2021/10/25 更新

写真a

カノウ ヨウスケ
加納 陽介
KANO Yosuke
所属
医歯学総合病院 光学医療診療部 助教
職名
助教
外部リンク

代表的な業績

    • 【論文】 Different risk factors for three major recurrence patterns of pathological stage II or III gastric cancer patients who completed adjuvant S-1 monotherapy.  2021年4月

    • 【論文】 Therapeutic value of splenectomy to dissect splenic hilar lymph nodes for type 4 gastric cancer involving the greater curvature, compared with other types.  2020年9月

    • 【論文】 Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body.  2019年9月

学位

  • 博士(医学) ( 2018年3月   新潟大学 )

経歴

  • 新潟大学   医歯学総合病院 光学医療診療部   助教

    2019年4月 - 現在

  • 新潟大学   医歯学総合病院 消化器外科   特任助教

    2014年10月 - 2015年3月

学歴

  • 新潟大学

    2012年4月 - 2018年3月

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    国名: 日本国

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  • 新潟大学   医学部   医学科

    2001年4月 - 2007年3月

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    国名: 日本国

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論文

  • Different risk factors for three major recurrence patterns of pathological stage II or III gastric cancer patients who completed adjuvant S-1 monotherapy. 国際誌

    Yosuke Kano, Manabu Ohashi, Yusuke Muneoka, Daisuke Takahari, Keisho Chin, Kensei Yamaguchi, Satoshi Ida, Koshi Kumagai, Rie Makuuchi, Takeshi Sano, Souya Nunobe

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: After curative gastrectomy followed by 1-year adjuvant S-1 monotherapy for pathological stage (pStage) II or III gastric cancer, some patients experience peritoneal, hematogenous, or lymph nodal recurrence. However, risk factors for each recurrence pattern despite completed adjuvant S-1 monotherapy remain unclear. The aim of this study was to determine which factors influence each recurrence type after curative gastrectomy followed by 1-year adjuvant S-1 monotherapy. MATERIALS AND METHODS: A total of 380 patients with pStage II or III gastric cancer who completed 1-year adjuvant S-1 monotherapy after R0 gastrectomy between January 2008 and December 2013 were enrolled in this study. The risk factors that were associated with peritoneal, hematogenous, and lymph nodal recurrence were investigated by univariate and multivariate analyses. RESULTS: Eighty (21.1%) of 380 patients developed recurrence. As the first site, peritoneal, hematogenous, and lymph nodal recurrence occurred in 42 (11.1%), 26 (6.8%), and 12 (3.2%) patients, respectively. In multivariate analysis, peritoneal metastasis was associated with signet ring cell carcinoma (P < 0.001), pT4 (P = 0.001), and pN3 (P < 0.001), while hematogenous recurrence was associated with pN3 (P = 0.019) and later initiation of S-1 (P = 0.013), and lymph nodal recurrence was associated with pN3 (P = 0.002). CONCLUSION: The risk factors for peritoneal, hematogenous, and lymph nodal recurrence in pStage II or III gastric cancer patients who complete adjuvant S-1 monotherapy differ. This information may be helpful for daily surveillance of recurrence in post-operative and chemotherapeutic patients. Furthermore, it may be a useful reference to develop novel perioperative chemotherapy.

    DOI: 10.1016/j.ejso.2021.04.018

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  • ASO Author Reflections: ypTNM Stage Grouping in the 8th Edition of the AJCC Cancer Staging Manual Refines the Prognostic Prediction for Patients with Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemotherapy. 国際誌

    Natsuru Sudo, Hiroshi Ichikawa, Yusuke Muneoka, Takaaki Hanyu, Yosuke Kano, Takashi Ishikawa, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Takeo Bamba, Satoru Nakagawa, Shin-Ichi Kosugi, Toshifumi Wakai

    Annals of surgical oncology   28 ( 2 )   661 - 662   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1245/s10434-020-09184-0

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  • Clinical Utility of ypTNM Stage Grouping in the 8th Edition of the American Joint Committee on Cancer TNM Staging System for Esophageal Squamous Cell Carcinoma. 国際誌

    Natsuru Sudo, Hiroshi Ichikawa, Yusuke Muneoka, Takaaki Hanyu, Yosuke Kano, Takashi Ishikawa, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Takeo Bamba, Satoru Nakagawa, Shin-Ichi Kosugi, Toshifumi Wakai

    Annals of surgical oncology   28 ( 2 )   650 - 660   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging system provided a specific 'ypTNM' stage grouping for patients with esophageal cancer. OBJECTIVE: This study aimed to evaluate the clinical utility of the AJCC 8th edition ypTNM stage grouping for patients with esophageal squamous cell carcinoma (ESCC). METHODS: We enrolled 152 patients with ESCC who underwent surgery after neoadjuvant cisplatin plus 5-fluorouracil (CF) therapy between June 2005 and December 2011. ypStage was evaluated according to the AJCC 7th and 8th editions. Predictive performance for disease-specific survival (DSS) and overall survival (OS) was compared between both editions. The prognostic significance of ypTNM stage grouping was evaluated using univariate and multivariate analyses. RESULTS: Revision of the AJCC 7th edition to the 8th edition was associated with a change in ypStage in 96 patients (63.2%). The AJCC 8th edition revealed a better predictive performance than the 7th edition in terms of DSS (Akaike's information criterion [AIC] 499 vs. 513; Bayesian information criterion [BIC] 505 versus 519; concordance index [C-index] 0.725 versus 0.679) and OS (AIC 662 vs. 674; BIC 669 vs. 681; C-index 0.662 vs. 0.622). On univariate and multivariate analyses, ypStage in the 8th edition was an independent prognostic factor for both DSS and OS. CONCLUSIONS: ypTNM stage grouping in the AJCC 8th edition provided a better predictive performance for DSS and OS than that in the 7th edition. ypStage in the 8th edition was the most reliable prognostic factor for ESCC patients who underwent surgery after neoadjuvant CF therapy.

    DOI: 10.1245/s10434-020-09181-3

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  • [Amelanotic Malignant Melanoma of the Esophagogastric Junction-A Case Report].

    Ryota Magara, Yosuke Kano, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Yusuke Muneoka, Kohei Miura, Kazuyasu Takizawa, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Kaori Takamura, Hajime Umezu, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 13 )   2083 - 2085   2020年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 73-year-old man presented with anemia, and gastroscopy showed a nonpigmented tumor in the esophagogastric junction. The result of the tumor biopsy initially suspected poorly differentiated adenocarcinoma. However, additional immunohistochemical examination revealed malignant melanoma. The final diagnosis was amelanotic malignant melanoma of the esophagogastric junction with adrenal and spinal metastasis. Although immunotherapy was performed, the patient died 132 days after diagnosis.

