Faculty Profiles - UCHIDA Hiroo

Evaluation of the risk factors for postoperative pectus excavatum and scoliosis in cystic lung disease. Reviewed

Takahisa T, Chiyoe S, Wataru S, Satoshi M, Hizuru A, Yoko K, Akihiro Y, Daiki K, Takuya M, Yousuke G, Hiroki I, Kazuki O, Akinari H, Hiroo U

Pediatric surgery international Vol. 41 ( 1 ) page： 62 2025.1

How many cases do young pediatric surgeons need to experience to achieve autonomy in performing pediatric endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan. Reviewed International journal

Masakazu Murakami, Yo Kurashima, Katsuhiro Ogawa, Shinichiro Yokoyama, Satoshi Obata, Go Miyano, Tetsuya Ishimaru, Hiroshi Kawashima, Hiroo Uchida, Tatsuro Tajiri, Atsuyuki Yamataka, Hiroomi Okuyama, Satoshi Ieiri

Pediatric surgery international Vol. 41 ( 1 ) page： 54 - 54 2024.12

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

PURPOSE: To ensure the safe prevalence of pediatric endoscopic surgery in Japan, a training curriculum should be established. In addition, the number of pediatric surgical cases is decreasing due to the decreasing birth rate in Japan, and it is necessary to clarify the number of surgical cases required for young pediatric surgeons to achieve autonomy in pediatric endoscopic surgery. METHODS: An online nationwide survey was conducted among young pediatric surgeons with 3-15 years of clinical experience in Japan. We assessed training experience, opinions concerning the ideal training curriculum, and the correlation between surgical experience and the level of autonomy for pediatric endoscopic surgeries. RESULTS: One hundred seventy participants responded to the survey (response rate: 35.2%). Only 18% answered that their training facility had a regular educational off-the-job training program. Ninety percent of respondents answered that an educational curriculum for pediatric endoscopic surgery was necessary. It took 11-20 cases to achieve autonomy in laparoscopic appendectomy and laparoscopic inguinal hernia repair. CONCLUSION: This survey revealed that off-the-job training programs were insufficient. The results of this study are expected to aid in the establishment of an effective curriculum for pediatric endoscopic surgery in the era of declining birth rates.

DOI： 10.1007/s00383-024-05958-9

Safety and feasibility of robot-assisted surgery for pediatric patients weighing ≤ 10 kg with congenital biliary dilatation Reviewed

Hiroo UCHIDA

Journal of Robotic Surgery Vol. 19 ( 1 ) page： 34 2024.12

Characteristics and outcomes of minimally invasive surgery for congenital biliary dilatation in children aged <6 years: Comparison between children and adults Reviewed

Hiroo UCHIDA

Journal of Hepato-biliary-pancreatic Sciences Vol. 31 ( 12 ) page： 876 - 885 2024.12

Usefulness of lateral-anteroposterior dimeter ratio in patients with tracheomalacia associated with esophageal atresia Reviewed

Hiroo UCHIDA

Pediatric Surgery International Vol. 40 ( 1 ) page： 282 2024.10

Nationwide questionnaire survey on pediatric pancreatic tumors in Japan Reviewed

Hiroo UCHIDA

World Journal of Gastrointestinal Oncology Vol. 16 ( 10 ) page： 4166 - 4176 2024.10

Portal vein hypoplasia is present in patients with biliary atresia at the time of diagnosis Reviewed

Hiroo UCHIDA

Journal of Pediatric Gastroenterology and Nutrition Vol. 79 ( 4 ) page： 818 - 825 2024.10

First pediatric pelvic surgery with the Senhance® robotic surgical system: A case series Reviewed

Daiki Kato, Hiroo Uchida, Chiyoe Shirota, Takahisa Tainaka, Satoshi Makita, Hizuru Amano, Miwa Satomi, Akihiro Yasui, Yoichi Nakagawa, Takuya Maeda, Hiroki Ishii, Kazuki Ota, Naoki Nagata, Akinari Hinoki

Asian Journal of Endoscopic Surgery Vol. 17 ( 4 ) page： e13379 2024.10

特集必携小児外科レジデントマニュアル2 手術器具 Reviewed

田井中貴久, 城田千代栄, 牧田智, 天野日出, 檜顕成, 内田広夫

小児外科 Vol. 56 ( 9 ) page： 933 - 937 2024.9

Impact of Portal Flow on the Prognosis of Children With Congenital Portosystemic Shunt: A Multicentric Observation Study in Japan. Reviewed International journal

Hajime Uchida, Masato Shinkai, Hiroomi Okuyama, Takehisa Ueno, Mikihiro Inoue, Toshihiro Yasui, Eiso Hiyama, Sho Kurihara, Yasunaru Sakuma, Yukihiro Sanada, Akinobu Taketomi, Shohei Honda, Motoshi Wada, Ryo Ando, Jun Fujishiro, Mariko Yoshida, Yohei Yamada, Hiroo Uchida, Takahisa Tainaka, Mureo Kasahara

Journal of pediatric surgery Vol. 59 ( 9 ) page： 1791 - 1797 2024.9

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

BACKGROUND: Although congenital portosystemic shunts (CPSSs) are increasingly being recognized, the optimal treatment strategies and natural prognosis remain unclear, as individual CPSSs show different phenotypes. METHODS: The medical records of 122 patients who were diagnosed with CPSSs at 15 participating hospitals in Japan between 2000 and 2019 were collected for a retrospective analysis based on the state of portal vein (PV) visualization on imaging. RESULTS: Among the 122 patients, 75 (61.5%) showed PV on imaging. The median age at the diagnosis was 5 months. The main complications related to CPSS were hyperammonemia (85.2%), liver masses (25.4%), hepatopulmonary shunts (13.9%), and pulmonary hypertension (11.5%). The prevalence of complications was significantly higher in patients without PV visualization than in those with PV visualization (P < 0.001). Overall, 91 patients (74.6%) received treatment, including shunt closure by surgery or interventional radiology (n = 82) and liver transplantation (LT) or liver resection (n = 9). Over the past 20 years, there has been a decrease in the number of patients undergoing LT. Although most patients showed improvement or reduced progression of symptoms, liver masses and pulmonary hypertension were less likely to improve after shunt closure. Complications related to shunt closure were more likely to occur in patients without PV visualization (P = 0.001). In 25 patients (20.5%) without treatment, those without PV visualization were significantly more likely to develop complications related to CPSS than those with PV visualization (P = 0.011). CONCLUSION: Patients without PV visualization develop CPSS-related complications and, early treatment using prophylactic approaches should be considered, even if they are asymptomatic. LEVEL OF EVIDENCE: Level III.

DOI： 10.1016/j.jpedsurg.2024.05.008

Eicosapentaenoic acid administration ameliorates the progression of liver fibrosis after laparoscopic Kasai portoenterostomy Reviewed

Hiroo UCHIDA

Pediatric Surgery International Vol. 40 ( 1 ) page： 239 2024.8

特集再手術の戦略と実際胆道閉鎖症 Reviewed

城田千代栄, 田井中貴久, 牧田智, 加藤大幾, 前田拓也, 里見美和, 石井宏樹, 太田和樹, 檜顕成, 内田広夫

小児外科 Vol. 56 ( 7 ) page： 701 - 703 2024.7

特集再手術の戦略と実際先天性横隔膜ヘルニア再発に対する手術アプローチ Reviewed

合田陽祐, 内田広夫, 横田一樹, 城田千代栄, 田井中貴久, 住田亙, 牧田智, 里見美和, 安井昭洋, 加藤大幾, 前田拓也, 石井宏樹, 太田和樹, 檜顕成

小児外科 Vol. 56 ( 7 ) page： 682 - 685 2024.7

Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study. Reviewed International journal

Patrick Ho Yu Chung, Toshio Harumatsu, Yoichi Nakagawa, Koichi Tsuboi, Edwin Kin Wai Chan, Michael Wai Yip Leung, Fanny Yeung, Mitsuru Muto, Takafumi Kawano, Hizuru Amano, Chiyoe Shirota, Hiroki Nakamura, Hiroyuki Koga, Go Miyano, Atsuyuki Yamataka, Satoshi Ieiri, Hiroo Uchida, Kenneth Kak Yuen Wong

Pediatric surgery international Vol. 40 ( 1 ) page： 196 - 196 2024.7

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

PURPOSE: This study evaluated portal hypertension (PHT) and its predictors among native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE). METHODS: This was a multicenter study using prospectively collected data. The subjects were patients who remained transplant-free for 5 years after KPE. Their status of PHT was evaluated and variables that predicted PHT were determined by regression analysis and receiver operating characteristic (ROC) curve. RESULTS: Six centers from East Asia participated in this study and 320 subjects with KPE between 1980 to 2018 were analyzed. The mean follow-up period was 10.6 ± 6.2 years. At the 5th year after KPE, PHT was found in 37.8% of the subjects (n = 121). Patients with KPE done before day 41 of life had the lowest percentage of PHT compared to operation at older age. At 12 months after KPE, PHT + ve subjects had a higher bilirubin level (27.1 ± 11.7 vs 12.3 ± 7.9 µmol/L, p = 0.000) and persistent jaundice conferred a higher risk for PHT (OR = 12.9 [9.2-15.4], p = 0.000). ROC analysis demonstrated that a bilirubin level above 38 µmol/L at 12 months after KPE predicted PHT development (sensitivity: 78%, specificity: 60%, AUROC: 0.75). CONCLUSIONS: In BA, early KPE protects against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE are at a higher risk of this complication. They should receive a more vigilant follow-up. LEVEL OF EVIDENCE: Level III.

DOI： 10.1007/s00383-024-05775-0

Bile lakes in patients with biliary atresia who presented with jaundice-free native liver survival indicating the risk of subsequent liver transplantation due to various factors. Reviewed International journal

Yousuke Gohda, Hiroo Uchida, Wataru Sumida, Chiyoe Shirota, Takahisa Tainaka, Satoshi Makita, Miwa Satomi, Akihiro Yasui, Daiki Kato, Takuya Maeda, Hiroki Ishii, Kazuki Ota, Yaohui Guo, Jiahui Liu, Akinari Hinoki

Pediatric surgery international Vol. 40 ( 1 ) page： 197 - 197 2024.7

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The prognostic factors of subsequent liver transplantation (LT) in patients with biliary atresia (BA) who presented with jaundice-free native liver survival were investigated. METHODS: This study retrospectively reviewed patients who underwent portoenterostomy (PE) for BA. Patients with jaundice-free native liver survival at 1 year postoperatively were divided into the autologous liver survivor and liver transplant recipient groups. Peri- and postoperative data were compared between the two groups. RESULTS: Among 97 patients with BA, 29 who received LT within 1 year after PE were excluded from the analysis. Further, 48 patients currently living with native liver and 20 who received LT after 1 year postoperatively were compared. Bile lake (BL) was the strongest risk factor of LT. The risk score was 2.38 ∗ B L s c o r e + 0.00466 ∗ T B A , and the area under the receiver operating characteristic curve was 0.83. Patients with BL and those without significantly differed in terms of the native liver survival rate. Patients with BL who presented with not only cholangitis but also gastrointestinal hemorrhage and hepatopulmonary syndrome received LT. CONCLUSION: BL can cause different pathologies. Moreover, it is an evident risk factor of subsequent LT in patients with BA who are living with native liver at 1 year after PE.

DOI： 10.1007/s00383-024-05786-x

Developing an effective off-the-job training model and an automated evaluation system for thoracoscopic esophageal atresia surgery Reviewed

Akihiro Yasui, Yuichiro Hayashi, Akinari Hinoki, Hizuru Amano, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Yoko Kano, Aitaro Takimoto, Yoichi Nakagawa, Maeda Takuya, Daiki Kato, Yousuke Gohda, Jiahui Liu, Yaohui Guo, Kensaku Mori, Hiroo Uchida

Journal of Pediatric Surgery 2024.7

Thoracoscopic primary repair is useful for esophageal atresia with tracheoesophageal fistula in neonates with low body weight. Reviewed International journal

Yousuke Gohda, Hiroo Uchida, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Miwa Satomi, Akihiro Yasui, Yoko Kanou, Yoichi Nakagawa, Daiki Kato, Takuya Maeda, Yaohui Guo, Jiahui Liu, Hiroki Ishii, Kazuki Ota, Akinari Hinoki

Pediatric surgery international Vol. 40 ( 1 ) page： 149 - 149 2024.6

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

PURPOSE: The surgical indication of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula is under debate. The current study aimed to investigate the outcome of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula in patients weighing < 2000 g and those who underwent emergency surgery at the age of 0 day. METHODS: The surgical outcomes were compared between patients weighing < 2000 g and those weighing > 2000 g at surgery and between patients who underwent surgery at the age of 0 day and those who underwent surgery at age ≥ 1 day. RESULTS: In total, 43 patients underwent thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula. The surgical outcomes according to body weight were similar. Patients who underwent surgery at the age of 0 day were more likely to develop anastomotic leakage than those who underwent surgery at the age of ≥ 1 day (2 vs. 0 case, p = 0.02). Anastomotic leakage was treated with conservative therapy. CONCLUSION: Thoracoscopic primary repair is safe and useful for esophageal atresia with tracheoesophageal fistula even in newborns weighing < 2000 g. However, emergency surgery at the age of 0 day should be cautiously performed due to the risk of anastomotic leakage.

DOI： 10.1007/s00383-024-05724-x

新専門医制度におけるサブスペシャルティ小児外科領域の現状施設認定委員会より Reviewed

木下義晶, 浮山越史, 文野誠久, 田中潔, 米田光宏, 佐々木英之, 内田広夫, 古村眞, 石丸哲也, 大久保龍二, 家入里志, 小野滋, 日本小児外科学会専門医制度委員会

日本小児外科学会雑誌 Vol. 60 ( 3 ) page： 374 - 374 2024.4

Duodenal duplication cyst at the second part of the duodenum with congenital duodenal position anomaly completely resected by laparoscopic partial duodenectomy: a case report. Reviewed International journal

Yoichi Nakagawa, Hiroo Uchida, Satoshi Makita, Takahisa Tainaka, Akinari Hinoki, Chiyoe Shirota, Wataru Sumida, Hizuru Amano, Akihiro Yasui, Yoko Kano, Takuya Maeda, Daiki Kato, Yousuke Gohda

Surgical case reports Vol. 10 ( 1 ) page： 73 - 73 2024.3

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

BACKGROUND: Duodenal duplication cysts (DDC) are rare duplications of the alimentary tract. Their treatment depends on their size and location. A radical treatment is total resection, if possible. However, partial excision, puncture, and marsupialization can be selected to prevent surgical injury to the pancreaticobiliary tract despite the risk of recurrence. There are some reports of pancreaticoduodenectomy for DDC because of the risk of recurrent symptoms and malignancy. However, this is considered excessively invasive for DDC, particularly in pediatric cases, because of its extremely low rate of malignancy and high morbidity and mortality rates. We encountered a case of DDC with a congenital duodenal position anomaly occurring in the second part of the duodenum. Taking advantage of the congenital duodenal position anomaly, the DDC was completely resected without injuring the pancreaticobiliary duct. CASE PRESENTATION: A 6-year-old boy was diagnosed with a duodenal duplication cyst with obstruction. There was a congenital duodenal position anomaly. The distal second part of the duodenum was the dorsal side of the proximal second part of the duodenum and ascended upward from the proximal second part of the duodenum. The third and fourth parts of the duodenum ran downward to the left and posterior parts of the portal vein, forming the ligament of Treitz. Complete laparoscopic resection of the duodenal duplication cyst and the second to fourth parts of the duodenum, and duodenojejunostomy with retrocolic reconstruction was performed because the duodenum was easily mobilized to the ligament of Treitz owing to the duodenal position anomaly. The duodenojejunostomy with retrocolic reconstruction achieved a more physiologically normal appearance compared to what would have been achieved with a Roux-en-Y reconstruction. The patient was discharged on postoperative day 12 without any complications. CONCLUSIONS: The procedure used in this case might not be easily applied in all laparoscopy cases. However, it could be an option for duodenal duplication cysts with congenital duodenal position anomalies.

DOI： 10.1186/s40792-024-01875-0

A systematic review of Sandifer syndrome in children with severe gastroesophageal reflux. Reviewed

Kato D, Uchida H, Amano H, Yokota K, Shirota C, Tainaka T, Sumida W, Makita S, Yasui A, Gohda Y, Maeda T, Hinoki A

Pediatric surgery international Vol. 40 ( 1 ) page： 91 2024.3

Surgical Strategies for Neonates with Prenatally Diagnosed Congenital Biliary Dilatation. Reviewed

Shirota C, Hinoki A, Tainaka T, Sumida W, Makita S, Amano H, Takimoto A, Yasui A, Nakagawa Y, Liu J, Guo Y, Kato D, Goda Y, Maeda T, Uchida H

Journal of pediatric surgery Vol. 59 ( 3 ) page： 385 - 388 2024.3

Scoring system for diagnosis and pretreatment risk assessment of neuroblastoma using urinary biomarker combinations. Reviewed International journal

Hizuru Amano, Hiroo Uchida, Kazuharu Harada, Atsushi Narita, Shigehisa Fumino, Yuji Yamada, Shun Kumano, Mayumi Abe, Takashi Ishigaki, Minoru Sakairi, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Shuhei Karakawa, Yuichi Mitani, Shojiro Matsumoto, Yutaka Tomioka, Hideki Muramatsu, Nobuhiro Nishio, Tsuyoshi Osawa, Masataka Taguri, Katsuyoshi Koh, Tatsuro Tajiri, Motohiro Kato, Kimikazu Matsumoto, Yoshiyuki Takahashi, Akinari Hinoki

Cancer science 2024.2

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

The urinary catecholamine metabolites, homovanillic acid (HVA) and vanillylmandelic acid (VMA), are used for the adjunctive diagnosis of neuroblastomas. We aimed to develop a scoring system for the diagnosis and pretreatment risk assessment of neuroblastoma, incorporating age and other urinary catecholamine metabolite combinations. Urine samples from 227 controls (227 samples) and 68 patients with neuroblastoma (228 samples) were evaluated. First, the catecholamine metabolites vanillactic acid (VLA) and 3-methoxytyramine sulfate (MTS) were identified as urinary marker candidates through comprehensive analysis using liquid chromatography-mass spectrometry. The concentrations of these marker candidates and conventional markers were then compared among controls, patients, and numerous risk groups to develop a scoring system. Participants were classified into four groups: control, low risk, intermediate risk, and high risk, and the proportional odds model was fitted using the L2-penalized maximum likelihood method, incorporating age on a monthly scale for adjustment. This scoring model using the novel urine catecholamine metabolite combinations, VLA and MTS, had greater area under the curve values than the model using HVA and VMA for diagnosis (0.978 vs. 0.964), pretreatment risk assessment (low and intermediate risk vs. high risk: 0.866 vs. 0.724; low risk vs. intermediate and high risk: 0.871 vs. 0.680), and prognostic factors (MYCN status: 0.741 vs. 0.369, histology: 0.932 vs. 0.747). The new system also had greater accuracy in detecting missing high-risk neuroblastomas, and in predicting the pretreatment risk at the time of screening. The new scoring system employing VLA and MTS has the potential to replace the conventional adjunctive diagnostic method using HVA and VMA.

DOI： 10.1111/cas.16116

Laparoscopic Fundoplication in Patients with Ventriculoperitoneal Shunts: A Systematic Review and Our Experience Reviewed

特集胆道閉鎖症の研究update 胆道閉鎖症診療ガイドラインの改訂に向けて Reviewed

仁尾正記, 虻川大樹, 内田広夫, 黒田達夫, 鈴木達也, 山髙篤行, 吉田雅博, 和田基, 佐々木英之, 大久保龍二

小児外科 Vol. 56 ( 2 ) page： 170 - 173 2024.2

Kato, D; Uchida, H; Tainaka, T; Amano, H; Ono, Y; Yasui, A; Shirota, C; Sumida, W; Yokota, K; Makita, S; Takimoto, A; Takada, S; Nakagawa, Y; Gohda, Y; Maeda, T; Hinoki, A

JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES Vol. 34 ( 3 ) page： 268 - 273 2024.1

M U-Net: Intestine Segmentation Using Multi-dimensional Features for Ileus Diagnosis Assistance Reviewed

Qin An, Hirohisa Oda, Yuichiro Hayashi, Takayuki Kitasaka, Akinari Hinoki, Hiroo Uchida, Kojiro Suzuki, Aitaro Takimoto, Masahiro Oda, Kensaku Mori

Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) Vol. 14313 page： 135 - 144 2024

Language：English Publishing type：Research paper (international conference proceedings)

The intestine is an essential digestive organ that can cause serious health problems once diseased. This paper proposes a method for intestine segmentation to intestine obstruction diagnosis assistance called multi-dimensional U-Net (M U-Net). We employ two encoders to extract features from two-dimensional (2D) CT slices and three-dimensional (3D) CT patches. These two encoders collaborate to enhance the segmentation accuracy of the model. Additionally, we incorporate deep supervision with the M U-Net to reduce the limitation of training with sparse label data sets. The experimental results demonstrated that the Dice of the proposed method was 73.22%, the recall was 79.89%, and the precision was 70.61%.

DOI： 10.1007/978-3-031-47076-9_14

食道閉鎖症に対する治療戦略：私達はなぜ胸腔鏡手術を選択するのか Reviewed

内田広夫, 田井中貴久, 城田千代栄, 住田亙, 牧田智, 横田一樹, 安井昭洋, 高田瞬也, 中川洋一, 前田拓也, 加藤大幾, 合田陽祐, 郭垚輝, 劉佳慧

日本周産期・新生児医学会雑誌 Vol. 59 ( 4 ) page： 470 - 474 2024

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：一般社団法人日本周産期・新生児医学会

はじめに　名古屋大学小児外科では，食道閉鎖症に対して胸腔鏡下根治術を第一選択としている．アメリカでの現状，meta-analysisに触れながら，当院の治療戦略について簡単に述べる．

DOI： 10.34456/jjspnm.59.4_470

当院におけるロボット支援腹腔鏡下胆道拡張症手術について Reviewed

田井中貴久, 城田千代栄, 牧田智, 里見美和, 狩野陽子, 安井昭和, 中川洋一, 加藤大幾, 前田拓也, 石井宏樹, 太田和樹, 天野日出, 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 Vol. 47 ( 0 ) page： 62 - 63 2024

Intestine Segmentation from CT Volume based on Bidirectional Teaching Reviewed

An, Q; Oda, H; Hayashi, Y; Kitasaka, T; Hinoki, A; Uchida, H; Suzuki, K; Takimoto, A; Oda, M; Mori, K

MEDICAL IMAGING 2024: IMAGE PROCESSING Vol. 12926 2024

10kg 未満の患者に対してもロボット支援腹腔鏡下先天性胆道拡張症手術は安全に行える Reviewed

石井宏樹, 内田広夫, 城田千代栄, 田井中貴久, 牧田智, 里見美和, 安井昭洋, 中川洋一, 加藤大幾, 前田拓也, 太田和樹

日本膵・胆管合流異常研究会プロシーディングス Vol. 47 ( 0 ) page： 66 - 66 2024

DDS-type near-infrared light absorber enables deeper lesion treatment in laser photothermal therapy while avoiding damage to surrounding organs. Reviewed International journal

Masataka Takahashi, Jun Fujishiro, Shinsuke Nomura, Manabu Harada, Akinari Hinoki, Masashi Arake, Eiichi Ozeki, Isao Hara, Ayano Satoh, Takahisa Tainaka, Hiro-O Uchida, Yuji Morimoto

Frontiers in bioengineering and biotechnology Vol. 12 page： 1444107 - 1444107 2024

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

The efficacy of drug delivery system (DDS)-type near-infrared (NIR) absorbing agents in enhancing laser photothermal therapy is widely acknowledged. Despite the acknowledged efficacy, the therapeutic advantages of photothermal therapy using DDS-type NIR-absorbing agents over simple photothermal therapy without such agents have not been fully elucidated. This study was designed to investigate two primary objectives: firstly, the ability of DDS-type NIR-absorbing agents to induce cell death at greater depths within tumors, and secondly, their capacity to minimize collateral damage to adjacent healthy organs. To investigate these objectives, we employed a combination of indocyanine green lactosome-a DDS-type NIR-absorbing agent-and a precision-controlled laser hyperthermia system. An orthotopic neuroblastoma tumor model was used to closely simulate clinical conditions. The findings revealed that photothermal therapy using the DDS-type NIR-absorbing agent not only facilitates deeper penetration of cell death within tumors but also significantly mitigates thermal damage to surrounding healthy tissues, when compared to simple phototherapy without the agent. Furthermore, the combined treatment significantly prolonged the survival periods of the animals involved. This study is the first to analyze these therapeutic efficacies using quantitative data from an orthotopic tumor animal model and substantiated the potential of DDS-type NIR-absorbing agents to deepen the therapeutic impact of photothermal therapy while safeguarding vital organs, thereby enhancing overall treatment outcomes.

