Faculty Profiles - UCHIDA Hiroo

Papers - UCHIDA Hiroo

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天野日出, 木村和恵, 今井佑太, 加藤竜司, 中澤温子, 城田千代栄, 滝本愛太朗, 住田亙, 牧田智, 岡本眞宗, 安井昭洋, 高田瞬也, 中川洋一, 加藤大幾, 檜顕成, 内田広夫

小児外科 Vol. 54 ( 10 ) page： 1007 - 1011 2022.10

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. Reviewed International journal

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

Surgical endoscopy Vol. 36 ( 10 ) page： 7352 - 7359 2022.10

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: After surgery for congenital biliary dilatation (CBD), hilar and hepatic bile duct stenosis and intrapancreatic bile duct remnants can cause many postoperative complications. We investigated the efficacy of laparoscopic surgery with aggressive bile ductoplasty and complete excision of the intrapancreatic bile duct in CBD patients compared to open surgery. METHODS: Pediatric patients who underwent surgery for CBD at our institution between 2006 and 2020 were divided into two groups: laparoscopic surgery (Lap group) and open surgery (Op group). Surgical outcomes were compared between the two groups. RESULTS: We enrolled 160 patients (85 in the Lap group and 75 in the Op group). Hilar bile ductoplasty was performed in 52 (61%) patients from the Lap group and 40 (53%) patients from the Op group. The operative time was significantly longer, the amount of blood loss was significantly lower, and the length of hospital stay was significantly shorter in the Lap group than in the Op group. Postoperative early and late complications occurred at a similarly low rate in both groups. When the surgical outcomes were compared between the group who underwent laparoscopic bile ductoplasty and the group that did not, postoperative early and late complications occurred similarly in both groups. CONCLUSIONS: Laparoscopic surgery for CBD with aggressive hilar bile ductoplasty and complete excision of the intrapancreatic bile duct is safe and effective, comparable to open surgery. However, it is necessary to verify whether long-term occurrence of hepatolithiasis similar to open definitive surgery can be obtained in the future.

DOI： 10.1007/s00464-022-09132-x

Web of Science

PubMed

PERSISTENT CHOLESTASIS AFTER KASAI PORTOENTEROSTOMY PREDICTS PORTAL HYPERTENSION IN NATIVE LIVER SURVIVORS OF BILIARY ATRESIA - RESULT FROM A LARGE COHORT MULTICENTRE ANALYSIS Reviewed

Hiroo UCHIDA

Hepatology Vol. 76 page： S1528 - S1529 2022.10

Laparoscopic internal intestinal drainage of bile lakes in a patient with recurrence of jaundice after laparoscopic revision of Kasai portoenterostomy for biliary atresia: A case report Reviewed

Gohda Yousuke, Uchida Hiroo, Hinoki Akinari, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Okamoto Masamune, Ogata Seiya, Takimoto Aitaro, Takada Shunya, Nakagawa Yoichi, Kato Daiki, Guo Yaohui

ASIAN JOURNAL OF ENDOSCOPIC SURGERY 2022.9

特集先天性胆道拡張症up-to-date 肝側合併症(肝内胆管狭窄)に対する肝内胆管形成術 Reviewed

中川洋一, 内田広夫, 檜顕成, 城田千代栄, 住田亙, 牧田智, 岡本眞宗, 尾形誠弥, 滝本愛太朗, 高田瞬也, 加藤大幾, 合田陽祐

小児外科 Vol. 54 ( 9 ) page： 904 - 907 2022.9

特集先天性胆道拡張症up-to-date 腹腔鏡下先天性胆道拡張症根治術中に膵管損傷した2例 Reviewed

加藤大幾, 檜顕成, 城田千代栄, 住田亙, 牧田智, 天野日出, 岡本眞宗, 尾形誠弥, 滝本愛太朗, 高田瞬也, 中川洋一, 合田陽祐, 内田広夫

小児外科 Vol. 54 ( 9 ) page： 924 - 927 2022.9

Laparoscopic bile duct plasty for hilar bile duct stenosis (HBDS) in patients with congenital biliary dilatation: Diagnosis of HBDS by preoperative MRCP and laparoscopic strategy to relieve HBDS. Reviewed

