kento, Kakiuchi, Yoshihiko, Yasui, Kazuya, Kikuchi, Satoru, Yoshida, Ryuichi, Tazawa, Hiroshi, Kagawa, Shunsuke, Yagi, Takahito, Urata, Yasuo, and Fujiwara, Toshiyoshi

Published
2024
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2. Excess mortality in COVID-19-affected solid organ transplant recipients across the pandemic

Author

Unagami, Kohei, Ishida, Hideki, Omoto, Kazuya, Kasahara, Mureo, Uchida, Hajime, Sakamoto, Seisuke, Futamura, Kenta, Nishikawa, Kenta, Imamura, Ryoichi, Nakazawa, Shigeaki, Hatano, Etsuro, Ito, Takashi, Masano, Yuki, Nishihira, Morikuni, Hirata, Yuta, Sakuma, Yasunaru, Onishi, Yasuharu, Yokoyama, Naoki, Yamamoto, Shingo, Yamada, Yusuke, Ogura, Yasuhiro, Kurata, Nobuhiko, Uchida, Junji, Kabei, Kazuya, Iwamoto, Hitoshi, Ikeda, Chie, Shinoda, Kazunobu, Yoshiike, Miki, Hotta, Kiyohiko, Hidaka, Yuji, Iwami, Daiki, Ishii, Yasuo, Kamiyama, Manabu, Yoshizumi, Tomoharu, Kosai-Fujimoto, Yukiko, Kobayashi, Takaaki, Motoyama, Kentaro, Yamamoto, Megumi, Asai, Toshihiro, Tasaki, Masayuki, Kenmochi, Takashi, Ito, Taihei, Tokodai, Kazuaki, Fujio, Atsushi, Tsukamoto, Yasumasa, Watanabe, Takuya, Akamatsu, Nobuhisa, Yamashina, Sachi, Ishii, Daisuke, Kitajima, Kazuki, Yamada, Yasutoshi, Mitsuke, Akihiko, Sakaguchi, Takashi, Nakamura, Michio, Tomita, Yusuke, Nakamura, Yuki, Ishimoto, Tatsuro, Ohdan, Hideki, Tanimine, Naoki, Fujiwara, Takuzo, Yanagihara, Mitsuki, Hatakeyama, Shingo, Takai, Manabu, Nose, Kazuhiro, Kikuchi, Takashi, Mori, Yasunori, Araki, Motoo, Sekito, Takanori, Nishimura, Shingo, Tanabe, Tatsu, Igarashi, Yuto, Hidaka, Sumi, Watanabe, Masaaki, Ariyoshi, Yuichi, Hasegawa, Yasushi, Kamiyama, Masato, Yoneda, Tatsuo, Shimizu, Tomokazu, Nishikawa, Kouhei, Fukumoto, Takumi, Kuramitsu, Kaoru, Kato, Masashi, Saito, Mitsuru, Shinkai, Makoto, Usui, Hidehito, Sato, Masaaki, Eguchi, Hidetoshi, Imamura, Hiroki, Kobayashi, Shogo, Soejima, Yuji, Mita, Atsuyoshi, Kobayashi, Takashi, Nakamura, Kenji, Ohtsuka, Masayuki, Nakada, Shinichiro, Yagi, Takahito, Yasui, Kazuya, Matsuno, Naoto, Mizuno, Chiharu, Sugimoto, Mikio, Ueda, Nobufumi, Okada, Yoshinori, Hirama, Takashi, Toyooka, Shinichi, Sugimoto, Seiichiro, Matsubara, Kei, Ikegami, Toru, Furukawa, Kenei, Nitta, Hiroyuki, Katagiri, Hirokatsu, Onita, Toru, Shiraishi, Takeshi, Mizuno, Shugo, Amiya, Eisuke, Shintani, Yasushi, Kanou, Takashi, Funaki, Soichiro, Miura, Yoshifumi, Nakajima, Daisuke, Urahashi, Taizen, Matsumiya, Goro, Watanabe, Michiko, Ebisu, Yosuke, Osawa, Ryosuke, Ono, Minoru, Sogawa, Hiroshi, Gomi, Harumi, Chen-Yoshikawa, Toyofumi, Yoshida, Kazunari, Ogawa, Naoko, Yamanaga, Shigeyoshi, Shimata, Keita, Ohfuji, Satoko, Yoshikawa, Mikiko, Natori, Yoichiro, Hibi, Taizo, Yuzawa, Kenji, and Egawa, Hiroto