DOI： 10.3389/fbioe.2024.1444107

HTSeg: Hybrid Two-Stage Segmentation Framework for Intestine Segmentation from CT Volumes Reviewed

Hiroo UCHIDA

Lecture Notes in Computer Science Vol. 15196 page： 32 - 41 2024

Anastomotic time was associated with postoperative complications: a cumulative sum analysis of thoracoscopic repair of tracheoesophageal fistula in a single surgeon's experience. Reviewed

Yaohui Guo, Akinari Hinoki, Kyoichi Deie, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Masamune Okamoto, Aitarou Takimoto, Akihiro Yasui, Shunya Takada, Yoichi Nakagawa, Daiki Kato, Takuya Maeda, Hizuru Amano, Hiroshi Kawashima, Hiroo Uchida, Chiyoe Shirota

Surgery today Vol. 53 ( 12 ) page： 1363 - 1371 2023.12

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

PURPOSE: This study aimed to evaluate the learning curve of thoracoscopic repair of tracheoesophageal fistula (TEF) by a single surgeon using a cumulative sum (CUSUM) analysis. METHODS: Prospective clinical data of consecutive Gross type-C TEF repairs performed by a pediatric surgeon from 2010 to 2020 were recorded. CUSUM charts for anastomosis and operating times were generated. The learning curves were compared with the effect of accumulation based on case experience. RESULTS: For 33 consecutive cases, the mean operative and anastomosis times were 139 ± 39 min and 3137 ± 1110 s, respectively. Significant transitions beyond the learning phase for total operating and anastomosis times were observed at cases 13 and 17. Both the total operating time and anastomosis time were significantly faster in the proficiency improvement phase than in the initial learning phase. Postoperative complications significantly decreased after the initial anastomosis learning phase but not after the initial total operating learning phase. CONCLUSIONS: Thoracoscopic repair of TEF is considered safe and feasible after 13 cases, where the surgeon can improve their proficiency with the total operation procedure, and 17 cases, which will enable the surgeon to achieve proficiency in anastomosis. Postoperative complications significantly decreased after gaining familiarity with the anastomosis procedure through the learning phase.

DOI： 10.1007/s00595-023-02687-9

Application of indocyanine green fluorescence imaging navigation in pediatric surgery: A single-center review Reviewed

Hiroo UCHIDA

Journal of Pediatric Surgery Open Vol. 4 2023.12

Preoperative management comprising tube irrigation using a trans-anal indwelling tube for infants with hirschsprung disease can allow single-stage radical surgery. Reviewed International journal

Nakagawa Y, Uchida H, Hinoki A, Tainaka T, Shirota C, Sumida W, Makita S, Yokota K, Amano H, Yasui A, Maeda T, Kato D, Gohda Y

BMC SURGERY Vol. 23 ( 1 ) page： 333 2023.11

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes Reviewed

Takada, S; Uchida, H; Hinoki, A; Shirota, C; Sumida, W; Tainaka, T; Makita, S; Takimoto, A; Nakagawa, Y; Maeda, T

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES Vol. 30 ( 11 ) page： 1241 - 1248 2023.11

A new criterion including the aspartate aminotransferase-to-platelet ratio index and liver and spleen stiffness to rule out varices needing treatment in children with biliary atresia: Modification of the Baveno VII criteria. Reviewed International journal

Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Hisanori Muto, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Shunya Takada, Yoichi Nakagawa, Takuya Maeda, Masanao Nakamura, Masatoshi Ishigami, Hiroo Uchida, Hiroki Kawashima

Hepatology research : the official journal of the Japan Society of Hepatology 2023.10

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

AIMS: Biliary atresia (BA) is a congestive biliary disease that develops in the neonatal period or early infancy. It may present with portal hypertension and varices needing treatment (VNT) even after successful Kasai portoenterostomy. This study aimed to stratify the risk of VNT in children and adolescents with BA. METHODS: In this prospective cross-sectional study, we measured liver stiffness (LS) and spleen stiffness (SS) by two-dimensional shear wave elastography and checked for VNT endoscopically in 53 patients with BA who attended for follow-up between July 2018 and September 2022. Varices needing treatment were defined as large esophageal varices, esophageal varices of any size with red color signs, and/or gastric varices along the cardia. RESULTS: Twenty-five patients (aged 0-18 years) had VNT. Eighteen patients met the Baveno VI criteria (LS <20 kPa; platelet count >150 000/L) and were deemed to be at low risk of VNT (spared endoscopies) while three had missed VNT (16.7%). Applying the Baveno VII criteria, which combines the SS cut-off value of 40 kPa with the Baveno VI criteria, resulted in five missed VNTs among 22 spared endoscopies (22.7%). A modification of the Baveno VII criteria using the aspartate aminotransferase-to-platelet ratio index (APRI) instead of the platelet count with cut-off values of 25 kPa, 30 kPa, and 1.04 for LS, SS, and APRI, respectively, missed only one VNT (5.0%) among 20 spared endoscopies. CONCLUSIONS: A novel diagnostic criterion that combines LS, SS, and APRI reduced the risk of missing VNT to 5% in children and adolescents with BA.

DOI： 10.1111/hepr.13976

Safe thoracoscopic repair of recurrent congenital diaphragmatic hernia after initial open abdominal repair Reviewed

Gohda, Y; Yokota, K; Uchida, H; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Takimoto, A; Takada, S; Nakagawa, Y; Maeda, T; Guo, YH; Hinoki, A

SURGERY TODAY 2023.10

Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report Reviewed

Nakagawa, Y; Uchida, H; Hinoki, A; Shirota, C; Sumida, W; Makita, S; Yokota, K; Amano, H; Yasui, A; Kato, D; Gohda, Y; Maeda, T

SURGICAL CASE REPORTS Vol. 9 ( 1 ) page： 169 2023.9

How many cases do instructor class pediatric surgeons need to experience to be an independent operator in performing advanced endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan Reviewed

Murakami, M; Onishi, S; Yamada, K; Ogawa, K; Yokoyama, S; Kurashima, Y; Miyano, G; Ishimaru, T; Kawashima, H; Uchida, H; Yamataka, A; Okuyama, H; Ieiri, S

PEDIATRIC SURGERY INTERNATIONAL Vol. 39 ( 1 ) page： 271 2023.9

Robotic versus laparoscopic radical surgery for pediatric congenital biliary dilatation: a comparison of surgical outcomes of a single surgeon's initial experience Reviewed

Maeda, T; Liu, JH; Uchida, H; Amano, H; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Takimoto, A; Takada, S; Nakagawa, Y; Gouda, A; Guo, YH; Hinoki, A

PEDIATRIC SURGERY INTERNATIONAL Vol. 39 ( 1 ) page： 261 2023.9

Management of congenital and postoperative chylothorax: Use of thoracoscopic lymphatic leak ligations with intraoperative ICG lymphangiography. Reviewed International journal

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

Journal of pediatric surgery Vol. 58 ( 9 ) page： 1754 - 1761 2023.9

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

BACKGROUND: Congenital chylothorax (CCT) and postoperative chylothorax (POCT) are rare and difficult to treat. We report our treatment strategy and outcomes for chylothorax, including thoracoscopic surgery with indocyanine-green (ICG) near-infrared fluorescence lymphangiography. METHODS: A retrospective review of patients with CCT and POCT from 2014 to 2021 was performed. After definitive diagnosis, conservative treatments with octreotide, followed by intravenous steroids as needed, were performed. Patients who were refractory to conservative treatment were transferred to surgical treatment, consisting of thoracoscopic lymphatic leak ligations using ICG intraoperative lymphangiography. The effectiveness of conservative and surgical treatment was then examined. RESULTS: We included 19 cases of CCT and 31 cases of POCT. The 31 POCT patients included 23 of 84 postoperative patients with congenital diaphragmatic hernia (CDH), 7 of 54 postoperative patients with esophageal atresia (EA), and 1 of 3 postoperative patients with lymphatic malformation. The efficacy of conservative treatment was 12/19 for CCT, 22/23 for CDH, and 4/7 for EA. Surgical intervention was performed in 10 patients, and the rate of resolution of chylothorax within 3 weeks after surgery was 90%. CONCLUSION: Thoracoscopic lymphatic leak ligations with intraoperative ICG lymphangiography are feasible and useful in patients with chylothorax refractory to conservative treatment. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1016/j.jpedsurg.2022.11.018

Comprehension of fundamental knowledge about pediatric endoscopic surgery: a cross-sectional study in Japan Reviewed

Yokoyama, S; Kurashima, Y; Ieiri, S; Yamataka, A; Okuyama, H; Uchida, H; Ishimaru, T; Hirano, S

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES Vol. 37 ( 8 ) page： 6408 - 6416 2023.8

BMC PEDIATRICS Vol. 23 ( 1 ) page： 376 2023.7

特集急性虫垂炎:診断,治療,研究複雑性虫垂炎の緊急手術 Reviewed

田井中貴久, 城田千代栄, 住田亙, 横田一樹, 牧田智, 岡本眞宗, 小梛地洋, 長島俊介, 檜顕成, 内田広夫

小児外科 Vol. 55 ( 7 ) page： 751 - 754 2023.7

Case report: Laparoscopic gastrojejunostomy for duodenal atresia with situs inversus and preduodenal portal vein: a report of two cases Reviewed

Nakagawa, Y; Sumida, W; Makita, S; Uchida, H; Hinoki, A; Shirota, C; Tainaka, T; Yokota, K; Amano, H; Yasui, A; Takimoto, A; Kato, D; Maeda, T; Gohda, Y

FRONTIERS IN PEDIATRICS Vol. 11 page： 1220393 2023.6

Case Report: Retropancreatic fascia hernia protruding into the thoracic cavity through a Bochdalek hernia Reviewed

Nakagawa, Y; Maeda, T; Uchida, H; Takada, S; Hinoki, A; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Amano, H; Takimoto, A; Gohda, Y

FRONTIERS IN PEDIATRICS Vol. 11 page： 1149515 2023.6

Preoperative Contrast Examinations Help Determine the Appropriate Cervical Approach for Congenital Gross Type C Esophageal Atresia: A Report of Two Cases Reviewed

Nakagawa, Y; Uchida, H; Shirota, C; Tainaka, T; Sumida, W; Amano, H; Takimoto, A; Ogata, S; Takada, S; Maeda, T; Gohda, Y; Guo, YH; Hinoki, A

AMERICAN JOURNAL OF CASE REPORTS Vol. 24 page： e938723 2023.6

CLINICAL VALIDATION OF NOVEL URINARY MARKERS FOR NEUROBLASTOMA DIAGNOSIS Reviewed

Hiroo UCHIDA

Pediatric Blood and Cancer Vol. 70 page： S95 - S95 2023.6

特集ロボット支援手術ロボット支援下胆管切除術 Reviewed

牧田智, 内田広夫, 住田亙, 檜顕成, 城田千代栄, 田井中貴久, 天野日出, 滝本愛太朗, 高田瞬也, 中川洋一, 合田陽祐, 前田拓也, 郭垚輝, 劉佳慧

小児外科 Vol. 55 ( 5 ) page： 544 - 551 2023.5

特集ロボット支援手術小児外科領域におけるプロクター制度 Invited

内田広夫

小児外科 Vol. 55 ( 5 ) page： 497 - 501 2023.5

Hemi-circumferential mucosal resection and anastomosis procedure for rectal prolapse following anorectoplasty for anorectal malformations. Reviewed

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

Surgery today Vol. 53 ( 5 ) page： 628 - 632 2023.5

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

PURPOSE: Rectal prolapse after radical surgery for anorectal malformations (ARMs) is a common postoperative complication that causes bleeding and stenosis, and sometimes requires surgical treatment. Different surgical techniques have been reported, but most are associated with high recurrence rates and a long postoperative stay. We performed the hemi-circumferential mucosal resection and anastomosis procedure (HCMR) to preserve anal muscle and anal function. Here, we report the success of our minimally invasive surgical approach to correct rectal prolapse in patients with ARMs. METHODS: The subjects of this retrospective review were patients who underwent HCMR for rectal prolapse after radical surgery for ARMs between January, 2014 and August, 2021. HCMR involves rectal mucosal resection without muscle plication. RESULTS: A collective 15 HCMR procedures were performed in 10 patients. The median age at repair was 1.8 years (range, 10 months-18 years). The median operation time and postoperative length of stay were 46 min (range, 17-85 min) and 3 days (range, 1-7 days), respectively. The median postoperative observation period was 3 years 4 months (range, 8 months-7 years 10 months) and no complications or recurrences were observed. CONCLUSIONS: HCMR is a safe and effective surgical treatment for rectal prolapse after radical operation for ARMs, which is minimally invasive and preserves rectal muscle and function.

DOI： 10.1007/s00595-022-02611-7

Single-cell RNA sequencing of intestinal immune cells in neonatal necrotizing enterocolitis. Reviewed International journal

Kazuo Oshima, Akinari Hinoki, Hiroo Uchida, Yujiro Tanaka, Yusuke Okuno, Yasuhiro Go, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Aitaro Takimoto, Yoko Kano, Shinichiro Sawa

Pediatric surgery international Vol. 39 ( 1 ) page： 179 - 179 2023.4

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

PURPOSE: Necrotizing enterocolitis (NEC) causes fatal intestinal necrosis in neonates, but its etiology is unknown. We analyzed the intestinal immune response to NEC. METHODS: Using single-cell RNA sequencing (scRNA-seq), we analyzed the gene expression profiles of intestinal immune cells from four neonates with intestinal perforation (two with NEC and two without NEC). Target mononuclear cells were extracted from the lamina propria of the resected intestines. RESULTS: In all four cases, major immune cells, such as T cells (15.1-47.7%), B cells (3.1-19.0%), monocytes (16.5-31.2%), macrophages (1.6-17.4%), dendritic cells (2.4-12.2%), and natural killer cells (7.5-12.8%), were present in similar proportions to those in the neonatal cord blood. Gene set enrichment analysis showed that the MTOR, TNF-α, and MYC signaling pathways were enriched in T cells of the NEC patients, suggesting upregulated immune responses related to inflammation and cell proliferation. In addition, all four cases exhibited a bias toward cell-mediated inflammation, based on the predominance of T helper 1 cells. CONCLUSION: Intestinal immunity in NEC subjects exhibited stronger inflammatory responses compared to non-NEC subjects. Further scRNA-seq and cellular analysis may improve our understanding of the pathogenesis of NEC.

DOI： 10.1007/s00383-023-05461-7

Rare case of a right Bochdalek hernia with retroperitoneal prolapse of organs into the thoracic cavity in infancy: A case report. Reviewed

Novel urinary marker for diagnosis and prognosis of neuroblastoma Reviewed

Hiroo UCHIDA

Cancer Research Vol. 83 ( 7 ) 2023.4

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

Asian journal of endoscopic surgery Vol. 16 ( 2 ) page： 284 - 288 2023.4

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

We report an extremely rare case of a right Bochdalek hernia with a sac, in which the retroperitoneal and intra-abdominal organs prolapsed into the thoracic cavity at the same time. The patient was a 7-month-old female with no comorbidities. She presented with cough and fever, and chest radiography revealed a right diaphragmatic hernia. Computed tomography showed that the right kidney, intestine, colon, and liver had prolapsed into the thoracic cavity. The patient underwent thoracoscopic surgery, which showed that the abdominal and retroperitoneal organs prolapsed into the thoracic cavity through the Bochdalek hernia. The herniated organs were spontaneously reduced using thoracoscopic insufflation. The defect hole was closed with artificial mesh. We adopted a thoracoscopic approach, in terms of easy reduction of herniated organs and accurate evaluation of the hernia orifice, which was useful.

DOI： 10.1111/ases.13139

Update on aortopexy and posterior tracheopexy for tracheomalacia in patients with esophageal atresia Reviewed

Editorial: Infants with cholestasis Reviewed

Uchida, H; Tiao, GM; Shivakumar, P; Wong, KKY; Asai, A; Amano, H

FRONTIERS IN PEDIATRICS Vol. 11 page： 1175231 2023.3

Sumida, W; Yasui, A; Shirota, C; Makita, S; Okamoto, M; Ogata, S; Takimoto, A; Takada, S; Nakagawa, Y; Kato, D; Gohda, Y; Amano, H; Guo, YH; Hinoki, A; Uchida, H

SURGERY TODAY Vol. 54 ( 3 ) page： 211 - 219 2023.2

A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases. Reviewed International journal

Yoichi Nakagawa, Hiroo Uchida, Satoshi Makita, Kazuki Yokota, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Hizuru Amano, Seiya Ogata, Aitaro Takimoto, Shunya Takada, Takuya Maeda, Yousuke Gohda

Surgical case reports Vol. 9 ( 1 ) page： 5 - 5 2023.1

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: We encountered two cases of a new type of retroperitoneal hernia. We herein report the unique features of these cases. CASE PRESENTATION: Case 1: A Japanese girl was born at a gestational age of 37 weeks, weighing 2550 g. She underwent laparotomic left diaphragmatic hernia repair for a left Bochdalek hernia at the age of one day. The postoperative course was uneventful; however, chest radiography at the age of 35 days revealed bowel gas in the mediastinum, while computed tomography exhibited intestinal prolapses from the medial side of the mesh into the thoracic cavity. Reoperation was performed at the age of 77 days, showing that the defect hole was not at the diaphragm but in the absence of retropancreatic fascia, which was connected to the posterior mediastinum from the supramesocolic space. The mediastinum space was closed with a suturing spine and artificial mesh, and the defect hole in the pancreatic body was sutured. Case 2: A Japanese boy was born at a gestational age of 40 weeks, weighing 3502 g. He was diagnosed with a left diaphragmatic hernia at birth and underwent laparotomy at the age of two days. Operative findings showed no defect hole in the diaphragm, and no intestine was observed in the abdominal cavity. After close observation of the abdominal cavity, the intestine was found around the pancreatic body, and manual reduction of the intestine was performed. The defect hole existed in the absence of the retropancreatic fascia, which was connected to the extra-pleural space. The defect hole in the pancreatic body was sutured and closed with a non-absorbable thread. CONCLUSIONS: We assumed that our cases were a new type of retroperitoneal hernia, which we named "retropancreatic fascia hernia".

DOI： 10.1186/s40792-023-01586-y

Laparoscopic restorative proctocolectomy with ileal-J-pouch anal canal anastomosis without diverting ileostomy for total colonic and extensive aganglionosis is safe and feasible with combined Lugol's iodine staining technique and indocyanine green fluorescence angiography Reviewed

Nakagawa, Y; Yokota, K; Uchida, H; Hinoki, A; Shirota, C; Tainaka, T; Sumida, W; Makita, S; Amano, H; Takimoto, A; Ogata, S; Takada, S; Maeda, T; Gohda, Y

FRONTIERS IN PEDIATRICS Vol. 10 page： 1090336 2023.1

Laparoscopic closure of Roux limb perforation during double-balloon endoscopic retrograde cholangiography with laparoscopy-assisted endoscopic hepatolithectomy 30 years after congenital biliary dilatation radical surgery: A case report. Reviewed

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

Asian journal of endoscopic surgery Vol. 16 ( 1 ) page： 118 - 122 2023.1

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

We report a case of hepatolithiasis 30 years after congenital biliary dilatation (CBD) surgery. A 31-year-old woman presented with fever and epigastric pain. She had a history of radical surgery for type I CBD at the age of 1 year and had no significant symptoms for approximately 30 years after surgery. Laboratory and imaging results showed hepatolithiasis at the common trunk of segments II and III with cholangitis. She was admitted to our hospital for antibiotics and underwent double-balloon endoscopic retrograde cholangiography (DBERC) to treat the hepatolithiasis. Roux-limb jejunum was perforated during DBERC; hence, emergent laparoscopic perforation site closure and simultaneous endoscopic lithotomy through the Roux-limb jejunum with exteriorization via umbilical incision were performed. The postoperative course was uneventful, and the patient was discharged without any complications.

DOI： 10.1111/ases.13116

Retroperitoneoscopic resection of a large paraganglioma surrounded by the right diaphragmatic crus on the dorsal side of the inferior vena cava: A pediatric case report. Reviewed

Aitaro Takimoto, Wataru Sumida, Chiyoe Shirota, Satoshi Makita, Masamune Okamoto, Seiya Ogata, Shunya Takada, Yoichi Nakagawa, Daiki Kato, Yosuke Goda, Akinari Hinoki, Hiroo Uchida

Asian journal of endoscopic surgery Vol. 16 ( 1 ) page： 131 - 134 2023.1

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

Pheochromocytomas and paragangliomas are rare tumors. A 10 year-old girl was brought to the emergency room with complaints of sudden vomiting and convulsions, and was initially diagnosed with hypertensive encephalopathy. Magnetic resonance imaging and computed tomography scan showed a large mass (6 × 3 × 3 cm) on the dorsal side of the inferior vena cava, surrounded by the right diaphragmatic crus, and closely attached to the aorta. Blood noradrenaline, urinary normetanephrine, and noradrenaline levels were elevated. The final diagnosis was retroperitoneal paraganglioma, then, surgery was contemplated. The location of the liver and great vessels in front of the tumor made the commonly performed transabdominal approach complicated. Therefore, retroperitoneoscopic surgery was preferred for safer resection, with better visualization in a sufficient space with less risk of damaging the surrounding organs. The retroperitoneoscopic approach is a good indication for tumors located behind the great vessels.

DOI： 10.1111/ases.13119

The presence of high-risk varices after sclerotherapy in biliary atresia. Reviewed International journal

Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Aitaro Takimoto, Yoichi Nakagawa, Shunya Takada, Masatoshi Ishigami, Hiroo Uchida, Hiroki Kawashima

Pediatrics international : official journal of the Japan Pediatric Society Vol. 65 ( 1 ) page： e15454 2023.1

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

BACKGROUND: Esophagogastric varices (EGVs) may develop as a result of portal hypertension in children with biliary atresia (BA). Although endoscopic injection sclerotherapy (EIS) with ethanolamine oleate (EO) is reported useful for children, risk factors associated with the presence of high-risk EGVs after treatment remain unknown. METHODS: The subjects were BA patients under 15 years of age who underwent EO-EIS. We retrospectively reviewed a total of 28 treatment sessions of EGVs with red signs and those larger than F2, which were considered to be at high risk of bleeding. Survival analysis was performed for the presence of high-risk EGVs at the time of follow-up endoscopy as the occurrence of an event. RESULTS: Univariate analysis showed a significantly increased risk of the presence of high-risk EGVs post-EO-EIS in patients with increased liver stiffness (LS) and Mac-2 binding protein glycan isomer (M2BPGi), with hazard ratios of 1.48 and 1.15, respectively. The median presence-free period was significantly shorter in the LS ≥ 2.8 m/sec patients than in those with LS < 2.8 m/sec (189 vs. 266 days). Similarly, the median presence-free period was significantly shorter in patients with M2BPGi ≥ 4.0 than in those with M2BPGi < 4.0 (182 vs. 203 days). The results of multivariate analysis revealed that the risk of the presence of high-risk EGVs was significantly higher only in the high-LS group, with a hazard ratio of 2.76. CONCLUSIONS: Increased LS is associated with risk of the presence of high-risk EGVs following EO-EIS in children with BA. (246 words).

DOI： 10.1111/ped.15454

先天性十二指腸閉鎖症・狭窄症に合併した膵・胆管合流異常の4例 Reviewed

牧田智, 内田広夫, 檜顕成, 寺脇幹, 城田千代栄, 田井中貴久, 住田亙, 横田一樹, 天野日出, 滝本愛太朗, 安井昭洋, 中川洋一, 加藤大幾, 合田陽祐, 前田拓也, 郭垚輝, 劉佳慧

日本膵・胆管合流異常研究会プロシーディングス Vol. 46 ( 0 ) page： 52 - 53 2023

AI画像解析による内視鏡外科手術手技のビデオ評価及び手術支援システムの構築 Reviewed

安井昭洋, 内田広夫, 森健策, 石田昇平, 出家亨一, 檜顕成, 城田千代栄, 小田昌宏, 林雄一郎

生体医工学 Vol. Annual61 ( Abstract ) page： 127_2 - 127_2 2023

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：公益社団法人日本生体医工学会

【はじめに】術後成長発達する小児患者にとって、低侵襲手術は非常に重要である。しかし患者数は限られているため、しっかりとした手術を行うためにoff the job-training(OJT)が重要である。さらにOJTでの効率的な手技獲得には、手技を客観的に評価しfeed backを行うシステムが必須である。また安全で効率的な内視鏡手術を行うためには、臓器の位置関係の把握が必要であるため、術中ナビゲーションは重要な要件となる。これらの課題に対して、AIを用いた内視鏡手技評価および手術支援システムの構築に着手しており現状の成果を報告する。【方法と結果】食道閉鎖症モデルを用いた吻合手技を被験者に課し、各被験者の手技を最初に人の目で「check 表」「エラー項目」「時間」を用いて評価した。次にビデオから検出した鉗子の動きと人が判定した手技優劣の関係性をAIで学習させ、上位88％・下位95％の精度で手技優劣が自動判定可能となった。この結果を解析することで今まで必要だった50項目以上の肉眼チェックが、わずか７項目チェックするだけで手技の優劣を判断できることが明らかになった。現在食道閉鎖症の手術画像を用いて、食道・迷走神経・気管を深層学習させ、各種構造物の自動認識を進めている。【まとめ】AI画像解析により内視鏡手技の優劣をビデオで判定可能となった。この結果から新たに効率的な手技判断基準を定めることができた。術中ナビゲーションは現在精度のさらなる向上を目指している。

DOI： 10.11239/jsmbe.annual61.127_2

Refractory tracheoesophageal fistula treated using multi-stage surgery: A case report. Reviewed International journal

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

Frontiers in pediatrics Vol. 10 page： 1053154 - 1053154 2022.12

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

A tracheoesophageal fistula (TEF) recurs in approximately 2%-13% of cases of esophageal atresia with TEF that are treated surgically. Currently, there is no consensus on the most effective treatment to prevent recurrent TEF (RTEF). Herein, we present a patient with type C esophageal atresia who underwent thoracoscopic esophago-esophageal anastomosis and TEF repair at 2 days old. However, RTEFs were observed at ages 3, 6, and 11 months, and thoracoscopic TEF repairs using a pleural patch, fascia lata graft, and pectoralis major myocutaneous (PMMC) flap were performed, respectively. A fourth recurrence led to mediastinitis, shock liver, disseminated intravascular coagulopathy, and a compromised respiratory status. Hence, laparoscopic esophageal transection was first performed to improve the respiratory condition by preventing the regurgitation of gastric contents. Once the patient was stable, a subtotal esophageal resection with TEF closure followed by gastric tube reconstruction was performed. In conclusion, we encountered a case of refractory RTEF that was repaired four times using various techniques, including a fascia lata graft and PMMC flap. However, TEF still recurred after these four operations. The final surgical strategy involved an esophageal transection as a palliative therapy, which improved the respiratory condition, followed by closure of the TEF and subtotal esophageal resection. Finally, esophageal reconstruction using a gastric tube after the complete remission of inflammation was effective. This multi-stage surgery was considered the only choice to rescue the patient and effectively prevent another recurrence.

