2022/05/17 更新

写真a

マキタ サトシ
牧田 智
MAKITA Satoshi
所属
医学部附属病院 小児外科 病院助教
職名
病院助教

学位 1

  1. 医学(博士) ( 2018年3月   名古屋大学 ) 

研究キーワード 1

  1. 小児外科

研究分野 1

  1. ライフサイエンス / 外科学一般、小児外科学

 

論文 40

  1. Patients with gastric volvulus recurrence have high incidence of wandering spleen requiring laparoscopic gastropexy and splenopexy 査読有り

    Nakagawa Yoichi, Uchida Hiroo, Amano Hizuru, Hinoki Akinari, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Takada Shunya, Kato Daiki

    PEDIATRIC SURGERY INTERNATIONAL   38 巻 ( 6 ) 頁: 875 - 881   2022年6月

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  2. Evaluation of minimally invasive surgical skills training: comparing a neonatal esophageal atresia/tracheoesophageal fistula model with a dry box 査読有り

    Deie Kyoichi, Nakagawa Yoichi, Uchida Hiroo, Hinoki Akinari, Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Fujiogi Michimasa, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Takada Shunya, Maeda Takuya

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES     2022年3月

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  3. Utility of endoscopic retrograde cholangiopancreatography in management of pediatric pancreaticobiliary disease 査読有り

    Makita Satoshi, Amano Hizuru, Kawashima Hiroki, Hinoki Akinari, Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Nakagawa Yoichi, Uchida Hiroo

    BMC PEDIATRICS   22 巻 ( 1 ) 頁: 134   2022年3月

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  4. Laparoscopic definitive surgery for congenital biliary dilatation with aggressive hilar bile ductoplasty and complete resection of the intrapancreatic bile duct in pediatric patients is safe and effective, comparable to open surgery 査読有り

    Tainaka Takahisa, Shirota Chiyoe, Hinoki Akinari, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Amano Hizuru, Tanaka Yujiro, Uchida Hiroo

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES     2022年2月

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  5. Safety and feasibility of primary radical surgery for meconium peritonitis considering patients' general condition and perioperative findings 査読有り

    Nakagawa Yoichi, Uchida Hiroo, Amano Hizuru, Hinoki Akinari, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Takada Shunya, Maeda Takuya

    NAGOYA JOURNAL OF MEDICAL SCIENCE   84 巻 ( 1 ) 頁: 148 - 154   2022年2月

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  6. Laparoscopic Kasai portoenterostomy can be a standard surgical procedure for treatment of biliary atresia. 査読有り

    Shirota C, Hinoki A, Tainaka T, Sumida W, Kinoshita F, Yokota K, Makita S, Amano H, Nakagawa Y, Uchida H

    World journal of gastrointestinal surgery   14 巻 ( 1 ) 頁: 56 - 63   2022年1月

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    記述言語:英語  

    DOI: 10.4240/wjgs.v14.i1.56

    PubMed

  7. Urinary N-1,N-12-diacetylspermine as a biomarker for pediatric cancer: a case-control study 査読有り

    Yokota Kazuki, Hinoki Akinari, Hiramatsu Kyoko, Amano Hizuru, Kawamura Machiko, Kuwatsuka Yachiyo, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Nakagawa Yoichi, Uchida Hiroo, Kawakita Masao

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 12 ) 頁: 1659 - 1665   2021年12月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Minimally invasive examinations are particularly important in pediatric patients. Although the significance of urinary N1,N12-diacetylspermine (DiAcSpm) as a tumor marker (TM) has been reported in many types of adult cancers, its usefulness in pediatric cancers has not been reported. This may be due to urinary DiAcSpm level variations with age. This study aims to measure the normal levels of urinary DiAcSpm in healthy individuals and investigate its usefulness as a TM in childhood cancer. Methods: Urinary samples were collected from pediatric patients with and without cancer. The urinary DiAcSpm levels were measured, and the values were compared. Results: A total of 32 patients with cancer and 405 controls were enrolled in the study. Of the 32 patients, 13 had neuroblastoma, 9 had malignant lymphoma (ML), and 10 had leukemia. In the control group, the urinary DiAcSpm values markedly fluctuated among those with young age, especially infants; meanwhile, the values converged among those aged roughly 10 years and above. The sensitivity of DiAcSpm was significantly different among the three types of cancers: neuroblastoma (30.8%), ML (77.8%), and leukemia (40%). Conclusion: The urinary DiAcSpm value is a useful TM for both screening and follow-up of ML.

    DOI: 10.1007/s00383-021-04987-y

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    PubMed

  8. Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience 査読有り

    Okamoto Masamune, Amano Hizuru, Uchida Hiroo, Hinoki Akinari, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Yasui Akihiro, Nakagawa Yoichi

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 12 ) 頁: 1675 - 1681   2021年12月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: The features of right-sided congenital diaphragmatic hernias (RCDHs) are quite different from those of left-sided CDHs (LCDHs). We have summarized the features of RCDHs experienced in our institution. Methods: This retrospective study analyzed the cases of patients with CDH registered at our institution between 2011 and 2020. Defects on each side were compared based on prenatal diagnosis, medical treatment, type of surgery, and outcomes. Results: A total of 101 patients underwent surgery at our institution during the neonatal period, and 11 had RCDHs. RCDHs and LCDHs were significantly different in terms of extracorporeal membrane oxygenation (36% vs. 6%, p = 0.002), patch repair (81% vs. 28%, p < 0.001), recurrence rate (36% vs. 11%, p = 0.022), and length of hospital stay (117 days vs. 51 days, p = 0.012). The severity of the fetal diagnosis did not reflect postnatal severity. All patients with RCDH survived to discharge, and there was no significant difference in survival rate between the right and left sides. Conclusion: Neonates with RCDH required more intensive treatments; however, the survival rate was comparable between RCDH and LCDH. RCDH was significantly different from LCDH and an optimal treatment strategy for RCDHs should be established.