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  • 診断に難渋した食道胃接合部メラニン欠乏性悪性黒色腫の1例

    真柄 亮太, 加納 陽介, 市川 寛, 羽入 隆晃, 石川 卓, 宗岡 悠介, 三浦 宏平, 滝沢 一泰, 島田 能史, 永橋 昌幸, 坂田 純, 小林 隆, 高村 佳緒里, 梅津 哉, 若井 俊文

    癌と化学療法   47 ( 13 )   2083 - 2085   2020年12月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    症例は73歳、男性。貧血精査目的の上部消化管内視鏡検査で、食道胃接合部に白色から発赤調で易出血性の不整な隆起性腫瘤を認めた。生検では充実型低分化腺癌が疑われたが確定診断が得られず、追加で施行した免疫組織化学染色で悪性黒色腫と診断した。食道胃接合部原発の悪性黒色腫、cT3N1M1(副腎、骨)、cStage IVb(食道癌取扱い規約第15版)に対して、ペムブロリズマブの投与を行ったが肺転移が出現し原病死した。本例は腫瘍の主局在が胃側にあり、メラニン欠乏性悪性黒色腫であったため典型的な肉眼的・組織学的所見が得られず診断に難渋した。食道胃接合部の腫瘍においても、メラニン欠乏性悪性黒色腫の可能性を念頭に置いて診断を行う必要がある。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00296&link_issn=&doc_id=20210118600115&doc_link_id=%2Fab8gtkrc%2F2020%2F004713%2F115%2F2083b2085%26dl%3D3&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2020%2F004713%2F115%2F2083b2085%26dl%3D3&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_4.gif

  • Facilitated completion of 1-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer by medical oncologists.

    Yosuke Kano, Manabu Ohashi, Naoki Hiki, Daisuke Takahari, Keisho Chin, Kensei Yamaguchi, Satoshi Ida, Koshi Kumagai, Takeshi Sano, Souya Nunobe

    Surgery today   50 ( 10 )   1197 - 1205   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Several factors are known to be significantly associated with a low completion rate of 1-year adjuvant S-1 monotherapy for gastric cancer. The present study investigated whether or not the specialties of physicians conducting adjuvant S-1 monotherapy affect the completion rate. METHODS: A total of 437 patients who underwent curative gastrectomy followed by adjuvant S-1 monotherapy for pathological stage II or III gastric cancer between 2008 and 2013 were retrospectively analyzed. Factors affecting completion of adjuvant S-1 monotherapy, including the physicians (medical oncologists or surgeons) administering S-1, were evaluated by a multivariate analysis. The relationship between patient factors and physicians was analyzed regarding the cumulative incidence of discontinuation. The number of times the dose was reduced, the schedule changed, or administration was suspended or delayed in patients completing adjuvant S-1 monotherapy was also counted. RESULTS: The multivariate analysis showed that old age (≥ 65 years old), excess body weight loss (≥ 15%), and surgeons were independently associated with discontinuation. In older patients, the cumulative incidence of discontinuation by medical oncologists was significantly lower than that by surgeons. Medical oncologists ensured that older patients continued S-1 by frequent suspension or a delay in each course. CONCLUSIONS: Medical oncologists may facilitate completion of adjuvant S-1 monotherapy.

    DOI: 10.1007/s00595-020-01995-8

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  • Therapeutic value of splenectomy to dissect splenic hilar lymph nodes for type 4 gastric cancer involving the greater curvature, compared with other types.

    Yosuke Kano, Manabu Ohashi, Satoshi Ida, Koshi Kumagai, Rie Makuuchi, Takeshi Sano, Naoki Hiki, Souya Nunobe

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   23 ( 5 )   927 - 936   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Whether splenectomy for splenic hilar lymph node (No. 10) dissection in type 4 gastric cancer involving the greater curvature is necessary is not established. Patients with type 4 gastric cancer often experience peritoneal relapse, despite curative surgery, and total gastrectomy with splenectomy is frequently associated with infectious complications. METHOD: Patients with cT2-T4 gastric cancer in the upper or middle third of the stomach, or both, involving the greater curvature who underwent R0 total gastrectomy with splenectomy between 2006 and 2016 were selected. Clinicopathological findings, postoperative complications, the incidence of lymph node metastasis, and the therapeutic value index of each station were compared between type 4 and non-type 4 gastric cancer. RESULTS: We enrolled 50 patients with type 4 and 60 with non-type 4. The former had a significantly higher proportion of the undifferentiated type and larger and deeper tumors. The overall incidence of Grade III or higher complications was 20.9%. The incidence of No. 10 metastasis was 26.0% in type 4 and 31.7% in non-type 4. Although the therapeutic value index of the No. 10 was 13.7 in type 4 and 15.0 in non-type 4, the index of type 4 ranked just below several peri-gastric stations and seventh, while that in non-type 4 ranked second. CONCLUSION: Splenectomy for No. 10 dissection may be oncologically valid for type 4 gastric cancer involving the greater curvature. A safer procedure for No. 10 dissection should be established.

    DOI: 10.1007/s10120-020-01072-6

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  • 上部胃癌に対する噴門側胃切除術の栄養学的意義と再建手技の検討

    羽入 隆晃, 市川 寛, 加納 陽介, 石川 卓, 根本 万理子, 酒井 剛, 宗岡 悠介, 廣瀬 雄己, 堅田 朋大, 三浦 宏平, 滝沢 一泰, 田島 陽介, 中野 麻恵, 中野 雅人, 島田 能史, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    日本外科学会定期学術集会抄録集   120回   DP - 7   2020年8月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • [A Case of High-Frequency Microsatellite Instability in Colorectal Cancer with MSH2 Mutation Detected Using Gene Panel Testing with a Next-Generation Sequencer].

    Yoshifumi Shimada, Hitoshi Kameyama, Mae Nakano, Chie Toshikawa, Kazuki Moro, Junko Tsuchida, Michiru Arabiki, Akio Matsumoto, Kana Tanaka, Kaoru Abe, Hidehito Oyanagi, Yosuke Tajima, Masato Nakano, Yuki Hirose, Yosuke Kano, Hiroshi Ichikawa, Takaaki Hanyu, Kazuyasu Takizawa, Masayuki Nagahashi, Jun Sakata, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 7 )   1113 - 1115   2020年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Here, we report about a woman in her 30s who had peritoneal dissemination and multiple colon cancer with high-frequency microsatellite instability(MSI-H). Her father, paternal grandfather, and maternal grandmother had a history of colorectal cancer treatment. Thus, Lynch syndrome was suspected. We performed R0 resection for peritoneal dissemination and subsequent peritoneal dissemination. A 435-gene panel testing using a next-generation sequencer identified MSH2 and other mutations in the tumor. Hence, we speculated that she could have a germline mutation of MSH2, which causes Lynch syndrome. In the future, if she wishes to receive genetic counseling and undergo germline testing for variants to confirm the diagnosis of Lynch syndrome, we will perform them after receiving informed consent.

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  • Primary lung squamous cell carcinoma and its association with gastric metastasis: A case report and literature review. 国際誌

    Mariko Nemoto, Pankaj Prasoon, Hiroshi Ichikawa, Takaaki Hanyu, Yosuke Kano, Yusuke Muneoka, Kenji Usui, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Ishikawa, Masanori Tsuchida, Toshifumi Wakai

    Thoracic cancer   11 ( 6 )   1708 - 1711   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Nearly 50% of primary lung carcinoma patients present with distant metastasis at their first visit. However, gastrointestinal tract (GIT) metastasis is an infrequent impediment. Herein, we report a case of progressive dysphagia and epigastralgia as an initial manifestation of recurrence as gastric metastasis of primary lung squamous cell carcinoma (SCC) after curative surgery. A 64-year-old man was diagnosed with primary lung SCC of the right lower lobe, and underwent thoracoscopic lower lobectomy. One year after lobectomy, computed tomography (CT) scan showed a gastric fundal mass located in the gastric cardia which measured 5 cm. Endoscopic biopsies and histopathology subsequently confirmed that tumor was SCC. The patient then underwent proximal gastrectomy with resection of the diaphragmatic crus. Following surgery, histopathological examination revealed gastric metastasis from primary lung SCC. KEY POINTS: Gastric metastasis of primary lung carcinoma is one of the rarest phenomena. Gastrointestinal symptoms should raise suspicion of the presence of advanced metastatic disease with poor prognosis.