Published
2024
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5. Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinoma

Author

Konishi, Daisuke, Umeda, Yuzo, Yoshida, Kazuhiro, Shigeyasu, Kunitoshi, Yano, Shuya, Toji, Tomohiro, Takeda, Sho, Yoshida, Ryuichi, Yasui, Kazuya, Fuji, Tomokazu, Matsumoto, Kazuyuki, Kishimoto, Hiroyuki, Michiue, Hiroyuki, Teraishi, Fuminori, Kato, Hironari, Tazawa, Hiroshi, Yanai, Hiroyuki, Yagi, Takahito, Goel, Ajay, and Fujiwara, Toshiyoshi

Published
2022
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16. Clinical characteristics of immunoglobulin IgG4-related sclerosing cholangitis: Comparison of cases with and without autoimmune pancreatitis in a large cohort

Author

Furumatsu, Keisuke, Sawai, Shigeaki, Goto, Takuma, Okumura, Toshikatsu, Suzuki, Daisuke, Otsuka, Masayuki, Kobori, Ikuhiro, Tamano, Masaya, Koizumi, Mitsuhito, Hiasa, Yoichi, Kawabe, Naoto, Hirooka, Yoshiki, Yamamoto, Satoshi, Asano, Yukio, Inui, Kazuo, Horiguchi, Akihiko, Watanabe, Hiroyuki, Toya, Daishu, Hatayama, Katsuko, Ueki, Toshiharu, Kinoshita, Norikatsu, Sugimoto, Mitsuru, Ohira, Hiromasa, Mukai, Tsuyoshi, Tomita, Eiichi, Iwata, Keisuke, Shimizu, Shogo, Suetsugu, Jun, Shimizu, Masahito, Tsuji, Keiji, Ishida, Ryoko, Ito, Masanori, Furukawa, Ryutaro, Sakamoto, Naoya, Araki, Masahiro, Tanno, Satoshi, Sakamoto, Yasunari, Ito, Tetsuhide, Takai, Satoshi, Ikeya, Shinichi, Yamada, Takanori, Kudara, Norihiko, Shimizu, Akinori, Hanada, Keiji, Ichiki, Yasunori, Kitada, Hideki, Hifumi, Michio, Kimura, Hiroyuki, Kurosaki, Masayuki, Izumi, Namiki, Sumi, Hajime, Haruta, Jun-ichi, Hayashi, Katsumi, Harada, Ryo, Inoue, Masafumi, Nakamura, Shinichiro, Ito, Tetsuya, Tomishima, Ko, Isayama, Hiroyuki, Oura, Kyoko, Masaki, Tsutomu, Shimokawahara, Naoto, Tanoue, Shirou, Maemura, Kousei, Ido, Akio, Mizushima, Ichiro, Kawano, Mitsuhiro, Yoshida, Katsunori, Naganuma, Makoto, Murata, Miki, Nishio, Akiyoshi, Fujita, Yuji, Teratani, Takuma, Matsubara, Shohei, Tamai, Hironao, Yoshida, Yuu, Azemoto, Ryousaku, Kamata, Ken, Watanabe, Tomohiro, Kurosu, Takahiro, Koizumi, Wasaburou, Fujita, Jun, Seki, Hideyuki, Ueda, Yasuhiro, Fukumoto, Takumi, Kousaki, Takuhiro, Uchida, Kazushige, Ochiai, Toshimasa, Kawasaki, Takeshi, Tanaka, Motohiko, Ishida, Etsuji, Notohara, Kenji, Mori, Hideaki, Mori, Toshiyuki, Kawabata, Hideaki, Miyata, Masatoshi, Sakagami, Junichi, Itoh, Yoshito, Shiokawa, Masahiro, Seno, Hiroshi, Watanabe, Noriko, Naitoh, Itaru, Kataoka, Hiromi, Aoki, Toshinori, Fujishiro, Mitsuhiro, Niihara, Toru, Nishimata, Hiroto, Mitoro, Akira, Yoshiji, Hitoshi, Yoshida, Motoyuki, Ikeda, Masafumi, Tomita, Kengo, Hokari, Ryota, Hayasaka, Kenji, Amano, Yuji, Shioji, Kazuhiko, Hayashi, Kazunao, Terai, Shuji, Nakajima, Michiko, Yamahana, Junya, Matsumoto, Ryusuke, Kikuchi, Hideaki, Kanamori, Akira, Kiriyama, Seiki, Iwatsu, Shinichi, Kato, Yuji, Horiguchi, Shigeru, Yagi, Takahito, Okada, Hiroyuki, Ohkawa, Kazuyoshi, Hirao, Motohiro, Hiramatsu, Naoki, Oza, Noriko, Imamura, Haruo, Baba, Takeshi, Nakano, Shigeru, Shinobi, Tetsuya, Ryozawa, Shomei, Motoya, Masayo, Nakase, Hiroshi, Kinoshita, Noboru, Ito, Kei, Miyake, Tatsuya, Kohge, Naruaki, Tobita, Hiroshi, Joshita, Satoru, Umemura, Takeji, Kawaguchi, Shinya, Ohno, Kazuya, Sonobe, Koichi, Satoh, Akihiko, Shimosegawa, Tooru, Miura, Fumihiko, Yagi, Minami, Sano, Keiji, Tanaka, Atsushi, Kin, Toshifumi, Katanuma, Akio, Koike, Kazuhiko, Miura, Shin, Masamune, Atsushi, Kawashima, Youhei, Kagawa, Tatehiro, Azuma, Seishin, Watanabe, Mamoru, Honjyo, Mitsuyoshi, Itoi, Takao, Honda, Akira, Kobayashi, Katsumasa, Asano, Toru, Kamisawa, Terumi, Mizuno, Suguru, Nishino, Takayoshi, Taniguchi, Hideaki, Tajiri, Kazuto, Yasuda, Ichiro, Tanaka, Yoshiya, Oe, Shinji, Harada, Masaru, Kurata, Masanao, Fukasawa, Mituharu, Enomoto, Nobuyuki, Kawaji, Yuki, Kitano, Masayuki, Nishise, Yuko, Hirakawa, Hidetoshi, Ishizawa, Tetsuya, Ueno, Yoshiyuki, Kaino, Miyuki, Fujimoto, Yuko, Sakaida, Isao, Kubota, Kensuke, Nakazawa, Takahiro, Takikawa, Hajime, Unno, Michiaki, Kawa, Shigeyuki, Nakamura, Seiji, and Okazaki, Kazuichi