    DOI: 10.1007/s00383-021-04999-8

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  9. An imaging study on tracheomalacia in infants with esophageal atresia: the degree of tracheal compression by the brachiocephalic artery is a good indicator for therapeutic intervention 査読有り

    Sumida Wataru, Tainaka Takahisa, Shirota Chiyoe, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Yasui Akihiro, Okamoto Masamune, Nakagawa Yoichi, Hinoki Akinari, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 12 ) 頁: 1719 - 1724   2021年12月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Tracheomalacia (TM) is a frequent complication after esophageal atresia (EA) repair. This study aimed to review patients who underwent aortopexy for TM after EA repair and to compare their imaging features. Methods: The patients who underwent thoracoscopic EA repair and contrast-enhanced computed tomography (CECT) at our hospital between 2013 and 2020 were retrospectively reviewed. The ratio of the lateral and anterior–posterior diameter of the trachea (LAR) where the brachiocephalic artery (BCA) crosses the trachea was defined. The LAR of the patients who underwent CECT for asymptomatic pulmonary disease was set as a normal reference. The Z-score of each LAR was calculated and compared between the patients that did or did not undergo aortopexy. Results: A total of 51 patients represented the controls, 5 patients underwent aortopexy, and 12 patients were discharged without surgery. The mean LARs in the patients who underwent aortopexy, did not undergo aortopexy, and controls were 3.54, 1.54, and 1.15, respectively. The mean Z-score of the aortopexy group was 21.2. After successful aortopexy, each patient’s LAR decreased to < 1.5. Conclusion: Aortopexy was preferred if the trachea was compressed by the BCA. The LAR is a useful indicator for predicting the therapeutic effect of aortopexy.

    DOI: 10.1007/s00383-021-04985-0

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  10. Long-term outcomes of the partial splenectomy for hypersplenism after portoenterostomy of patients with biliary atresia 査読有り

    Tainaka Takahisa, Hinoki Akinari, Tanaka Yujiro, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Oshima Kazuo, Amano Hizuru, Takimoto Aitaro, Kano Yoko, Uchida Hiroo

    NAGOYA JOURNAL OF MEDICAL SCIENCE   83 巻 ( 4 ) 頁: 765 - 771   2021年11月

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  11. Single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for inguinal hernia with prolapsed ovary 査読有り

    Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Amano Hizuru, Okamoto Masamune, Takimoto Aitaro, Yasui Akihiro, Nakagawa Yoichi, Hinoki Akinari, Uchida Hiroo

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES     2021年10月

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    記述言語:日本語   出版者・発行元:Surgical Endoscopy  

    Background: Most studies reporting the outcomes of laparoscopic ovarian prolapsed hernia operations with large sample sizes are based on intracorporeal closure, while studies on extraperitoneal closure have limited sample sizes. We proactively used the single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) technique and obtained favorable outcomes, which we report in this paper. Methods: We retrospectively reviewed patients who had undergone laparoscopic surgery for inguinal hernia at our institution. They were retrospectively classified into two groups based on the pre- or intraoperative diagnosis of hernia with a prolapsed ovary, namely the prolapse group and the non-prolapse group, respectively. The data were statistically analyzed and p < 0.05 was considered statistically significant. Results: A total of 771 subjects underwent SILPEC during the study period, including 400 girls. Among them, 63 girls were diagnosed with an ovarian prolapsed hernia. SILPEC was successfully performed through a single port in all cases, with a single exception, in whom the forceps was inserted directly through the right lower quadrant to pull up the ovary. The duration of surgery in the prolapse group was not higher than that in the non-prolapse group. During the SILPEC surgery, the ovaries were successfully reverted into the abdominal cavity by external compression of the inguinal area alone in 38 of the 63 patients. In the remaining 25 cases, the ovaries were reverted into the abdominal cavity by external compression of the inguinal area and traction of the round ligament with forceps. None of these cases failed to return to the ovaries. Conclusion: Our study results indicate that SILPEC may be performed safely for the treatment of ovarian prolapsed inguinal hernia. Since the ovary and fallopian tube are close to the internal inguinal ring due to the short round ligament, the procedure requires careful suturing with traction of the round ligament.

    DOI: 10.1007/s00464-021-08777-4

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  12. Factors associated with bleeding after endoscopic variceal ligation in children 査読有り

    Yokoyama Shinya, Ishizu Yoji, Ishigami Masatoshi, Honda Takashi, Kuzuya Teiji, Ito Takanori, Hinoki Akinari, Sumida Wataru, Shirota Chiyoe, Tainaka Takahisa, Makita Satoshi, Yokota Kazuki, Uchida Hiroo, Fujishiro Mitsuhiro

    PEDIATRICS INTERNATIONAL   63 巻 ( 10 ) 頁: 1223 - 1229   2021年10月

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    記述言語:日本語   出版者・発行元:Pediatrics International  

    Background: Endoscopic variceal ligation (EVL) is a widely accepted treatment for esophagogastric varices in patients with portal hypertension (PHT). It is used for urgent treatment and prophylactic treatment of esophagogastric varices in pediatric as well as adult patients. However, major life-threatening adverse events such as early rebleeding can occur. Although early rebleeding after EVL among children and adolescents has been reported, the risk factors remain obscure. This study evaluated the risk factors for early rebleeding after EVL in children and adolescents. Methods: The subjects were children and adolescents (<18 years) with PHT who underwent EVL for esophagogastric varices. Early rebleeding was defined as hematemesis, active bleeding, or blood retention in the stomach, confirmed by esophagogastroduodenoscopy from 2 h to 5 days after EVL. Results: A total of 50 EVL sessions on 22 patients were eligible for this study. There were four episodes of early rebleeding. No other major adverse event has occurred. Multivariate analysis showed that EVL implemented at cardiac varices just below the esophagogastric junction (EGJ), within 5 mm from the EGJ, is the independent factor for a higher risk of early rebleeding: odds ratio 18.2 (95% confidence interval: 1.40–237.0), P = 0.02. Conclusions: Children and adolescents who undergo EVL for cardiac varices just below the EGJ have a higher risk of early rebleeding than those who do not.

    DOI: 10.1111/ped.14614

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  13. Late postoperative complications of congenital biliary dilatation in pediatric patients: a single-center experience of managing complications for over 20 years 査読有り

    Amano Hizuru, Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Tanaka Yujiro, Hinoki Akinari, Kawashima Hiroki, Uchida Hiroo

    SURGERY TODAY   51 巻 ( 9 ) 頁: 1488 - 1495   2021年9月

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    記述言語:日本語   出版者・発行元:Surgery Today  

    Purpose: To investigate late complications after surgery for congenital biliary dilatation (CBD). Methods: We retrospectively reviewed the patients treated for late postoperative complications of extrahepatic bile duct resection with bilioenteric anastomosis for CBD at our hospital between 1999 and 2019. Results: Twenty-seven complications, including bile duct stenosis with (n = 19) or without (n = 3) hepatolithiasis, remnant intrapancreatic bile duct (n = 2), intestinal obstruction (n = 2), and refractory cholangitis (n = 1) were treated in 26 patients. The median age at radical surgery and the initial treatment of complications was 3 years, 2 months and 14 years, 5 months, respectively. The median period from radical surgery to initial treatment of complications was 7 years, 1 month. Before 2013, bile duct stenosis was initially treated with bile duct plasty (n = 11) or hepatectomy (n = 3), and 71.4% (n = 10) of patients needed further treatment; after 2013, double-balloon endoscopic retrograde cholangiography (DBERC) was used (n = 8), and 25% (n = 2) of patients needed further treatment. Patients with remnant intrapancreatic bile duct, intestinal obstruction, and refractory cholangitis required surgery. Conclusion: Long-term follow-up is necessary after surgery for congenital biliary dilatation. DBERC is thus considered to be useful for bile duct stenosis management.