    DOI: 10.1111/1759-7714.13410

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  • 当科における進行胃癌に対する術前補助化学療法の検討(Analyses of neoadjuvant chemotherapy for advanced gastric cancer)

    羽入 隆晃, 市川 寛, 加納 陽介, 石川 卓, 根本 万理子, 酒井 剛, 宗岡 悠介, 島田 能史, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    日本胃癌学会総会記事   92回   288 - 288   2020年3月

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    記述言語:英語   出版者・発行元:(一社)日本胃癌学会  

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  • Long-Term Trends in Respiratory Function After Esophagectomy for Esophageal Cancer. 国際誌

    Takahiro Otani, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Yosuke Kano, Tatsuo Kanda, Shin-Ichi Kosugi, Toshifumi Wakai

    The Journal of surgical research   245   168 - 178   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Esophagectomy for esophageal cancer is known to lead to deterioration in respiratory function (RF). The aim of this study was to assess long-term trends in RF after esophagectomy and the impact of different operative procedures. METHODS: A total of 52 patients with thoracic esophageal cancer who were scheduled for esophagectomy from 2003 to 2012 were enrolled. We prospectively evaluated patients for vital capacity (VC), forced expiratory volume in 1 s (FEV1.0), and 6-min walk distance (6MWD) before and after esophagectomy at 3, 6, 12, 24, and 60 mo. RESULTS: Patients had mostly recovered their VC and FEV1.0 after 12 mo. After that point, VC and FEV1.0 declined again, reaching levels lower than baseline at 60 mo, with a median change ratio of 0.85 and 0.86, respectively. Although the 6MWD after open esophagectomy declined, patients treated with transhiatal esophagectomy and minimally invasive esophagectomy maintained above baseline levels throughout the follow-up period. Furthermore, we identified transhiatal esophagectomy (odds ratio [OR] = 0.03, 95% confidence interval [CI] 0.002-0.43, P = 0.01) and minimally invasive esophagectomy (OR = 0.14, 95% CI 0.02-0.94, P = 0.04) as favorable factors and postoperative pulmonary complication (OR = 9.14, 95% CI 1.22-68.6, P = 0.03) as an unfavorable factor for RF after 12 mo. Operative procedures had no significant impact on RF after 60 mo. CONCLUSIONS: Our results support the notion that RF does not recover to the baseline level, and operative procedures have no significant impact on RF at late phase after esophagectomy.

    DOI: 10.1016/j.jss.2019.07.040

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  • [A Case of Esophageal Cancer Achieving a Pathological Complete Response after Preoperative Docetaxel, Cisplatin, and 5-Fluorouracil Therapy].

    Daisuke Motegi, Hiroshi Ichikawa, Yosuke Kano, Takaaki Hanyu, Takashi Ishikawa, Kenji Usui, Takeshi Sakai, Yuki Hirose, Kohei Miura, Masayuki Nagahashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 13 )   2192 - 2194   2019年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 66-year-old man with middle thoracic esophageal squamous cell carcinoma with supraclavicular lymph node metastasis visited our hospital. He underwent 3 courses of preoperative chemotherapy with docetaxel, cisplatin, and 5-FU(DCF)with a clinically-determined partial response. Minimally-invasive esophagectomy with 3-fieldlymphad enectomy was subsequently performed. Histopathologic examination revealedno viable tumor cells in the resectedesophagus andsupraclavicular lymph node. DCF is a promising preoperative chemotherapy regimen for locally advanced esophageal cancer because of its higher complete response rate comparedto that for cisplatin plus 5-FU.

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  • [A Case of Esophageal Primary Malignant Melanoma That Developed During the Follow-Up of Esophageal Melanocytosis].

    Daisuke Yamai, Hiroshi Ichikawa, Yosuke Kano, Takaaki Hanyu, Takashi Ishikawa, Kenji Usui, Mariko Nemoto, Yuki Hirose, Kohei Miura, Masayuki Nagahashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 13 )   2012 - 2014   2019年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 78-year-old woman was endoscopically followed up for benign melanocytosis in the middle thoracic esophagus that was detected 3 years prior. She presented with chest tightness, and an endoscopic examination revealed a protruding tumor at the melanotic lesion. She was histologically diagnosedwith an esophageal primary malignant melanoma. Computedtomography showedno metastatic lesions. She underwent minimally invasive esophagectomy with 2-fieldlymphad enectomy. Immunotherapy with nivolumab is ongoing for liver metastasis, which developed1 year and6 months after esophagectomy. Careful follow-up for esophageal melanocytosis is important for early diagnosis of esophageal primary malignant melanoma.

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  • 食道メラノーシスの経過観察中に発症した食道原発悪性黒色腫の1切除例

    山井 大介, 市川 寛, 加納 陽介, 羽入 隆晃, 石川 卓, 臼井 賢司, 根本 万理子, 廣瀬 雄己, 三浦 宏平, 永橋 昌幸, 島田 能史, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    癌と化学療法   46 ( 13 )   2012 - 2014   2019年12月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    症例は78歳、女性。健診目的の上部消化管内視鏡検査で胸部中部食道に食道メラノーシスを認め、経過観察されていた。3年後に胸部圧迫感を自覚し上部消化管内視鏡検査を施行したところ、食道メラノーシスの部位に一致して1型腫瘍を認めた。生検にて食道原発悪性黒色腫と診断された。cT2N0M0、Stage II(食道癌取扱い規約第11版)であったため、根治的な食道切除術を施行した。術後1年6ヵ月のCT検査で肝転移を認め、一次治療としてnivolumabによる免疫療法を施行中である。食道メラノーシスに対しては食道原発悪性黒色腫の発症を念頭に置いた注意深い経過観察が必要である。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00296&link_issn=&doc_id=20200117590034&doc_link_id=%2Fab8gtkrc%2F2019%2F004613%2F034%2F2012-2014%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2019%2F004613%2F034%2F2012-2014%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 術前DCF療法により組織学的完全奏効が得られた進行食道癌の1例

    茂木 大輔, 市川 寛, 加納 陽介, 羽入 隆晃, 石川 卓, 臼井 賢司, 酒井 剛, 廣瀬 雄己, 三浦 宏平, 永橋 昌幸, 島田 能史, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    癌と化学療法   46 ( 13 )   2192 - 2194   2019年12月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    症例は66歳、男性。右頸部に腫瘤を自覚し、精査にて48×34mm大の右鎖骨上リンパ節転移を伴う胸部中部食道扁平上皮癌、cT2N2M0、cStage IIIと診断された。術前docetaxel/cisplatin/5-FU(DCF)療法を3コース施行され、部分奏効と判定された。手術は胸腔鏡下食道切除術、3領域リンパ節郭清、胸骨後経路胃管再建を施行された。術後病理組織学的診断にて原発巣および右鎖骨上リンパ節転移巣ともに腫瘍細胞の遺残を認めず、組織学的完全奏効と判定された。進行食道癌に対する術前DCF療法は高い組織学的完全奏効割合から新規術前化学療法として有望である。(著者抄録)

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  • Timing and site-specific trends of recurrence in patients with pathological stage II or III gastric cancer after curative gastrectomy followed by adjuvant S-1 monotherapy.