Yoichi Nakagawa, Hiroo Uchida, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Akihiro Yasui, Aitaro Takimoto, Yaohui Guo

Journal of hepato-biliary-pancreatic sciences 2022.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/PURPOSE: Congenital biliary dilatation (CBD) is a disease associated with pancreaticobiliary maljunction. The most frequent postoperative complication is intrahepatic stones, which are caused by hilar bile duct stenosis (HBDS). METHODS: We retrospectively reviewed the records of patients who underwent primary surgery for CBD between 2013 and 2021. We evaluated images and videos of HBDS, the laparoscopic technique of releasing the stenosis, and its occurrence rate and compared intraoperative bile duct findings with those of preoperative magnetic resonance cholangiopancreatography (MRCP). RESULTS: There were 87 CBD cases in this study. HBDS occurred in 52% and preoperative MRCP for HBDS showed a 96% sensitivity and 74% specificity in this study. Bile duct plasty was performed in 45% of the cases and videos demonstrated typical methods of laparoscopic bile duct plasty. The mid- to long-term complications were hepatolithiasis in three patients, anastomotic site stricture in three, and postoperative obstruction in two. CONCLUSIONS: Our study revealed that preoperative imaging studies are useful for the prediction of HBDS. Our laparoscopic meticulous probing method for finding BDS reveals more intrahepatic BDS through magnification. Therefore, this may reduce the incidence of intrahepatic stones. Preoperative imaging and intraoperative findings can be complemented to plan management that reduces long-term complications.

DOI： 10.1002/jhbp.1235

Web of Science

PubMed

食道疾患の診療 Ⅳ　その他の食道疾患の診療　6　先天異常に伴う食道疾患 Invited

内田広夫

臨床消化器内科 Vol. 37 ( 9 ) page： 1203 - 1210 2022.8

Evaluation of minimally invasive surgical skills training: comparing a neonatal esophageal atresia/tracheoesophageal fistula model with a dry box. Reviewed International journal

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

Surgical endoscopy Vol. 36 ( 8 ) page： 6035 - 6048 2022.8

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Pediatric surgeons require highly advanced minimally invasive surgical skills to perform rare and complex surgeries in a very vulnerable population. We developed a neonatal esophageal atresia (EA) model to improve thoracoscopic surgical skills. This study aimed to evaluate the concurrent validity of the model by undertaking pre- and post-training skills assessments in two groups of students with no prior experience performing minimally invasive surgery, using the EA model and a dry box (DB). METHODS: A pilot study was performed. The participants were randomly divided into two groups: one trained using the DB and one trained using the EA model. Both groups practiced a minimally invasive surgical suture task. The task completion time, 29-point checklist score, modified suturing error sheet score, and three-dimensional forceps movement in both groups were compared pre-and post-training by video analysis. RESULTS: The EA model task was significantly more difficult than that of the DB. Both groups showed significant improvement in the task time, 29-point checklist score, and modified suturing error sheet score; however, the EA model training was more efficient in improving each error item. Regarding forceps movement, the EA model training significantly decreased wasted motion, whereas the DB was limited in this regard. CONCLUSIONS: Short-term training on the EA model, which was more technically demanding than the DB, decreased technical error and wasted motion, and allowed learners to acquire surgical skills more efficiently than training with the DB model. These facts revealed the concurrent validity of the EA model.