    DOI: 10.1007/s00595-021-02238-0

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  14. 集学的治療により根治切除し得た後腹膜横紋筋肉腫の13歳女児例 査読有り

    加藤 大幾, 牧田 智, 植村 則久, 仲野 聡, 新井 利幸, 宮島 雄二

    日本小児外科学会雑誌   57 巻 ( 5 ) 頁: 878 - 883   2021年8月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本小児外科学会  

    <p>症例は13歳女児で,左下腹部痛を主訴に受診した.腹部CTで骨盤内に130 mm大の腫瘍を認め,左尿管および左腸骨動静脈を巻き込んでいた.腹腔鏡補助下生検で横紋筋肉腫と診断した.化学放射線療法後に腫瘍縮小を認めたため根治切除の方針とした.左総腸骨動静脈および左尿管の合併切除を伴う腫瘍摘出術を施行し,左総腸骨動脈は人工血管を用いて再建し,左尿管は右尿管に吻合する交叉性尿管尿管吻合を施行した.術後経過は良好で術後化学療法を施行し,現在術後3年3か月経過したが無再発生存中である.左尿管および左腸骨動静脈浸潤を伴う後腹膜原発横紋筋肉腫に対して,集学的治療により良好な予後が得られている症例を経験した.主要血管や尿管の合併切除を要するような横紋筋肉腫においても,各領域の専門家と連携して治療することで安全にかつ有用な治療を施行できると考える.</p>

    DOI: 10.11164/jjsps.57.5_878

    CiNii Research

  15. 胆管穿孔をきたした先天性胆道拡張症に対して,腹腔鏡下に一期的根治術を施行した1例 査読有り

    石井 宏樹, 牧田 智, 安井 昭洋, 滝本 愛太朗, 横田 一樹, 住田 亙, 田井中 貴久, 城田 千代栄, 内田 広夫

    日本小児外科学会雑誌   57 巻 ( 5 ) 頁: 855 - 859   2021年8月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本小児外科学会  

    <p>症例は1歳9か月女児,嘔吐と発熱を主訴に前医受診,先天性胆道拡張症の診断で入院となった.入院6日目に胆道穿孔が明らかになり当科に転院し,緊急手術を行った.手術では総胆管と胆囊管合流部に約2 cm大の穿孔部を認めた.胆道ドレナージや穿孔部の修復は極めて困難であり,腹腔鏡下に一期的根治術を施行した.また,肝門部の左右胆管に強い膜様狭窄を認め胆管形成も施行した.合併症なく経過し,術後10日目に軽快退院となった.胆道穿孔をきたした先天性胆道拡張症に対する治療は二期的手術が推奨されている.一方,近年は一期的根治術が有用であるという報告が散見されるが,ほとんどは開腹手術である.今回,我々は腹腔鏡下に一期的根治術を施行した1例を経験した.胆道穿孔症例でも,腹腔鏡下胆道拡張症手術に習熟した施設において,全身状態が良好な症例であれば腹腔鏡下での一期的手術は有用であると考える.</p>

    DOI: 10.11164/jjsps.57.5_855

    CiNii Research

  16. Development of a novel diagnostic system for bile duct cancer using urinary metabolites. 査読有り

    Amano Hizuru, Hinoki Akinari, Uchida Hiroo, Yokota Kazuki, Ishigaki Takashi, Sakairi Minoru, Abe Mayumi, Terui Yasushi, Oda Hirohisa, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Takimoto Aitaro, Okamoto Masamune, Yasui Akihiro, Nakagawa Yoichi

    CANCER RESEARCH   81 巻 ( 13 )   2021年7月

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    記述言語:日本語  

    Web of Science

  17. Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation (vol 37, pg 229, 2021) 査読有り

    Takimoto Aitaro, Sumida Wataru, Amano Hizuru, Shirota Chiyoe, Tainaka Takahisa, Yokota Kazuki, Makita Satoshi, Yasui Akihiro, Kanou Yoko, Hinoki Akinari, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 6 ) 頁: 835 - 835   2021年6月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    A correction to this paper has been published: https://doi.org/10.1007/s00383-021-04873-7.

    DOI: 10.1007/s00383-021-04873-7

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  18. NOVEL BIOMARKER DISCOVERY FOR CHILDHOOD RHABDOMYOSARCOMA USING URINARY METABOLITES 査読有り

    Amano Hizuru, Hinoki Akinari, Uchida Hiroo, Yokota Kazuki, Ishigaki Takashi, Sakairi Minoru, Abe Mayumi, Terui Yasushi, Oda Hirohisa, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Takimoto Aitaro, Kano Yoko, Okamoto Masamune, Yasui Akihiro, Nakagawa Yoichi

    PEDIATRIC BLOOD & CANCER   68 巻   頁: S46 - S46   2021年6月

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    記述言語:日本語  

    Web of Science

  19. Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation 査読有り

    Shirota Chiyoe, Kawashima Hiroki, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Amano Hizuru, Takimoto Aitaro, Hinoki Akinari, Uchida Hiroo

    SCIENTIFIC REPORTS   11 巻 ( 1 ) 頁: 11052   2021年5月

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    記述言語:日本語   出版者・発行元:Scientific Reports  

    Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

    DOI: 10.1038/s41598-021-90550-7

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  20. Urinary biomarkers for monitoring treatment response in neuroblastoma patients. 査読有り

    Amano Hizuru, Hinoki Akinari, Uchida Hiroo, Yokota Kazuki, Ishigaki Takashi, Sakairi Minoru, Abe Mayumi, Takahashi Yoshiyuki, Narita Atsushi, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Takimoto Aitaro, Kano Yoko, Yasui Akihiro, Okamoto Masamune, Nakagawa Yoichi

    JOURNAL OF CLINICAL ONCOLOGY   39 巻 ( 15 )   2021年5月

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  21. 手術経験数による腹腔鏡下胆道閉鎖症手術成績の検討 査読有り

    藏野 結衣, 城田 千代栄, 檜 顕成, 田井中 貴久, 住田 亙, 横田 一樹, 牧田 智, 滝本 愛太朗, 内田 広夫

    日本小児外科学会雑誌   57 巻 ( 3 ) 頁: 596 - 599   2021年4月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本小児外科学会  