    Ryo Takahashi, Manabu Ohashi, Yosuke Kano, Satoshi Ida, Koshi Kumagai, Souya Nunobe, Keisho Chin, Kensei Yamaguchi, Masato Nagino, Takeshi Sano, Naoki Hiki

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   22 ( 6 )   1256 - 1262   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Adjuvant S-1 monotherapy prolongs the survival of patients with pathological stage II or III gastric cancer undergoing D2 gastrectomy. This therapeutic regimen is standard in Japan. Unfortunately, some patients who undergo this treatment suffer from recurrent disease. However, information regarding the timing and site-specific trends of recurrence is insufficient. METHODS: Among 396 patients who underwent D2 gastrectomy followed by adjuvant S-1 monotherapy between 2008 and 2012, 122 experienced a recurrence. We retrospectively determined the timing and sites of recurrence. RESULTS: The median RFS of the 122 patients was 19.5 months, and their 1-, 3- and 5-year RFS rates were 67.2%, 23.0% and 5.7%, respectively. There were no significant differences in RFS among disease substages. Local recurrence, lymph node involvement and peritoneal and hematogenous metastases were found in 6, 25, 63 and 42 patients, respectively. Approximately 10% of patients presented with contemporaneous sites of recurrence. Local recurrence and lymph node metastasis plateaued 3 years after gastrectomy. Peritoneal and hematogenous metastasis increased within 5 years after surgery. In patients with hematogenous metastasis, the number of liver metastases plateaued but increased in others. CONCLUSIONS: In patients with recurrent disease who underwent D2 gastrectomy followed by adjuvant S-1 monotherapy, 80% of recurrences occur within 3 years after gastrectomy. The timing of recurrence is not significantly different among substages. Although the rates of local recurrence and lymph node and liver metastasis plateau after 3 years, peritoneal and the other hematogenous metastases increase within 5 years.

    DOI: 10.1007/s10120-019-00953-9

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  • Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body.

    Yosuke Kano, Manabu Ohashi, Satoshi Ida, Koshi Kumagai, Souya Nunobe, Takeshi Sano, Naoki Hiki

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   22 ( 5 )   1060 - 1068   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The upper gastric body is of particular interest in relation to gastrectomy because this area includes a border; that is, both distal and proximal gastrectomy for early gastric cancer can involve this area. Laparoscopic subtotal gastrectomy (LsTG) is reported to be suitable procedure compared with laparoscopic proximal and total gastrectomy (LPG, LTG), regarding postoperative nutritional status and surgical safety. However, whether LsTG is an oncologically acceptable procedure for early gastric cancer in the upper gastric body is unclear. METHODS: We analyzed 215 patients with cT1N0M0 gastric cancer limitedly located in the upper gastric body. The frequency of conversion from each intended procedure to an alternative procedure, the width of the pathological margin, the incidence of lymph node metastasis at each station and the 3-year overall survival (OS) and relapse-free survival (RFS) were evaluated. RESULTS: LsTG was planned for 65 patients, and LPG for 72 and LTG for 78, respectively. Conversion to other procedures was required in about 10% of patients for whom LsTG or LPG was planned. The width of the pathological margin in patients who underwent LsTG was significantly shorter than patients who underwent the others. No patients who underwent LsTG, LPG or LTG had metastases in station no. 2 or 4sa lymph node. The 3-year OS and RFS rates of patients for whom each procedure was planned were not different. CONCLUSIONS: LsTG could be an oncologically acceptable procedure for cT1N0M0 gastric cancer in the upper gastric body. LsTG could be one option for such disease.

    DOI: 10.1007/s10120-019-00947-7

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  • Hyperbilirubinemia predicts the infectious complications after esophagectomy for esophageal cancer. 国際誌

    Yusuke Muneoka, Hiroshi Ichikawa, Shin-Ichi Kosugi, Takaaki Hanyu, Takashi Ishikawa, Yosuke Kano, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Kohei Akazawa, Toshifumi Wakai

    Annals of medicine and surgery (2012)   39   16 - 21   2019年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Surgical stress and inflammation can cause hyperbilirubinemia, which sometimes occurs after esophagectomy for esophageal cancer (EC). The aim of this study was to elucidate the clinical significance of postoperative hyperbilirubinemia in the management of EC patients. Materials and methods: We retrospectively reviewed records of 81 EC patients who underwent esophagectomy from 2009 to 2014. We compared the clinicopathological and perioperative factors, including the presence of hyperbilirubinemia (total bilirubin ≥1.5 mg/dL), between patients with postoperative infectious complications (PIC group) and those without (Non-PIC group). Results: PIC developed in 52 patients (64.2%). There were significant differences in incidence of postoperative hyperbilirubinemia between the PIC group and the non-PIC group (34.6% vs. 3.4%, P = 0.002), as well as the approach of esophagectomy (P = 0.045), the surgical duration (469 vs. 389 min, P < 0.001), the amount of blood loss (420 vs. 300 mL, P = 0.018), the frequency of intraoperative blood transfusions (32.7% vs. 6.9%, P = 0.012) and the peak postoperative C-reactive protein level (17.3 vs. 8.6 mg/dL, P = 0.007). Multivariate analysis revealed hyperbilirubinemia was independently associated with the occurrence of PICs (odds ratio: 38.6, P = 0.010). The median time to the diagnosis of hyperbilirubinemia was significantly shorter than that of PICs (3.0 vs. 4.5 days, P = 0.025). Conclusions: Postoperative hyperbilirubinemia was associated with the occurrence of PICs and frequently occurred before any PICs become apparent. More attention should be paid to the serum bilirubin level in the management after esophagectomy for EC.

    DOI: 10.1016/j.amsu.2019.02.004

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  • Phospho-Sphingosine Kinase 1 Expression in Lymphatic Spread of Esophageal Squamous Cell Carcinoma. 国際誌

    Mariko Nemoto, Hiroshi Ichikawa, Masayuki Nagahashi, Takaaki Hanyu, Takashi Ishikawa, Yosuke Kano, Yusuke Muneoka, Toshifumi Wakai

    The Journal of surgical research   234   123 - 131   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Lymphatic spread is the main mode of progression of esophageal squamous cell carcinoma (ESCC). Sphingosine-1-phosphate (S1P) is a pleiotropic bioactive lipid mediator, which produced by sphingosine kinase 1 (SphK1) activated by phosphorylation. The SphK1-S1P axis has a crucial role in lymphangiogenesis. However, the significance of phospho-SphK1 (pSphK1) in the progression of ESCC has not been fully investigated. MATERIALS AND METHODS: We evaluated pSphK1 expression in 92 surgically resected tumor tissues of ESCC by the immunohistochemistry. Fifty-nine (64%) patients with moderate or strong expression and 33 (36%) with negative or weak expression were classified in the pSphK1-high and pSphK1-low groups, respectively. RESULTS: Higher pathological N category (pN) was more frequently observed in the pSphK1-high group (P < 0.01). The median number of lymph node metastasis (pSphK1-high: 2 versus pSphK1-low: 0; P < 0.01), the proportion of patients with lymphatic invasion (69% versus 18%; P < 0.01) and that with intramural metastasis (27% versus 3%; P < 0.01) were significantly higher in the pSphK1-high group. The presence of lymphatic invasion (odds ratio [OR] 5.63; P < 0.01) and pN1-3 (OR 3.26; P = 0.04) were independently associated with high pSphK1 expression. The 5-y overall survival rate of the pSphK1-high group was significantly lower than that of the pSphK1-low group (50.8% versus 67.3%; P = 0.01). High pSphK1 expression was not identified as a significant independent prognostic factor. CONCLUSIONS: We provide the first evidence of the association between high expression of pSphK1 and both lymphatic spread and patient outcomes in ESCC.