Published
2021
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24. Effect of herbal medicine daikenchuto on oral and enteral caloric intake after liver transplantation: A multicenter, randomized controlled trial

Author

Kaido, Toshimi, Shinoda, Masahiro, Inomata, Yukihiro, Yagi, Takahito, Akamatsu, Nobuhisa, Takada, Yasutsugu, Ohdan, Hideki, Shimamura, Tsuyoshi, Ogura, Yasuhiro, Eguchi, Susumu, Eguchi, Hidetoshi, Ogata, Satoshi, Yoshizumi, Tomoharu, Ikegami, Toshihiko, Yamamoto, Michio, Morita, Satoshi, and Uemoto, Shinji

Published
2018
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30. Robotic surgery for congenital biliary dilatation using the scope switch technique (with video).

Author

Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Fuji, Tomokazu, Yasui, Kazuya, Yagi, Takahito, and Fujiwara, Toshiyoshi

Abstract

Minimally invasive congenital biliary dilatation (CBD) surgery is technically demanding. However, few studies have reported surgical approaches of robotic surgery for CBD. This report presents robotic CBD surgery using a scope-switch technique. Our robotic surgery technique for CBD consisted of four steps: step 1, Kocher's maneuver; step 2, dissection of the hepatoduodenal ligament using the scope switch technique; step 3, preparation for the Roux-en-Y loop; and step 4, hepaticojejunostomy. The scope switch technique can provide different surgical approaches for dissecting the bile duct, including anterior approach by the standard position and right approach by the scope switch position. When approaching the ventral and left side of the bile duct, anterior approach with the standard position is suitable. In contrast, the lateral view by the scope switch position is preferable for approaching the bile duct laterally and dorsally. Using this technique, the dilated bile duct can be dissected circumferentially from four directions: anterior, medial, lateral, and posterior. Thereafter, complete resection of the choledochal cyst can be achieved. The scope switch technique in robotic surgery for CBD can be useful for dissecting around the bile duct with different surgical views, leading to the complete resection of the choledochal cyst. [ABSTRACT FROM AUTHOR]