    <p>【目的】腹腔鏡下胆道閉鎖症手術(腹腔鏡下肝門部空腸吻合術)の執刀を熟練した術者に限定する必要性の有無を明らかにすることを目的として,自施設での治療成績を後方視的に検討した.</p><p>【方法】2014年4月から2018年8月の期間中,胆道閉鎖症に対して当院で腹腔鏡下肝門部空腸吻合術を施行した35例を対象とした.腹腔鏡下肝門部空腸吻合術を5例以上経験した術者が執刀した患者(A群:12例)と執刀経験4例以下の術者が執刀した患者(B群:23例)とに分類し,手術,術後経過と術後6か月,1年,2年の各時点における無黄疸自己肝生存についてそれぞれ統計学的解析を行い比較,検討した.</p><p>【結果】A群とB群で手術日齢,体重,出血量,ドレーン抜去時期,経口開始時期に有意差は認められなかったが,手術時間はA群が有意に短かった(<i>p</i>=0.0049).無黄疸自己肝生存率は術後6か月(A群58.3%,B群60.9%,<i>p</i>=0.506),術後1年(A群66.7%,B群65.2%,<i>p</i>=0.932),術後2年(A群58.3%,B群56.5%,<i>p</i>=0.918)でいずれの時点でも有意差は認められなかった.</p><p>【結論】今回の検討では,腹腔鏡下胆道閉鎖症手術に熟練した術者の指導の下では,執刀経験量による減黄率の有意な差は認められなかった.</p>

    DOI: 10.11164/jjsps.57.3_596

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  22. 腹壁破裂を合併した結腸閉鎖症に対して,器械吻合による一期的結腸吻合後sutureless腹壁閉鎖を施行した1例 査読有り

    千馬 耕亮, 田中 裕次郎, 城田 千代栄, 田井中 貴久, 住田 亙, 横田 一樹, 大島 一夫, 牧田 智, 内田 広夫

    日本小児外科学会雑誌   57 巻 ( 1 ) 頁: 22 - 26   2021年2月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本小児外科学会  

    <p>症例は36週4日,2,370 gで出生した腹壁破裂の女児.出生後,脱出した腸管を確認すると結腸閉鎖を合併していた.その口側盲端にはpinholeがあいていたが腹腔内の汚染はなく,一旦サイロ造設し翌日結腸閉鎖に対する手術を施行した.腸管を洗浄しながら癒着剥離を行い結腸閉鎖部の口側・肛門側を確認し,血流の十分ある部分で自動縫合器による機能的端々吻合を行った.腸管は浮腫が強く腹腔内に還納できなかったため,再度サイロを造設して手術を終了した.その後1週間かけて腸管を腹腔内に還納し,第9生日にsutureless法で腹壁閉鎖を行った.術後経過は良好で,第19生日にfull feedingとなり,第32生日に退院した.結腸閉鎖合併腹壁破裂症例では人工肛門造設が一般的であるが,自動縫合器を用いることで口径差を気にせず吻合を行うことができるため,有効な方法と考えられた.</p>

    DOI: 10.11164/jjsps.57.1_22

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  23. Identification of novel neuroblastoma biomarkers in urine samples 査読有り

    Yokota Kazuki, Uchida Hiroo, Sakairi Minoru, Abe Mayumi, Tanaka Yujiro, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Oshima Kazuo, Makita Satoshi, Amano Hizuru, Hinoki Akinari

    SCIENTIFIC REPORTS   11 巻 ( 1 ) 頁: 4055   2021年2月

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    記述言語:日本語   出版者・発行元:Scientific Reports  

    Urine is a complex liquid containing numerous small molecular metabolites. The ability to non-invasively test for cancer biomarkers in urine is especially beneficial for screening child patients. This study attempted to identify neuroblastoma biomarkers by comprehensively analysing urinary metabolite samples from children. A total of 87 urine samples were collected from 54 participants (15 children with neuroblastoma and 39 without cancer) and used to perform a comprehensive analysis. Urine metabolites were extracted using liquid chromatography/mass spectrometry and analysed by Metabolon, Inc. Biomarker candidates were extracted using the Wilcoxon rank sum test, random forest method (RF), and orthogonal partial least squares discriminant analysis (OPLS-DA). RF identified three important metabolic pathways in 15 samples from children with neuroblastoma. One metabolite was selected from each of the three identified pathways and combined to create a biomarker candidate (3-MTS, CTN, and COR) that represented each of the three pathways; using this candidate, all 15 cases were accurately distinguishable from the control group. Two cases in which known biomarkers were negative tested positive using this new biomarker. Furthermore, the predictive value did not decrease in cases with a low therapeutic effect. This approach could be effectively applied to identify biomarkers for other cancer types.

    DOI: 10.1038/s41598-021-83619-w

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  24. Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation 査読有り

    Takimoto Aitaro, Sumida Wataru, Amano Hizuru, Shirota Chiyoe, Tainaka Takahisa, Yokota Kazuki, Makita Satoshi, Yasui Akihiro, Kanou Yoko, Hinoki Akinari, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 2 ) 頁: 229 - 234   2021年2月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: This study aimed to investigate the negative effects of intestinal obstruction for jaundice-free native liver survival after Kasai portoenterostomy (PE) for biliary atresia (BA). Methods: We retrospectively reviewed the records of patients who underwent PE for BA between 2006 and 2019. We evaluated the postoperative morbidity of intestinal obstruction for up to 2 years after PE and the effects of intestinal obstruction on jaundice-free native liver survival. On the basis of their initial operation, patients were divided into open portoenterostomy (Open-PE) and laparoscopic portoenterostomy (Lap-PE) groups, and morbidity was compared. Results: Of the 87 patients reviewed, 6 (6.9%) patients developed postoperative intestinal obstruction and underwent surgery to relieve the obstruction. The morbidity of early postoperative intestinal obstruction was 1.68 per 10,000 person days. The jaundice-free native liver survival rate among patients who once achieved jaundice-free status after PE was significantly lower in the patients with intestinal obstruction compared to in those without intestinal obstruction (0% vs. 73.8%; RR = 3.81, p = 0.007). No significant differences were seen in postoperative intestinal obstructions between the Open-PE and Lap-PE groups (p = 0.242). Conclusions: Intestinal obstruction negatively impact jaundice-free native liver survival, even in patients who once achieved jaundice-free status after PE for BA.