    DOI: 10.1016/j.jss.2018.09.012

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  • [Chemoresistance in Microsatellite Instability-High Gastric Cancer-A Case Report].

    Takahiro Otani, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Takeshi Sakai, Mariko Nemoto, Yusuke Muneoka, Kenji Usui, Natsuru Sudo, Yosuke Kano, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   1895 - 1897   2018年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 74-year-old woman with cT4aN2M0, cStage ⅢB gastric cancer underwent neoadjuvant chemotherapy comprising 2 courses of S-1 plus cisplatin, and the clinical response was determined as non-CR/non-PD according to RECIST ver 1.1. Although distal gastrectomy with D2 lymphadenectomy was planned, the tumor was considered as unresectable with peritoneal metastases during laparotomy. After the subsequent chemotherapy with 1 course of capecitabine plus cisplatin, tumor bleeding, and obstruction due to rapid tumor progression occurred. We performed palliative distal gastrectomy; however, the patient died 17 days after gastrectomy. A comprehensive genomic analysis using cancer-gene panel identified the tumor as a microsatellite instability-high(MSI-H). Recently post hoc analysis of the large-scale clinical trials showed no clinical benefit of perioperative chemotherapy in MSI-H gastric cancer. MSI status has a potential to optimize the perioperative treatment strategy in gastric cancer.

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  • 化学療法に抵抗性を示した高度マイクロサテライト不安定性胃癌の1例

    大渓 隆弘, 市川 寛, 羽入 隆晃, 石川 卓, 酒井 剛, 根本 万理子, 宗岡 悠介, 臼井 賢司, 須藤 翔, 加納 陽介, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    癌と化学療法   45 ( 13 )   1895 - 1897   2018年12月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    症例は74歳、女性。心窩部痛の精査目的に当院を紹介され、多発リンパ節転移を伴う進行胃癌、cT4aN2M0、cStage IIIBと診断した。術前補助化学療法としてSP療法(S-1 100mg day 1〜21、cisplatin 80mg day 8)を2コース施行した。効果判定はnon-CR/non-PD(RECIST ver1.1)と診断した。切除を試みたが、腹腔内に多数の腹膜播種転移を認め、根治切除不能と判断した。化学療法をXP療法(capecitabine 3,000mg day 1〜14、cisplatin 112mg day 1)に変更したが、1コース施行後に原発巣の増大による腫瘍出血と狭窄症状を認めた。化学療法を中止して姑息的な幽門側胃切除術を行ったが、全身状態の改善に乏しく、胃切除後17病日に死亡した。癌遺伝子パネルによる解析を施行したところ、高度マイクロサテライト不安定性(MSI-H)胃癌と判定した。近年の遺伝子解析の結果から、大腸癌と同様に胃癌においてもMSI-H症例に対する周術期化学療法は効果に乏しい可能性がある。本症例は、胃癌における分子生物学的背景に基づいた治療戦略を検討する上で示唆に富む症例であると考えられた。(著者抄録)

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  • Correction to: Favorable long-term outcomes of one-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer treated at a high-volume center.

    Yosuke Kano, Manabu Ohashi, Naoki Hiki, Daisuke Takahari, Keisho Chin, Kensei Yamaguchi, Yasuo Tsuda, Yoshiaki Shoji, Itaru Yasufuku, Kojiro Eto, Satoshi Ida, Koshi Kumagai, Souya Nunobe, Takeshi Sano

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   21 ( 6 )   1072 - 1072   2018年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In the original publication of this article, the 5-year OS rates of the S-1 group in the ACTS-GC according to TNM-6 were described incorrectly in Table 4. The revised Table 4 is given in this correction.

    DOI: 10.1007/s10120-018-0849-3

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  • Favorable long-term outcomes of one-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer treated at a high-volume center.

    Yosuke Kano, Manabu Ohashi, Naoki Hiki, Daisuke Takahari, Keisho Chin, Kensei Yamaguchi, Yasuo Tsuda, Yoshiaki Shoji, Itaru Yasufuku, Kojiro Eto, Satoshi Ida, Koshi Kumagai, Souya Nunobe, Takeshi Sano

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   21 ( 6 )   1024 - 1030   2018年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: One-year adjuvant S-1 monotherapy following D2 gastrectomy has been the Japanese treatment standard for pathological stage II or III gastric cancer since the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer (ACTS-GC) was concluded in 2007. Trial patients were selected according to the 13th edition of the Japanese classification (JC-13). The JC-13 and the TNM classification underwent major revisions in 2010 (JC-14/TNM-7). However, neither the recent therapeutic results for patients with stage II/III disease defined by the current system nor comparisons with the ACTS-GC-results have been reported. METHODS: The 390 study patients had pathological stage II/III gastric cancer defined by the JC-14/TNM-7 and treated with S-1 following D2 gastrectomy between 2008 and 2012. The completion rate of 1-year S-1, first relapse site, and stage-specific survival according to the JC-14/TNM-7, JC-13, and TNM-6 were examined and the results compared with those of the ACTS-GC. RESULTS: The completion rate for 1-year S-1 (69.5%) was slightly higher than in the ACTS-GC. The recurrence pattern was almost identical. The 5-year overall survival rates of pathological IIA, IIB, IIIA, IIIB, and IIIC in the JC-14/TNM-7 were 96.0, 85.5, 81.8, 72.0, and 51.1%, respectively. Their 5-year overall and relapse-free survival rates by the JC-13 and TNM-6 systems were favorable as compared to those of ACTS-GC patients for all substages. CONCLUSIONS: Survival outcome shown in this study of patients treated with 1-year adjuvant S-1 after D2 gastrectomy at a high-volume cancer hospital will provide a reference for future adjuvant trials targeting JC-14/TNM-7 stage II/III disease.

    DOI: 10.1007/s10120-018-0827-9

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  • Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications.