DOI： 10.1007/s00464-022-09185-y

Web of Science

PubMed

Thoracoscopic posterior tracheopexy during primary esophageal atresia repair ameliorate tracheomalacia in neonates: a single-center retrospective comparative cohort study. Reviewed International journal

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

BMC surgery Vol. 22 ( 1 ) page： 285 - 285 2022.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Esophageal atresia (EA) is often associated with tracheomalacia (TM). The severity of TM symptoms varies widely, with serious cases requiring prolonged respiratory support and surgical treatment. Although we performed thoracoscopic posterior tracheopexy (TPT) during primary EA repair to prevent or reduce the symptoms of TM, few studies have investigated the safety and effectiveness of TPT during primary EA repair. Therefore, this study aimed to evaluate the safety and efficacy of TPT in neonates. METHODS: We retrospectively reviewed the records of all patients diagnosed with TM who underwent primary thoracoscopic EA repair between 2013 and 2020 at the Nagoya University Hospital. Patients were divided into two groups: TPT (TPT group) and without TPT (control group). TPT has been performed in all patients with EA complicated by TM since 2020. We compared patient backgrounds, surgical outcomes, postoperative complications, and treatment efficacy. RESULTS: Of the 22 patients reviewed, eight were in the TPT group and 14 were in the control group. There were no statistically significant differences in the surgical outcomes between the groups (operation time: p = 0.31; blood loss: p = 0.83; time to extubation: p = 0.30; time to start enteral feeding: p = 0.19; time to start oral feeding: p = 0.43). Conversion to open thoracotomy was not performed in any case. The median operative time required for posterior tracheopexy was 10 (8-15) min. There were no statistically significant differences in postoperative complications between the groups (chylothorax: p = 0.36; leakage: p = 1.00; stricture: p = 0.53). The respiratory dependence rate 30 days postoperative (2 [25%] vs. 11 [79%], p = 0.03) and the ratio of the lateral and anterior-posterior diameter of the trachea (LAR) were significantly lower in the TPT group (1.83 [1.66-2.78] vs. 3.59 [1.80-7.70], p = 0.01). CONCLUSIONS: TPT during primary EA repair for treatment of TM significantly lowered respiratory dependence rate at 30 days postoperative without increasing the risk of postoperative complications. This study suggested that TPT could improve TM associated with EA.

DOI： 10.1186/s12893-022-01738-1

Web of Science

PubMed

Laparoscopic definitive surgery for choledochal cyst is performed safely and effectively in infants. Reviewed International journal

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

Journal of minimal access surgery Vol. 18 ( 3 ) page： 372 - 377 2022.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Laparoscopic definitive surgery for choledochal cyst (CC) in infants requires advanced skills because of their small size. If patients with a prenatal diagnosis of CC have any biliary symptoms, they need semi-emergency definitive surgery. This study aimed to estimate whether laparoscopic definitive surgery for CC can be performed safely and effectively in infants, especially when emergency surgery is required. PATIENTS AND METHODS: From January 2006 to December 2019, 21 patients under 1 year of age underwent laparoscopically or open definitive surgery, and 16 patients aged 3-5 years underwent laparoscopic surgery for CC at our institution. In cases of prenatal diagnosis, elective surgery (EL) was performed at about 6 months of age for patients with no biliary symptoms; the semi-emergency surgery (EM) was performed when patients had any biliary symptoms. Surgical outcomes were retrospectively compared between the Lap <1 y and Op <1 y groups and between the Lap <1 y and Lap 3-5 y groups. In addition, the surgical outcomes of those who underwent EM were also evaluated. RESULTS: Operative time was significantly longer, and blood loss was significantly lower in the Lap <1 y group than in the Op <1 y group. All surgical outcomes were similar between the Lap <1 y and Lap 3-5 y groups and between the EM and EL groups. CONCLUSION: Laparoscopic definitive surgery for CC in infants under 1 year of age is safe and feasible. Even semi-emergency laparoscopic surgery can be performed safely and effectively in small infants.

DOI： 10.4103/jmas.JMAS_98_21

Web of Science

PubMed

Patients with gastric volvulus recurrence have high incidence of wandering spleen requiring laparoscopic gastropexy and splenopexy. Reviewed International journal