    DOI: 10.1007/s00383-020-04807-9

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  25. Thoracoscopic surgery for congenital lung cysts: an attempt to limit pulmonary resection in cases of lesions involving multiple lobes 査読有り

    Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Amano Hizuru, Hinoki Akinari, Ono Yasuyuki, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 2 ) 頁: 213 - 221   2021年2月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Although we generally perform thoracoscopic lobectomy for congenital lung cysts (CLCs), we recently began performing thoracoscopic-limited pulmonary resection (segmentectomy or small partial lung resection) on relatively small lesions and on lesions involving multiple lobes. Our study aimed to determine the therapeutic outcomes of thoracoscopic CLC surgery. Methods: We retrospectively reviewed patients aged ≤ 18 years who underwent their first CLC surgery at our facility between 2013 and 2020. Results: A comparison between patients < 4 months old and those ≥ 4 months old showed no significant difference in operating time or incidence of complications. Blood loss volume (mL/kg) was significantly greater in patients < 4 months old and in patients who had undergone semi-urgent or urgent surgery. Operating time and postoperative complications were not increased in semi-urgent or urgent surgeries. There was no significant difference in operating time, blood loss volume, or postoperative complications between patients with a preoperative history of pneumonia and patients with no such history. Conclusion: In most patients, thoracoscopic surgery for CLC was safely performed. Limited pulmonary resection is considered difficult to perform thoracoscopically in children, but can be safely performed using new devices and navigation methods. Level of evidence: III.

    DOI: 10.1007/s00383-020-04793-y

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  26. Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation 査読有り

    Tanaka Yujiro, Tainaka Takahisa, Hinoki Akinari, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Oshima Kazuo, Makita Satoshi, Amano Hizuru, Takimoto Aitaro, Kano Yoko, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   37 巻 ( 2 ) 頁: 235 - 240   2021年2月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: One of the main causes of stricture at hepaticojejunostomy site after surgery for congenital biliary dilatation is inflammation or infection associated with bile leak. The aim of this study was to determine the risk factors and outcomes of bile leak after laparoscopic surgery. Methods: We retrospectively reviewed the demographics and outcomes of patients who underwent laparoscopic surgery for congenital biliary dilatation between September 2013 and December 2019. Data from patients with bile leak were compared to data from patients without bile leak. Results: Fourteen of 78 patients had bile leak. Hepatic duct diameter at anastomosis was the only risk factor of bile leak. Patients with the diameter ≤ 10 mm had higher incidence of bile leak than in patients with the diameter > 10 mm (P = 0.0023). Among them, bile leak occurred more frequently in patients operated on by non-qualified surgeons based on the Japan Society for Endoscopic Surgery endoscopic surgical skill qualification system than by qualified surgeons (P = 0.027). However, none of the patients with bile leak developed anastomotic stricture afterwards. Conclusion: Although good technical skill is necessary to avoid bile leak in narrow hepatic duct cases (≤ 10 mm), slight bile leak may not result in anastomotic stricture.

    DOI: 10.1007/s00383-020-04791-0

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  27. 先天性胆道拡張症の晩期合併症についての検討 査読有り

    城田 千代栄, 天野 日出, 檜 顕成, 住田 亙, 横田 一樹, 牧田 智, 岡本 眞宗, 滝本 愛太朗, 安井 昭洋, 高田 瞬也, 中川 洋一, 前田 拓也, 内田 広夫

    日本膵・胆管合流異常研究会プロシーディングス   44 巻 ( 0 ) 頁: 50 - 51   2021年

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    記述言語:日本語   出版者・発行元:日本膵・胆管合流異常研究会  

    DOI: 10.34410/jspbm.44.0_50

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  28. 先天性胆道拡張症において術前MRI 画像による胆管狭窄部位の予測と術中胆管形成の検討 査読有り

    中川 洋一, 内田 広夫, 檜 顕成, 城田 千代栄, 住田 亙, 横田 一樹, 牧田 智, 岡本 眞宗, 滝本 愛太朗, 安井 昭洋, 高田 舜也, 前田 拓也

    日本膵・胆管合流異常研究会プロシーディングス   44 巻 ( 0 ) 頁: 72 - 73   2021年

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    記述言語:日本語   出版者・発行元:日本膵・胆管合流異常研究会  

    DOI: 10.34410/jspbm.44.0_72

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  29. A novel Lugol's iodine staining technique to visualize the upper margin of the surgical anal canal intraoperatively for Hirschsprung disease: a case series 査読有り

    Yokota Kazuki, Amano Hizuru, Kudo Toyoki, Yamamura Takeshi, Tanaka Yujiro, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Takimoto Aitaro, Nakamura Masanao, Fujishiro Mitsuhiro, Hinoki Akinari, Uchida Hiroo

    BMC SURGERY   20 巻 ( 1 ) 頁: 317   2020年12月

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    記述言語:日本語   出版者・発行元:BMC Surgery  

    Background: In cases of Hirschsprung disease, complete and reproducible resection of the aganglionic bowel is ideal to achieve good postoperative bowel function. Reliable identification of the upper margin of the surgical anal canal, which is the squamous-columnar junction, is necessary during transanal pull-through. Here, we describe a novel staining technique using Lugol’s iodine stain to visualize the upper margin of the surgical anal canal. Methods: Lugol’s iodine staining was performed in five patients with Hirschsprung disease treated using a single-stage laparoscopic transanal pull-through modified Swenson procedure. In two of these patients, endocytoscopic observation with ultra-high magnification was performed using methylene blue and crystal violet to mark the border of the squamous epithelium at 1 week before surgery. The alignment between the incisional line, which was revealed using Lugol’s iodine staining and endocytoscopic marking, was evaluated. Complications, including postoperative bowel dysfunction, were evaluated. Results: In all cases, Lugol’s iodine staining produced a well-demarcated line. The endocytoscopic marking of the upper margin of the surgical anal canal was aligned with the line revealed by Lugol’s iodine staining. There were no complications associated with the transanal pull-through procedure, including postoperative bowel dysfunction. Conclusions: Lugol’s iodine staining could be a safe and practical method to visualize the upper margin of the surgical anal canal intraoperatively. This finding may be useful for surgeons to make a consistent removal of the aganglionic bowel during surgery for Hirschsprung disease.