    Kojiro Eto, Naoki Hiki, Koshi Kumagai, Yoshiaki Shoji, Yasuo Tsuda, Yosuke Kano, Itaru Yasufuku, Yasuhiro Okumura, Masahiro Tsujiura, Satoshi Ida, Souya Nunobe, Manabu Ohashi, Takeshi Sano, Toshiharu Yamaguchi

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   21 ( 4 )   703 - 709   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The occurrence of postoperative complications may have a significant negative impact on the prognosis of patients with gastrointestinal cancers. The inflammatory response releases systemic cytokines, which may induce residual cancer cell growth. Recently, neoadjuvant chemotherapy (NAC) was found to improve the prognosis of advanced gastric cancer (GC). We hypothesize that when postoperative complications occur after gastrectomy, NAC treatment of micrometastases can prevent residual cancer cell growth. METHODS: This study included 101 patients who underwent curative resection after NAC for GC from 2005 to 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Overall survival (OS) and relapse-free survival (RFS) were compared between the patients with complications and those without complications. RESULTS: Of the 101 patients, 35 (34.7%) had grade 2 or higher complications. Among those with complications, the 3- and 5-year OS rates were 63.5 and 58.2% and the 3- and 5-year RFS rates 41.7 and 41.7%, respectively. Among those without complications, the 3- and 5-year OS rates were 65.9 and 56.3% and the 3- and 5-year RFS rates 51.1 and 43.9%, respectively. There was no significant difference in prognosis between the patients with complications and those without complications. CONCLUSION: Our study is the first to demonstrate the potential of NAC to abolish the poor prognosis induced by postoperative complications after curative resection for GC.

    DOI: 10.1007/s10120-017-0781-y

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  • Pancreatic Compression during Lymph Node Dissection in Laparoscopic Gastrectomy: Possible Cause of Pancreatic Leakage. 国際誌

    Satoshi Ida, Naoki Hiki, Takeaki Ishizawa, Yugo Kuriki, Mako Kamiya, Yasuteru Urano, Takuro Nakamura, Yasuo Tsuda, Yosuke Kano, Koshi Kumagai, Souya Nunobe, Manabu Ohashi, Takeshi Sano

    Journal of gastric cancer   18 ( 2 )   134 - 141   2018年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.

    DOI: 10.5230/jgc.2018.18.e15

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  • リン酸化スフィンゴシンキナーゼ1の発現と胃癌の進行についての関連

    羽入 隆晃, 永橋 昌幸, 市川 寛, 石川 卓, 小杉 伸一, 角田 知行, 須藤 翔, 根本 万理子, 加納 陽介, 宗岡 悠介, 中島 真人, 田島 陽介, 三浦 宏平, 廣瀬 雄己, 油座 築, 島田 能史, 坂田 純, 小林 隆, 亀山 仁史, 若井 俊文

    日本外科学会定期学術集会抄録集   118回   961 - 961   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 当科における胃癌根治切除後S-1補助化学療法症例の検討

    羽入 隆晃, 市川 寛, 石川 卓, 須藤 翔, 加納 陽介, 宗岡 悠介, 根本 万理子, 永橋 昌幸, 島田 能史, 坂田 純, 小林 隆, 亀山 仁史, 小杉 伸一, 若井 俊文

    日本胃癌学会総会記事   90回   555 - 555   2018年3月

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    記述言語:日本語   出版者・発行元:(一社)日本胃癌学会  

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  • Pathogenic germline BRCA1/2 mutations and familial predisposition to gastric cancer. 国際誌

    Hiroshi Ichikawa, Toshifumi Wakai, Masayuki Nagahashi, Yoshifumi Shimada, Takaaki Hanyu, Yosuke Kano, Yusuke Muneoka, Takashi Ishikawa, Kazuyasu Takizawa, Yosuke Tajima, Jun Sakata, Takashi Kobayashi, Hitoshi Kemeyama, Hiroshi Yabusaki, Satoru Nakagawa, Nobuaki Sato, Takashi Kawasaki, Keiichi Homma, Shujiro Okuda, Stephen Lyle, Kazuaki Takabe

    JCO precision oncology   2   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1200/PO.18.00097

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  • [A Case of Advanced Gastric Cancer with Portosystemic Shunt Successfully Treated with Percutaneous Transvenous Coil Embolization].

    Kenji Usui, Takaaki Hanyu, Hiroshi Ichikawa, Takashi Ishikawa, Yusuke Muneoka, Yu Sato, Yosuke Kano, Takahiro Otani, Mariko Hishiki, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Shinichi Kosugi, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   1917 - 1919   2016年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 57-year-old man with advanced gastric cancer and multiple liver metastases was referred to our hospital. He underwent a palliative gastrectomy to treat hemorrhage, and S-1 and cisplatin therapy was administered. After 7 courses of chemotherapy, a new liver metastatic lesion and a tumor thrombus in the right portal vein appeared. Moreover, the serum level of ammonia was elevated(296 mg/dL)following a consciousness disorder. Enhanced CT revealed an inferior mesenteric vein to left renal vein shunt, which led to the diagnosis of portal systemic encephalopathy due to portosystemic shunt. Percutaneous transvenous coil embolization was performed. The serum ammonia level decreased, and the encephalopathy disappeared. As a result, he was able to continue chemotherapy.

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  • [A Case of Advanced Gastric Cancer Resected for Rebleeding after Palliative Radiotherapy for Hemostasis].

    Yusuke Muneoka, Hiroshi Ichikawa, Takashi Ishikawa, Takaaki Hanyu, Yu Sato, Yosuke Kano, Kenji Usui, Takahiro Otani, Mariko Hishiki, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Shinichi Kosugi, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   1936 - 1938   2016年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report a case of advanced gastric cancer(AGC)that was resected for rebleeding after palliative radiotherapy for hemostasis. A 74-year-old man with Stage IV gastric cancer received chemotherapy and achieved stable disease. After 23 months, he experienced continuous bleeding from the tumor due to regrowth. Palliative radiotherapy was conducted to control the bleeding, and the tumor successfully achieved hemostasis. However, 6 weeks later, the patient experienced rebleeding and developed hemostatic shock. We then performed a successful emergency gastrectomy. Bleeding negatively affects quality of life in patients with AGC and is potentially lethal. Although palliative radiotherapy for bleeding of gastric cancer is a safe and useful treatment within a short time frame in cases of rebleeding, emergency gastrectomy may be necessary. Therefore, when we select this treatment, the possibility of subsequent surgical treatment must be considered.

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  • 胃癌の腫瘍出血に対する緩和的放射線治療後に再出血を来し胃切除を要した1例

    宗岡 悠介, 市川 寛, 石川 卓, 羽入 隆晃, 佐藤 優, 加納 陽介, 臼井 賢司, 大渓 隆弘, 日紫喜 万理子, 三浦 宏平, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 小杉 伸一, 若井 俊文

    癌と化学療法   43 ( 12 )   1936 - 1938   2016年11月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    近年、胃癌の腫瘍出血に対する緩和的放射線治療の報告が散見される。今回われわれは、胃癌出血に対する緩和的放射線治療後に再出血を来し、胃切除術を要した症例を経験した。症例は74歳、男性。Stage IV胃癌に対し化学療法を施行し、stable diseaseを維持していた。しかし、化学療法開始から23ヵ月後に腫瘍の再増大と出血を認め、止血目的の緩和的放射線治療を施行した。いったん止血が得られたが、1ヵ月半後に再出血を来した。入院後に出血性ショックを来し、緊急で姑息的胃切除術を施行した。腫瘍出血に対する緩和的放射線治療は安全かつ有効な治療として選択されることが多い。しかし、再出血を来した際には緊急での胃切除術が避けられないことがある。本症例では迅速な手術治療により救命が得られた。(著者抄録)

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  • 門脈体循環シャントに対する経皮的コイル塞栓術が著効し化学療法を継続し得た胃癌の1例

    臼井 賢司, 羽入 隆晃, 市川 寛, 石川 卓, 宗岡 悠介, 佐藤 優, 加納 陽介, 大渓 隆弘, 日紫喜 万理子, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 小杉 伸一, 若井 俊文