Published
2023
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34. Multiple Hepatolithiasis Following Hepaticojejunostomy Successfully Treated with Left Hemihepatectomy and Double Hepaticojejunostomy Reconstruction

Author

Nagai, Yasuo, Takagi, Kosei, Kuise, Takashi, Umeda, Yuzo, Yoshida, Ryuichi, Yoshida, Kazuhiro, Yasui, Kazuya, Yagi, Takahito, and Fujiwara, Toshiyoshi

Subjects
hepatectomy, hepaticojejunostomy, hepatolithiasis
Abstract

Surgical intervention for hepatolithiasis following hepaticojejunostomy (HJ) has rarely been reported. Herein, we present a case of post-HJ multiple hepatolithiasis treated with left hemihepatectomy with double HJ reconstruction. A 72-year-old woman who had undergone HJ for iatrogenic bile duct injury developed repeated cholangitis due to complicated hepatolithiasis accompanied by an atrophied left hepatic lobe and HJ stricture. Since endoscopic intervention was unsuccessful, the patient underwent left hemihepatectomy with HJ re-anastomoses of the common hepatic duct and left hepatic duct (double HJ technique). The double HJ technique with hepatectomy can be a useful option for treating complicated hepatolithiasis following HJ.

Published
2021

35. Rituximab Induction to Prevent the Recurrence of PSC After Liver Transplantation—The Lessons Learned From ABO-Incompatible Living Donor Liver Transplantation

Author

Yamada, Yohei, Hoshino, Ken, Fuchimoto, Yasushi, Matsubara, Kentaro, Hibi, Taizo, Yagi, Hiroshi, Abe, Yuta, Shinoda, Masahiro, Kitago, Minoru, Obara, Hideaki, Yagi, Takahito, Okajima, Hideaki, Kaido, Toshimi, Uemoto, Shinji, Suzuki, Tatsuya, Kubota, Keiichi, Yoshizumi, Tomoharu, Maehara, Yoshihiko, Inomata, Yukihiro, Kitagawa, Yuko, Egawa, Hiroto, and Kuroda, Tatsuo

Published
2018
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36. Laparoscopic Hepatectomy for the Patient with Hemophilia A with High Titer Factor VIII Inhibitor

Author

Matsuda, Tatsuo, Umeda, Yuzo, Yoshida, Kazuhiro, Matsuda, Tadakazu, Uno, Masatoshi, Abe, Masaya, Asada, Noboru, Maeda, Yoshinobu, Yagi, Takahito, and Fujiwara, Toshiyoshi

Subjects
inhibitor, hepatectomy, laparoscopy, hemophilia A, hepatocellular carcinoma
Abstract

We present the first case of laparoscopic left lateral segmentectomy for hepatocellular carcinoma (HCC) in a patient with hemophilia A, acquired hepatitis C, and high-titer factor VIII inhibitor, which was confirmed by preoperative diagnosis. He underwent laparoscopic left lateral segmentectomy with the administration of recombinant activated factor VII. Surgery could be performed with reduced intraoperative hemorrhage. He experienced postoperative intra-abdominal wall hemorrhage, which was successfully managed with red cell concentrates transfusion and administration of recombinant activated factor VII. Laparoscopic hepatectomy can be applied for hemophilia patients with high titer inhibitors.

Published
2021

37. Promising therapeutic efficacy of a novel reduced expression in immortalized cells/dickkopf‐3 expressing adenoviral vector for hepatocellular carcinoma

Author

Sawahara, Hiroaki, Shiraha, Hidenori, Uchida, Daisuke, Kato, Hironari, Kato, Ryo, Oyama, Atsushi, Nagahara, Teruya, Iwamuro, Masaya, Horiguchi, Shigeru, Tsutsumi, Koichiro, Mandai, Mari, Mimura, Tetsushige, Wada, Nozomu, Takeuchi, Yasuto, Kuwaki, Kenji, Onishi, Hideki, Nakamura, Shinichiro, Watanabe, Masami, Sakaguchi, Masakiyo, Takaki, Akinobu, Nouso, Kazuhiro, Yagi, Takahito, Nasu, Yasutomo, Kumon, Hiromi, and Okada, Hiroyuki

Published
2017
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38. Clinical implications and optimal extent of lymphadenectomy for intrahepatic cholangiocarcinoma: A multicenter analysis of the therapeutic index.