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

Pediatric surgery international Vol. 38 ( 6 ) page： 875 - 881 2022.6

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Though gastric volvulus in neonates and infants resolves by conservative therapy and aging, some cases require surgical intervention. This study aimed to review the cases of gastric volvulus requiring surgical intervention and evaluate their characteristics. METHODS: We retrospectively reviewed gastric volvulus cases requiring surgical intervention. Surgical indication was persistent acute gastric volvulus and repeated hospitalization for gastric volvulus. We evaluated the characteristics of those cases requiring surgical intervention and the surgical results of laparoscopic gastropexy. RESULTS: The median age of patients included was 4 years (range: 1-6 years). All eight cases of gastric volvulus requiring sugery had congenital spleen diseases. Six of the eight cases suffered from a wandering spleen, while two cases presented with situs inversus with asplenia. Both splenopexy (preperitoneal distension balloon [PDB] or blunt separaion methods) and gastropexy were performed in cases with wandering spleen. No postoperative complications were reported in any of the eight cases, except the recurrence of gastric volvulus due to suture shedding in one case. CONCLUSION: Laparoscopic gastropexy for gastric volvulus and splenopexy for cases concomitant with wandering spleen were found to be effective surgical approaches. Both PDB and blunt separation methods for making extraperitoneal pockets for the spleen were employed successfully.

DOI： 10.1007/s00383-022-05125-y

Web of Science

PubMed

METABOLOMICS OF URINARY METABOLITES IN CHILDHOOD RHABDOMYOSARCOMA TO DISCOVER NOVEL BIOMARKERS Reviewed

Hiroo UCHIDA

Pediatric Blood and Cancer Vol. 69 2022.6

Serum matrix metalloproteinase-7 in biliary atresia: A Japanese multicenter study. Reviewed International journal

Hirotaka Sakaguchi, Ken-Ichiro Konishi, Ryosuke Yasuda, Hideyuki Sasaki, Koichiro Yoshimaru, Takahisa Tainaka, Suguru Fukahori, Yukihiro Sanada, Itaru Iwama, Hiromichi Shoji, Masahiro Kinoshita, Toshiharu Matsuura, Jun Fujishiro, Hiroo Uchida, Masaki Nio, Yushiro Yamashita, Tatsuki Mizuochi

Hepatology research : the official journal of the Japan Society of Hepatology Vol. 52 ( 5 ) page： 479 - 487 2022.5

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Biliary atresia (BA) is among the commonest indications for liver transplantation (LT) in children. We examined whether serum matrix metalloproteinase-7 (MMP-7) is useful for diagnosis of BA in Japanese infants, and whether serum MMP-7 concentrations before and after Kasai portoenterostomy (KP) predicted LT within a year. METHODS: Subjects under 6 months old at eight pediatric centers in Japan were enrolled retrospectively, including patients with cholestasis and normal controls (NC) without liver disease. Patients with cholestasis were divided into groups representing BA versus cholestasis from other causes (non-BA). Serum samples were collected from patients with BA at diagnosis and 1 and 4 weeks after KP, as well as from non-BA and NC. RESULTS: Serum MMP-7 concentrations were significantly higher in BA at diagnosis (median, 89.1 ng/ml) than in non-BA (11.0; p < 0.001) or NC (10.3; p < 0.001). Receiver operating characteristic (ROC) analysis of MMP-7 for BA versus non-BA yielded an area under the ROC curve of 0.99 (95% confidence interval, 0.96-1.00). An optimal cut-off value of 18.6 ng/ml for serum MMP-7 in diagnosing BA demonstrated sensitivity and specificity of 100% and 90%, respectively. Serum MMP-7 before and 1 week and 4 weeks after KP did not differ significantly between BA requiring only KP and BA requiring LT after KP. CONCLUSION: Serum MMP-7 is a useful marker for diagnosis of BA in Japanese infants, but it could not predict LT within a year.