    癌と化学療法   43 ( 12 )   1917 - 1919   2016年11月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

    胃癌肝転移による門脈腫瘍栓により、門脈体循環シャント(portosystemic shunt:PSS)・門脈体循環性脳症(Portal systemic encephalopathy:PSE)を来したまれな1例を経験した。症例は57歳、男性。多発肝転移を伴うStage IV胃癌に対し、出血制御目的に幽門側胃切除術を行った。術後S-1+cisplatin療法を導入したが、7コース施行後に肝S7の新規病変と門脈腫瘍栓が出現した。weekly paclitaxel療法に変更して化学療法を継続した。術後1年1ヵ月ごろより意識障害が出現し、術後1年3ヵ月には血中アンモニア濃度296μg/dLと高アンモニア血症を呈した。腹部CT検査で下腸間膜静脈-左腎静脈シャントを認め、PSSによるPSEの診断に至った。経皮的コイル塞栓術で短絡路の遮断を行い、脳症・高アンモニア血症は改善し、化学療法の継続が可能になった。その後、吻合部局所再発に対して残胃全摘術を施行し、以降も化学療法を継続したが、初回手術後3年5ヵ月に死亡した。(著者抄録)

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  • Risk Factors and Clinical Outcomes of Recurrent Laryngeal Nerve Paralysis After Esophagectomy for Thoracic Esophageal Carcinoma. 国際誌

    Yu Sato, Shin-ichi Kosugi, Naotaka Aizawa, Takashi Ishikawa, Yosuke Kano, Hiroshi Ichikawa, Takaaki Hanyu, Kotaro Hirashima, Takeo Bamba, Toshifumi Wakai

    World journal of surgery   40 ( 1 )   129 - 36   2016年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The objectives of this study were to assess the incidence of recurrent laryngeal nerve paralysis (RLNP) using laryngoscopy after esophagectomy for thoracic esophageal carcinoma and to clarify the risk factors influencing postoperative RLNP. METHODS: A total of 299 patients who underwent laryngoscopic examination after esophagectomy were retrospectively reviewed. Patients who were found to have postoperative RLNP were followed up every 1–3 months, with a median follow-up period of 3 months. Recovery from paralysis was also evaluated on the basis of each affected nerve. Multivariate analyses using logistic regression were used to identify independent risk factors for RLNP. Cumulative recovery rate was calculated using Kaplan–Meier method. RESULTS: A total of 178 (59.5%) patients were diagnosed with RLNP by first laryngoscopy [bilateral in 59 (33.1%) patients, right in 15 (8.4%), and left in 104 (58.4%)]. In 206 patients who underwent transthoracic and thoracoscopic esophagectomy, independent risk factors for RLNP were lymph node dissection along the right RLN (odds ratio [OR] 3.01, 95% confidence interval [CI] 1.06–8.54, P = 0.04) and cervical anastomosis (OR 5.94, 95% CI 1.78–19.80, P < 0.01). Cumulative recovery rate from RLNP was 61.7% at 12 months after esophagectomy with 91 nerves eventually recovering from paralysis. Median recovery time was 6 months. CONCLUSIONS: RLNP developed in 60 % of patients after esophagectomy and may be associated with lymphadenectomy around the right RLN and cervical esophageal mobilization. Although 62% of affected nerves recovered within 12 months, great attention should be given when performing these procedures.

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  • Prognostic significance of peritoneal lavage cytology at three cavities in patients with gastric cancer. 国際誌

    Yosuke Kano, Shin-ichi Kosugi, Takashi Ishikawa, Takahiro Otani, Yusuke Muneoka, Yu Sato, Takaaki Hanyu, Kotaro Hirashima, Takeo Bamba, Toshifumi Wakai

    Surgery   158 ( 6 )   1581 - 9   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: We sought to determine the prognostic significance of intraoperative peritoneal lavage cytology (CY) at 3 different abdominal cavities and establish the optimal treatment for gastric cancer patients with positive peritoneal cytology (CY1). METHODS: A total of 1,039 patients with primary gastric adenocarcinoma who underwent CY at 3 cavities (Douglas' pouch, left subphrenic cavity, and right subhepatic cavity) were enrolled; 116 (11%) patients had at least one positive cavity. We retrospectively analyzed the clinicopathologic characteristics and survival of these 116 patients with CY1. RESULTS: Seventeen (15%) of the patients had negative cytology at Douglas' pouch but positive cytology at one or both of the other cavities. The 116 patients' overall 2-year survival rate was 22.9%, with the median survival time of 11 months. The overall 2-year survival rates for the patients with positive cytology at 1, 2, and 3 cavities were 41.9%, 35.8%, and 15%, with median survival times of 17, 18, and 9 months, respectively (P < .01). A multivariate analysis revealed that macroscopic type 4 tumor, R2 resection, lymph node metastasis, and postoperative chemotherapy were independent prognostic factors. Among the CY1 patients with type 4 tumors, there was no substantial difference in survival between the patients who underwent R1 or R2 resection, although the statistical power of this subgroup analysis was low. CONCLUSION: CY at 3 cavities might be a useful method to decrease the false-negative rate. Palliative gastrectomy for CY1 patients with type 4 tumors is still controversial.

    DOI: 10.1016/j.surg.2015.04.004

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  • Severe cellulitis and abdominal wall emphysema following laparoscopic colonic surgery: A case report.

    Ryo Tanaka, Hitoshi Kameyama, Tadasu Chida, Tatsuo Kanda, Yosuke Kano, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Shin-Ichi Kosugi, Toshifumi Wakai

    Asian journal of endoscopic surgery   8 ( 2 )   193 - 6   2015年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Abdominal wall emphysema is a common complication of laparoscopic surgery. This condition is usually harmless; however, if an infection occurs, it can develop into a serious condition such as necrotizing fasciitis. We report a case of a 51-year-old woman suffering from severe cellulitis that spread from an area of abdominal wall emphysema after laparoscopic surgery for sigmoid colon cancer. Recognizing this complication, early diagnosis, and prompt treatment are cornerstones for successful management of this potentially fatal disease.

    DOI: 10.1111/ases.12159

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  • 当科における4型胃癌の治療成績

    加納 陽介, 小杉 伸一, 石川 卓, 佐藤 優, 市川 寛, 羽入 隆晃, 番場 竹生, 若井 俊文

    日本胃癌学会総会記事   87回   461 - 461   2015年3月

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    記述言語:日本語   出版者・発行元:(一社)日本胃癌学会  

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  • イマチニブ治療中止によるGIST再燃症例の検討

    石川 卓, 神田 達夫, 加納 陽介, 市川 寛, 羽入 隆晃, 平島 浩太郎, 番場 竹生, 小杉 伸一, 若井 俊文

    日本胃癌学会総会記事   87回   383 - 383   2015年3月

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    記述言語:日本語   出版者・発行元:(一社)日本胃癌学会  

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  • 胃癌同時性肝転移に対して肝切除を行い長期生存が得られた2例

    番場 竹生, 加納 陽介, 佐藤 優, 市川 寛, 平島 浩太郎, 羽入 隆晃, 石川 卓, 小杉 伸一, 若井 俊文

    日本胃癌学会総会記事   87回   452 - 452   2015年3月

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    記述言語:日本語   出版者・発行元:(一社)日本胃癌学会  