    DOI: 10.1186/s12893-020-00986-3

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  30. Laparoscopic Kasai portoenterostomy is advantageous over open Kasai portoenterostomy in subsequent liver transplantation 査読有り

    Shirota Chiyoe, Murase Naruhiko, Tanaka Yujiro, Ogura Yasuhiro, Nakatochi Masahiro, Kamei Hideya, Kurata Nobuhiko, Hinoki Akinari, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Oshima Kazuo, Uchida Hiroo

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES   34 巻 ( 8 ) 頁: 3375 - 3381   2020年8月

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    記述言語:日本語   出版者・発行元:Surgical Endoscopy  

    Background: Native liver survival after laparoscopic Kasai portoenterostomy (Lap-PE) for biliary atresia (BA) is controversial. We examined whether a jaundice-free native liver survival rate is comparable between conventional Kasai portoenterostomy (Open-PE) and Lap-PE. Then, the impact of the two types of PE on subsequent living-donor liver transplantation (LTx) was addressed in this study. Methods: The jaundice-free rate in 1- and 2-year-old patients who underwent Open-PE and Lap-PE from January 2006 to December 2017 was investigated. Additionally, perioperative data (duration from the start of surgery to the completion of hepatectomy and others) of patients aged 2 years or younger who underwent LTx after either Open-PE or Lap-PE from 2006 to 2017 were evaluated. Results: Thirty-one (67%) out of 46 Open-PE patients and 23 (77%) out of 30 Lap-PE patients showed native liver survival with jaundice-free status at 1 year of age (p = 0.384); 29 (63%) out of 46 Open-PE patients and 19 (70%) out of 27 Lap-PE patients showed native liver survival with jaundice-free status at 2 years of age (p = 0.524); there were no significant differences. Additionally, there were 37 LTx cases after PE within 2 years of birth, including 29 Open-PE and 8 Lap-PE cases. The patients in the Lap-PE group had fewer adhesions and significantly shorter durations of surgery up to the completion of the recipient’s hepatectomy and durations of post-LTx hospital stay compared to the Open-PE group. There were no differences in blood loss or duration of stay in intensive care unit between the Lap-PE and Open-PE groups. Conclusions: Jaundice-free native liver survival rate has been comparable between Open-PE and Lap-PE. Lap-PE resulted in fewer adhesions, contributing to better outcomes of subsequent LTx compared to Open-PE.

    DOI: 10.1007/s00464-019-07108-y

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  31. 単孔式腹腔鏡補助下手術が診断・治療に有用であった回腸重複腸管穿孔の1例 査読有り

    加藤 大幾, 関 崇, 岡本 眞宗, 牧田 智, 新井 利幸

    日本小児外科学会雑誌   56 巻 ( 3 ) 頁: 330 - 334   2020年6月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本小児外科学会  

    <p>症例は6歳男児.腹痛を主訴に受診.腹部CTで腹腔内遊離ガス像を認めたが穿孔部位を同定することはできなかった.穿孔性腹膜炎の診断で緊急手術を施行した.臍に逆Y字切開(以下,Benz切開)をおき,multi-channel port(5 mm port 2本)を装着して腹腔鏡で腹腔内を観察した.回腸に炎症所見を認め創外へ引き出すと,回腸末端から40 cm口側に3 cm大の囊胞状構造を認め,基部で穿孔していた.回腸重複腸管穿孔と診断して,小腸部分切除を施行した.今回,術前診断が困難であった重複腸管穿孔というまれな疾患に対して,創を延長することなく単孔式腹腔鏡補助下手術を完遂した.Benz切開を用いた単孔式腹腔鏡補助下手術は,小児における急性腹症の診断,治療を行う上で有用であった.</p>

    DOI: 10.11164/jjsps.56.3_330

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  32. Safe diagnostic management of malignant mediastinal tumors in the presence of respiratory distress: a 10-year experience 査読有り

    Tanaka Tomoko, Amano Hizuru, Tanaka Yujiro, Takahashi Yoshiyuki, Tajiri Tatsuro, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Tani Yukiko, Hinoki Akinari, Uchida Hiroo

    BMC PEDIATRICS   20 巻 ( 1 ) 頁: 292   2020年6月

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    記述言語:日本語   出版者・発行元:BMC Pediatrics  

    Background: The fundamental treatment for patients with pediatric malignant mediastinal tumors is chemotherapy. Therefore, accurate diagnosis is essential for selecting the appropriate chemotherapeutic regimen. However, malignant mediastinal tumors occasionally cause respiratory distress, and biopsies under general anesthesia are dangerous for such patients as invasive mechanical ventilation can aggravate airway obstruction caused by mass effect. In this study, we reviewed our 10-year diagnostic experience to evaluate the efficacy of our practices and confirm a safe diagnostic protocol for future patients. Methods: We retrospectively reviewed medical records of children with malignant mediastinal tumors diagnosed at Nagoya University Hospital from 2007 to 2018 who demonstrated respiratory distress. Respiratory distress included dyspnea, massive pleural effusion, wheezing, and hypoxemia owing to tumors. Data on sex, age at onset, primary symptoms, location of tumor, management strategy (especially the method of diagnosis and definitive diagnosis), clinical course, prognosis during the acute phase (within 3 months from the onset of respiratory symptoms), and long-term outcome were collected. Results: Twelve pediatric patients met the review criteria. There were seven anterior mediastinal tumors and five posterior mediastinal tumors. All anterior mediastinal tumors were diagnosed via bone marrow smear, thoracentesis, or core needle biopsy while maintaining spontaneous breathing. Regarding posterior tumors, two patients were diagnosed via a core needle biopsy and lymph node excisional biopsy under spontaneous breathing. Two cases were initially diagnosed solely using tumor markers. One patient with severe tracheal compression underwent tumor resection with extracorporeal membrane oxygenation stand-by. No patient died of diagnostic procedure-related complications. Conclusions: In 11 of the 12 cases reviewed, safe and accurate tumor diagnosis was accomplished without general anesthesia. A diagnostic strategy without general anesthesia considering the tumor location proved to be useful.

    DOI: 10.1186/s12887-020-02183-w

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  33. 術中膵管損傷に対して内視鏡的に膵管ステントを挿入した1例 査読有り

    城田 千代栄, 田井中 貴久, 住田 亙, 横田 一樹, 牧田 智, 天野 日出, 滝本 愛太朗, 安井 昭洋, 石井 宏樹, 檜 顕成, 内田 広夫

    日本膵・胆管合流異常研究会プロシーディングス   43 巻 ( 0 ) 頁: 84 - 85   2020年

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    記述言語:日本語   出版者・発行元:日本膵・胆管合流異常研究会  

    DOI: 10.34410/jspbm.43.0_84

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  34. 小児腹腔鏡手術における肝内胆管形成術 査読有り

    田井中 貴久, 城田 千代栄, 住田 亙, 横田 一樹, 牧田 智, 滝本 愛太朗, 安井 昭洋, 石井 宏樹, 檜 顕成, 内田 広夫

    日本膵・胆管合流異常研究会プロシーディングス   43 巻 ( 0 ) 頁: 36 - 36   2020年

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    記述言語:日本語   出版者・発行元:日本膵・胆管合流異常研究会  