DOI： 10.3389/fped.2022.1053154

Preoperative imaging contributes to pathologically complete resection of the urachal remnant by determining an appropriate surgical approach without unnecessary and excessive surgical invasion: a retrospective study. Reviewed International journal

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

BMC urology Vol. 22 ( 1 ) page： 207 - 207 2022.12

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

BACKGROUND: The urachus is an embryonic structure that connects the bladder to the allantois during early embryonic development. Occasionally, it fails to disappear at birth, leading to a case of urachal remnant (UR). This study aimed to determine whether our policy for selecting an appropriate UR resection approach is valid. We performed preoperative imaging to examine whether UR continued toward the bladder apex. If so, the UR and bladder apex were excised using the trans-umbilical approach, in addition to laparoscopy, if necessary. If preoperative imaging indicated that the UR ended near the umbilicus, the UR from the umbilicus to the duct end was resected. Pathological evaluations were performed to determine the appropriateness of the surgical approach indicated by preoperative imaging. METHODS: We retrospectively reviewed pediatric patients with UR who underwent surgery between 2015 and 2021. Their background characteristics and surgical outcomes were evaluated. RESULTS: Twenty patients with UR were included (median age, 7 [interquartile range, 2-10.25] years). UR continued toward the bladder apex in 10 patients and ended near the umbilicus in 10 patients. Urachus tissue at the bladder site was observed when the UR and bladder apex were excised. When UR was resected from the umbilicus to the duct end, urachus tissue was not pathologically detected at the resection margin. CONCLUSION: Our policy results in complete resection without excessive surgical invasion.

DOI： 10.1186/s12894-022-01153-x

Endoscopic injection sclerotherapy with polidocanol for cardiac varices in children and adolescents. Reviewed International journal

Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Akinari Hinoki, Wataru Sumida, Chiyoe Shirota, Takahisa Tainaka, Satoshi Makita, Kazuki Yokota, Hiroo Uchida, Masatoshi Ishigami

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie 2022.12

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

BACKGROUND: Like esophageal varices, cardiac varices are often treated with endoscopic variceal ligation (EVL). However, we previously reported that EVL for cardiac varices may be associated with a high risk of rebleeding from the ulcer if the O-ring spontaneously drops off early. The efficacy and safety of para-variceal endoscopic injection sclerotherapy (EIS) with polidocanol for the treatment of cardiac varices in children and adolescents were evaluated. METHODS: Eleven patients under 18 years of age with portal hypertension who underwent para-variceal EIS with polidocanol for cardiac varices with red signs, which were considered to be at high risk of bleeding, were retrospectively reviewed. RESULTS: One session of para-variceal polidocanol-EIS was performed for each of the 11 patients. One patient experienced temporary hypoxia due to aspiration of saliva when the tracheal intubation tube was removed after the procedure but recovered by endotracheal suctioning; there were no other adverse events. In six of the eight cases in which efficacy could be evaluated, eradication of cardiac varices was achieved. CONCLUSION: Para-variceal polidocanol-EIS may be considered instead of EVL for small cardiac varices with red signs in pediatric patients with cardiac varices.

DOI： 10.1016/j.arcped.2022.11.016

Adding a spur valve to laparoscopic portoenterostomy for patients with biliary atresia can achieve a high jaundice clearance rate and lower the number of episodes of cholangitis. 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

Pediatric surgery international Vol. 38 ( 12 ) page： 1881 - 1885 2022.12

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

PURPOSE: This study aimed to evaluate the efficacy of adding a spur valve to laparoscopic portoenterostomy for patients with biliary atresia. METHODS: We retrospectively reviewed the records of all patients diagnosed with biliary atresia (BA) who underwent laparoscopic portoenterostomy (Lap-PE) between 2013 and 2021. The patients were divided into two groups: Lap-PE with a spur valve (spur group) and without it (control group). Perioperative management was the same in both groups. We compared patient backgrounds and clinical outcomes, including jaundice clearance and the number of postoperative cholangitis episodes. RESULTS: Of 63 patients reviewed, 16 received a spur valve. There were no statistically significant differences in the patient backgrounds between the groups. All patients in the spur group achieved jaundice clearance. The number of postoperative cholangitis episodes one year after surgery was significantly lower in the spur group than in the control group (1 [0-3] vs. 3 [0-9], p = 0.04). The jaundice-free survival rate with the native liver at one year after surgery was significantly higher in the spur group (100% vs. 53%, p = 0.01). CONCLUSIONS: Adding a spur valve during Lap-PE significantly lowered the number of cholangitis episodes 1 year after surgery.

DOI： 10.1007/s00383-022-05230-y

Laparoscopic revision of Kasai portoenterostomy after initial laparoscopic portoenterostomy in patients with biliary atresia: a limited but positive effect on native liver survival. Reviewed International journal

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

Pediatric surgery international Vol. 38 ( 12 ) page： 1821 - 1827 2022.12

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

PURPOSE: It is important for patients with biliary atresia (BA) to retain the native liver after Kasai portoenterostomy (PE). Laparoscopic PE (Lap-PE) is standard, whereas laparoscopic revision of PE (Lap-revision) is performed as needed. We report the medium-term outcomes of Lap-revision. METHODS: We retrospectively reviewed the demographics and outcomes of 63 patients who underwent Lap-PE between 2013 and 2021. Indications for revision included recurrent jaundice, repeat cholangitis, and persistent jaundice with temporary biliary excretion following the initial PE. We compared liver transplantation (LT) data of patients who underwent Lap-revision with those of patients who did not. RESULTS: Lap-revision was performed in 20 patients. Of those 17 (excluding the two who were jaundice-free before the age of 1, and the one who underwent open conversion for bleeding), 11 (65%) were jaundice-free 1 year after Lap-revision. The surgical parameters of LT did not differ between patients who underwent Lap-revision and those who did not. CONCLUSION: Lap-revision for patients with BA had a limited but positive effect on native liver survival and did not adversely affect subsequent LT. Therefore, Lap-revision could be second-line standard therapy in patients with BA who have demonstrated biliary drainage at least once after initial PE.

DOI： 10.1007/s00383-022-05235-7

Encouraging Young Pediatric Surgeons and Evaluation of the Effectiveness of a Pediatric Endosurgery Workshop by Self-Assessment and an Objective Skill Validation System. Reviewed International journal

Katsuhiro Ogawa, Satoshi Ieiri, Toshihiko Watanabe, Yuko Bitoh, Hiroo Uchida, Atsuyuki Yamataka, Yasuharu Ohno, Masayuki Ohta, Masafumi Inomata, Elena Dorofeeva, Yulia Podurovskaya, Ekaterina Yarotskaya, Seigo Kitano

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 32 ( 12 ) page： 1272 - 1279 2022.12

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

Background: Japanese pediatric endosurgery experts conducted a workshop for young pediatric surgeons in Russia in collaboration with Russian expert pediatric surgeons. This study was aimed to develop a contributive workshop program and evaluate its impact on young pediatric surgeons. Methods: A 2-day pediatric endosurgery workshop was held in Moscow in February 2020. After conducting a needs assessment survey, Japanese and Russian faculties developed the workshop contents, including pre- and postworkshop skills assessments, lectures, and hands-on training. Skills assessments were performed using the objective skill validation system, the "A-Lap Mini," mimicking intestinal anastomosis. The trainees self-evaluated their knowledge and skills using a five-point scale. Results: Fifteen novice trainee participated and 14 (93.3%) completed the workshop program. The completion rate for the suturing task before and after the workshop was 40.0% (6/15) and 85.7% (12/14), respectively. The following five skill evaluation criteria, which were objectively evaluated: performance time changed from 751.6 ± 247.1 seconds to 780.0 ± 313.3 seconds (P > .05), number of full-thickness sutures improved from 1.0 ± 1.41 to 2.64 ± 0.84 (P = .003), area of wound-opening changed from 0.42 ± 0.83 mm2 to 0.53 ± 1.13 mm2 (P > .05), suture tension improved from 55.48% ± 19.51% to 61.95% ± 23.91% (P > .05), and maximum air leakage pressure improved from 3.76 ± 2.11 kPa to 8.42 ± 7.68 kPa (P > .05). Regarding the self-assessed questionnaire administered before and after the workshop, the confidence in endosurgery skills significantly improved as follows: forceps manipulation ability improved from 2.7 to 3.7 (P < .05), and suturing performance improved from 2.5 to 3.6 (P < .05). The usefulness of the workshop for clinical surgery was scored at 4.3. Conclusions: Quantitative skill evaluation with an automatic feedback function was useful for endosurgery training. Delivering feedback concerning the assessment results to the trainee helps them to determine the specific training requirements needed for clinical endosurgery.

DOI： 10.1089/lap.2022.0152

Biochemical markers to predict the development of gastrointestinal bleeding and esophageal varices after portoenterostomy in biliary atresia. Reviewed International journal

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

Pediatric surgery international Vol. 38 ( 12 ) page： 1799 - 1805 2022.12

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

PURPOSE: Gastrointestinal bleeding (GIB) due to esophageal varices (EV) is one of the factors that negatively impact native liver survival of patients with biliary atresia (BA). Gastrointestinal fibroscopy (GIF) is usually used to determine the presence of EVs; however, it requires general anesthesia. The aim of this study is to search for markers in blood tests obtained during routine check-ups that can predict the development of GIB. METHODS: Data of patients with BA who underwent portoenterostomy at our hospital from 2014 to 2020 were retrospectively reviewed. The patients' data were assigned to three groups according to specific time points: Group B, which included data at GIB; Group NB-T, which included data at GIF and EV treatment; and Group NB-NT, which included data at GIF without treatment. The data in Group B were compared to those of other groups. RESULTS: In our study, GIB occurred in 11 patients, and 12 cases and 8 cases were classified into Groups NB-NT and NB-T, respectively. Compared with the other groups, only ChE and M2BPGi in Group B showed statistically significant differences. CONCLUSIONS: ChE and M2BPGi are useful for predicting GIB.

DOI： 10.1007/s00383-022-05243-7

Combined negative pressure wound therapy with irrigation and dwell time and artificial dermis prevents infection and promotes granulation formation in a ruptured giant omphalocele: a case report. Reviewed International journal

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

BMC pediatrics Vol. 22 ( 1 ) page： 680 - 680 2022.11

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

BACKGROUND: Omphalocele is a congenital abdominal wall defect of the umbilical cord insertion site. A giant omphalocele, with a fascial defect > 5 cm in diameter and/or containing > 50% of the liver within the hernia sac, can be challenging for pediatric surgeons. Recently, negative pressure wound therapy has been reported as an effective management for giant omphaloceles; however, it is not recommended for an infected wound with necrotic tissue as it may exacerbate infection. We adopted negative pressure wound therapy with irrigation and dwell time (NPWTi-d) for a case of a ruptured giant omphalocele. Artificial membranes, followed by artificial dermis, were used to promote fibrous capsule formation, and then NPWTi-d was used to promote granulation while controlling infection. However, studies have not been conducted regarding NPWTi-d for ruptured giant omphaloceles; hence, we present our treatment experience with NPWTi-d for a giant omphalocele. CASE PRESENTATION: The patient was a boy born at 38 weeks and 3 days of gestation, weighing 1896 g. He was diagnosed with a ruptured giant omphalocele with a total liver and intestine defect hole of 10 cm × 10 cm. The patient underwent silo placement using an artificial mesh, followed by plicating the artificial mesh at 4 days of age. The herniated viscera were gradually reduced into the abdominal cavity; however, the defect size was still large. Hence, a collagen-based artificial dermis was patched on the defect hole. After creating a fresh and smooth granulated tissue, NPWTi-d was applied at 33 days of age to promote granulation and control infection. We used the 3 M™ V.A.C.® Ulta Therapy Unit with 3 M™ VeraFlo™ therapy. NPWTi-d was stopped at 60 days of age when the granulation tissue was well formed including at the artificial dermis site. The wound was managed with prostandin ointment and appropriate debridement, resulting in complete epithelialization at 5 months of age. CONCLUSIONS: Artificial membranes followed by artificial dermis were used to promote a fibrous capsule and artificial dermis granulation, which protects against organ damage. NPWTi-d achieved better control of infection and promoted wound healing. NPWTi-d combined with artificial dermis can effectively treat ruptured giant omphaloceles.

DOI： 10.1186/s12887-022-03755-8

Laparoscopic Duodenal-Caudal Detachment Method: Early Experience of a Novel Technique for Malrotation with Volvulus in Neonates. Reviewed International journal

Aitaro Takimoto, Hizuru Amano, Wataru Sumida, Chiyoe Shirota, Kazuki Yokota, Satoshi Makita, Masamune Okamoto, Seiya Ogata, Shunya Takada, Youichi Nakagawa, Daiki Kato, Yosuke Goda, Akinari Hinoki, Hiroo Uchida

Journal of laparoendoscopic & advanced surgical techniques. Part A 2022.11

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Purpose: A laparoscopic approach for malrotation is feasible and safe in hemodynamically stable neonates without intestinal necrosis; however, volvulus is associated with recurrence and conversion. We developed a novel approach using a laparoscopic duodenal-caudal detachment method to perform the Ladd procedure for neonates with volvulus under the limited view of laparoscopy. This study presents the results, effectiveness, and details of the method. Materials and Methods: In the laparoscopic duodenal-caudal detachment method, we first detached the adhesions around the duodenum, including the Ladd's band. After the adhesions were completely removed, the duodenum was freely drawn caudally, leading to the release of torsion. We retrospectively reviewed the medical records of patients who underwent surgery for malrotation of the volvulus at 30 days of age between January 2014 and September 2021. Results: Seven neonates underwent the laparoscopic duodenal-caudal detachment method and 13 underwent the open Ladd procedure. The new technique was performed in all 7 patients, and there were no conversions or recurrences. The operation time was significantly longer in the laparoscopic procedure group (55 minutes versus 111 minutes; P < .01). Conclusions: Our detorsion method, involving an initial incision of the Ladd's band, is safe and effective for neonates and may lead to an improvement in the conversion rates.

DOI： 10.1089/lap.2022.0390

Development of wearable multi-lead ECG measurement device using cubic flocked electrode. Reviewed International journal

Toshihiro Takeshita, Manabu Yoshida, Yusuke Takei, Atsushi Ouchi, Akinari Hinoki, Hiroo Uchida, Takeshi Kobayashi

Scientific reports Vol. 12 ( 1 ) page： 19308 - 19308 2022.11

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

This paper describes the fabrication and fundamental evaluation of the cubic flocked electrode (CFE), which is a dry electrode that is fabricated using electrostatic flocking technology. The development of a wearable multi-lead electrocardiogram (ECG) measurement device using the CFE is also reported. To enable the measurement of ECG signals with sufficient quality for medical applications, the occurrence of motion artifacts (MAs) is the most important problem to be overcome. Therefore, it is necessary to stabilize the contact between the patient's skin and the dry electrode. Because the CFE developed in this work offers both contact stability and flexibility, it is expected to enable ECG measurements with low MA levels. In this study, it is demonstrated that the number of MAs caused by respiration can be reduced when the CFE contact is made at a contact pressure of approximately 500 Pa using MA evaluation equipment that was developed in-house. Additionally, a wearable multi-lead ECG is designed and fabricated based on this contact pressure (500 Pa). The results of the demonstration experiment show that the ECG measurements are successful to the same extent as a conventional medical device.

DOI： 10.1038/s41598-022-24043-6

Case report: A giant bilateral inguinal hernia requiring artificial mesh and multi-stage surgery in infancy; hernioplasty with silo placement to prevent acute compartment syndrome. Reviewed International journal

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

Frontiers in pediatrics Vol. 10 page： 1030934 - 1030934 2022.11

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

Hernioplasty for giant inguinal hernias can cause abdominal compartment syndrome (ACS) in adults but rarely does in infants. We encountered a case of a giant bilateral inguinal hernia in infancy complicated by ACS after hernioplasty. Silo placement via a skin incision effectively treated ACS, after which the abdominal wall was safely closed. Hernioplasty performed early in the clinical course can help expand the abdominal cavity and avoid ACS. Thus, hernioplasty should be performed earlier if the hernia size in the flank space gradually increases.

DOI： 10.3389/fped.2022.1030934

Intraoperative indocyanine green fluorescence cholangiography can rule out biliary atresia: A preliminary report. Reviewed International journal

Chiyoe Shirota, Akinari Hinoki, Takao Togawa, Shogo Ito, Wataru Sumida, Satoshi Makita, Hizuru Amano, Aitaro Takimoto, Shunya Takada, Masamune Okamoto, Yoichi Nakagawa, Daiki Kato, Hiroo Uchida

Frontiers in pediatrics Vol. 10 page： 1005879 - 1005879 2022.11

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

BACKGROUND: The prognosis of BA is known to be poor if definitive surgery is performed too late. Therefore, excluding BA as a diagnosis at an early stage is crucial. Conventional cholangiography requiring cannulation through the gallbladder may be unnecessarily invasive for patients, especially when ruling out BA. Therefore, a less invasive alternative such as indocyanine green (ICG) cholangiography, which does not require cannulation, should be established. In this study, we focused on excluding BA and confirmed the usefulness of intravenous ICG fluorescence cholangiography. To the best of our knowledge, this is the first preliminary study to report the use of intravenous ICG cholangiography for BA exclusion. METHODS: The study participants were patients who underwent liver biopsy and intraoperative cholangiography after they were suspected to have BA, between 2013 and 2022. ICG fluorescence cholangiography was performed on all patients who provided informed consent. RESULTS: During the study period, 88 patients underwent a laparoscopic liver biopsy and cholangiography. Among them, 65 (74%) were diagnosed with BA and underwent a subsequent laparoscopic Kasai portoenterostomy. BA was ruled out intraoperatively in 23 patients. Of the 23 patients in whom BA was ruled out, 14 underwent ICG cholangiography, 11 had gallbladder (GB) fluorescence, and 9 had both GB and common bile duct (CBD) fluorescence. Conventional cholangiography was very difficult in 2 of 23 cases: in 1 case, cannulation of the atrophic gallbladder was impossible, and cholecystectomy was indicated after multiple attempts; in 1 case, upstream cholangiography was not possible. In both cases, ICG fluorescence cholangiography successfully imaged the CBD and the GB. CONCLUSIONS: In conclusion, intravenous ICG fluorescence cholangiography might be a useful and less invasive diagnostic procedure that can rule out BA in infants.

DOI： 10.3389/fped.2022.1005879

Circumumbilical incision for neonatal abdominal surgery: additional skin incision when there is difficulty in manipulating the intestine. Reviewed

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

Nagoya journal of medical science Vol. 84 ( 4 ) page： 716 - 722 2022.11

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

This study aimed to evaluate the safety and effectiveness of circumumbilical incision (CUI) for neonates requiring intestinal anastomosis. Seventy neonates requiring intestinal anastomosis at our institution between 2003 and 2020 were included in this retrospective case-control study. Patients were classified into the CUI (25 patients: 36%) and transverse incision (TI) groups (45 patients: 64%). Postoperative complications and surgical outcomes were compared between the two groups. Intestinal perforation at the non-anastomotic site occurred significantly more often in the CUI group than in the TI group (3 patients: 12%, and 0 patients: 0%, respectively (p = 0.042)). There were no between-group differences regarding anastomotic leakages, anastomotic strictures, time to enteral feeding, operative time, and blood loss. Neonatal intestinal surgery employing CUI might be associated with increased intestinal perforation at the non-anastomotic site. Hesitating to enlarge the skin incision to maintain favorable cosmetic outcomes might cause severe injury to the delicate neonatal intestine during the surgical procedure owing to the restricted surgical field. When performing CUI, we suggest that the skin incision should be extended without hesitation whenever there is difficulty in manipulating the intestine.

DOI： 10.18999/nagjms.84.4.716

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

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

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

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

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

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

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

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

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

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

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

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

多発肝内胆管狭窄を伴う先天性胆道拡張症術後難治性肝内結石の１例 Reviewed

牧田智, 内田広夫, 檜顕成, 城田千代栄, 住田亙, 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, 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： 74 - 75 2022

Multi-class prediction for improving intestine segmentation on non-fecal-tagged CT volume Reviewed

Oda, H; Hayashi, Y; Kitasaka, T; Takimoto, A; Hinoki, A; Uchida, H; Suzuki, K; Oda, M; Mori, K

MEDICAL IMAGING 2022: COMPUTER-AIDED DIAGNOSIS Vol. 12033 2022

特集小児外科疾患の家族内発生胆道閉鎖症の家族内発症 Reviewed

安井昭洋, 内田広夫, 城田千代栄, 住田亙, 横田一樹, 牧田智, 岡本眞宗, 滝本愛太朗, 高田瞬也, 中川洋一

小児外科 Vol. 53 ( 12 ) page： 1288 - 1290 2021.12

保険収載からみた国内小児内視鏡外科手術の導入・普及の解析 30年間の多施設共同全国調査 Reviewed

小川雄大, 村上雅一, 家入里志, 松本紘明, 皆尺寺悠史, 當寺ヶ盛学, 白下英史, 衛藤剛, 内田広夫, 山高篤行, 岩中督, 猪股雅史, 外科系学会社会保険委員会

日本内視鏡外科学会雑誌 Vol. 26 ( 7 ) page： MO068 - 4 2021.12

＜Editors' Choice＞ Long-term outcomes of the partial splenectomy for hypersplenism after portoenterostomy of patients with biliary atresia. Reviewed

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

Nagoya journal of medical science Vol. 83 ( 4 ) page： 765 - 771 2021.11

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

Massive splenomegaly and hypersplenism in patients with biliary atresia after Kasai portoenterostomy were treated with partial splenic embolization or total splenectomy. We performed partial splenectomy to reduce the complications of partial splenic embolization and avoid overwhelming post-splenectomy infection. This study aimed to evaluate the long-term effects of partial splenectomy for hypersplenism on postoperative liver and spleen function in patients with biliary atresia. Among jaundice-free patients with biliary atresia who underwent Kasai portoenterostomy between January 1992 and December 2012, 15 underwent partial splenectomy for massive splenomegaly and hypersplenism at our institution. Changes in the laboratory data 10 years post partial splenectomy were retrospectively investigated, and these along with the latest data were measured. A total of four patients (27%) required living-donor liver transplantation after partial splenectomy, a proportion similar to those who did not undergo partial splenectomy. Compared to the preoperative baseline, the platelet counts were significantly higher at 1 and 3 years after surgery (p < 0.05). Aspartic aminotransferase-to-platelet ratio index was significantly lower at 1, 7, and 10 years after partial splenectomy (p < 0.05). No further surgeries were required for hypersplenism after partial splenectomy over 10 years, and there were no cases of overwhelming post-splenectomy infection after partial splenectomy. Partial splenectomy is safe and effective for the treatment of hypersplenism with biliary atresia over a long time period. It could be considered as an alternative to partial splenic embolization as it can suppress hypersplenism for a long time and induces fewer postoperative complications.

DOI： 10.18999/nagjms.83.4.765

Single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for inguinal hernia with prolapsed ovary. Reviewed

Urinary Biomarkers Predicting Treatment Outcomes in Neuroblastoma Reviewed

Atsushi Narita, Akinari Hinoki, Kazuki Yokota, Motoharu Hamada, Shinsuke Kataoka, Nozomu Kawashima, Hideki Muramatsu, Nobuhiro Nishio, Hiroo Uchida, Yoshiyuki Takahashi

PEDIATRIC BLOOD & CANCER Vol. 68 2021.11

Shirota C, Tainaka T, Sumida W, Yokota K, Makita S, Amano H, Okamoto M, Takimoto A, Yasui A, Nakagawa Y, Hinoki A, Uchida H

Surgical endoscopy 2021.10

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

Factors associated with bleeding after endoscopic variceal ligation in children Reviewed

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 Vol. 63 ( 10 ) page： 1223 - 1229 2021.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

Late postoperative complications of congenital biliary dilatation in pediatric patients: a single-center experience of managing complications for over 20 years Reviewed

SERUM MATRIX METALLOPROTEINASE-7 IN JAPANESE INFANTS WITH BILIARY ATRESIA Reviewed

Hiroo UCHIDA

Hepatology Vol. 74 page： 1178A - 1178A 2021.10

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

SURGERY TODAY Vol. 51 ( 9 ) page： 1488 - 1495 2021.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

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 Reviewed

血清MMP-7は胆道閉鎖症の肝移植予測マーカーとなりうるか? 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

日本小児栄養消化器肝臓学会雑誌 Vol. 35 ( Suppl. ) page： 106 - 106 2021.9

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 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

Urinary N-1,N-12-diacetylspermine as a biomarker for pediatric cancer: a case-control study Reviewed

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 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

Comparative study of open and laparoscopic Kasai portoenterostomy in children undergoing living donor liver transplantation for biliary atresia Reviewed

Takeda Masahiro, Sakamoto Seisuke, Uchida Hajime, Shimizu Seiichi, Yanagi Yusuke, Fukuda Akinari, Uchida Hiroo, Yamataka Atsuyuki, Kasahara Mureo

PEDIATRIC SURGERY INTERNATIONAL 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Pediatric Surgery International

Purpose: The effectiveness of laparoscopic Kasai portoenterostomy (Laparoscopic-KPE) for biliary atresia (BA) has been reported but remains controversial. We reviewed our own cases and cases described in previous studies of liver transplantation (LT) for BA after Laparoscopic-KPE to investigate the efficacy of Laparoscopic-KPE. Methods: Subjects were children of ≤ 2 years old with LT for BA after KPE who underwent Laparoscopic-KPE (n = 10) or Open-KPE (n = 115) between 2009 and 2020. Propensity score matching was performed to reduce the effect of treatment selection bias. The clinical data regarding the preoperative characteristics and surgical results were compared. Results: The rates of hypoplastic portal vein and retrograde portal vein flow were lower in the Laparoscopic-KPE group than in the Open-KPE group (0 vs. 40.0%, p = 0.02 and 0 vs. 35.0%, p = 0.04). There was no marked difference in the operation time or duration of hepatectomy. For portal vein reconstruction, a vein graft was not required in the Laparoscopic-KPE group (0 vs. 35.0%, p = 0.03). No patients in the Laparoscopic-KPE group developed portal vein complications or required re-laparotomy for bowel perforation or re-bleeding, in contrast to the Open-KPE group (0 vs. 15.0% and 0 vs. 10.0%, respectively). Conclusion: Laparoscopic-KPE may reduce postoperative complications that necessitate re-laparotomy in LT.