Author

Umeda, Yuzo, Takagi, Kosei, Matsuda, Tatsuo, Fuji, Tomokazu, Kojima, Toru, Satoh, Daisuke, Hioki, Masayoshi, Endo, Yoshikatsu, Inagaki, Masaru, Oishi, Masahiro, Yagi, Takahito, and Fujiwara, Toshiyoshi

Abstract

Aims: Lymph node metastases (LNM) are associated with lethal prognosis in intrahepatic cholangiocarcinoma (ICC). Lymphadenectomy is crucial for accurate staging and hopes of possible oncological treatment. However, the therapeutic implications and optimal extent of lymphadenectomy remain contentious. Methods: To clarify the prognostic value and optimal extent of lymphadenectomy, the therapeutic index (TI) for each lymph node was analyzed for 279 cases that had undergone lymphadenectomy in a multi‐institutional database. Tumor localization was divided into hilar lesions (n = 130), right peripheral lesions (n = 60), and left peripheral lesions (n = 89). In addition, the lymph node station was classified as Level 1 (LV1: hepatoduodenal ligament node), Level 2 (LV2: postpancreatic or common hepatic artery nodes), or Level 3 (LV3: gastrocardiac, left gastric artery, or celiac artery nodes). Results: Lymph node metastases were confirmed in 109 patients (39%). Five‐y survival rates were 45.3% for N0 disease, 27.1% for LV1‐LNM, 22.9% for LV2‐LNM, and 7.3% for LV3‐LNM (P < 0.001). LV3‐LNM were the most frequent and earliest recurrence outcome, including multisite recurrence, followed by LV2, LV1, and N0 disease. The 5‐year TI (5year‐TI) for lymphadenectomy was 7.2 for LV1, 5.5 for LV2, and 1.9 for LV3. Regarding tumor location, hilar lesions showed 5‐year TI >5.0 in LV1 and LV2, whereas bilateral peripheral lesions showed 5‐year TI > 5.0 in LV1. Conclusion: The implications and extent of lymphadenectomy for ICC appear to rely on tumor location. In the peripheral type, the benefit of lymphadenectomy would be limited and dissection beyond LV1 should be avoided, while in the hilar type, lymphadenectomy up to LV2 could be recommended. [ABSTRACT FROM AUTHOR]

Published
2023
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39. A subclinical high tricuspid regurgitation pressure gradient independent of the mean pulmonary artery pressure is a risk factor for the survival after living donor liver transplantation

Author

Saragai, Yosuke, Takaki, Akinobu, Umeda, Yuzo, Matsusaki, Takashi, Yasunaka, Tetsuya, Oyama, Atsushi, Kaku, Ryuji, Nakamura, Kazufumi, Yoshida, Ryuichi, Nobuoka, Daisuke, Kuise, Takashi, Takagi, Kosei, Adachi, Takuya, Wada, Nozomu, Takeuchi, Yasuto, Koike, Kazuko, Ikeda, Fusao, Onishi, Hideki, Shiraha, Hidenori, Nakamura, Shinichiro, Morimatsu, Hiroshi, Ito, Hiroshi, Fujiwara, Toshiyoshi, Yagi, Takahito, and Okada, Hiroyuki

Published
2018
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42. Role of the Pfannenstiel Incision in Robotic Hepato-Pancreato-Biliary Surgery.

Author

Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Fuji, Tomokazu, Yasui, Kazuya, Kimura, Jiro, Hata, Nanako, Yagi, Takahito, and Fujiwara, Toshiyoshi

Subjects
SURGICAL robots, MINIMALLY invasive procedures, PANCREATECTOMY, PANCREATIC surgery, SURGICAL site infections, OPERATIVE surgery
Abstract

Studies remain limited on the role of the Pfannenstiel incision in minimally invasive hepato-pancreato-biliary (HPB) surgery, especially robotic surgery. The role of various extraction sites in robotic HPB surgery should be understood. Herein, we describe the surgical techniques, outcomes, advantages, and disadvantages of the Pfannenstiel incision in robotic pancreatic surgery. Seventy patients underwent robotic pancreatectomy at our institution between September 2020 and October 2022. The Pfannenstiel incision was used for specimen retrieval in 55 patients. Advantages of the Pfannenstiel incision include less pain, cosmetic benefits, and a lower incidence of complications. Moreover, the specimen could be removed using the robotic system docked. However, all complex reconstructions should be performed intra-abdominally during robotic pancreatoduodenectomies. The incidence of mortality and postoperative pancreatic fistula (grade B) was 0% and 9.1%, respectively. During the median follow-up (11.2 months) after surgery, complications at the Pfannenstiel incision site included surgical site infection (n = 1, 1.8%) and incisional hernia (n = 1, 1.8%). The Pfannenstiel incision can be a useful option for specimen retrieval in minimally invasive HPB surgery, according to the surgeon's preferences and the patient's condition. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis.