    DOI: 10.34410/jspbm.43.0_36

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  35. Identification and Validation of Novel Non-invasive Biomarkers in Patient Urine Samples for Diagnosis of New and Recurrent Neuroblastoma 査読有り

    Yokota Kazuki, Uchida Hiroo, Hinoki Akinari, Sakairi Minoru, Abe Mayumi, Tanaka Yujiro, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Oshima Kazuo, Makita Satoshi, Takimoto Aitaro, Kano Yoko, Inada Kosuke

    PEDIATRIC BLOOD & CANCER   66 巻   頁: S106 - S106   2019年12月

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    記述言語:日本語  

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  36. Efficacy of and prognosis after steroid pulse therapy in patients with poor reduction of jaundice after laparoscopic Kasai portoenterostomy 査読有り

    Tanaka Yujiro, Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Oshima Kazuo, Makita Satoshi, Tanaka Tomoko, Tani Yukiko, Chiba Kosuke, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   35 巻 ( 10 ) 頁: 1059 - 1063   2019年10月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: High-dose postoperative steroid therapy after Kasai portoenterostomy is reported to improve jaundice clearance and a strong anti-inflammatory activity might prevent fibrous tissue formation which is often observed at the porta hepatis in revision surgery. We started steroid pulse therapy for the patients with cessation of decrease in jaundice and aimed to evaluate the efficacy in this study. Methods: The demographics and outcomes of patients who underwent laparoscopic Kasai portoenterostomy and received steroid pulse therapy within 2 months postoperatively between September 2014 and December 2018 were retrospectively reviewed; the therapy was determined successful when the serum total bilirubin level decreased to or below two-thirds of the pre-therapy level after 2 weeks. Patient data in the successful group were compared with those in the unsuccessful group. Results: Steroid pulse therapy was successful in seven of 16 patients (43.8%). The percentage of patients whose serum total bilirubin level decreased to normal was significantly higher in the successful group at 3 months (85.7% vs. 11.1%, P = 0.0028) and after all (100% vs. 33.3%, P = 0.011). Conclusions: Steroid pulse therapy was effective for some patients. Unsuccessful cases may have little chances of jaundice clearance; revision Kasai portoenterostomy would be a good option.

    DOI: 10.1007/s00383-019-04537-7

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  37. Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome 査読有り

    Shirota Chiyoe, Tanaka Yujiro, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Oshima Kazuo, Tanaka Tomoko, Tani Yukiko, Uchida Hiroo

    PEDIATRIC SURGERY INTERNATIONAL   35 巻 ( 10 ) 頁: 1071 - 1076   2019年10月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Thoracoscopic repair can be safely performed in most types of congenital esophageal atresia (EA), including in patients with long gap EA or very low birth weight. Accordingly, we performed single- or multistage thoracoscopic repair for various EA types. We aimed to report our therapeutic strategy for thoracoscopic radical surgery for treating EA and its outcome. Methods: Outcomes of radical surgeries for treating congenital EA at our institute from 2013 to 2018 were retrospectively evaluated. Results: Thirty-eight radical surgeries were evaluated: 3 Gross type-A, 1 type-B, 30 type-C, 1 type-D, and 3 type-E. The cervical approach was performed in 5 cases and thoracoscopic esophageal anastomosis in 33, including 26 single-stage (all type-C) and 7 multistage surgeries (3 type-A, 3 type-C, and 1 type-D). There were no cases of thoracotomies or intraoperative thoracoscopic surgery complications. Three cases of minor leakage were conservatively resolved. Three postoperative chylothorax surgeries (9%) and seven balloon dilatations (21%) for anastomotic stenosis were performed. Conclusion: Thoracoscopic radical surgery for treating EA, including single- and multistage procedures, can be performed, except in type-E cases or when the end of the proximal esophagus is located higher than the clavicle.

    DOI: 10.1007/s00383-019-04541-x

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  38. Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula 査読有り

    Shirota Chiyoe, Suzuki Keisuke, Uchida Hiroo, Kawashima Hiroshi, Hinoki Akinari, Tainaka Takahisa, Sumida Wataru, Murase Naruhiko, Oshima Kazuo, Chiba Kosuke, Makita Satoshi, Tanaka Yujiro

    PEDIATRIC SURGERY INTERNATIONAL   34 巻 ( 10 ) 頁: 1117 - 1120   2018年10月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Anovestibular fistula (AVF) is the most common type of anorectal malformation in females. Delayed anorectoplasty with fistula dilatation is commonly performed during infancy; however, we have been actively performing anorectoplasty in neonates. We report the surgical complications and postoperative defecation function associated with single-stage anorectoplasty performed in neonates. Methods: Patients who underwent surgery for AVF between 2007 and 2017 at two institutions were retrospectively studied. The operation time, amount of bleeding, time to start oral intake, perioperative complications, and Kelly’s score were compared among patients who underwent surgery as neonates and those who underwent surgery as infants. Results: Eighteen neonates and 17 infants underwent anterior sagittal anorectoplasty. The median operation time and time to start oral intake were significantly shorter in the neonatal group (72 min; 3 days, respectively) than in the infant group (110 min, p = 0.0002; 5 days, p = 0.0024, respectively). Postoperative wound disruption was significantly more frequent in the infant group. Of the ten patients each in the neonatal and infant groups, there was no significant difference in Kelly’s score at age ≥ 4 years. Conclusion: Single-stage anorectoplasty in neonates with AVF can be feasibly performed and does not impair postoperative defecation function. Levels of evidence: III.

    DOI: 10.1007/s00383-018-4324-3

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  39. Long-term outcomes and complications after laparoscopic-assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation 査読有り

    Tainaka Takahisa, Uchida Hiroo, Tanaka Yujiro, Hinoki Akinari, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Oshima Kazuo, Chiba Kosuke, Ishimaru Tetsuya, Kawashima Hiroshi

    PEDIATRIC SURGERY INTERNATIONAL   34 巻 ( 10 ) 頁: 1111 - 1115   2018年10月

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    記述言語:日本語   出版者・発行元:Pediatric Surgery International  

    Purpose: Laparoscopic-assisted anorectoplasty (LAARP) is a minimally invasive procedure in which the levator ani muscle is left to potentially improve postoperative fecal continence. This study aimed to retrospectively evaluate postoperative complications and long-term outcomes of fecal continence after LAARP and compare them to those after posterior sagittal anorectoplasty (PSARP). Methods: Forty-five male patients with high and intermediate anorectal malformation (aged ≥ 4 years) who underwent LAARP or PSARP (LAARP 29, PSARP 16) from 1999 to 2013 were included. Postoperative complications and postoperative fecal continence were retrospectively evaluated and compared. Postoperative complications were also compared before and after introducing a urethroscope during fistula resection. Results: Complications after LAARP and PSARP were seen in 12 vs. 2 cases (p = 0.09) of mucosal prolapse and in 9 vs. 1 case (p = 0.07) of posterior urethral diverticulum (PUD), respectively. The incidence of PUD decreased after introduction of a urethroscopy from 40% in 8/20 cases to 11% in 1/9 cases. No significant difference was found in terms of fecal continence in both groups. Conclusion: Through our study, greater improvement of postoperative fecal continence after LAARP has not been shown. LAARP was at higher risk for mucosal prolapse and PUD. However, precise dissection of the urethral fistula could be performed after the introduction of urethroscopy.