DOI： 10.1007/s00383-021-04994-z

Current thoracoscopic approach for mediastinal neuroblastoma in Japan-results from nationwide multicenter survey Reviewed

Kawano Takafumi, Souzaki Ryota, Sumida Wataru, Shimojima Naoki, Hishiki Tomoro, Kinoshita Yoshiaki, Uchida Hiroo, Tajiri Tatsuro, Yoneda Akihiro, Oue Takaharu, Kuroda Tatsuo, Hirobe Seiichi, Koshinaga Tsugumichi, Hiyama Eiso, Nio Masaki, Inomata Yukihiro, Taguchi Tomoaki, Ieiri Satoshi

PEDIATRIC SURGERY INTERNATIONAL 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Pediatric Surgery International

Background: Minimally invasive surgery (MIS) is appropriate for the treatment of some neuroblastomas (NBs); however, the indications and technical issues are unclear. This study aimed to clarify the current status of MIS for mediastinal NB in Japan. Methods: Preliminary questionnaires requesting the numbers of neuroblastoma cases in which MIS was performed from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery. Secondary questionnaires were sent to institutions with MIS cases to collect detailed data. Results: One hundred thirty-four (84.2%) institutions returned the preliminary questionnaire and 83 institutions (52.2%) reported a total of 1496 operative cases. MIS was performed for 175 (11.6%) cases. Among the 175 cases, completed forms of 140 patients were returned and 40 (male, n = 28; female, n = 12) cases had mediastinal NB. Fourteen patients received thoracoscopic biopsy, none were converted to thoracotomy. Twenty-eight patients received MIS for radical resection, none were converted to thoracotomy. Perioperative complications (Horner’s syndrome) were recognized after radical resection in one (2.5%) case. Conclusions: MIS was performed in a limited number of mediastinal NB cases. A thoracoscopic approach would be feasible for mediastinal NB.

DOI： 10.1007/s00383-021-04998-9

Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience Reviewed

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 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

Double common bile duct associated with pancreaticobiliary maljunction Reviewed

Yamada Kenta, Ishikawa Takuya, Ohno Eizaburo, Iida Tadashi, Suzuki Hirotaka, Uetsuki Kota, Yashika Jun, Yoshikawa Masakatsu, Takami Hideki, Inokawa Yoshikuni, Uchida Hiroo, Kawashima Hiroki, Fujishiro Mitsuhiro

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 83 ( 3 ) page： 655 - 661 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Nagoya Journal of Medical Science

A 45-year-old female was admitted to the hospital with a diagnosis of acute pancreatitis. A computed tomography scan showed two extrahepatic bile ducts. Magnetic resonance cholangiopancreatography suggested a stone in one of the bile ducts. Endoscopic retrograde cholangiopancreatography revealed two extrahepatic bile ducts joining at the hilum of the liver accompanied with pancreaticobiliary maljunction. Sphincterotomy was performed and a protein plug was drained from the bile duct. Several treatment options were discussed, and the patient was treated with laparoscopic cholecystectomy without extrahepatic bile duct resection and planned to be followed up considering the risk of carcinogenesis in the bile ducts.

DOI： 10.18999/nagjms.83.3.655

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01113&link_issn=&doc_id=20210830170011&doc_link_id=%2Fes5shoge%2F2021%2F005705%2F017%2F0884-0888%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fes5shoge%2F2021%2F005705%2F017%2F0884-0888%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

日本小児外科学会小児外科卒前教育アンケート調査 2019 Reviewed

大植孝治, 内田広夫, 石丸哲也, 井上幹大, 大竹耕平, 神山雅史, 五藤周, 永田公二, 中原さおり, 奈良啓悟, 矢内俊裕, 令和2、3年度日本小児外科学会教育委員会

日本小児外科学会雑誌 Vol. 57 ( 5 ) page： 884 - 888 2021.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本小児外科学会

小児外科卒前教育の現況と問題点について検討した。全国の医育機関(大学医学部、医学系大学)82施設の医学部長医学系大学長宛にアンケート調査用紙を郵送し、73施設(89%)から回答を得た。小児外科診療部門は70施設(96%)に存在しており、卒前教育を担当する部署が97%の施設にあり、以前より多くなっていた。小児外科の講義はすべての医育機関で行われており、6年間で中央値6時間と比較的多くの時間を費やして講義が行われていた。また、施設内で臨床実習を行っている64施設(89%)のうち小児外科単独で行っているのは32施設(50%)であり、施設内・外を含めて臨床実習が行われていない施設が5施設あり、3施設には専門医がいなかった。施設外で臨床実習を行っていない39施設のうち、12施設が他施設での臨床実習を希望していた。特に関東の施設で他施設実習の希望が多く認められた。

Development of a novel diagnostic system for bile duct cancer using urinary metabolites. Reviewed

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 Vol. 81 ( 13 ) 2021.7

A patient with very early onset FH-deficient renal cell carcinoma diagnosed at age seven Reviewed

Taniguchi Rieko, Muramatsu Hideki, Okuno Yusuke, Yoshida Taro, Wakamatsu Manabu, Hamada Motoharu, Shirota Chiyoe, Sumida Wataru, Hinoki Akinari, Tainaka Takahisa, Gotoh Yoshimitsu, Tsuzuki Toyonori, Tanaka Yukichi, Kojima Seiji, Uchida Hiroo, Takahashi Yoshiyuki

FAMILIAL CANCER 2021.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Familial Cancer

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by heterozygous germline variants in the fumarate hydratase (FH) gene and is associated with increased susceptibility to cutaneous leiomyomas, uterine leiomyomas, and renal cell carcinoma (RCC). HLRCC-associated RCC usually occurs in the middle age, with the median age being 40–44 years. This report describes a seven-year-old (84-month-old) male who developed a large right kidney tumor with multiple cystic lesions that contained enhanced solid components. There was no evidence of distant metastasis. The male patient underwent right nephrectomy and has been recovering well without metastasis or recurrence. Pathological examination revealed that tumor cells with relatively prominent nucleoli and surrounded by halos, were located in a limited area. Immunohistochemical staining was negative for FH. Whole-exome sequencing identified his germline variant in the FH gene and its loss of heterozygosity in the tumor. At nine years (114 months) of age, the male patient showed no recurrence of the tumor. This was the youngest-onset case of HLRCC-associated RCC to date. This report may affect the starting age for future RCC-surveillance programs for patients with HLRCC.

DOI： 10.1007/s10689-021-00268-8

Laparoscopic approach for abdominal neuroblastoma in Japan: results from nationwide multicenter survey Reviewed

Kawano Takafumi, Souzaki Ryota, Sumida Wataru, Ishimaru Tetsuya, Fujishiro Jun, Hishiki Tomoro, Kinoshita Yoshiaki, Kawashima Hiroshi, Uchida Hiroo, Tajiri Tatsuro, Yoneda Akihiro, Oue Takaharu, Kuroda Tatsuo, Koshinaga Tsugumichi, Hiyama Eiso, Nio Masaki, Inomata Yukihiro, Taguchi Tomoaki, Ieiri Satoshi

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 2021.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Surgical Endoscopy

Background: Some neuroblastoma (NB) cases are suitable for minimally invasive surgery (MIS), but indication and technical issue are unclear. We assessed the current status of MIS for abdominal NB after mass screening period in Japan. Methods: Preliminary questionnaires requesting the numbers of NB cases that underwent MIS from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery. The secondary questionnaires were then sent to the institutions that reported MIS cases of NB in order to collect detailed data. Results: One hundred and thirty-four (84.2%) institutions responded to the preliminary questionnaires, and 83 (52.2%) reported managing operative cases. The total number of operative cases was 1496. MIS was performed for 175 (11.6%) cases, of which the completed forms of 140 patients were returned, including 100 abdominal NB cases. The male/female ratio was 51/49. Forty-seven cases underwent a laparoscopic biopsy, and 2 (4.3%) cases were converted to laparotomy due to bleeding. Sixty-five cases underwent MIS for radical resection, and 7 (10.8%) were converted to laparotomy. The reasons for open conversion were bleeding and severe adhesion. Regarding open conversion, there were no significant relationships between conversion and neo-adjuvant chemotherapy, biopsies, stage, size, or MYCN amplification. We found no relationship between resectability and vascular encasement in this study. There was relationship between the resected tumor size and the patients’ height, which was expressed using the following formula: y= 0.0316 x+ 1.4812 (x, patients height, y, tumor size; p = 0.004219, SE: 1.55566). Postoperative complications after radical resection were recognized in 7 (10.8%) cases. Conclusions: MIS was performed in limited cases of abdominal NB. A laparoscopic biopsy with careful attention to bleeding is feasible. The resected tumor size was shown to correlate with the patients’ height. Tumor size within 6 cm of maximum diameter can be resected safely.

DOI： 10.1007/s00464-021-08599-4

Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation (vol 37, pg 229, 2021) Reviewed

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 Vol. 37 ( 6 ) page： 835 - 835 2021.6

NOVEL BIOMARKER DISCOVERY FOR CHILDHOOD RHABDOMYOSARCOMA USING URINARY METABOLITES Reviewed

PEDIATRIC BLOOD & CANCER Vol. 68 page： S46 - S46 2021.6

胆道閉鎖症におけるオキシステロール及び胆汁酸分析の有用性 a pilot study Reviewed

小西健一郎, 水落建輝, 橋詰直樹, 八木実, 松浦俊治, 田口智章, 眞田幸弘, 田井中貴久, 内田広夫, 佐々木英之, 仁尾正記, 藤代準, 武井一, 入戸野博, 木村昭彦

日本小児外科学会雑誌 Vol. 57 ( 4 ) page： 786 - 787 2021.6

Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation Reviewed

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

SCIENTIFIC REPORTS Vol. 11 ( 1 ) page： 11052 2021.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

A Retrospective Study on the Effect of Surgical Experiences of Laparoscopic Kasai Portenterostomy Reviewed

特集シミュレーションとナビゲーション精索静脈瘤 Reviewed

田井中貴久, 田中裕次郎, 檜顕成, 城田千代栄, 住田亙, 横田一樹, 牧田智, 内田広夫

小児外科 Vol. 53 ( 5 ) page： 560 - 563 2021.5

Urinary biomarkers for monitoring treatment response in neuroblastoma patients Reviewed

Hiroo UCHIDA

Journal of Clinical Oncology Vol. 39 ( 15 ) 2021.5

Kurano Yui, Shirota Chiyoe, Hinoki Akinari, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 57 ( 3 ) page： 596 - 599 2021.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

Purpose: The treatment outcomes of patients with laparoscopic surgery for biliary atresia (laparoscopic portoenterostomy) were retrospectively evaluated to determine whether to limit the laparoscopic surgery for biliary atresia to fully experienced surgeons.Methods: We included 37 patients with laparoscopic portoenterostomy for biliary atresia at our institution from 2014 to 2018. Twelve patients were treated by a surgeon fully experienced in laparoscopic portoenterostomy (Group A) and 23 patients were treated by other surgeons (Group B). Jaundice reduction and jaundice-free survival of patients with the native liver in the two groups were compared.Results: Differences in age at the time of surgery, body weight, perioperative blood loss, time of drain removal, and time that milk or formula feeding resumed in both groups were not significant. The duration of surgery was significantly shorter in Group A than in Group B. The jaundice-free survival rates of patients with the native liver were 58.3% in Group A and 60.9% in Group B at 6 months after surgery, 66.7% in Group A and 65.2% in Group B at 1 year after surgery, and 58.3% in Group A and 56.5% in Group B at 2 years after surgery. No significant difference was observed.Conclusions: In this study, no significant difference in the rate of jaundice-free survival of patients with the native liver depending on the amount of surgical experience was observed under the guidance of an operator who was skilled in laparoscopic portoenterostomy.

DOI： 10.11164/jjsps.57.3_596

A Japanese prospective multicenter study of urinary oxysterols in biliary atresia Reviewed

Konishi Ken-ichiro, Mizuochi Tatsuki, Takei Hajime, Yasuda Ryosuke, Sakaguchi Hirotaka, Ishihara Jun, Takaki Yugo, Kinoshita Masahiro, Hashizume Naoki, Fukahori Suguru, Shoji Hiromichi, Miyano Go, Yoshimaru Koichiro, Matsuura Toshiharu, Sanada Yukihiro, Tainaka Takahisa, Uchida Hiroo, Kubo Yumiko, Tanaka Hiromu, Sasaki Hideyuki, Murai Tsuyoshi, Fujishiro Jun, Yamashita Yushiro, Nio Masaki, Nittono Hiroshi, Kimura Akihiko

SCIENTIFIC REPORTS Vol. 11 ( 1 ) page： 4986 2021.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Scientific Reports

Diagnosis of biliary atresia (BA) can involve uncertainties. In the present prospective multicenter study, we considered whether urinary oxysterols represent a useful marker for diagnosis of BA in Japanese children. Subjects under 6 months old at 7 pediatric centers in Japan were prospectively enrolled, including patients with cholestasis and healthy controls (HC) without liver disease. Patients with cholestasis constituted 2 groups representing BA patients and others with cholestasis from other causes (non-BA). We quantitatively analyzed 7 oxysterols including 4β-, 20(S)-, 22(S)-, 22(R)-, 24(S)-, 25-, and 27-hydroxycholesterol by liquid chromatography/electrospray ionization-tandem mass spectrometry. Enrolled subjects included 14 with BA (median age 68 days; range 26–170) and 10 non-BA cholestatic controls (59; 14–162), as well as 10 HC (57; 25–120). Total urinary oxysterols were significantly greater in BA (median, 153.0 μmol/mol creatinine; range 24.1–486.7; P < 0.001) and non-BA (36.2; 5.8–411.3; P < 0.05) than in HC (2.7; 0.8–7.6). In patients with BA, urinary 27-hydroxycholesterol (3.61; 0.42–11.09; P < 0.01) was significantly greater than in non-BA (0.71; 0–5.62). In receiver operating characteristic (ROC) curve analysis for distinguishing BA from non-BA, the area under the ROC curve for urinary 27-hydroxycholesterol was 0.83. In conclusion, this first report of urinary oxysterol analysis in patients with BA indicated that 27-hydroxycholesterol may be a useful marker for distinguishing BA from other causes of neonatal cholestasis.

DOI： 10.1038/s41598-021-84445-w

Identification of novel neuroblastoma biomarkers in urine samples Reviewed

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 Vol. 11 ( 1 ) page： 4055 2021.2

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：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

Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation Reviewed International journal

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 Vol. 37 ( 2 ) page： 235 - 240 2021.2

Thoracoscopic surgery for congenital lung cysts: an attempt to limit pulmonary resection in cases of lesions involving multiple lobes Reviewed International journal

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

PEDIATRIC SURGERY INTERNATIONAL Vol. 37 ( 2 ) page： 213 - 221 2021.2

Usefulness of web search queries for early detection of diseases in infants Reviewed

Yamaguchi Shuji, Hinoki Akinari, Tsubouchi Kota, Amandu Hizuru, Tajima Akira, Uchida Hiroo

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 83 ( 1 ) page： 107 - 111 2021.2

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Nagoya Journal of Medical Science

Early detection of diseases is critical in infants. This study evaluates the usefulness of web searches in predicting diseases in order to encourage guardians to consult a doctor promptly if their children are ill. We collected six months of search queries from Yahoo! JAPAN Search between October 2016 and March 2017. Using a machine learning model, we investigated the accuracy of the search query’s ability to predict the diagnosis of biliary atresia and hypertrophic pyloric stenosis. Both diseases were modeled with an accuracy of approximately 80&, and symptoms related to the disease were significant features in the model. These findings suggest the possibility of detecting diseases from web search queries performed by guardians. Through future research, we intend to propose a method that uses web search queries for early detection of these diseases by providing appropriate and timely information to support the guardians of patients.

DOI： 10.18999/nagjms.83.1.107

One-Stage Functional End-To-End Anastomosis Followed by Sutureless Abdominal Wall Closure for Colonic Atresia With Gastroschisis Reviewed

Chiba Kosuke, Tanaka Yujiro, Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Oshima Kazuo, Makita Satoshi, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 57 ( 1 ) page： 22 - 26 2021

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

The patient was a newborn female with colonic atresia and gastroschisis. A silo was placed immediately after birth and surgery was scheduled the following day. Adhesive detachment was performed by washing the intestinal tract with saline. The oral and anal segments of the colonic atresia were identified, and functional end-to-end anastomosis was performed. Severe edema precluded the immediate return of the intestines to the abdominal cavity and required ongoing treatment with a silo. The intestines gradually returned to the abdominal cavity during the following week. The abdominal wall was closed on postnatal day 9 by a sutureless method. The patient's postoperative course was good, and full feeding was initiated on postnatal day 19. The patient was discharged from the hospital on postnatal day 32 and recovered without complications. In cases of gastroschisis with colonic atresia, a two-stage surgical procedure is commonly employed. However, functional end-to-end anastomosis using a linear stapler is also an effective method because anastomoses can be performed without regard to differences in intestinal caliber.

DOI： 10.11164/jjsps.57.1_22

Laparoscopic One-Stage Radical Surgery for Congenital Biliary Dilatation With Biliary Perforation Reviewed

Ishii Hiroki, Makita Satoshi, Yasui Akihiro, Takimoto Aitaro, Yokota Kazuki, Sumida Wataru, Tainaka Takahisa, Shirota Chiyoe, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 57 ( 5 ) page： 855 - 859 2021

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

A 21-month-old girl with chief complaints of vomiting and fever was admitted to a hospital and diagnosed as having congenital biliary dilatation. Magnetic resonance imaging performed on the sixth day of hospitalization revealed bile duct perforation, and the patient was transferred to our department for further treatment. A perforation approximately 2 cm in diameter was found at the confluence of the common bile duct and cystic duct. We concluded that biliary drainage and repair of the perforation would not improve her pathophysiology. Therefore, laparoscopic one-stage radical surgery was performed. In addition, bile duct plasty was performed to treat the severe intrahepatic bile duct membranous stenosis that were observed in the right and left bile ducts of the hepatic hilum. The patient was discharged without complications on the tenth postoperative day.Two-stage surgery is the recommended treatment method for congenital biliary dilatation with biliary perforation. However, in recent years, there have been few reports showing that one-stage open radical surgery is useful. In this case, we successfully performed laparoscopic one-stage radical surgery for congenital biliary dilatation with biliary perforation. If laparoscopic radical surgery for congenital biliary dilatation is established at the institution, and the patient is in good general condition, laparoscopic one-stage radical surgery may be an effective modality for treating this condition.

DOI： 10.11164/jjsps.57.5_855

Intestinal region reconstruction of ileus cases from 3D CT images based on graphical representation and its visualization Reviewed

Hirohisa Oda, Yuichiro Hayashi, Takayuki Kitasaka, Yudai Tamada, Aitaro Takimoto, Akinari Hinoki, Hiroo Uchida, Kojiro Suzuki, Hayato Itoh, Masahiro Oda, Kensaku Mori

Medical Imaging 2021: Computer-Aided Diagnosis Vol. 11597 2021

先天性胆道拡張症の晩期合併症についての検討 Reviewed

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 Vol. 44 ( 0 ) page： 50 - 51 2021

Intestine Segmentation with Small Computational Cost for Diagnosis Assistance of Ileus and Intestinal Obstruction. Reviewed

Hirohisa Oda, Yuichiro Hayashi, Takayuki Kitasaka, Aitaro Takimoto, Akinari Hinoki, Hiroo Uchida, Kojiro Suzuki, Masahiro Oda, Kensaku Mori

Clinical Image-Based Procedures, Distributed and Collaborative Learning, Artificial Intelligence for Combating COVID-19 and Secure and Privacy-Preserving Machine Learning - 10th Workshop, CLIP 2021, Second Workshop, DCL 2021, First Workshop, LL-COVID19 2021, and First Workshop and Tutorial, PPML 2021, Held in Conjunction with MICCAI 2021, Strasbourg, France, September 27 and October 1(CLIP/DCL/LL-COVID19/PPML@MICCAI) Vol. 12969 page： 3 - 12 2021

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 Reviewed

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 Vol. 44 ( 0 ) page： 72 - 73 2021

特集小児がん手術の問題点-わたしはここを重視している当院での腹腔鏡下腫瘍生検の実際 Reviewed

住田亙, 田井中貴久, 城田千代栄, 横田一樹, 牧田智, 滝本愛太朗, 安井昭洋, 天野日出, 石井宏樹, 檜顕成, 内田広夫

小児外科 Vol. 52 ( 12 ) page： 1331 - 1335 2020.12

A novel Lugol's iodine staining technique to visualize the upper margin of the surgical anal canal intraoperatively for Hirschsprung disease: a case series Reviewed International journal

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 Vol. 20 ( 1 ) 2020.12

URINARY OXYSTEROLS IN BILIARY ATRESIA: A PROSPECTIVE MULTICENTER STUDY IN JAPAN Reviewed

Konishi Ken-ichiro, Mizuochi Tatsuki, Takei Hajime, Yesuda Ryosuke, Sakaguchi Hirotaka, Ishihara Jun, Takaki Yugo, Kinoshita Masahiro, Hashizume Naoki, Fukahori Suguru, Shoji Hiromichi, Miyano Go, Yoshimaru Koichiro, Matsuura Toshiharu, Sanada Yukihiro, Tainaka Takahisa, Uchida Hiroo, Kubo Yumiko, Tanaka Hiromu, Sasaki Hideyuki, Murai Tsuyoshi, Fujishiro Jun, Yamashita Yushiro, Nio Masaki, Nittono Hiroshi, Kimura Akihiko

HEPATOLOGY Vol. 72 page： 224A - 225A 2020.11

食道胃静脈瘤に対する内視鏡治療後に菌血症、肝膿瘍を生じた小児胆道閉鎖症の1例 Reviewed

横山晋也, 石上雅敏, 本多隆, 石津洋二, 今井則博, 伊藤隆徳, 山本健太, 内田広夫, 藤城光弘

日本門脈圧亢進症学会雑誌 Vol. 26 ( 3 ) page： 138 - 138 2020.10

Safe diagnostic management of malignant mediastinal tumors in the presence of respiratory distress: a 10-year experience Reviewed International journal

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 Vol. 20 ( 1 ) 2020.6

Clinical characteristics and surgical outcomes of retroperitoneal tumors: a comprehensive data collection from multiple departments Reviewed International journal

Sassa Naoto, Yokoyama Yukihiro, Nishida Yoshihiro, Yamada Suguru, Uchida Hiroo, Kajiyama Hiroaki, Nagino Masato, Kodera Yasuhiro, Gotoh Momokazu

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY Vol. 25 ( 5 ) page： 929 - 936 2020.5

特集 Hirschsprung病手術の現在腹腔鏡補助下Swenson法 Reviewed

横田一樹, 内田広夫, 田井中貴久, 城田千代栄, 住田亙, 牧田智, 大島一夫, 滝本愛太朗, 狩野陽子

小児外科 Vol. 52 ( 4 ) page： 369 - 373 2020.4

Intestinal flow after anastomotic operations in neonates Reviewed International journal

Ito Yasumasa, Asato Koichiro, Cho Inhyeok, Sakai Yasuhiko, Iwano Koji, Tainaka Takahisa, Uchida Hiroo

COMPUTERS IN BIOLOGY AND MEDICINE Vol. 118 2020.3

Novel zinc alloys for biodegradable surgical staples Reviewed International journal

Amano Hizuru, Miyake Koichi, Hinoki Akinari, Yokota Kazuki, Kinoshita Fumie, Nakazawa Atsuko, Tanaka Yujiro, Seto Yasuhiro, Uchida Hiroo

WORLD JOURNAL OF CLINICAL CASES Vol. 8 ( 3 ) page： 504 - 516 2020.2

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 Reviewed

城田千代栄, 檜顕成, 内田広夫, 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

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

小児腹腔鏡手術における肝内胆管形成術 Reviewed

田井中貴久, 内田広夫, 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

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

Visualizing intestines for diagnostic assistance of ileus based on intestinal region segmentation from 3D CT images Reviewed

Hirohisa Oda, Kohei Nishio, Takayuki Kitasaka, Hizuru Amano, Aitaro Takimoto, Hiroo Uchida, Kojiro Suzuki, Hayato Itoh, Masahiro Oda, Kensaku Mori

MEDICAL IMAGING 2020: COMPUTER-AIDED DIAGNOSIS Vol. 11314 2020

Language：English Publishing type：Research paper (international conference proceedings) Publisher：SPIE-INT SOC OPTICAL ENGINEERING

This paper presents a visualization method of intestine (the small and large intestines) regions and their stenosed parts caused by ileus from CT volumes. Since it is difficult for non-expert clinicians to find stenosed parts, the intestine and its stenosed parts should be visualized intuitively. Furthermore, the intestine regions of ileus cases are quite hard to be segmented. The proposed method segments intestine regions by 3D FCN (3D U-Net). Intestine regions are quite difficult to be segmented in ileus cases since the inside the intestine is filled with fluids. These fluids have similar intensities with intestinal wall on 3D CT volumes. We segment the intestine regions by using 3D U-Net trained by a weak annotation approach. Weak-annotation makes possible to train the 3D U-Net with small manually-traced label images of the intestine. This avoids us to prepare many annotation labels of the intestine that has long and winding shape. Each intestine segment is volume-rendered and colored based on the distance from its endpoint in volume rendering. Stenosed parts (disjoint points of an intestine segment) can be easily identified on such visualization. In the experiments, we showed that stenosed parts were intuitively visualized as endpoints of segmented regions, which are colored by red or blue.