Author

Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Fuji, Tomokazu, Yasui, Kazuya, Kimura, Jiro, Hata, Nanako, Yagi, Takahito, and Fujiwara, Toshiyoshi

Subjects
OPERATIVE surgery, SURGICAL anastomosis, PANCREATICODUODENECTOMY, GASTRIC bypass, STAPLERS (Surgery), GASTRIC emptying
Abstract

Background: Delayed gastric emptying (DGE) is a major complication of pancreatoduodenectomy (PD). Several efforts have been made to decrease the incidence of DGE. However, the optimal anastomotic method for gastro/duodenojejunostomy (GJ) remains debatable. Moreover, few studies have reported the impact of GJ surgical techniques on outcomes following robotic pancreatoduodenectomy (RPD). This study aimed to investigate the surgical outcomes of robot-sewn and stapled GJ anastomoses in RPD. Methods: Forty patients who underwent RPD at the Okayama University Hospital between September 2020 and October 2022 were included. The outcomes between robot-sewn and stapled anastomoses were compared. Results: The mean [standard deviation (SD)] operative and GJ time were 428 (63.5) and 34.0 (15.0) minutes, respectively. Postoperative outcomes included an overall incidence of DGE of 15.0%, and the mean postoperative hospital stays were 11.6 (5.3) days in length. The stapled group (n = 21) had significantly shorter GJ time than the robot-sewn group (n = 19) (22.7 min versus 46.5 min, p < 0.001). Moreover, stapled GJ cases were significantly associated with a lower incidence of DGE (0% versus 21%, p = 0.01). Although not significant, the stapled group tended to have shorter postoperative hospital stays (9.9 days versus 13.5 days, p = 0.08). Conclusions: Our findings suggest that stapled GJ anastomosis might decrease anastomotic GJ time and incidence of DGE after RPD. Surgeons should select a suitable method for GJ anastomosis based on their experiences with RPD. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Surgical Outcomes of Laparoscopic versus Open Hepatectomy for Left Hepatocellular Carcinoma: Propensity Score Analyses Using Retrospective Japanese and Korean Individual Patient Data.

Author

Kaibori, Masaki, Yoshii, Kengo, Umeda, Yuzo, Yagi, Takahito, Okabayashi, Takehiro, Sui, Kenta, Mori, Akira, Hamaguchi, Yuhei, Kajiyama, Kiyoshi, Hokuto, Daisuke, Monden, Kazuteru, Yoshizumi, Tomoharu, Nomura, Yoriko, Toriguchi, Kan, Kim, Jong Man, Choi, Gi Hong, Ryu, Je Ho, Koh, Yangseok, Kang, Koo Jeong, and You, Young Kyoung

Subjects
HEPATOCELLULAR carcinoma, HEPATECTOMY, LAPAROSCOPIC surgery, SURGICAL complications, OVERALL survival
Abstract

Introduction: This study aimed to compare the prognostic impact of laparoscopic left hepatectomy (LLH) with that of open left hepatectomy (OLH) on patient survival after resection of left hepatocellular carcinoma (HCC). Methods: Among the 953 patients who received initial treatment for primary HCC that was resectable by either LLH or OLH from 2013 to 2017 in Japan and Korea, 146 patients underwent LLH and 807 underwent OLH. The inverse probability of treatment weighting approach based on propensity scoring was used to address the potential selection bias inherent in the recurrence and survival outcomes between the LLH and OLH groups. Results: The occurrence rate of postoperative complications and hepatic decompensation was significantly lower in the LLH group than in the OLH group. Recurrence-free survival (RFS) was better in the LLH group than in the OLH group (hazard ratio, 1.33; 95% confidence interval, 1.03–1.71; p = 0.029), whereas overall survival (OS) was not significantly different. Subgroup analyses of RFS and OS revealed an almost consistent trend in favor of LLH over OLH. In patients with tumor sizes of ≥4.0 cm or those with single tumors, both RFS and OS were significantly better in the LLH group than in the OLH group. Conclusions: LLH decreases the risk of tumor recurrence and improves OS in patients with primary HCC located in the left liver. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Neonatal hemochromatosis with epsilon gamma delta beta-thalassemia: a case report and analysis of serum iron regulators