DOI： 10.1111/hepr.13753

Web of Science

PubMed

Utility of endoscopic retrograde cholangiopancreatography in management of pediatric pancreaticobiliary disease. Reviewed International journal

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

BMC pediatrics Vol. 22 ( 1 ) page： 134 - 134 2022.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The purpose of this study was to evaluate the utility of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients with pancreaticobiliary diseases. METHODS: A retrospective review was performed on patients who underwent ERCP for the treatment of biliary tract disease and detailed examination of pancreatitis at our institution from January 1999 to December 2020. RESULTS: ERCP was performed for congenital biliary dilatation (CBD) (n = 42), choledocholithiasis (n = 9), common bile duct stenosis (n = 1), and several types of pancreatitis (n = 13). The only severe complication of ERCP was common bile duct injury. Three (5.8%) of 52 biliary diseases failed to be treated by ERCP. All patients with pancreatic disease were correctly diagnosed and treated. CONCLUSIONS: Endoscopic biliary drainage with a temporary stent was adequate for symptomatic relief in CBD. Stenting of the pancreatic duct was useful for improving the angulation and drainage of the pancreatic duct. ERCP was useful for understanding the anatomy of the pancreatic duct and revealing potential treatments. Therefore, ERCP and transendoscopic therapy are sufficiently feasible in pediatric patients and should be actively introduced for the investigation and treatment of pancreaticobiliary diseases.

DOI： 10.1186/s12887-022-03207-3

Web of Science

PubMed

特集プライマリケアにおける単純X線検査-ここまで読影することができる胸部:各論肺葉の異常　囊胞性肺疾患 Reviewed

内田広夫, 城田千代栄, 田井中貴久, 住田亙

小児内科 Vol. 54 ( 3 ) page： 423 - 431 2022.3

Safety and feasibility of primary radical surgery for meconium peritonitis considering patients' general condition and perioperative findings. Reviewed

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

Nagoya journal of medical science Vol. 84 ( 1 ) page： 148 - 154 2022.2

Language：English Publishing type：Research paper (scientific journal)

We reviewed the outcomes of meconium peritonitis and evaluated the safety and feasibility of primary radical surgery for meconium peritonitis. A total of 21 cases of meconium peritonitis between 2006 and 2020 were retrospectively reviewed. The patients were classified into two groups based on the type of surgery: group I (primary radical surgery, n = 16) and group II (multistage surgery; drainage only or ileostomy, followed by elective surgery, n = 5). Patient backgrounds and surgical outcomes were compared between the two groups. The term of prenatal diagnosis, preoperative white blood cell count, and preoperative catecholamine use were not significantly different between the two groups. Group I included more mature neonates than group II (gestational age at birth, 35w1d vs 30w1d, p = 0.02; birth weight, 2.5 kg vs 1.1 kg, p < 0.01). Preoperative C-reactive protein was significantly lower in group I (0.37 mg/dL vs 2.8 mg/dL, p < 0.05). Operation time, blood loss, time to enteral feeding, and complication rates were not significantly different between the two groups. The surgical outcomes of primary radical surgery were comparable to those of multistage surgery, although the patients' backgrounds were different. Our strategy of selecting one-stage or multiple-stage surgery for treatment of meconium peritonitis, depending on the patient's general condition and degree of intestinal ischemia, was reasonable.

DOI： 10.18999/nagjms.84.1.148

Web of Science

PubMed

血清MMP-7は胆道閉鎖症の葛西手術後1年以内の肝移植を予測できるか? Reviewed

安田亮輔, 坂口廣高, 深堀優, 吉丸耕一朗, 松浦俊治, 眞田幸弘, 藤代準, 田井中貴久, 内田広夫, 佐々木英之, 仁尾正記, 水落建輝

日本小児外科学会雑誌 Vol. 58 ( 1 ) page： 119 - 120 2022.2

Laparoscopic Kasai portoenterostomy can be a standard surgical procedure for treatment of biliary atresia. Reviewed

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 Vol. 14 ( 1 ) page： 56 - 63 2022.1

胆道拡張症術後肝内結石への DBERC 中に小腸穿孔をきたし、腹腔鏡下穿孔部閉鎖＋内視鏡下採石した1例 Reviewed

中川洋一, 内田広夫, 檜顕成, 城田千代栄, 住田亙, 牧田智, 岡本眞宗, 尾形誠弥, 滝本愛太朗, 高田瞬也, 加藤大幾, 合田陽祐

日本膵・胆管合流異常研究会プロシーディングス Vol. 45 ( 0 ) page： 77 - 78 2022

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Papers - UCHIDA Hiroo