DOI： 10.1117/12.2548910

特集ピーンチ!私はこうして切り抜けた胆道閉鎖症　腹腔鏡手術中に門脈から出血 Reviewed

Other Link： https://dblp.uni-trier.de/db/journals/corr/corr2003.html#abs-2003-01290

Identification and Validation of Novel Non-invasive Biomarkers in Patient Urine Samples for Diagnosis of New and Recurrent Neuroblastoma Reviewed International journal

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 Vol. 66 page： S106 - S106 2019.12

内田広夫, 田中裕次郎, 田井中貴久, 城田千代栄, 住田亙, 牧田智, 横田一樹, 滝本愛太郎, 大島一夫, 狩野陽子, 稲田亘佑

小児外科 Vol. 51 ( 10 ) page： 1020 - 1023 2019.10

Biodegradable Surgical Staple Composed of Magnesium Alloy.

Amano H, Hanada K, Hinoki A, Tainaka T, Shirota C, Sumida W, Yokota K, Murase N, Oshima K, Chiba K, Tanaka Y, Uchida H

Scientific reports Vol. 9 ( 1 ) page： 14671 2019.10

Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome

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

PEDIATRIC SURGERY INTERNATIONAL Vol. 35 ( 10 ) page： 1071-1076 2019.10

Efficacy of and prognosis after steroid pulse therapy in patients with poor reduction of jaundice after laparoscopic Kasai portoenterostomy

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

PEDIATRIC SURGERY INTERNATIONAL Vol. 35 ( 10 ) page： 1059-1063 2019.10

NON-INVASIVE SCREENING FOR DETECTING ESOPHAGOGASTRIC VARICES IN CHILDREN WITH BILIARY ATRESIA Reviewed International journal

Yokoyama Shinya, Ishigami Masatoshi, Honda Takashi, Kuzuya Teiji, Ishizu Yoji, Ito Takanori, Shirota Chiyoe, Uchida Hiroo, Fujishiro Mitsuhiro

HEPATOLOGY Vol. 70 page： 200A - 200A 2019.10

Laparoscopic Kasai portoenterostomy is advantageous over open Kasai portoenterostomy in subsequent liver transplantation.

Shirota C, Murase N, Tanaka Y, Ogura Y, Nakatochi M, Kamei H, Kurata N, Hinoki A, Tainaka T, Sumida W, Yokota K, Makita S, Oshima K, Uchida H

Surgical endoscopy 2019.9

Spleen stiffness by 2-D shear wave elastography is the most accurate predictor of high-risk esophagogastric varices in children with biliary atresia.

Yokoyama S, Ishigami M, Honda T, Kuzuya T, Ishizu Y, Ito T, Hirooka Y, Tanaka Y, Tainaka T, Shirota C, Chiba K, Uchida H, Fujishiro M

Hepatology research : the official journal of the Japan Society of Hepatology 2019.5

特集技術認定取得医が解説する高難度内視鏡外科手術胆道閉鎖症に対する腹腔鏡による肝門部空腸吻合術 Reviewed

内田広夫

小児外科 Vol. 51 ( 4 ) page： 393 - 398 2019.4

Relationship between Contact Pressure and Motion Artifacts in ECG Measurement with Electrostatic Flocked Electrodes Fabricated on Textile. Reviewed International journal

Toshihiro Takeshita, Manabu Yoshida, Yusuke Takei, Atsushi Ouchi, Akinari Hinoki, Hiroo Uchida, Takeshi Kobayashi

Scientific reports Vol. 9 ( 1 ) page： 5897 - 5897 2019.4

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

To develop a wearable multi-lead electrocardiogram (ECG) measuring system, we fabricated the electrodes and wires by using electrostatic flocking technology on a textile. By using this technology, it was possible to fabricate many electrodes and wires, simultaneously. Also the flocked electrodes and wires had stretchability and washing resistance properties. To use dry electrodes, it is important to reduce the influence of motion artifacts (MAs). The results of the experiment with the skin phantom revealed that the contact pressure between the skin and the electrode is an important factor in MA reduction. Then, we conducted experiments with a human body to determine the relationship between the contact pressure and the MAs. Under the pressures of 200 Pa and 500 Pa, MAs were observed. Meanwhile, under the pressures of 1000 Pa, 2000Pa and 4000 Pa, the ECG signals under rest and deep breathing conditions were able to be measured without MAs. Considering the comfortability, the contact pressure from 1000 Pa to 2000 is preferable. Finally, we fabricated the wearable ECG measuring system and succeeded in measuring 18-lead ECG signals. The measured ECG waveform is in good agreement with the ECG waveform measured by a commercial system.

DOI： 10.1038/s41598-019-42027-x

静電植毛技術を用いた心電図測定用立体ドライ電極の作製と応用 Reviewed

竹下俊弘, 吉田学, 竹井裕介, 大内篤, 檜顕成, 内田広夫, 小林健

エレクトロニクス実装学術講演大会講演論文集 Vol. 33 ( 0 ) page： 13A2-01 2019

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：一般社団法人エレクトロニクス実装学会

心電図モニタリング用のドライ電極の開発を行った。ドライ電極を用いた心電図モニタリングにおいての課題は皮膚-電極間の安定した接触である。我々は立体構造の樹脂に銀メッキ加工を施した繊維を静電植毛することにより、体の形状に沿った形状であり、皮膚-電極間の安定した接触を実現した、ドライ電極の作製を行った。また作製したドライ電極を用いて心電図モニタリングウェアを作製し、医療的意義のある心電図測定に成功した。

DOI： 10.11486/ejisso.33.0_13a2-01

内視鏡外科手術における熟練医の追体験トレーニングシステムとその評価 Reviewed

安藤英由樹, 坂井義治, 小濱和貴, 内田広夫, 出家亨一, 松田公志, 吉田健志, 早石直広

生体医工学 Vol. 57 ( 0 ) page： S198_1 - S198_1 2019

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：公益社団法人日本生体医工学会

腹腔鏡手術は低侵襲性であることから普及が進んでいる。しかしながら、カメラを通じた状況把握、ポート留置部を支点とするため移動方向が手の動きと逆になる腹腔鏡用鉗子の利用など、手術の難易度が高く、習得に時間がかかることことから熟練者不足が問題となっている。また熟練医の不足は修練者のための教育に当てる時間も不足するという悪循環を生んでいる。従って、熟練者を短期間で養成し増やすための術式教育そのものが重要な課題である。本研究では、内視鏡外科手術は術野像がモニタによって同じ視野が「共有される」という特性を利用して、段階的な学習ステップに応じた、熟練者の適切かつスムースな動きを修練者が追体験することで、非言語的なスキルの伝達を行い、効果的なトレーニングを行うシステムである「追いトレ」を用いた場合の効果について、妥当性、効果の範囲、適応可能な範囲を明らかし、製品化・実用化・普及を実現するエビデンスを獲得するために、様々な内視鏡外科分野で十分な検証実験を踏まえたデータ取得とデータ解析を行なうことを目的とした。

DOI： 10.11239/jsmbe.Annual57.S198_1

Spaciousness Filters for Non-contrast CT Volume Segmentation of the Intestine Region for Emergency Ileus Diagnosis

Hirohisa Oda, Kohei Nishio, Takayuki Kitasaka, Benjamin Villard, Hizuru Amano, Kosuke Chiba, Akinari Hinoki, Hiroo Uchida, Kojiro Suzuki, Hayato Itoh, Masahiro Oda, Kensaku Mori

MICCAI 2019 Vol. 11840 page： 104 - 114 2019

Nuss procedure for patients with pectus excavatum with a history of intrathoracic surgery.

Takanari K, Toriyama K, Kambe M, Nakamura Y, Uchibori T, Ebisawa K, Shirota C, Tainaka T, Uchida H, Kamei Y

Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2018.12

Air test as a simple method of screening for Hirschsprung's disease Reviewed

Sumida W, Uchida H, Ono Y, Tanaka Y, Tainaka T, Shirota C, Yokota K, Oshima K, Chiba K

Clin Radiol Vol. 73 ( 12 ) page： 1041 - 1045 2018.12

Indications for total esophagogastric dissociation in children with gastroesophageal reflux disease Reviewed

Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida

Surgery Today Vol. 48 ( 11 ) page： 971 - 977 2018.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Tokyo

Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications. In total, 147 neurologically impaired patients and 28 neurologically normal patients were identified. The total rate of complications requiring re-operation was 17.2% in neurologically impaired patients and 32.1% in normal patients, both higher than the rates associated with fundoplication. Although most authors added pyloroplasty when there was a concern of gastric emptying, this sometimes caused bile reflux. Nutritional and metabolic complications, including dumping syndrome and chronic digestive malabsorption, were also reported to occur after TED. TED is an option for the treatment of neurologically impaired patients with recurrent GER after fundoplication or who are at a high risk of recurrence of GER with fundoplication. However, neurologically normal patients who have the ability to obtain nutrition orally should consider options other than TED, as postoperative complications are frequent.

DOI： 10.1007/s00595-018-1636-9

A new laparoscopic triangle fixation technique for gastrostomy: a safe and effective procedure for reduction of the wound infection rate. Reviewed

Michimasa Fujiogi, Yujiro Tanaka, Hizuru Amano, Kyoichi Deie, Keisuke Suzuki, Hiroshi Kawashima, Naruhiko Murase, Hiroo Uchida

Nagoya journal of medical science Vol. 80 ( 4 ) page： 497 - 503 2018.11

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

Gastrostomy is often performed with fundoplication in handicapped children. We devised a new laparoscopic triangle fixation technique for gastrostomy. In this study, 100 patients underwent gastrostomy with fundoplication between January 2008 and January 2016. We retrospectively reviewed the early postoperative results between the new laparoscopic procedure (NLP) group (n = 63) and conventional procedure (CP) group (n = 37). In the CP, the gastrostomy tube was inserted with a purse-string ligature at the gastric wall, and the gastric wall was sutured to the peritoneum under a small laparotomy. In NLP, three sutures were placed on the gastric wall, forming the three sides of a triangle, and the tube was inserted into the center of the triangle. The ends of each suture were pulled directly through the abdominal wall using a laparoscopic percutaneous extraperitoneal closure needle to join the gastric wall and peritoneum. Both groups showed no significant differences in age, body weight, and external leakage rate. The wound infection rate was significantly lower in the NLP group. In conclusions, the NLP is straightforward and can achieve firm fixation between the stomach and abdominal wall by suturing in the form of a triangle. The NLP was associated with a lower complication rate, especially concerning infection.

DOI： 10.18999/nagjms.80.4.497

Laparoscopically Assisted Anorectoplasty for Intermediate-Type Imperforate Anus: Comparison of Surgical Outcomes with the Sacroperineal Approach

Ishimaru Tetsuya, Kawashima Hiroshi, Tainaka Takahisa, Suzuki Keisuke, Takami Shohei, Kakihara Tomo, Katoh Reiko, Aoyama Tomohiro, Uchida Hiroo, Iwanaka Tadashi

JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES 2018.10

Oral administration of eicosapentaenoic acid suppresses liver fibrosis in postoperative patients with biliary atresia

Sumida Wataru, Uchida Hiroo, Tainaka Takahisa, Shirota Chiyoe, Hinoki Akinari, Kato Takazumi, Yokota Kazuki, Oshima Kazuo, Shirotuki Ryo, Chiba Kosuke, Tanaka Yujiro

PEDIATRIC SURGERY INTERNATIONAL Vol. 34 ( 10 ) page： 1059-1063 2018.10

Long-term outcomes and complications after laparoscopic-assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation. Reviewed International journal

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

Pediatric surgery international Vol. 34 ( 10 ) page： 1111 - 1115 2018.10

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

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

Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula. Reviewed International journal

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

Pediatric surgery international Vol. 34 ( 10 ) page： 1117 - 1120 2018.10

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

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

Introduction of resection of intrahepatic bile duct stenosis-causing membrane or septum into laparoscopic choledochal cyst excision. Reviewed International journal

Yujiro Tanaka, Takahisa Tainaka, Wataru Sumida, Akinari Hinoki, Chiyoe Shirota, Naruhiko Murase, Kazuo Oshima, Ryo Shirotsuki, Kosuke Chiba, Hiroo Uchida

Pediatric surgery international Vol. 34 ( 10 ) page： 1087 - 1092 2018.10

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

PURPOSE: We previously showed that meticulous probing and resection of the intrahepatic bile duct stenosis (IHBDS)-causing membrane or septum was effective in preventing hepatolithiasis after choledochal cyst excisions in open surgeries. Then, we introduced this maneuver into laparoscopic choledochal cyst excisions in 2014 and performed routine resections since then. The aim of this study was to show the feasibility of this method in laparoscopic surgery. METHODS: We retrospectively reviewed the demographics and outcomes of patients who underwent laparoscopic choledochal cyst excisions at our hospital between January 2014 and December 2017. The patients who underwent surgical treatment for IHBDS-causing membrane or septum were compared with those who did not undergo the procedure. The outcomes of the patients with IHBDS were also compared between patients who were ≥ 3 years of age and those < 3 years at operation. RESULTS: Seventeen of 35 patients underwent laparoscopic resection of IHBDS-causing membrane or septum. There were no complications related to the procedure although the operative time and intraoperative bleeding amount increased in the patients with IHBDS who were ≥ 3 years of age. CONCLUSIONS: Meticulous probing and excision of the IHBDS-causing membrane or septum is safe and feasible during laparoscopic choledochal cyst excision.

DOI： 10.1007/s00383-018-4320-7

The impact of body weight on stapled anastomosis in pediatric patients. Reviewed International journal

Hizuru Amano, Yujiro Tanaka, Takahisa Tainaka, Akinari Hinoki, Hiroshi Kawashima, Tomo Kakihara, Kaori Morita, Hiroo Uchida

Journal of pediatric surgery Vol. 53 ( 10 ) page： 2036 - 2040 2018.10

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

PURPOSE: The purpose of this study is to clarify the impact of body weight on outcomes of stapled anastomosis in pediatric patients. METHODS: A total of 253 pediatric patients who underwent intestinal anastomosis were classified according to body weight (<3.5 kg: light group, ≥3.5 kg: heavy group), and clinical outcomes of stapled and hand-sewn anastomoses were compared. RESULTS: The light and heavy groups included 77 (stapled: n = 13, hand-sewn: n = 64) and 176 (stapled: n = 58, hand-sewn: n = 118) patients, respectively. In both groups, stapled anastomosis was associated with reduced time to initial oral feeding (light group: 4 vs. 7 days, p = 0.006; heavy group: 3 vs. 5 days, p < 0.001) and full feeding (light group: 12 vs. 16 days, p = 0.026; heavy group: 7 vs. 9 days, p = 0.001), whereas its complication rate was not significantly different from that of hand-sewn anastomosis (light group: 30.8 vs. 12.5%, p = 0.112; heavy group: 3.4 vs. 2.5%, p = 0.665). In patients who underwent stapled anastomosis, the complication rate was significantly higher in the light group (30.8 vs. 3.4%, p = 0.009), with two cases of volvulus related to anastomotic dilatation. CONCLUSIONS: Stapled anastomosis is an effective procedure facilitating prompt oral feeding. However, the risk of complications, including volvulus related to anastomotic dilatation, should be considered among patients weighing <3.5 kg. LEVEL OF EVIDENCE: III.

DOI： 10.1016/j.jpedsurg.2018.04.030

Single-stage laparoscopic transanal pull-through modified Swenson procedure without leaving a muscular cuff for short- and long-type Hirschsprung disease: a comparative study. Reviewed International journal

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

Pediatric surgery international Vol. 34 ( 10 ) page： 1105 - 1110 2018.10

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

PURPOSE: The Soave procedure (SO) is performed most commonly for Hirschsprung disease. SO reduces the risk of injury to the pelvic structures; however, a residual aganglionic muscle cuff could interfere with bowel movement and lead to obstructive enterocolitis. The Swenson procedure is considered ideal in terms of peristalsis. Currently, laparoscopic surgery provides better visualization and facilitates precise dissection, possibly leading to feasible performance of the laparoscopic modified Swenson procedure (SW). We present our operative technique and the efficacy of the SW compared with that of SO. METHODS: We retrospectively reviewed the records of 16 and 27 patients who underwent SW and SO, respectively, between 2012 and 2017. RESULTS: Operative time, blood loss, length of stay, and frequency of bowel movements showed no significant difference between the two groups. In the SW group, temporary dysuria occurred in one patient, postoperative enterocolitis in two, wound infection in one, and severe perianal excoriation in four, whereas in the SO group, obstructive symptoms occurred in three patients, small-bowel obstruction in one, and severe perianal excoriation in three. The complications and outcomes were comparable between both groups. CONCLUSION: Laparoscopic SW was safe and feasible for the short-term follow-up outcomes.

DOI： 10.1007/s00383-018-4318-1

BESNet: Boundary-enhanced Segmentation of Cells in Histopathological Images

Hirohisa Oda, Holger Roth, Kosuke Chiba, Jure Sokolic, Takayuki Kitasaka, Masahiro Oda, Akinari Hinoki, Hiroo Uchida, Julia A Schnabel, Kensaku Mori

MICCAI 2018, LNCS 11071 page： 228-236 2018.9

Automated ganglion cell detection using fully convolutional networks and evaluation under different training losses

Hirohisa Oda, Kosuke Chiba, Holger R. Roth, Takayuki Kitasaka, Masahiro Oda, Akinari Hinoki, Hiroo Uchida, Kensaku Mori

International Journal of Computer Assisted Radiology and Surgery Vol. 13 ( 1 ) page： s104-106 2018.6

Development of multi-lead ECG measurement wear using electrostatic flocking technology Reviewed

T. Takeshita, M. Yosihda, A. Ouchi, A. Hinoki, H. Uchida, T. Kobayashi

2018 International Conference on Electronics Packaging and iMAPS All Asia Conference, ICEP-IAAC 2018 page： 145 - 146 2018.6

Language：English Publishing type：Research paper (international conference proceedings) Publisher：Institute of Electrical and Electronics Engineers Inc.

We developed textile-based multi-lead ECG measurement wear. The textile-based ECG measurement wear was fabricated by printed electronics and electrostatic flocking technology. We also developed a wireless communication system of multi-lead ECG signals. Moreover, we succeeded to get 18-lead ECG signals around heart using the ECG measurement wear and the wireless measuring system.

DOI： 10.23919/ICEP.2018.8374690

Novel thoracoscopic navigation surgery for neonatal chylothorax using indocyanine-green fluorescent lymphography. Reviewed International journal

Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka

Journal of pediatric surgery Vol. 53 ( 6 ) page： 1246 - 1249 2018.6

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

BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation. NIR imaging was performed 1h after an inter-toe injection of ICG. Thoracoscopic ligations against the NIR-detected leakage sites were performed with sutures. RESULTS: The thoracic duct or lymphatic leakage was directly visualized in each patient. In 8 surgeries with first thoracoscopic TEF operation, one case had suspected minor chylous leakage without postoperative chylothorax. Another case with no chylous leakage at the first operation resulted in chylothorax at postoperative day 11. In three neonates with postoperative chylothorax, leakage points were detected near the ablation site of the azygos vein during the first operation. These points were properly ligated, and postoperative chylous leakage ceased with no adverse events. CONCLUSIONS: Thoracoscopic ICG-NIR imaging encourages the repair of refractory chylothorax and seems reliable. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.jpedsurg.2018.01.019

特集小児外科における消化器内視鏡外科手術胆道閉鎖症に対する腹腔鏡下肝門部空腸吻合術 Reviewed

内田広夫, 田中裕次郎, 田井中貴久, 城田千代栄, 住田亙, 村瀬成彦

手術 Vol. 72 ( 6 ) page： 861 - 870 2018.5

Clinical, Pathologic, and Genetic Features of Neonatal Dubin-Johnson Syndrome: A Multicenter Study in Japan

Togawa Takao, Mizuochi Tatsuki, Sugiura Tokio, Kusano Hironori, Tanikawa Ken, Sasaki Takato, Ichinose Fumio, Kagimoto Seiichi, Tainaka Takahisa, Uchida Hiroo, Saitoh Shinji

JOURNAL OF PEDIATRICS Vol. 196 page： 161-+ 2018.5

Evaluation of Surgical Devices Using an Artificial Pediatric Thoracic Model: A Comparison Between Robot-Assisted Thoracoscopic Suturing Versus Conventional Video-Assisted Thoracoscopic Suturing. Reviewed International journal

Shinya Takazawa, Tetsuya Ishimaru, Kanako Harada, Kyoichi Deie, Akinari Hinoki, Hiroo Uchida, Naohiko Sugita, Mamoru Mitsuishi, Tadashi Iwanaka, Jun Fujishiro

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 28 ( 5 ) page： 622 - 627 2018.5

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

BACKGROUND: Pediatric robot-assisted surgery is increasingly being performed, but it is difficult to perform this procedure in infants. A pediatric thoracoscopic model of a 1-year-old patient was developed in our previous study, and this model was used to evaluate the use of a surgical robot for infant surgery. METHODS: Eight pediatric surgeons performed an intracorporeal suturing and knot-tying task using the da Vinci Xi Robotic Surgical System. The task completion time, number of needle manipulations, and force applied during suturing of the robot-assisted thoracoscopic surgery (RATS) group were compared with those of the video-assisted thoracoscopic surgery (VATS) group whose data had been collected from the same 8 surgeons in our previous study. RESULTS: The RATS group showed a significantly shorter completion time than the VATS group in the knot-tying phase (P = .016) and in the total phase (P = .0078). The RATS group showed a significantly smaller number of manipulations than the VATS group in the total phase (P = .039). The RATS group showed a significantly smaller pushing force index than the VATS group in the suturing phase (P = .031), knot-tying phase (P = .031), and in the total phase (P = .031). A seventh rib in the model was dislocated in all RATS group cases. CONCLUSIONS: The da Vinci Surgical System might be useful in infants because of fast movement and small pushing force. However, the robotic 8 mm instruments were too large for use in the thoracic cavity of the 1-year-old infant.

DOI： 10.1089/lap.2017.0307

Usefulness of fetal magnetic resonance imaging for postnatal management of congenital lung cysts: prediction of probability for emergency surgery. Reviewed International journal

Chiyoe Shirota, Takahisa Tainaka, Toshiki Nakane, Yujiro Tanaka, Akinari Hinoki, Wataru Sumida, Naruhiko Murase, Kazuo Oshima, Kosuke Chiba, Ryo Shirotsuki, Hiroo Uchida

BMC pediatrics Vol. 18 ( 1 ) page： 105 - 105 2018.3

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

BACKGROUND: Emergency rescue lung resection is rarely performed to treat congenital lung cysts (CLCs) in neonates. Many reports have described fetal CLC treatment; however, prenatal predictors for postnatal respiratory failure have not been characterized. We hypothesized that fetal imaging findings are useful predictors of emergency surgery. METHODS: We retrospectively studied patients with CLC who underwent lung surgery during the neonatal period in our hospital between January 2001 and December 2015. The demographic data, fetal imaging findings, and intra- and postoperative courses of patients who underwent emergency surgery (Em group) were compared with those of patients who received elective surgery, i.e., non-emergency surgery (Ne group). RESULTS: The Em group and Ne group included 7 and 11 patients, respectively. No significant difference was noted in gestational age, time at prenatal diagnosis, birth weight, and body weight at surgery. The volumes of contralateral lung per thoracic volume were significantly smaller in the Em group than in the Ne group (p = 0.0188). Mediastinal compression was more common in the Em group (7/7) than in the Ne group (4/11) (p = 0.0128). CONCLUSIONS: This is the report describing neonatal emergency lobectomy in patients with CLC evaluated by fetal MRI using the lung volume ratio and mediastinal shift. In patients with CLC, mediastinal shift and significant decreases in contralateral lung volumes during the fetal stages are good prenatal predictors of postnatal emergency lung resection.