Author

Tsuge, Mitsuru, Kodera, Aya, Sumitomo, Hiromi, Araki, Tooru, Yoshida, Ryuichi, Yasui, Kazuya, Sato, Hiroki, Washio, Yosuke, Washio, Kana, Shigehara, Kenji, Yashiro, Masato, Yagi, Takahito, and Tsukahara, Hirokazu

Subjects
Liver transplantation, Case report, Hepcidin, Neonatal hemochromatosis, Thalassemia, Growth differentiation factor-15, Gestational alloimmune liver disease, Ineffective erythropoiesis
Abstract

Background Neonatal hemochromatosis causes acute liver failure during the neonatal period, mostly due to gestational alloimmune liver disease (GALD). Thalassemia causes hemolytic anemia and ineffective erythropoiesis due to mutations in the globin gene. Although neonatal hemochromatosis and thalassemia have completely different causes, the coexistence of these diseases can synergistically exacerbate iron overload. We report that a newborn with epsilon gamma delta beta-thalassemia developed neonatal hemochromatosis, which did not respond to iron chelators and rapidly worsened, requiring living-donor liver transplantation. Case presentation A 1-day-old Japanese boy with hemolytic anemia and targeted red blood cells was diagnosed with epsilon gamma delta beta-thalassemia by genetic testing, and required frequent red blood cell transfusions. At 2 months after birth, exacerbation of jaundice, grayish-white stool, and high serum ferritin levels were observed, and liver biopsy showed iron deposition in hepatocytes and Kupffer cells. Magnetic resonance imaging scans showed findings suggestive of iron deposits in the liver, spleen, pancreas, and bone marrow. The total amount of red blood cell transfusions administered did not meet the criteria for post-transfusion iron overload. Administration of an iron-chelating agent was initiated, but iron overload rapidly progressed to liver failure without improvement in jaundice and liver damage. He underwent living-donor liver transplantation from his mother, after which iron overload disappeared, and no recurrence of iron overload was observed. Immunohistochemical staining for C5b-9 in the liver was positive. Serum hepcidin levels were low and serum growth differentiation factor-15 levels were high prior to living-donor liver transplantation. Conclusions We reported that an infant with epsilon gamma delta beta-thalassemia developed NH due to GALD, and that coexistence of ineffective erythropoiesis in addition to erythrocyte transfusions may have exacerbated iron overload. Low serum hepcidin levels, in this case, might have been caused by decreased hepcidin production arising from fetal liver damage due to neonatal hemochromatosis and increased hepcidin-inhibiting hematopoietic mediators due to the ineffective hematopoiesis observed in thalassemia.

Published
2022

48. Surgical Strategies to Dissect around the Superior Mesenteric Artery in Robotic Pancreatoduodenectomy.

Author

Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Fuji, Tomokazu, Yasui, Kazuya, Kimura, Jiro, Hata, Nanako, Mishima, Kento, Yagi, Takahito, and Fujiwara, Toshiyoshi

Subjects
MESENTERIC artery, PANCREATICODUODENECTOMY, TUMOR surgery, TISSUE adhesions, LYMPHADENECTOMY, ROBOTICS, MESENTERIC ischemia
Abstract

The concept of the superior mesenteric artery (SMA)-first approach has been widely accepted in pancreatoduodenectomy. However, few studies have reported surgical approaches to the SMA in robotic pancreatoduodenectomy (RPD). Herein, we present our surgical strategies to dissect around the SMA in RPD. Among the various approaches, our standard protocol for RPD included the right approach to the SMA, which can result in complete tumor resection in most cases. In patients with malignant diseases requiring lymphadenectomy around the SMA, we developed a novel approach by combining the left and right approaches in RPD. Using this approach, circumferential dissection around the SMA can be achieved through both the left and right sides. This approach can also be helpful in patients with obesity or intra-abdominal adhesions. The present study summarizes the advantages and disadvantages of both the approaches during RPD. To perform RPD safely, surgeons should understand the different surgical approaches and select the best approach or a combination of different approaches, depending on demographic, anatomical, and oncological factors. [ABSTRACT FROM AUTHOR]

Published
2022
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