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  • Internal hernia after laparoscopic-assisted proximal gastrectomy with jejunal interposition for gastric cancer: a case report. 国際誌

    Kotaro Hirashima, Takashi Ishikawa, Shin-Ichi Kosugi, Yosuke Kano, Yu Sato, Hiroshi Ichikawa, Takaaki Hanyu, Takeo Bamba, Toshifumi Wakai

    Surgical case reports   1 ( 1 )   49 - 49   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Internal hernia after gastrectomy is a rare complication. It can progress rapidly to vascular disturbance, necrosis, and perforation, therefore early diagnosis and surgical treatment is essential. We present a case of internal hernia following laparoscopic-assisted proximal gastrectomy with jejunal interposition reconstruction in a 68-year-old man, who presented with acute abdominal pain and vomiting. Computed tomography showed a whirl sign, ascites, and a closed-loop formation of the small intestine. We diagnosed an internal hernia and performed emergency surgery. Laparotomy revealed chyle-like ascites and extensive small intestine with poor color. We recognized that about 20 cm of jejunum from the ligament of Treitz was strangulated behind the pedicle of the jejunum lifted during laparoscopic-assisted proximal gastrectomy. We relieved the strangulation, whereupon the color of the strangulated intestine was restored. Therefore, we did not perform intestinal resection and reconstruction. Finally, we fixed the jejunal pedicle and mesentery of the transverse colon. We report this case as there are few reported cases of internal hernia after laparoscopic-assisted proximal gastrectomy.

    DOI: 10.1186/s40792-015-0051-3

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  • Intrathoracic esophagojejunostomy using OrVil™ for gastric adenocarcinoma involving the esophagus. 国際誌

    Kazuhito Yajima, Tatsuo Kanda, Shin-Ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai

    World journal of gastrointestinal surgery   6 ( 12 )   235 - 40   2014年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrVil™. METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrVil™was inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009, we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min (range; 210-367 min), and median blood loss was 210 mL (range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3 (range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. The median hospital stay was 16 d (range: 15-20 d). The median length of esophageal involvement was 14 mm (range: 6-48 mm) and that of the resected esophagus was 40 mm (range: 35-55 mm); all resected specimens had tumor-free margins. CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.

    DOI: 10.4240/wjgs.v6.i12.235

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  • 手術手技 経裂孔的アプローチによる下縦隔郭清と下部食道切除再建術

    加納 陽介, 小杉 伸一, 神田 達夫, 矢島 和人, 鈴木 力, 若井 俊文

    手術   68 ( 5 )   723 - 727   2014年4月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

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  • [Gastrectomy for a patient with advanced gastric cancer with spleen metastases following induction chemotherapy with S-1 plus cisplatin].

    Yosuke Kano, Kyo Ueki, Kazuhito Yajima, Takashi Tada, Dai Ishizuka, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   41 ( 2 )   249 - 52   2014年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    An asymptomatic 56-year-old woman, upon medical examination, was diagnosed with advanced adenocarcinoma of the upper third of the stomach. Computed tomography showed that the primary gastric tumor was directly invading the splenic hilum, and there were multiple metastases in the spleen; incurable gastric cancer was confirmed. S-1 plus cisplatin therapy was introduced as the induction regimen, and the main tumor and splenic metastases reduced significantly. Total gastrectomy with splenectomy and D2 lymphadenectomy was performed after 9 courses of chemotherapy. The surgery was completed with no residual tumor, and intraperitoneal washing cytology was negative. Histologically, the primary tumor was classified as Grade 2, reflecting the effect of chemotherapy, and viable metastatic tumors were confirmed in the spleen. S-1-based treatment was continued as adjuvant chemotherapy, and the patient was alive with no evidence of tumor recurrence 39 months after the initiation of chemotherapy. Although metastasis to the spleen from gastric adenocarcinoma has been reported as a rare metastatic pattern with poor prognosis, our patient had a long survival time after gastrectomy following induction chemotherapy.

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  • 酸性物質による腐食性胃炎後の噴門・幽門狭窄に対して鏡視下胃全摘を施行した1例

    田中 亮, 矢島 和人, 加納 陽介, 角田 知行, 市川 寛, 石川 卓, 小杉 伸一, 神田 達夫, 畠山 勝義, 西倉 健

    新潟医学会雑誌   127 ( 2 )   115 - 115   2013年2月

  • Two-step laparoscopic surgery for a patient with synchronous double cancer of the colon and stomach accompanied by severe chronic obstructive pulmonary disease. 国際誌

    Kazuhito Yajima, Shin-Ichi Kosugi, Yosuke Kano, Takaaki Hanyu, Hiroshi Ichikawa, Takashi Ishikawa, Hitoshi Nogami, Toshifumi Wakai

    Case reports in surgery   2013   246515 - 246515   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Laparoscopic treatment strategies for synchronous intra-abdominal malignancies have not yet been standardized. We report a successful case of two-step laparoscopic surgery for synchronous double cancer of the colon and stomach accompanied by severe chronic obstructive pulmonary disease (COPD). A 66-year-old man with COPD was diagnosed as having advanced colon cancer and early gastric cancer. On admission, he could not go upstairs (Grade III according to the Hugh-Jones classification) and his forced expiratory volume in 1 second was 600 mL (35.9%). The patient initially underwent laparoscopy-assisted sigmoidectomy with D3 lymphadenectomy, followed by laparoscopy-assisted distal gastrectomy with D1 lymphadenectomy 68 days later. The patient's each postoperative course was uneventful with no pulmonary complications, and the patient was discharged 9 and 11 days after the first and second operations, respectively. The present case demonstrates that two-step laparoscopic surgery may be a safe and feasible surgical procedure for high-risk patients with synchronous intra-abdominal malignancies.

    DOI: 10.1155/2013/246515

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  • 当院におけるESD後の組織学的SM癌症例の追跡調査

    小林 和明, 矢島 和人, 加納 陽介, 石川 卓, 小杉 伸一, 神田 達夫, 畠山 勝義, 竹内 学, 小林 正明

    新潟医学会雑誌   126 ( 9 )   509 - 509   2012年9月

  • 化学放射線療法で治療したG-CSF産生食道扁平上皮癌の1例

    臼井 賢司, 矢島 和人, 加納 陽介, 石川 卓, 小杉 伸一, 神田 達夫, 畠山 勝義, 笹本 龍太, 青山 英史, 三浦 智史

    新潟医学会雑誌   126 ( 9 )   509 - 509   2012年9月

  • 食道癌根治的化学放射線療法後の腹腔内リンパ節再発に対してSalvage手術を施行した1例

    加納 陽介, 矢島 和人, 神田 達夫, 小林 和明, 石川 卓, 小杉 伸一, 畠山 勝義, 小林 正明, 竹内 学, 笹本 龍太, 味岡 洋一, 鈴木 力

    新潟医学会雑誌   126 ( 4 )   230 - 230   2012年4月

  • 進行GISTに対する集学的治療のあり方 エビデンスと実地臨床から イマチニブ二次耐性GISTに対する集学的治療

    石川 卓, 神田 達夫, 高野 徹, 加納 陽介, 小林 和明, 矢島 和人, 小杉 伸一, 畠山 勝義

    日本胃癌学会総会記事   84回   157 - 157   2012年2月

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    記述言語:日本語   出版者・発行元:(一社)日本胃癌学会  

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