DOI： 10.1186/s12887-018-1085-z

Fabrication of Multi-lead ECG measurement wear using electrostatic flocking technology Reviewed

Proceedings of JIEP Annual Meeting Vol. 32 ( 0 ) page： 179 - 180 2018

Idiopathic Omental Torsion Relieved With Conservative Management Reviewed

Yokota Kazuki, Chiba Kosuke, Uchida Hiroo, Tanaka Yujiro, Tainaka Takahisa, Shirota Chiyoe, Hinoki Akinari, Sumida Wataru, Kato Takazumi, Oshima Kazuo

Journal of the Japanese Society of Pediatric Surgeons Vol. 54 ( 2 ) page： 302 - 306 2018

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

The patient was a 5-year-old boy who had no medical history. He was referred to us with suspected acute appendicitis and complaints of fever and lower abdominal pain. Although his abdominal pain was intense, rebound tenderness and muscular protection were negative. There were no symptoms of problems in the digestive tract such as vomiting or diarrhea. His blood examination revealed an increase in inflammatory reactions, as indicated by the increased white blood cell count and C-reactive protein levels. Computed tomography (CT) revealed wall thickening of the ascending colon; therefore, we started antibiotic administration after acute enterocolitis was diagnosed. After admission, we performed CT again and found a fatty and dense mass with a swirling structure inside the mass; therefore, we diagnosed the patient as having idiopathic omental torsion. Because the symptoms were relieved, conservative management was continued and the patient was discharged on the fourth day after hospitalization. Omental torsion is a rare condition, particularly seen in children; its classical treatment option is surgery. Although conservative management was successful in this case, there are few reports on it. There are many cases where surgery is performed after an initial diagnosis of acute appendicitis is made owing to the presence of similar symptoms. However, in recent years, because of advances in imaging diagnostic techniques such as CT, more patients are being accurately diagnosed. We believe that if patients are accurately diagnosed, surgery will always be required; however, conservative management is sometimes possible.

DOI： 10.11164/jjsps.54.2_302

BESNet: Boundary-Enhanced Segmentation of Cells in Histopathological Images Reviewed

Oda Hirohisa, Roth Holger R., Chiba Kosuke, Sokolic Jure, Kitasaka Takayuki, Oda Masahiro, Hinoki Akinari, Uchida Hiroo, Schnabel Julia A., Mori Kensaku

MEDICAL IMAGE COMPUTING AND COMPUTER ASSISTED INTERVENTION - MICCAI 2018, PT II Vol. 11071 page： 228 - 236 2018

The efficacy of resection of intrahepatic bile duct stenosis-causing membrane or septum for preventing hepatolithiasis after choledochal cyst excision. Reviewed

Tanaka Y, Tainaka T, Sumida W, Shirota C, Hinoki A, Murase N, Oshima K, Shirotsuki R, Chiba K, Uchida H

Journal of pediatric surgery Vol. 52 ( 12 ) page： 1930-1933 2017.12

新生児Dubin-Johnson症候群の全国多施設研究肝組織像の検討 Reviewed

水落建輝, 戸川貴夫, 杉浦時雄, 草野弘宣, 谷川健, 佐々木理人, 一ノ瀬文男, 鍵本聖一, 田井中貴久, 内田広夫, 齋藤伸治

日本小児栄養消化器肝臓学会雑誌 Vol. 31 ( 2 ) page： 103 - 103 2017.12

Intralobar pulmonary sequestration expanding toward the contralateral thorax: two case reports. Reviewed

Amano H, Fujishiro J, Hinoki A, Uchida H

BMC surgery Vol. 17 ( 1 ) page： 110 2017.11

Excellent prognosis of patients with intermediate-risk neuroblastoma and residual tumor postchemotherapy. Reviewed

Amano H, Uchida H, Tanaka Y, Tainaka T, Mori M, Oguma E, Kishimoto H, Kawashima H, Arakawa Y, Hanada R, Koh K

Journal of pediatric surgery 2017.11

Mesh hiatal reinforcement in laparoscopic Nissen fundoplication for neurologically impaired children is safe and feasible. Reviewed

Amano H, Tanaka Y, Kawashima H, Deie K, Suzuki K, Fujiogi M, Morita K, Iwanaka T, Uchida H

Nagoya journal of medical science Vol. 79 ( 4 ) page： 427-433 2017.11

Comparison of outcomes of thoracoscopic primary repair of gross type C esophageal atresia performed by qualified and non-qualified surgeons. Reviewed

Tanaka Y, Tainaka T, Sumida W, Shirota C, Murase N, Oshima K, Shirotsuki R, Chiba K, Uchida H

Pediatric surgery international Vol. 33 ( 10 ) page： 1081-1086 2017.10

A Novel Laparoscopic Surgery Model with a Device to Expand the Abdominal Working Space in Rats: The Influence of Pneumoperitoneum and Skin Incision Length on Postoperative Inflammatory Cytokines. Reviewed

Murase N, Tainaka T, Uchida H, Hinoki A, Shirota C, Yokota K, Oshima K, Shirotsuki R, Chiba K, Tanaka Y

Journal of investigative surgery : the official journal of the Academy of Surgical Research page： 1-6 2017.9

Review of redo-Kasai portoenterostomy for biliary atresia in the transition to the liver transplantation era. Reviewed

Sumida W, Uchida H, Tanaka Y, Tainaka T, Shirota C, Murase N, Oshima K, Shirotsuki R, Chiba K

Nagoya journal of medical science Vol. 79 ( 3 ) page： 415-420 2017.8

Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases. Reviewed

Amano H, Tanaka Y, Kawashima H, Deie K, Fujiogi M, Suzuki K, Morita K, Iwanaka T, Uchida H

Surgical endoscopy 2017.6

New Navigation Surgery for Resection of Lymphatic Malformations Using Indocyanine Green Fluorescence Imaging. Reviewed

Shirota C, Hinoki A, Takahashi M, Tanaka Y, Tainaka T, Sumida W, Murase N, Oshima K, Shirotsuki R, Chiba K, Morimoto Y, Uchida H

The American journal of case reports Vol. 18 page： 529-531 2017.5

New Navigation Surgery for Resection of Lymphatic Malformations Using Indocyanine Green Fluorescence Imaging

Shirota Chiyoe, Hinoki Akinari, Takahashi Masataka, Tanaka Yujiro, Tainaka Takahisa, Sumida Wataru, Murase Naruhiko, Oshima Kazuo, Shirotsuki Ryo, Chiba Kosuke, Morimoto Yuji, Uchida Hiroo

AMERICAN JOURNAL OF CASE REPORTS Vol. 18 2017.5

Laparoscopic resection of neuroblastomas in low- to high-risk patients without image-defined risk factors is safe and feasible. Reviewed

Shirota C, Tainaka T, Uchida H, Hinoki A, Chiba K, Tanaka Y

BMC pediatrics Vol. 17 ( 1 ) page： 71 2017.3

Two-Stage Thoracoscopic Repair of Long-Gap Esophageal Atresia Using Internal Traction Is Safe and Feasible. Reviewed

Tainaka T, Uchida H, Tanano A, Shirota C, Hinoki A, Murase N, Yokota K, Oshima K, Shirotsuki R, Chiba K, Amano H, Kawashima H, Tanaka Y

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 27 ( 1 ) page： 71-75 2017.1

Pure Laparoscopic Partial Hepatectomy for Hepatoblastoma in an Infant: A Case Report Reviewed

Amano Hizuru, Kawashima Hiroshi, Tanaka Yujiro, Deie Kyoichi, Fujiogi Michimasa, Suzuki Keisuke, Morita Kaori, Iwanaka Tadashi, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 53 ( 5 ) page： 1073 - 1078 2017

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

Reports on laparoscopic hepatectomy for malignant tumors in children are few. We present a case of pure laparoscopic partial hepatectomy for hepatoblastoma. A baby girl with Beckwith-Wiedemann syndrome underwent surgical closure of an omphalocele on the sixth day of life. At 4 months, sonographic screening revealed a liver tumor. The alpha-fetoprotein level was 23,060.69 ng/ml, and contrast-enhanced computed tomography revealed a 3.7-cm mass at the left lateral segment of the liver. A biopsy of the mass confirmed the diagnosis of hepatoblastoma (PRETEXT I). After 4 cycles of cisplatin monotherapy, the size of the tumor decreased to 2.7 cm. Laparoscopic partial hepatectomy was performed when she was 6 months old. An umbilical incision was made in an inverted Y shape, allowing for E-Z AccessTM with a Lap ProtectorTM insertion through which a 1.2-cm trocar was introduced. Two 5-mm working ports were placed lateral to the rectus muscle of either side immediately superior to the umbilicus. After placing a tape around the porta hepatis for the Pringle maneuver in the case of severe bleeding, intraoperative ultrasonography was performed for the identification of the vascular tree and hepatic and portal veins, and the localization of the tumor for accurate and safe resection. Enseal® was used to divide the hepatic parenchyma. Branched vessels and ducts were clipped and transected using Enseal®. The surgical specimen was extracted through the umbilical incision without enlarging the incision. The patient had an uncomplicated recovery. No recurrence was observed during a 2-year follow-up.

DOI： 10.11164/jjsps.53.5_1073

Comparing surgical outcomes of complete thoracoscopic lobectomy for congenital cystic lung disease between neonatal and infantile patients. Reviewed

Tainaka T, Uchida H, Tanaka Y, Shirota C, Yokota K, Murase N, Oshima K, Shirotsuki R, Chiba K, Hinoki A

Nagoya journal of medical science Vol. 78 ( 4 ) page： 447-454 2016.12

Large retroperitoneal immature teratoma leading to renovascular hypertension. Reviewed

Tainaka T, Ono Y, Yamada Y, Mutoh D, Uchida H

Pediatrics international : official journal of the Japan Pediatric Society Vol. 58 ( 12 ) page： 1363-1364 2016.12

◆実践報告先天性中枢性肺胞低換気症候群に合併したヒルシュスプルング病乳児の作業療法─ストレス反応の軽減と姿勢コントロールの獲得 Reviewed

吉田彬人, 辛島千恵子, 牧田智, 西川貴久子, 内田広夫

作業療法 Vol. 35 ( 6 ) page： 654 - 661 2016.12

Risk factors for thoracic and spinal deformities following lung resection in neonates, infants, and children. Reviewed

Makita S, Kaneko K, Ono Y, Uchida H

Surgery today 2016.10

Neonatal Cholestasis in East-Asian patients with Dubin-Johnson Syndrome: Clinical, Pathological and Genetic Features Reviewed International journal

Takao Togawa, Tokio Sugiura, Tatsuki Mizuochi, Hironori Kusano, Ken Tanikawa, Takahisa Tainaka, Hiroo Uchida, Tomoko Hara, Ryusuke Nambu, Seiichi Kagimoto, Shinji Saitoh

HEPATOLOGY Vol. 64 page： 278A - 278A 2016.10

Classification of biliary atresia in the laparoscopic era. Reviewed

Nakamura H, Murase N, Koga H, Cazares J, Lane GJ, Uchida H, Yamataka A

Pediatric surgery international 2016.9

More than one-third of successfully nonoperatively treated patients with complicated appendicitis experienced recurrent appendicitis: Is interval appendectomy necessary? Reviewed

Tanaka Y, Uchida H, Kawashima H, Fujiogi M, Suzuki K, Takazawa S, Deie K, Amano H, Iwanaka T

Journal of pediatric surgery 2016.9

Long-term outcomes after revision of Kasai portoenterostomy for biliary atresia. Reviewed

Shirota C, Uchida H, Ono Y, Murase N, Tainaka T, Yokota K, Oshima K, Shirotsuki R, Hinoki A, Ando H

Journal of hepato-biliary-pancreatic sciences 2016.9

Steroid pulse therapy prevents restenosis following balloon dilatation for esophageal stricture. Reviewed

Yokota K, Uchida H, Tanano A, Shirota C, Tainaka T, Hinoki A, Murase N, Oshima K, Shirotsuki R, Chiba K

Pediatric surgery international Vol. 32 ( 9 ) page： 875-9 2016.9

Contraindications and image-defined risk factors in laparoscopic resection of abdominal neuroblastoma. Reviewed

Tanaka Y, Kawashima H, Mori M, Fujiogi M, Suzuki K, Amano H, Morita K, Arakawa Y, Koh K, Oguma E, Iwanaka T, Uchida H

Pediatric surgery international Vol. 32 ( 9 ) page： 845-50 2016.9

Laparoscopic side-to-side pancreaticojejunostomy for chronic pancreatitis in children. Reviewed

Deie K, Uchida H, Kawashima H, Tanaka Y, Fujiogi M, Amano H, Murase N, Tainaka T

Journal of minimal access surgery 2016.5

Left thoracoscopic two-stage repair of tracheoesophageal fistula with a right aortic arch and a vascular ring. Reviewed

Oshima K, Uchida H, Tainaka T, Tanano A, Shirota C, Yokota K, Murase N, Shirotsuki R, Chiba K, Hinoki A

Journal of minimal access surgery 2016.5

Cytomegalovirus (CMV) Monitoring After Liver Transplantation: Comparison of CMV Pp65 Antigenemia Assay with Real-Time PCR Calibrated to WHO International Standard. Reviewed

Kamei H, Ito Y, Onishi Y, Suzuki M, Imai H, Kurata N, Hori T, Tainaka T, Uchida H, Ogura Y

Annals of transplantation Vol. 21 page： 131-6 2016.3

A feasibility of single-incision laparoscopic percutaneous extraperitoneal closure for treatment of incarcerated inguinal hernia in children: our preliminary outcome and review of the literature. Reviewed

Murase N, Uchida H, Seki T, Hiramatsu K

Nagoya journal of medical science Vol. 78 ( 1 ) page： 19-25 2016.2

Naruhiko Murase, Hiroo Uchida, Takashi Seki, Kiyoshi Hiramatsu

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 78 ( 1 ) page： 19 - 25 2016.2

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

The purpose of this study is to examine the feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (LPEC) for incarcerated inguinal hernia (IIH) repair. 6 single-incision LPEC procedures were performed for IIH repair and 60 procedures were performed for reducible inguinal hernia (RIH) in the same period of time in one hospital. The laparoscope and one pair of grasping forceps were placed through the same umbilical incision. In IIH repair, the herniated organ was gently pulled using the grasping forceps with external manual pressure. If it was difficult to reduce the herniated organ with one pair of forceps, another pair of forceps were inserted through a multi-channel port without extending the umbilical incidion. Using the LPEC needle, the hernia orifice was closed extraperitoneally. We performed a retrospective analysis to compare the outcomes of single-incision LPEC for IIH repair or reducible inguinal hernia. All procedures were completed by single-incision without open conversion. A multi-channel port with another pair of forceps was needed in three cases. The operation time and the length of stay were significantly longer with IIH repair than with RIH repair. There were no major complications and there was no evidence of early recurrence in any patient. In conclusion, single-incision LPEC with a multi-channel port is feasible and safe for IIH repair.

Murase Naruhiko, Uchida Hiroo, Seki Takashi, Hiramatsu Kiyoshi

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 78 ( 1 ) page： 19 - 25 2016.2

Operative procedures of single-incision laparoscopic repair of pediatric epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle Reviewed International journal

Kyoichi Deie, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Hizuru Amano, Naruhiko Murase, Takahisa Tainaka

Journal of Pediatric Surgery Case Reports Vol. 4 page： 22 - 26 2016.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Inc.

We describe a simple and feasible procedure for single-incision laparoscopic repair of a pediatric epigastric hernia using a novel suture-assisting needle. A multichannel port was inserted through the umbilical vertical incision. After the orifice of the hernia was identified, a suture-assisting needle, which can hold a suture at its tip, with a 2-0 thread was pierced through the skin into one side of the rectus muscle sheath into the abdominal cavity. Next, after releasing the thread, the needle was pulled out to the subcutis and pierced through another side of the rectus muscle sheath. The needle, grasping the thread again, was subsequently pulled out through the abdominal wall outside, and the thread was tied extracorporeally. This knot was buried subcutaneously. Operative procedures of single-incision laparoscopic repair of an epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle with an excellent cosmetic result.

DOI： 10.1016/j.epsc.2015.11.010

A Case of Fibrolamellar Hepatocellular Carcinoma Treated by Gemcitabine/Oxaliplatin Chemotherapy (GEMOX Chemotherapy) Preoperatively and Postoperatively Reviewed

Makita Satoshi, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 52 ( 6 ) page： 1251 - 1255 2016

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

Fibrolamellar hepatocellular carcinoma (FLHCC) is rare in children. In Japan, there are only six reports of children with FLHCC. We report a case of FLHCC aggressively treated by surgery and chemotherapy. A 12-year-old girl with liver tumor was admitted to our hospital for treatment. FLHCC with lymph node metastases was suspected from various imaging studies and definitively diagnosed as FLHCC by laparotomy biopsy. One cycle of gemcitabine/oxaliplatin (GEMOX) chemotherapy was administered preoperatively because of multiple lymph node metastases. After chemotherapy, her PIVKA-II level decreased but there was no reduction in tumor size. As a result, left hepatectomy and lymphadenectomy were performed. GEMOX chemotherapy was administered as a postoperative adjuvant. After 2 cycles of GEMOX chemotherapy, she developed adhesive ileus and adhesiotomy was performed. Ten cycles of GEMOX chemotherapy were administered after adhesiotomy, and then she was discharged. To date, 3 years after surgery, there is no evidence of recurrence.

DOI： 10.11164/jjsps.52.6_1251

Emergency hepatectomy for hepatic arteriovenous malformation combined with pulmonary hypertension in an infant Reviewed International journal

Naruhiko Murase, Hiroo Uchida, Akihide Tanano, Chiyoe Shirota, Akinari Hinoki, Takahisa Tainaka, Kazuki Yokota, Kazuo Oshima, Ryo Shirotsuki

Journal of Pediatric Surgery Case Reports Vol. 3 ( 12 ) page： 534 - 536 2015.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Inc.

Patients with hepatic arteriovenous malformations rarely present with pulmonary hypertension. We report the case of a 3-month-old boy who developed severe pulmonary hypertension due to a hepatic arteriovenous malformation. The use of pulmonary vasodilators to treat the patient's pulmonary hypertension worsened his high-output heart failure. This is the first case in which emergency hepatectomy rescued a patient with hepatic arteriovenous malformations who developed pulmonary hypertension.

DOI： 10.1016/j.epsc.2015.10.017

Accessory scrotum with perineal lipoma diagnosed prenatally: case report and review of the literature Reviewed

Laparoscopic-assisted pancreaticoduodenectomy in a child with gastrinoma. Reviewed

Murase N, Uchida H, Tainaka T, Kawashima H, Tanaka Y, Amano H, Kishimoto H

Pediatrics international : official journal of the Japan Pediatric Society Vol. 57 ( 6 ) page： 1196-8 2015.12

Pediatric Surgery. Reviewed

Iwanaka T, Yamataka A, Uemura S, Okuyama H, Segawa O, Nio M, Yoshizawa J, Yagi M, Ieiri S, Uchida H, Koga H, Sato M, Soh H, Take H, Hirose R, Fukuzawa H, Mizuno M, Watanabe T

Asian journal of endoscopic surgery Vol. 8 ( 4 ) page： 390-407 2015.11

An Easy and Safe Technique for Laparoscopic Pyloromyotomy: Using a Vascular Clamp for Stabilization of the Pylorus. Reviewed

Fujiogi M, Tanaka Y, Kawashima H, Toma M, Suzuki K, Amano H, Morita K, Uchida H, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A 2015.8

Influence of surgical intervention on neurodevelopmental outcome in infants with focal intestinal perforation. Reviewed

Tanaka Y, Uchida H, Kawashima H, Sato K, Takazawa S, Deie K, Masuko T, Kanno K, Shimizu M

Pediatrics international : official journal of the Japan Pediatric Society Vol. 57 ( 4 ) page： 687-9 2015.8

A new modification of laparoscopic percutaneous extraperitoneal closure procedure for repairing pediatric femoral hernias involving a special needle and a wire loop. Reviewed

Tainaka T, Uchida H, Ono Y, Tanano A, Shirota C, Yokota K, Murase N, Makita S, Shirotsuki R

Nagoya journal of medical science Vol. 77 ( 3 ) page： 531-5 2015.8

Accessory scrotum with perineal lipoma diagnosed prenatally: case report and review of the literature. Reviewed

Murase N, Uchida H, Hiramatsu K

Nagoya journal of medical science Vol. 77 ( 3 ) page： 501-6 2015.8

Naruhiko Murase, Hiroo Uchida, Kiyoshi Hiramatsu

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 77 ( 3 ) page： 501 - 506 2015.8

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

We report a case of accessory scrotum (AS) in the perineal region with peduncular lipoma, diagnosed prenatally. A male fetus of 31 weeks' gestation was referred to our department with a perineal mass. Prenatal ultrasonography and magnetic resonance imaging showed a mass of 1.0 x 1.2 cm located posterior to the scrotum. No other abnormalities were noted during pregnancy. The patient was delivered vaginally at 38 weeks of gestation. On physical examination, a soft peduncular mass with a rugged and pigmented swelling was located between the normally developed scrotum and the anus. There were no specific symptoms or any other associated congenital anomalies. We completely excised the mass at one month of age. A histological examination revealed lipoma, with tissue suggestive of scrotum, so a definite diagnosis of AS was made. AS is a rare congenital anomaly of the scrotum. We review the literature.

A new modification of laparoscopic percutaneous extraperitoneal closure procedure for repairing pediatric femoral hernias involving a special needle and a wire loop Reviewed

Takahisa Tainaka, Hiroo Uchida, Yasuyuki Ono, Akihide Tanano, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Satoshi Makita, Ryo Shirotsuki

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 77 ( 3 ) page： 531 - 535 2015.8

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

Femoral hernias are relatively rare in children, and more than half of pediatric femoral hernias are misdiagnosed. A 3-year-old boy was treated for an indirect inguinal hernia at the age of 2, but he exhibited an inguinal bulge one month after the operation. He underwent laparoscopy, and a right femoral hernia was detected. The femoral hernia was laparoscopically repaired via two small incisions: a 1.0-cm umbilical incision for a 3-mm 30 degrees laparoscope and 3-mm grasping forceps and a 5-mm right lateral incision for 3-mm grasping forceps. After the hernia sac had been reflected into the abdominal cavity and resected, the iliopubic tract was sutured to Cooper's ligament using a laparoscopic percutaneous extracorporeal closure (LPEC) needle and 2-0 non-absorbable sutures. Laparoscopy enables the accurate diagnosis of rare and often missed pediatric femoral hernias. Our laparoscopic technique for treating femoral hernias is easy and effective. Although these early results are encouraging, more cases involving longer follow-up periods should be accumulated to confirm the efficacy of our technique.

Long-term outcomes of operative versus nonoperative treatment for uncomplicated appendicitis. Reviewed

Tanaka Y, Uchida H, Kawashima H, Fujiogi M, Takazawa S, Deie K, Amano H

Journal of pediatric surgery 2015.7

Prophylactic effect of H2 blocker for anastomotic stricture after esophageal atresia repair. Reviewed

Murase N, Uchida H, Kaneko K, Ono Y, Makita S, Yokota K

Pediatrics international : official journal of the Japan Pediatric Society Vol. 57 ( 3 ) page： 461-4 2015.6

Current Practice and Outcomes of Thoracoscopic Esophageal Atresia and Tracheoesophageal Fistula Repair: A Multi-institutional Analysis in Japan. Reviewed

Okuyama H, Koga H, Ishimaru T, Kawashima H, Yamataka A, Urushihara N, Segawa O, Uchida H, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 25 ( 5 ) page： 441-4 2015.5

Effectiveness and safety of immunization with live-attenuated and inactivated vaccines for pediatric liver transplantation recipients. Reviewed

Kawano Y, Suzuki M, Kawada J, Kimura H, Kamei H, Ohnishi Y, Ono Y, Uchida H, Ogura Y, Ito Y

Vaccine Vol. 33 ( 12 ) page： 1440-5 2015.3

Laparoscopic ligation of varicocele testis in children:TANKO operation Reviewed

Vol. 69 ( 2 ) page： 179 - 185 2015.2

Laparoscopic partial gastrectomy of a huge gastric duplication cyst in an infant. Reviewed

Takazawa S, Uchida H, Kawashima H, Tanaka Y, Sato K, Jimbo T, Iwanaka T

Nagoya journal of medical science Vol. 77 ( 1-2 ) page： 291-6 2015.2

LAPAROSCOPIC PARTIAL GASTRECTOMY OF A HUGE GASTRIC DUPLICATION CYST IN AN INFANT Reviewed

Shinya Takazawa, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Kaori Sato, Takahiro Jimbo, Tadashi Iwanaka

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 77 ( 1-2 ) page： 291 - 296 2015.2

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

Gastric duplication cyst is a rare anomaly, and most cases are recognized during childhood. Recently, several pediatric cases with small gastric duplication cysts treated by laparoscopic resection have been reported. Here, we describe an infant in whom we successfully performed laparoscopic partial gastrectomy for the treatment of a huge gastric duplication cyst. To the best of our knowledge, this is the largest gastric duplication cyst treated by laparoscopic surgery among infants. We introduce our procedure and some tips.

Laparoendoscopic-assisted Single-site Surgery of an Ileal Duplication Diagnosed Prenatally as an Intraabdominal Cyst Reviewed

The umbilical Benz incision for reduced port surgery in pediatric patients. Reviewed

Amano H, Uchida H, Kawashima H, Deie K, Murase N, Makita S, Yokota K, Tanaka Y

JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons Vol. 19 ( 1 ) page： e2014.00238 2015.1

Initial treatment of septated parapneumonic empyema with drainage plus fibrinolytic agents is equally effective as video-assisted thoracoscopic surgery, and is suitable as first-line therapy. Reviewed

Shirota C, Uchida H

Translational pediatrics Vol. 4 ( 1 ) page： 41-4 2015.1

MURASE Naruhiko, UCHIDA Hiroo, HIRAMATSU Kiyoshi, AMEMIYA Takeshi, SEKI Takashi, ARAI Toshiyuki

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 76 ( 3 ) page： 529 - 533 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Surgical Association

A baby girl delivered at the gestational age of 38 week's was referred to our department because of an intraabdominal cyst diagnosed prenatally. There were no specific symptoms after birth. USG revealed a cyst-like structure with gut signature, and CT showed a cystic mass in the abdomen containing air. A preoperative diagnosis of duplication of the alimentary tract or Meckel's diverticulum was made, and a laparoendoscopic single-site surgery was performed when the baby girl was ten months old. An inverted Y-shaped incision was made at the umbilicus, and laparoscopic exploration revealed a cystic mass sharing a common wall and blood supply with the ileum on the mesenteric side. We exteriorized the duplication cyst with normal ileum from the umbilical incision, and performed resection of the segment of the small bowel including the cystic mass. Histopathology revealed that the ileal duplication cyst was lined with gastric epithelium. The postoperative course was uneventful.