    DOI: 10.1007/s00383-018-4323-4

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  40. Risk factors for thoracic and spinal deformities following lung resection in neonates, infants, and children 査読有り

    Makita Satoshi, Kaneko Kenitiro, Ono Yasuyuki, Uchida Hiroo

    SURGERY TODAY   47 巻 ( 7 ) 頁: 810 - 814   2017年7月

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    記述言語:日本語   出版者・発行元:Surgery Today  

    Purpose: We aimed to identify the risk factors for thoracic and spinal deformities following lung resection during childhood and to elucidate whether thoracoscopic surgery reduces the risk of complications after lung resection. Methods: We retrospectively examined the medical records of all pediatric patients who underwent lung resection for congenital lung disease at our institution between 1989 and 2014. Results: Seventy-four patients underwent lung resection during the study period and were followed-up. The median age of the patients at the time of surgery was 5 months (range 1 day–13 years), and 22 were neonates. Thoracotomy and thoracoscopy were performed in 25 and 49 patients, respectively. Thoracic or spinal deformities occurred in 28 of the 74 patients (37%). Univariate analyses identified thoracotomy, being a neonate (age: <1 month) at the time of surgery, and being symptomatic at the time of surgery as risk factors for these deformities. However, a multivariate analysis indicated that only thoracotomy and being a neonate were risk factors for deformities. Conclusions: Thoracoscopic surgery reduced the risk of thoracic and spinal deformities following lung resection in children. We suggest that, where possible, lung resection should be avoided until 2 or 3 months of age.

    DOI: 10.1007/s00595-016-1434-1

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▼全件表示

科研費 3

  1. 小児がんの診断治療に資する新規蛍光プローブの開発研究

    研究課題/研究課題番号:21K08640  2021年4月 - 2024年3月

    科学研究費助成事業  基盤研究(C)

    城田 千代栄, 浦野 泰照, 神谷 真子, 内田 広夫, 檜 顕成, 田井中 貴久, 住田 亙, 牧田 智, 横田 一樹, 滝本 愛太朗, 安井 昭洋, 岡本 眞宗

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    担当区分:研究分担者 

    小児がんは発見時にすでに進行していることが多く、遠隔転移症例の治療法の確立は喫緊の課題である。遠隔転移巣を確実に手術で摘出できれば患児の予後は劇的に改善するが、現時点では術中に微小転移巣を同定する方法がなく完全切除が難しいため、繰り返し手術が必要となることもある。そこで、特定の分子と反応すると分子構造が変化して強い蛍光を発したり、蛍光の色調が変化したりする機能性分子であり、生理活性物質の動態をリアルタイムに観測する研究ツールである蛍光プローブに着目した。本研究では、術中に迅速に簡便に小児がんの検出が可能な蛍光プローブの開発を行う。

  2. 組織再生を目指したペプチドによる材料表面設計の研究

    研究課題/研究課題番号:21K16379  2021年4月 - 2023年3月

    科学研究費助成事業  若手研究

    牧田 智

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    担当区分:研究代表者 

    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    現在、外科手術で用いられている非生体吸収性の補強材料は、強固で癒着防止の機能があるが、違和感や疼痛があったり、異物として感染源となったり、成長によって位置がずれるという欠点がある。一方で生体吸収性補強材の場合は、異物反応を起こさない強みがあるが、機械的特性が不十分だったり、非選択的な接着性により重要な臓器への癒着が起こるなどの課題がある。
    このような課題が生じる要因として、材料周囲の細胞に対する制御が不十分であると考え、本研究では、細胞の接着・増殖・分化の制御に関わる細胞外マトリックスタンパク質に着目し、その配列中の機能部位であるペプチドを新規アプローチとして考えた。

  3. DDS型光吸収超分子を用いた光温熱治療による難治性小児肺がん治療

    研究課題/研究課題番号:19K20708  2019年4月 - 2021年3月

    科学研究費助成事業  若手研究

    牧田 智

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    担当区分:研究代表者 

    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    小児固形がんは、原発浸潤巣・転移巣の適切な治療により予後を著明に改善できることが知られている。申請者は、診断と治療の一期的施行(セラノスティクス)を可能とした新しいDDS(ドラッグデリバリーシステム)型薬剤であるICGラクトソームが浸潤性がんモデル動物の病巣に選択的に集積することを証明し、ICGラクトソームの近赤外光吸収を利用した温熱作用によってがん病巣を縮退させることに成功した。本研究では、ICGラクトソームを用いた光温熱治療によるがん転移巣の治療技術を確立し、がん病巣の根治を目指す。
    研究代表者はすでに発光遺伝子を組み込んだ神経芽腫細胞を用いた後腹膜浸潤の同所性病態モデルマウスを確立し、ICGラクトソームによる蛍光イメージングならびに近赤外光照射による光温熱のよる腫瘍縮退が誘導できることを確認している。神経芽腫モデルにおいてICGラクトソームによる蛍光イメージングならびに近赤外光温熱による腫瘍縮退の誘導を確認しつつ、骨肉腫肺転移モデル確立を目指した。
    腫瘍にICGmが選択的に集積していた.ICGmは投与後72時間で最も腫瘍内へ集積し、4日目には腫瘍皮膜へ移動して徐々に排泄されていくことが示された。
    小児「がん」は小児病死原因の第1位であり、他臓器浸潤を認めることが多く、従来的な治療(外科手術・化学療法・放射線療法)での完全除去は非常に難しい。一方で、浸潤・転移巣を含めて完全に取り除くことができれば、予後が改善することが知られている。
    研究代表者らは、ドラッグデリバリーシステムを用いた選択的な光温熱治療による浸潤性がんを除去する治療技術を確立している。
    本研究課題では、神経芽腫同所性病態モデルでのICGラクトソームの有効性を検証した。実臨床で根治の難しい骨肉腫肺転移モデル動物を作製できた。