DOI： 10.3919/jjsa.76.529

A New Era of Laparoscopic Revision of Kasai Portoenterostomy for the Treatment of Biliary Atresia. Reviewed

Murase N, Uchida H, Ono Y, Tainaka T, Yokota K, Tanano A, Shirota C, Shirotsuki R

BioMed research international Vol. 2015 page： 173014 2015

Laparoscopic ligation of varicocele testis in children: Tanko operation Reviewed International journal

Kawashima, H., Tada, M., Sato, A., Hori, Y., Funakoshi, D., Uchida, H.

Japanese Journal of Clinical Urology Vol. 69 ( 2 ) page： 179 - 185 2015

Laparoscopic partial nephrectomy for the treatment of large cystic nephroma in children. Reviewed

Tanaka Y, Uchida H, Kawashima H, Masuko T, Takazawa S, Deie K, Amano H, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 24 ( 12 ) page： 901-6 2014.12

Surgical complications, especially gastroesophageal reflux disease, intestinal adhesion obstruction, and diaphragmatic hernia recurrence, are major sequelae in survivors of congenital diaphragmatic hernia. Reviewed

Yokota K, Uchida H, Kaneko K, Ono Y, Murase N, Makita S, Hayakawa M

Pediatric surgery international Vol. 30 ( 9 ) page： 895-9 2014.9

Urethroscopic holmium: YAG laser ablation for acquired posterior urethral diverticulum after repair of anorectal malformations. Reviewed

Takazawa S, Uchida H, Kawashima H, Tanaka Y, Masuko T, Deie K, Amano H, Kobayashi K, Tada M, Iwanaka T

Pediatric surgery international Vol. 30 ( 9 ) page： 945-9 2014.9

Full-thickness small intestine necrosis with midgut volvulus, distributed in a patchy fashion, is reversible with moderate blood flow: resumption of normal function to non-viable intestine. Reviewed

Amano H, Uchida H, Kawashima H, Tanaka Y, Kishimoto H

Nagoya journal of medical science Vol. 76 ( 3-4 ) page： 375-80 2014.8

Massive hemorrhage after Kasai portoenterostomy in a patient with a congenital extrahepatic portosystemic shunt, malrotation and a double aortic arch: report of a case. Reviewed

Takazawa S, Uchida H, Kawashima H, Tanaka Y, Sato K, Jimbo T, Deie K, Koiwai K, Nomura K, Iwanaka T

Surgery today Vol. 44 ( 8 ) page： 1561-4 2014.8

FULL-THICKNESS SMALL INTESTINE NECROSIS WITH MIDGUT VOLVULUS, DISTRIBUTED IN A PATCHY FASHION, IS REVERSIBLE WITH MODERATE BLOOD FLOW: RESUMPTION OF NORMAL FUNCTION TO NON-VIABLE INTESTINE Reviewed

Hizuru Amano, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Hiroshi Kishimoto

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 76 ( 3-4 ) page： 375 - 380 2014.8

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

Midgut volvulus is a highly life-threatening condition that carries a high risk of short gut syndrome. We report a case of catastrophic neonatal midgut volvulus in which second-look laparotomy revealed apparently non-viable remnant small intestine but with a moderate blood supply. Full-thickness small intestine necrosis was distributed in a patchy fashion, with non-viable and necrotic areas distributed so widely that no portion of the intestine could be resected. A section of full-thickness necrotic intestine preserved at surgery was able to regenerate, and normal function was restored over a period of 1 month. This case indicated that intestinal resumption may be dependent on blood flow. Even when intestinal viability is questionable, preservation enables the chance of regeneration if moderate blood flow is present.

OP-052-7 当施設における小児膵SPT(Solid pseudopapillary tumor)の治療経験(OP-052 膵 IPMN・その他,一般演題,第114回日本外科学会定期学術集会) Reviewed

牧田智, 金子健一朗, 小野靖之, 横田一樹, 村瀬成彦, 内田広夫

日本外科学会雑誌 Vol. 115 ( 2 ) page： 408 2014.3

【直腸肛門奇形術後遠隔期の評価と再手術】遺残瘻孔の嚢胞化に対する再手術

高澤慎也, 内田広夫

小児外科 Vol. 46 ( 1 ) page： 31 - 34 2014.1

Thoracoscopic Resection of an Intralobar Pulmonary Sequestration in a Neonate With Heart Failure Reviewed

Murase Naruhiko, Kaneko Kenichiro, Ono Yasuyuki, Yokota Kazuki, Makita Satoshi, Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 50 ( 5 ) page： 946 - 949 2014

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

High-output heart failure in a neonate due to pulmonary sequestration is rare. We report a case of neonatal heart failure relieved with thoracoscopic resection of an intralobar pulmonary sequestration. A male neonate of 39-week gestational age presented with respiratory distress, chest X-ray and echocardiography revealed high-output heart failure. A computed tomography showed a left lower pulmonary sequestration with venous drainage into the azygos system. Preoperative diagnosis is an extralobar pulmonary sequestration, and high-output heart failure is caused by arteriovenous shunt in the pulmonary sequestration. We intervened with thoracoscopic resection on day-of-life 21. Intraoperative diagnosis is an intralobar pulmonary sequestration. Postoperative course was uneventful, and the patient was discharged on postoperative day 20 without any sign of heart failure.

DOI： 10.11164/jjsps.50.5_946

NOTES for Surgical Treatment of Long-Segment Hirschsprung's Disease: Report of Three Cases Reviewed

Li, N; Zhang, W; Yu, DH; Sun, XY; Wei, MF; Weng, YZ; Feng, JX

JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES Vol. 23 ( 12 ) page： 1020 - 1023 2013.12

Laparoscopic excision of urachal remnants is a safe and effective alternative to open surgery in children. Reviewed

Masuko T, Uchida H, Kawashima H, Tanaka Y, Deie K, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 23 ( 12 ) page： 1016-9 2013.12

Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula Reviewed

Yamataka Atsuyuki, Morikawa Yasuhide, Yagi Makoto, Kimura Osamu, Kuroda Tatsuo, Ueno Shigeru, Iwanaka Tadashi, Iwai Jun, Zaizen Yoshio, Koga Hiroyuki, Shimono Ryuichi, Yagi Makoto, Kimura Osamu, Kubota Masayuki, Murase Naruhiko, Kanamori Yutaka, Tanaka Hideaki, Takahashi Masataka, Ikeda Taro, Kubota Akio, Nara Keigo, Satoh Kaori, Amano Hizuru, Takazawa Shinya, Tanaka Yujiro, Uchida Hiroo, Kawashima Hiroshi, Jimbo Takahiro, Fukumoto Kohji, Ueno Shigeru, Ishimaru Tetsuya

JOURNAL OF PEDIATRIC SURGERY Vol. 48 ( 12 ) page： 2383-2388 2013.12

External stabilization for severe tracheobronchomalacia using separated ring-reinforced ePTFE grafts is effective and safe on a long-term basis. Reviewed

Takazawa S, Uchida H, Kawashima H, Tanaka Y, Masuko T, Deie K, Nagase Y, Iwanaka T

Pediatric surgery international Vol. 29 ( 11 ) page： 1165-9 2013.11

Single-incision laparoscopic-assisted appendectomy in children: exteriorization of the appendix is a key component of a simple and cost-effective surgical technique. Reviewed

Deie K, Uchida H, Kawashima H, Tanaka Y, Masuko T, Takazawa S

Pediatric surgery international Vol. 29 ( 11 ) page： 1187-91 2013.11

Complete thoracoscopic versus video-assisted thoracoscopic resection of congenital lung lesions. Reviewed

Tanaka Y, Uchida H, Kawashima H, Sato K, Takazawa S, Masuko T, Deie K, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 23 ( 8 ) page： 719-22 2013.8

Successful two-stage thoracoscopic repair of long-gap esophageal atresia using simple internal traction and delayed primary anastomosis in a neonate: report of a case. Reviewed

Tanaka Y, Uchida H, Kawashima H, Sato K, Takazawa S, Jimbo T, Iwanaka T

Surgery today Vol. 43 ( 8 ) page： 906-9 2013.8

Development of a needle driver with multiple degrees of freedom for neonatal laparoscopic surgery. Reviewed

Ishimaru T, Takazawa S, Uchida H, Kawashima H, Fujii M, Harada K, Sugita N, Mitsuishi M, Iwanaka T

Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 23 ( 7 ) page： 644-8 2013.7

Long-term survivor of relapsed stage IV malignant rhabdoid tumor of the kidney Reviewed

Kato Motohiro, Koh Katsuyoshi, Oshima Koichi, Oguma Eiji, Uchida Hiroo, Kishimoto Hiroshi, Kikuchi Akira, Hanada Ryoji

PEDIATRICS INTERNATIONAL Vol. 55 ( 2 ) page： 245-248 2013.4

Sacrococcygeal yolk sac tumor developing after teratoma: a clinicopathological study of pediatric sacrococcygeal germ cell tumors and a proposal of the pathogenesis of sacrococcygeal yolk sac tumors. Reviewed

Yoshida M, Matsuoka K, Nakazawa A, Yoshida M, Inoue T, Kishimoto H, Nakayama M, Takaba E, Hamazaki M, Yokoyama S, Horie H, Tanaka M, Gomi K, Ohama Y, Kigasawa H, Kitano Y, Uchida H, Kanamori Y, Iwanaka T, Tanaka Y

Journal of pediatric surgery Vol. 48 ( 4 ) page： 776-81 2013.4

Long-term survivor of relapsed stage IV malignant rhabdoid tumor of the kidney. Reviewed

Kato M, Koh K, Oshima K, Oguma E, Uchida H, Kishimoto H, Kikuchi A, Hanada R

Pediatrics international : official journal of the Japan Pediatric Society Vol. 55 ( 2 ) page： 245-8 2013.4

Minimally invasive surgery for pediatric cases of large extraovarian teratoma with considerable solid component Reviewed International journal

Shinya Takazawa, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Kaori Sato, Takahiro Jimbo, Takayuki Masuko, Kyoichi Deie, Tadashi Iwanaka

Journal of Pediatric Surgery Case Reports Vol. 1 ( 8 ) page： 226 - 229 2013

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Inc.

Pediatric patients with large extraovarian teratomas with a significant solid component are usually treated using open surgery because the size of the intracorporeal cavity does not facilitate the manipulation of large tumors. Here, we describe the cases of 3 children who underwent minimally invasive surgery for large extraovarian teratomas (diameter &gt
10 cm), including 2 cases of retroperitoneal teratoma and 1 case of a thoracic teratoma. All tumors had a large amount of sebaceous material that displaced other surrounding organs. Tumor volumes were reduced by intraoperative needle aspiration using a SAND balloon catheter with a double balloon that is designed to minimize the risk of spillage. Intraoperative needle aspiration of cystic content can provide sufficient working space and facilitates safe separation of the major vessels from the tumor. Treatment of large extraovarian teratomas by minimally invasive surgery involving skin incisions that result in a less noticeable scar, such as a Pfannenstiel incision or axillary incision, can achieve improved cosmetic outcomes. © 2013 The Authors.

DOI： 10.1016/j.epsc.2013.07.003

22. 絞扼性イレウスによりY脚消失,および短腸症候群となった総胆管拡張症術後の1例の治療戦略(一般演題,第47回日本小児外科学会関東甲信越地方会) Reviewed

肺転移を認めるStage IV肝芽腫の1例 Reviewed

森麻希子, 康勝好, 磯部清孝, 秋山康介, 安井直子, 関正史, 高橋寛吉, 加藤元博, 田中裕次郎, 内田広夫, 小熊栄二, 岸本宏志, 花田良二

日本小児血液・がん学会雑誌 Vol. 49 ( 3 ) page： 410 - 410 2012.10

Stapled intestinal anastomosis is a simple and reliable method for management of intestinal caliber discrepancy in children. Reviewed

Sato K, Uchida H, Tanaka Y, Takazawa S, Jimbo T, Deie K

Pediatric surgery international Vol. 28 ( 9 ) page： 893-8 2012.9

【虫垂炎-最近の話題】急性虫垂炎の術式選択腫瘤形成性虫垂炎に対するinterval appendectomy

高澤慎也, 内田広夫

小児外科 Vol. 44 ( 5 ) page： 451 - 454 2012.5

【小児消化管内視鏡:診断と治療の最前線】小児膵疾患に対する内視鏡的経乳頭的治療

高澤慎也, 内田広夫, 糸井隆夫

小児外科 Vol. 44 ( 3 ) page： 287 - 291 2012.3

Differences in the characteristics and management of pyriform sinus fistula between neonates and young children. Reviewed

Amano H, Uchida H, Sato K, Kawashima H, Tanaka Y, Takazawa S, Jimbo T

Pediatric surgery international Vol. 28 ( 1 ) page： 15-20 2012.1

益子貴行, 内田広夫, 川嶋寛, 田中裕次郎, 出家亨一

日本小児外科学会雑誌 Vol. 48 ( 7 ) page： 1078 2012

WS2-10 単孔式腹腔鏡下鼠径ヘルニア根治術は鼠径ヘルニア根治術の標準術式となりうるか : 手術習熟度からみた考察(ワークショップ2 手術の教育) Reviewed

内田広夫, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 出家亨一, 小岩井和樹, 多田実, 小林堅一郎, 益子貴行

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 400 2012

WS2-08 内視鏡手術手技トレーニングシステムの構築(ワークショップ2 手術の教育) Reviewed

高澤慎也, 内田広夫, 田中裕次郎, 佐藤かおり, 益子貴行, 神保教広, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 399 2012

V2-02 左肺底動脈大動脈起始症に対する胸腔鏡手術(ビデオセッション2 食道・肺) Reviewed

田中裕次郎, 内田広夫, 佐藤かおり, 高澤慎也, 神保教広, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 445 2012

V1-02 腎孟尿管移行部狭窄症に対する腹腔鏡下腎孟形成術 : laparoscopic Anderson-Hynes dismembered pyeloplasty(ビデオセッション1 泌尿器他) Reviewed

内田広夫, 多田実, 川島寛, 益子貴行, 小林堅一郎, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 443 2012

V1-01 大動脈食道瘻により大量吐血した,胆道閉鎖症,門脈大循環シャントType 1を合併した重複大動脈弓症の一例(ビデオセッション1 泌尿器他) Reviewed

高澤慎也, 内田広夫, 田中裕次郎, 佐藤かおり, 神保教広, 出家亨一, 小岩井和樹, 宮林寛, 菅野啓一, 清水正樹, 野村耕司

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 443 2012

P9-05 骨髄移植後のStage IV神経芽細胞腫に対する腹腔鏡下摘出術(ポスターセッション9 腫瘍1) Reviewed

神保教広, 内田広夫, 田中裕次郎, 佐藤かおり, 高澤慎也, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 539 2012

P43-05 虫垂炎に対する単孔式腹腔鏡補助下虫垂切除術 : 多孔式腹腔鏡下虫垂切除より,簡便で経済的な術式を目指して(ポスターセッション43 虫垂炎) Reviewed

出家亨一, 内田広夫, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 668 2012

P23-04 当センターにおける極低出生体重児の外科手術とその予後(ポスターセッション23 新生児) Reviewed

田中裕次郎, 内田広夫, 佐藤かおり, 高澤慎也, 神保教広, 出家亨一, 小岩井和樹, 清水正樹, 菅野啓一

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 596 2012

P19-04 完全胸腔鏡下肺葉切除術の実際 : 胸腔鏡補助下肺葉切除術との比較(ポスターセッション19 循環呼吸器外科の最前線1) Reviewed

高澤慎也, 内田広夫, 田中裕次郎, 佐藤かおり, 神保教広, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 585 2012

O9-02 手術歴のない腸閉塞症患児に対する治療戦略(一般口演9 腸管) Reviewed

神保教広, 内田広夫, 田中裕次郎, 佐藤かおり, 高澤慎也, 出家亨一, 小岩井和樹

日本小児外科学会雑誌 Vol. 48 ( 3 ) page： 505 2012

32. 胃軸捻の原因となった遊走脾に対して腹腔鏡下脾固定術(腹膜外ポケット法)を行った1例(一般演題,第46回日本小児外科学会関東甲信越地方会) Reviewed

高澤慎也, 内田広夫, 田中裕次郎, 佐藤かおり, 神保教広

日本小児外科学会雑誌 Vol. 48 ( 1 ) page： 143 - 143 2012

小児に対する腹腔鏡下腎摘除術

高澤慎也, 多田実, 小林堅一郎, 益子貴行, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 神保教広, 宮川亨平, 中村譲

埼玉県医学会雑誌 Vol. 46 ( 1 ) page： 55 - 57 2011.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：埼玉県医学会

腹腔鏡下腎摘除術を施行した小児患者16例(男児4例、女児12例、中央値5歳)の成績を報告した。男児の基礎疾患はそれぞれ精嚢腺嚢胞と同側単純性尿管瘤合併、膀胱尿管逆流症と腎盂尿管移行部狭窄合併、単純性尿管瘤とMCDK合併、尿管異所開口であった。女児は全例尿管異所開口で、9例は開口部が同定不能であった。手術は患側を上にした半側臥位とし、3ポート或いは4ポートで行った。経腹腔的に腎に到達し、腎周囲を電気メス、超音波凝固切開装置を用いて剥離した。尿管と腎茎部の血管はエンドループ或いはクリップを用いて切離し、臍の創より腎臓を摘出した。手術時間は中央値120分、麻酔時間217分、出血量0mlで、術中合併症はなかった。術後在院日数は中央値5.5日で、精嚢腺嚢胞切除を併施した1例に術後尿閉を認め、一時的な間歇導尿を要したが自然に軽快した。病理組織学的にはhypoplastickidnyが多く、一部にrenal dysplasiaを伴うものも認めた。

精巣を伴った鼠径部異所性陰嚢の一例

高澤慎也, 多田実, 小林堅一郎, 益子貴行, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 神保教広, 渡邊彰二

小児外科 Vol. 43 ( 9 ) page： 1003 - 1005 2011.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

1歳4ヵ月男児。出生時より右陰嚢が鼠径部に認められ、産院で異所性陰嚢と診断後、著者らの施設へ紹介来院となった。初診時、陰嚢右側は本来の位置から離れ右鼠径部にあり、内部には精巣が存在していた。一方、陰嚢左側と左精巣は正常の位置に存在しており、陰嚢正中に縫線が認められた。また他の体表奇形はみられず、腹部エコーでも泌尿生殖器系の異常は認められなかった。そこで、1歳4ヵ月目に手術が施行され、手術はZ形成術により右鼠径部の陰嚢を本来の位置に移動させた。その結果、合併症は認めず、術後5日目で退院となり、更に術後1ヵ月経過では右陰嚢の色調良好が確認された。尚、右精巣にも萎縮性変化は認められなかった。

Sialolipoma of the submandibular gland in a child. Reviewed

Sato K, Gotoh C, Uchida H, Kawashima H, Yoshida M, Kitano Y, Kishimoto H

Journal of pediatric surgery Vol. 46 ( 2 ) page： 408-10 2011.2

【小児腹部救急における腹腔鏡手術の適応と限界】小児腹部救急疾患に対する腹腔鏡手術

吉田真理子, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 高澤慎也, 岩中督

日本腹部救急医学会雑誌 Vol. 31 ( 1 ) page： 31 - 35 2011.1

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本腹部救急医学会

腹腔鏡手術は低侵襲で整容的に優れるため,腹部救急疾患に対しても適応が拡大しつつある。当科では最近12年間に,急性虫垂炎・肥厚性幽門狭窄症を除く小児腹部救急疾患75例に対し腹腔鏡手術を行った。診断は腸閉塞17例,脳室腹腔シャント障害9例,卵巣・卵管捻転8例,Meckel憩室(腸閉塞を除く),横隔膜ヘルニア各7例等であった。診断確定目的の腹腔鏡を21例に行い6例は観察のみで終了した。新生児例は捻転のない腸回転異常症と卵巣嚢腫捻転の計3例であった。術中小腸損傷は2例(2.5%),開腹移行は4例(5.0%)あった。腹部救急疾患に対して腹腔鏡手術を行うには,迅速な開腹移行にも対応できる,チームとしての熟練が必要である。腹腔鏡手術の絶対的禁忌は全身麻酔・気腹のハイリスク例であり,相対的禁忌として腸管壊死を伴う絞扼性イレウスがあげられるが,その他の症例では腹腔鏡手術の適応を考慮できると考えられた。(著者抄録)

DOI： 10.11231/jaem.31.31

WS2-03 Hirschsprung病根治術の術後合併症と排便機能 : 開腹Duhamel法と腹腔鏡補助下Soave伝田法の比較(Hirschsprung病術後の術式別排便機能,ワークショップII,第48回日本小児外科学会学術集会) Reviewed

高澤慎也, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 神保教広, 宮川亨平, 天野日出, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 516 - 516 2011

8.臍帯を利用し非縫合的腹壁閉鎖術を行った新生児腹壁異常の2例(一般演題,第45回日本小児外科学会関東甲信越地方会) Reviewed

宮川亨平, 内田広夫, 五藤周, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也, 天野日出

日本小児外科学会雑誌 Vol. 47 ( 3 ) page： 376 - 377 2011

O-16 腹腔鏡補助下鎖肛根治術の術後合併症と術後排便機能(鎖肛術後の排便機能,一般口演,第48回日本小児外科学会学術集会) Reviewed

川嶋寛, 内田広夫, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 582 - 582 2011

O-27 単孔式腹腔鏡下鼠径ヘルニア根治術(SILPEC)におけるSILPEC鉗子の開発と有用性(私はこうしている(各種デバイスを用いた一工夫)2,一般口演,第48回日本小児外科学会学術集会) Reviewed

神保教広, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 588 - 588 2011

P-264 梨状窩瘻の診断と治療 : 梨状窩嚢胞と瘻孔の違いと確実な摘出法の確立(頸部,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

天野日出, 内田広夫, 佐藤かおり, 川嶋寛, 田中裕次郎, 高澤慎也, 神保教広

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 715 - 715 2011

P-304 肺分画症を合併した横隔膜ヘルニアの3例(横隔膜2,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

高澤慎也, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 神保教広, 宮川亨平, 天野日出

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 732 - 732 2011

P-322 小児における器械吻合の有用性(手術の工夫,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 田中裕次郎, 高澤慎也, 神保教広

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 741 - 741 2011

P-342 当院で経験した卵巣腫瘍58症例の検討と卵巣腫瘍茎捻転の治療戦略(良性腫瘍3,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

神保教広, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 751 - 751 2011

P-350 腹腔内精巣より発生した成熟奇形腫の1例(良性腫瘍4,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

宮川亨平, 多田実, 小林堅一郎, 内田広夫, 川嶋寛, 佐藤かおり, 田中裕次郎, 高澤慎也, 神保教広, 天野日出, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 755 - 755 2011

P-46 小児における脾臓温存膵体尾部切除術の実際 : 2つの異なったアプローチによる脾臓温存の試み(膵・脾,ポスターセッション,第48回日本小児外科学会学術集会) Reviewed

田中裕次郎, 内田広夫, 川嶋寛, 佐藤かおり, 高澤慎也, 神保教広, 宮川亨平, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 610 - 610 2011

S1-04 極低出生体重児の腹部疾患の特殊性と手術の短期および長期予後(低出生体重児に対する外科治療の長期予後,シンポジウムI,第48回日本小児外科学会学術集会) Reviewed

内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 490 - 490 2011

S5-5.極低出生体重児の外科疾患と予後(シンポジウム5「外科治療を受けた低出生体重児の予後」,低出生体重児の外科,第27回日本小児外科学会秋季シンポジウム) Reviewed

田中裕次郎, 内田広夫, 佐藤かおり, 高澤慎也, 神保教広

日本小児外科学会雑誌 Vol. 47 ( 6 ) page： 929 - 929 2011

V-03 A型long gap食道閉鎖症に対する食道延長による二期的胸腔鏡下食道食道吻合術(ビデオセッション1,第48回日本小児外科学会学術集会) Reviewed

田中裕次郎, 内田広夫, 川嶋寛, 佐藤かおり, 高澤慎也, 神保教広, 宮川亨平, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 560 - 560 2011

V-13 腹腔鏡下根治術を施行した先天性十二指腸狭窄の1例(ビデオセッション3,第48回日本小児外科学会学術集会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 田中裕次郎, 高澤慎也, 神保教広

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 565 - 565 2011

V-18 膵体部Solid pseudopapillary tumorに対する腹腔鏡下脾臓,脾動静脈温存膵体尾部切除術(ビデオセッション4,第48回日本小児外科学会学術集会) Reviewed

内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 岸本宏志

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 567 - 567 2011

V-19 膵中央切除を行ったSolid Pseudopapirally Tumorの1例(ビデオセッション4,第48回日本小児外科学会学術集会) Reviewed

川嶋寛, 内田広夫, 神保教広, 田中裕次郎, 佐藤かおり, 高澤慎也

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 568 - 568 2011

V-20 下大静脈内腫瘍塞栓が肝静脈流入部を越えて浸潤した腎芽腫に対する下大静脈のplicationを用いた腫瘍摘出術(ビデオセッション5,第48回日本小児外科学会学術集会) Reviewed

内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也, 神保教広, 康勝好, 松野良介, 岸本宏志, 野村耕司

日本小児外科学会雑誌 Vol. 47 ( 4 ) page： 568 - 568 2011

8.短腸症候群に尿路結石を合併した1例(一般演題,第40回日本小児外科代謝研究会) Reviewed

高澤慎也, 多田実, 小林堅一郎, 内田広夫, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 宮川亨平

日本小児外科学会雑誌 Vol. 47 ( 2 ) page： 298 - 299 2011

JOS-0862.腹腔鏡下精巣検索および手術に難渋した臍帯ヘルニア術後(Beckwith-Wiedemann症候群)の3症例(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

多田実, 川嶋寛, 内田広夫, 小林堅一郎, 宮川享平, 高澤慎也

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 167 - 167 2011

JOS-0867.経尿道的逆流防止術を施行した原発性膀胱尿管逆流症(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

小林堅一郎, 多田実, 高澤慎也, 宮川享平, 川嶋寛, 内田広夫

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 168 - 168 2011

JOS-0868.小児に対する腹腔鏡下腎摘除術(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

高澤慎也, 多田実, 小林堅一郎, 内田広夫, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 宮川亨平

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 168 - 169 2011

JOS-0883.急性腹症における腹腔鏡手術の有用性(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 五藤周, 田中裕次郎, 高澤慎也, 宮川亨平, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 173 - 174 2011

JOS-0890.3歳未満の乳幼児に対する完全胸腔鏡下肺切除術の検討 : 胸腔鏡補助下手術との比較(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

川嶋寛, 内田広夫, 五藤周, 田中裕次郎, 佐藤かおり, 高澤慎也, 宮川亨平, 岩中督

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 175 - 176 2011

JOS-0912.腹腔鏡下に摘出した巨大後腹膜奇形腫の1乳児例(要望演題・一般演題,第30回日本小児内視鏡外科・手術手技研究会) Reviewed

五藤周, 内田広夫, 川嶋寛, 佐藤かおり, 高澤慎也, 田中裕次郎, 宮川亨平

日本小児外科学会雑誌 Vol. 47 ( 1 ) page： 182 - 183 2011

3.重症尿路感染後に無機能腎となり腹腔鏡下腎摘出術を施行した1例(一般演題,第45回日本小児外科学会関東甲信越地方会) Reviewed

高澤慎也, 多田実, 小林堅一郎, 内田広夫, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 宮川亨平, 天野日出

日本小児外科学会雑誌 Vol. 47 ( 3 ) page： 375 - 375 2011

12.完全胸腔鏡下に摘出した後縦隔まで進展した肺葉内肺分画症の1例(一般演題,第45回日本小児外科学会関東甲信越地方会) Reviewed

天野日出, 内田広夫, 岸本宏志, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 高澤慎也, 宮川亨平

日本小児外科学会雑誌 Vol. 47 ( 3 ) page： 377 - 377 2011

33.肺靭帯を通して後縦隔まで進展した先天性肺葉内肺分画症の1例(セッション7 一般演題(嚢胞性肺疾患),第21回日本小児呼吸器外科研究会) Reviewed

天野日出, 内田広夫, 岸本宏志, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 高澤慎也, 宮川亨平

日本小児外科学会雑誌 Vol. 47 ( 7 ) page： 1094 - 1094 2011

Inguinal hernia repair in children using single-incision laparoscopic-assisted percutaneous extraperitoneal closure. Reviewed

Uchida H, Kawashima H, Goto C, Sato K, Yoshida M, Takazawa S, Iwanaka T

Journal of pediatric surgery Vol. 45 ( 12 ) page： 2386-9 2010.12

当センターにおける完全胸腔鏡下および胸腔鏡補助下肺葉切除術の検討 Reviewed

高澤慎也, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 城宏輔, 岩中督

埼玉県医学会雑誌 Vol. 45 ( 1 ) page： 91 - 93 2010.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：埼玉県医学会

2000年1月〜2009年12月に胸腔鏡補助下(VATS)12例および完全胸腔鏡下(CTL)肺葉切除3例について、手術成績・合併症などを後方視的に検討した。VATSとCTLにおける中央値はそれぞれ、手術時年齢5歳10ヵ月・1歳3ヵ月、手術時体重は17.8kg・9.5kg、手術時間は184分・222分、出血量は116g・28g、術後在院日数は8.5日・6日であった。VATSで1例が出血のため開胸移行したが、いずれも術後合併症は認めなかった。

【高位鎖肛基礎から臨床の最前線まで】腹腔鏡補助下肛門形成術後の問題点と排便機能

内田広夫, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 高澤慎也, 宮川亨平, 石丸哲也, 岩中督

小児外科 Vol. 42 ( 11 ) page： 1187 - 1190 2010.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

2005年以降に腹腔鏡補助下肛門形成術(LAARP)を施行した28症例(男児22例、女児6例、手術時平均月齢6.5±3.1ヵ月)を対象に術式の問題点および術後の排便機能について後方視的に検討した。その結果、平均手術時間は194±61分、出血量は7.8±8.4mlで、早期合併症としては直腸肛門縫合不全が3例にみられ、1例は保存的に軽快、2例は再吻合を要した。晩期合併症としては大きな尿道後部嚢胞が3例にみられ、うち2例は嚢胞摘出標本に直腸粘膜がみられたことから、瘻孔切離部が直腸側に寄りすぎたため遺残瘻孔となり、徐々に増大したと考えられた。術後1年以上経過時に施行のMRIでは1.5cm以下の嚢胞が6例に認められたが、それらは2年以上経過しても増大傾向はみられなかった。排便機能は4歳時では1日おきに浣腸を行っている症例が多くみられたが、失禁はほとんどみられず時に汚染がみられる症例が多かった。7・8歳時では4歳時と比べ各項目で徐々に改善がみられ、便意と総合点では有意な改善が認められた。尚、肛門静止圧・肛門管長・直腸肛門弛緩反射についてはPSARPと差は認められなかった。

Laparoscopic spleen-preserving distal pancreatectomy for solid pseudopapillary tumor with conservation of splenic vessels in a child. Reviewed

Uchida H, Goto C, Kishimoto H, Kawashima H, Sato K, Yoshida M, Takazawa S

Journal of pediatric surgery Vol. 45 ( 7 ) page： 1525-9 2010.7

Histopathologic improvement in biliary cirrhosis after definitive surgery for choledochal cyst Reviewed International journal

Tetsuya Ishimaru, Yoshihiro Kitano, Hiroo Uchida, Hiroshi Kawashima, Chikashi Gotoh, Kaori Satoh, Mariko Yoshida, Hiroshi Kishimoto, Tadashi Iwanaka

JOURNAL OF PEDIATRIC SURGERY Vol. 45 ( 5 ) page： E11 - E14 2010.5

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

Choledochal cyst causes liver fibrosis, the extent of which varies with each case. Liver damage seldom progresses to cirrhosis, but when it does, it is generally irreversible. We report an infantile case of liver cirrhosis associated with choledochal cyst in which complete clinical resolution was achieved by surgery. Pancytopenia caused by splenomegaly, massive ascites, hypoalbuminemia, and coagulation abnormality that were observed during the early postoperative period had disappeared within 4 months after surgery. Needle liver biopsy performed at 1 year after surgery revealed marked improvement in liver fibrosis. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jpedsurg.2010.01.030

重症心身障害児における小児外科医の役割腹腔鏡下噴門形成術の長期予後 Reviewed

川嶋寛, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 524 - 524 2010.5

S7-4.重症心身障害児に発症した絞扼性イレウスの4例(シンポジウム7「緊急手術」,障がい児を支える-小児外科医の役割-,第26回日本小児外科学会秋季シンポジウム) Reviewed

五藤周, 内田広夫, 川嶋寛, 田中裕次郎, 佐藤かおり, 高澤慎也, 宮川亨平

日本小児外科学会雑誌 Vol. 46 ( 6 ) page： 911 - 912 2010

PO-205 当院における小腸瘻閉鎖術の術後合併症と小児における器械吻合の可能性(各種手術の工夫,ポスターセッション,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 五藤周, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 701 - 701 2010

PS-059 当センターにおける先天性肺嚢胞性疾患に対する術式の検討(頚・胸部疾患治療の最前線,ポスターシンポジウム,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会) Reviewed

高澤慎也, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 520 - 520 2010

PS-068 腹腔鏡下噴門形成術の長期予後(重症心身障害児における小児外科医の役割2,ポスターシンポジウム,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会) Reviewed

川嶋寛, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 524 - 524 2010

PS-119 小児急性虫垂炎に対する保存療法の有用性 : 待機手術は本当に必要か?(虫垂炎の診断と治療,ポスターシンポジウム,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会) Reviewed

吉田真理子, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 550 - 550 2010

PS-140 術創が残らない単孔式腹腔鏡下鼠径ヘルニア根治術(SILPEC)の確立(内視鏡手術の進歩2,ポスターシンポジウム,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会) Reviewed

内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 3 ) page： 560 - 560 2010

11. 腹腔鏡補助下造肛術の術後合併症(要望演題II,第66回直腸肛門奇形研究会) Reviewed

内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也, 岩中督, 石丸哲也

日本小児外科学会雑誌 Vol. 46 ( 1 ) page： 136 - 136 2010

84.新生児・乳児における腸捻転症53例の検討(一般演題,第29回日本小児内視鏡外科・手術手技研究会) Reviewed

吉田真理子, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 6 ) page： 1011 - 1011 2010

55.両側腎動脈瘤の1男児例(一般演題,第29回日本小児内視鏡外科・手術手技研究会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 五藤周, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 6 ) page： 1004 - 1004 2010

20.肛門膣前庭瘻に子宮・膣欠損を合併した1例(一般演題,第29回日本小児内視鏡外科・手術手技研究会) Reviewed

高澤慎也, 五藤周, 内田広夫, 川嶋寛, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 46 ( 6 ) page： 995 - 996 2010

2.小児膵疾患に対する内視鏡的経乳頭的治療の経験(一般演題,第37回日本小児内視鏡研究会) Reviewed

高澤慎也, 糸井隆夫, 川嶋寛, 五藤周, 田中裕次郎, 佐藤かおり, 宮川享平, 内田広夫

日本小児外科学会雑誌 Vol. 46 ( 6 ) page： 1014 - 1015 2010

16.原因不明の発熱・下痢・嘔吐を繰り返した1乳児例(一般演題,第44回日本小児外科学会関東甲信越地方会) Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 五藤周, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 4 ) page： 800 - 800 2010

11.術前に頭蓋内出血を認めた胆道閉鎖症の7例(一般演題,第36回日本胆道閉鎖症研究会) Reviewed

五藤周, 内田広夫, 川嶋寛, 佐藤かおり, 吉田真理子, 高澤慎也

日本小児外科学会雑誌 Vol. 46 ( 4 ) page： 820 - 821 2010

小児内視鏡外科における機能温存と低侵襲の追及小児内視鏡手術における機能温存と低侵襲の追求胸腔鏡下食道閉鎖症根治術 Reviewed

川嶋寛, 岩中督, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也, 古村眞, 田中裕次郎, 石丸哲也

日本内視鏡外科学会雑誌 Vol. 14 ( 7 ) page： 203 - 203 2009.12

重症心身障害児に対する内視鏡手術胃食道逆流症とその治療戦略 Reviewed

川嶋寛, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也

日本内視鏡外科学会雑誌 Vol. 14 ( 7 ) page： 276 - 276 2009.12

腹腔鏡補助下鎖肛根治術の問題点と術後排便機能 Reviewed

内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也

日本内視鏡外科学会雑誌 Vol. 14 ( 7 ) page： 391 - 391 2009.12

Stage 3の神経芽腫に対して集学的な治療は必要か Reviewed

内田広夫, 康勝好, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也, 花田良二

小児がん Vol. 46 ( プログラム・総会号 ) page： 312 - 312 2009.11

【低出生体重児の外科Update】院外出生後、当センターに搬送された低出生体重児の外科手術症例 Reviewed

川嶋寛, 内田広夫, 吉田真理子

小児外科 Vol. 41 ( 11 ) page： 1222 - 1225 2009.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

1999〜2008年の10年間に著者等の施設における2500g未満の低出生体重児で外科手術を行った124症例(男児71例、女児53例)を対象に、出生体重・在胎週数・診断・予後について後方視的に検討した。その結果、平均在胎週数は34(21〜41)週、出生体重は平均1817(506〜2486)gで、出生体重の内訳は1000g未満の超低出生体重児25例、1000g以上1500g未満の極低出生体重児10例、1500g以上2500g未満の低出生体重児89例であった。疾病別では腸閉鎖・狭窄22例、消化管穿孔21例、直腸肛門奇形20例、食道閉鎖症16例、腸回転異常症8例、壊死性腸炎7例、臍帯ヘルニア6例、腹壁破裂5例、肥厚性幽門狭窄症4例、横隔膜ヘルニア・ヒルシュスプルング病・胆道閉鎖症各2例であった。出生前診断は124例中14例(11.2%)で、全国集計の26.7%より胎児診断率が低かった。予後では術後死亡率は13%(16例)で全国集計の16.2%と同等であった。

Growth spurt-related recurrence after Nuss procedure Reviewed International journal

Tetsuya Ishimaru, Yoshihiro Kitano, Hiroo Uchida, Hiroshi Kawashima, Chikashi Gotoh, Kaori Satoh, Mariko Yoshida, Ayanori Sugita, Tadashi Iwanaka

JOURNAL OF PEDIATRIC SURGERY Vol. 44 ( 8 ) page： E13 - E16 2009.8

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

We report 2 cases of growth spurt-related recurrence after Nuss procedure. Each of the 2 cases underwent bar insertion at the age of 6 and I I years, respectively. The support bar was removed 2 years later followed by severe redepression during the growth spurt. One patient underwent redo Nuss procedure elsewhere. The other patient was diagnosed as idiopathic precocious puberty and is in treatment. The possibility of growth spurt-related recurrence must be explained to those who undergo early correction before surgery, and follow-up is mandatory at least until patients' puberty is over. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jpedsurg.2009.04.014

S4-4.腹腔鏡補助下造肛術の術後合併症と排便機能(シンポジウム4「鏡視下鎖肛手術の適応と問題点」,術後評価からみた高位鎖肛各術式の功罪,第25回日本小児外科学会秋季シンポジウム) Reviewed

当院における先天性胆道拡張症の長期予後 Reviewed

佐藤かおり, 内田広夫, 川嶋寛, 五藤周, 芳田真理子, 高澤慎也

日本膵・胆管合流異常研究会プロシーディングス Vol. 32 page： 41 - 41 2009.8

Recurrence of a congenital pancreatic cyst mimicking omental cyst after laparoscopic cyst resection. Reviewed

Ishimaru T, Uchida H, Yotsumoto K, Gotoh C, Yoshida M, Oguma E, Kishimoto H, Iwanaka T, Kitano Y

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie Vol. 19 ( 1 ) page： 53-4 2009.2

Residual fistula after laparoscopically assisted anorectoplasty: is it a rare problem? Reviewed

Uchida H, Iwanaka T, Kitano Y, Kudou S, Ishimaru T, Yotsumoto K, Gotoh C, Yoshida M

Journal of pediatric surgery Vol. 44 ( 1 ) page： 278-81 2009.1

内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 高澤慎也, 岩中督

日本小児外科学会雑誌 Vol. 45 ( 6 ) page： 920 - 921 2009

MW-01 非触知精巣に対する腹腔鏡手術(ミニワークショップ停留精巣・非蝕知精巣をどうするか?,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

川嶋寛, 多田実, 小林堅一郎, 北野良博, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 447 - 447 2009

O-33 開腹手術歴のない腸閉塞に対する腹腔鏡下手術の有用性(一般口演虫垂炎・ヘルニア他,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

内田広夫, 北野良博, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 499 - 499 2009

O-37 ラブドイド腫瘍8例の検討(一般口演悪性腫瘍,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

吉田真理子, 北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 501 - 501 2009

O-78 小児外科学会指導医の現状(一般口演その他,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 522 - 522 2009

P-008 当院で手術した胆道閉鎖症90例の予後(ポスター移植2,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 526 - 526 2009

P-123 当科での臍ヘルニア・臍突出に対する手術方法(ポスターへそ4,Science and Art for Sick Children,第46回日本小児外科学会学術集会) Reviewed

佐藤かおり, 北野良博, 内田広夫, 川嶋寛, 五藤周, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 3 ) page： 584 - 584 2009

15.腹腔鏡補助下鎖肛根治術の功罪(一般演題,第19回日本小児外科QOL研究会) Reviewed

内田広夫, 北野良博, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 5 ) page： 890 - 890 2009

8.肛門膣前庭瘻に対するanterior sagittal anorectoplasty(ASARP)(要望演題「低位鎖肛治療のコンセンサス」,第65回直腸肛門奇形研究会) Reviewed

五藤周, 北野良博, 内田広夫, 川嶋寛, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 269 - 270 2009

8.当院における喉頭気管分離術症例のまとめ(一般演題,第19回日本小児呼吸器外科研究会) Reviewed

吉田真理子, 北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 274 - 274 2009

5.無瘻孔性鎖肛の初期診断(要望演題「低位鎖肛治療のコンセンサス」,第65回直腸肛門奇形研究会) Reviewed

北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 269 - 269 2009

42.再手術を要した手術合併症(要望演題・一般演題,第28回日本小児内視鏡外科・手術手技研究会) Reviewed

北野良博, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 302 - 303 2009

35. 卵管捻転の3例(第43回日本小児外科学会関東甲信越地方会) Reviewed

佐藤かおり, 北野良博, 内田広夫, 川嶋寛, 五藤周, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 4 ) page： 794 - 794 2009

33.重症心身障害児の胃食道逆流症に対する治療戦略(要望演題・一般演題,第28回日本小児内視鏡外科・手術手技研究会) Reviewed

内田広夫, 北野良博, 佐藤かおり, 川嶋寛, 五藤周, 吉田真理子

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 300 - 300 2009

32. 高位鎖肛に対する腹腔鏡補助下根治術後の機能評価(一般演題,第38回日本小児消化管機能研究会) Reviewed

工藤寿美, 北野良博, 内田広夫, 四本克己, 石丸哲也, 五藤周, 川嶋寛, 金子道夫, 岩中督

日本小児外科学会雑誌 Vol. 45 ( 4 ) page： 813 - 814 2009

22.再発予防の観点から再考したNuss法の至適手術時期(要望演題・一般演題,第28回日本小児内視鏡外科・手術手技研究会) Reviewed

石丸哲也, 内田広夫, 川嶋寛, 五藤周, 佐藤かおり, 吉田真理子, 杉田礼典, 北野良博

日本小児外科学会雑誌 Vol. 45 ( 2 ) page： 297 - 298 2009

Seminal vesicle abscesses associated with ipsilateral multicystic dysplastic kidney in an infant. Reviewed

Fujinaga S, Hirano D, Hara S, Uchida H, Kitano Y, Kobayashi K, Tada M, Someya T, Ohtomo Y, Shimizu T

Pediatric nephrology (Berlin, Germany) Vol. 23 ( 9 ) page： 1551-4 2008.9

Present status of pancreas transplantation in Japan-donation predominantly from marginal donors and modified surgical technique: Report of Japan pancreas transplantation registry Reviewed

Ishibashi M., Ito T., Sugitani A., Furukawa H., Sekiguchi S., Gotoh M., Teraoka S., Sato Y., Matsuno N., Kenmochi S., Uchida H., Yoshimura N., Nakajima Y., Kuroda Y., Odan H., Idezuki Y., Kanazawa Y.

TRANSPLANTATION PROCEEDINGS Vol. 40 ( 2 ) page： 486 - 490 2008.3

Present status of pancreas transplantation in Japan-donation predominantly from marginal donors and modified surgical technique: Report of Japan pancreas transplantation registry Reviewed

M. Ishibashi, T. Ito, A. Sugitani, H. Furukawa, S. Sekiguchi, M. Gotoh, S. Teraoka, Y. Sato, N. Matsuno, S. Kenmochi, H. Uchida, N. Yoshimura, Y. Nakajima, Y. Kuroda, H. Odan, Y. Idezuki, Y. Kanazawa

TRANSPLANTATION PROCEEDINGS Vol. 40 ( 2 ) page： 486 - 490 2008.3

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

In Japan, organ donation has been still limited because of the strict donor criteria. The aim of this study was to show the effectiveness of pancreas transplantation (PTx) by analyzing the outcomes even under poor donor conditions. Thirty-six cases of PTx (32 simultaneous pancreas and kidney transplantations [SPK], 4 pancreas after kidney transplantations) performed during the last 8 years were examined especially for donor characteristics. Mean donor age of 41.4 +/- 11.9 years was considerably older compared with that in the United States and Europe; donors aged over 40 years comprised 67% of the total. According to the criteria described by Kapur, 29 cases (81%) in our series would be considered marginal. Thus, to increase blood supply into the pancreatic head, the gastroduodenal artery (GDA) was anastomosed using donor artery to common hepatic artery or iliac Y graft. These procedures were performed in 16 of the 24 cases in which there was liver procurement. Eventually, 34 cases (94%) preserved GDA continuity. Mean total cold ischemic time of pancreatic grafts was 12 hours 1.5 minutes. Of 214 registrants, 17 patients on the waiting list for SPK died of diabetic complications. To date, patient survival remains 100% with a mean follow-up period of 33 months. Pancreas graft survivals at 1, 3, and 5 years posttransplantation were 92%, 80%, and 80%, respectively. In contrast, kidney survivals were 91%, 91%, and 91%, respectively. The integrity of the pancreas head and duodenum by preservation of the GDA continuity might have decreased the risk associated with the marginal donors.

DOI： 10.1016/j.transproceed.2008.01-047

VS-005 Laparoscopic fundoplication-Our procedure(Video Symposium Endoscopic surgical skill qualification system in pediatric minimally invasive surgery using laparoscopic fundoplication,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Kawashima Hiroshi

Journal of the Japanese Society of Pediatric Surgeons Vol. 44 ( 3 ) page： 386 - 386 2008

B-011 Our screening program for solid tumors in patients with malformation syndromes(Oral Presentation Oncology 2,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Yoshida Mariko

Journal of the Japanese Society of Pediatric Surgeons Vol. 44 ( 3 ) page： 392 - 392 2008

B-049 Patient satisfaction of Nuss Procedure(Oral Presentation Funnel chest,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Ishimaru Tetsuya

Journal of the Japanese Society of Pediatric Surgeons Vol. 44 ( 3 ) page： 410 - 410 2008

S2-5.高位鎖肛に対する腹腔鏡補助下造肛術 : 術後排便機能と晩期合併症(シンポジウム-2:直腸肛門奇形,小児内視鏡手術,第24回日本小児外科学会秋季シンポジウム) Reviewed

岩中督, 川嶋寛, 内田広夫, 北野良博, 工藤寿美, 江村隆起

日本小児外科学会雑誌 Vol. 44 ( 6 ) page： 764 - 765 2008

S4-1.腹腔鏡下幽門筋切開術(シンポジウム-4:幽門狭窄症,小児内視鏡手術,第24回日本小児外科学会秋季シンポジウム) Reviewed

佐藤かおり, 北野良博, 内田広夫, 川嶋寛, 五藤周, 吉田真理子

日本小児外科学会雑誌 Vol. 44 ( 6 ) page： 781 - 782 2008

S5-1.腹腔鏡下噴門形成術 : 当院での手術法(シンポジウム-5:噴門形成術,小児内視鏡手術,第24回日本小児外科学会秋季シンポジウム) Reviewed

川嶋寛, 北野良博, 内田広夫, 五藤周, 佐藤かおり, 吉田真理子

日本小児外科学会雑誌 Vol. 44 ( 6 ) page： 784 - 784 2008

42 腹腔鏡下噴門形成術再手術後に生じた絞扼性横隔膜ヘルニアの1例(一般演題,第27回日本小児内視鏡外科・手術手技研究会) Reviewed

五藤周, 北野良博, 内田広夫, 四本克己, 石丸哲也, 芳田真理子, 岩中督, 川嶋寛

日本小児外科学会雑誌 Vol. 44 ( 1 ) page： 102 - 102 2008

The laparoscopic approach of neuroblastoma. Reviewed

Iwanaka T, Kawashima H, Uchida H

Seminars in pediatric surgery Vol. 16 ( 4 ) page： 259-65 2007.11

Usability Needs to be Improved for Patient Safety Reviewed

SOMA T, UCHIDA H, HITSUISHI H, TAKEDA S, NAKAJIMA K

Japan Journal of Medical Informatics Vol. 27 ( 1 ) page： 29 - 32 2007.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Association for Medical Informatics

Information and communication technology has been introduced rapidly into health-care field, and can contribute to system complexity and new human errors. Nielsen has defined 5 facets of usability: learnability, efficiency, memorability, errors and satisfaction. The more the usability progress, the more likely patient safety will be achieved, however, there is the trade-off relationship between safety ensuring and efficiency seeking. Technology needs to be designed and improved to support real workflow and care processes.

DOI： 10.14948/jami.27.29

R-006 Evaluation of laparoscopically assisted anorectoplasty for high and intermediate-type imperforted anus(Minimally invasive surgery I, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Uchida Hiroo

Journal of the Japanese Society of Pediatric Surgeons Vol. 43 ( 3 ) page： 373 - 373 2007

P-032B Surgical complications with open Duhamel procedure and laparoscopy assisted endorectal pullthrough(Gastrointestinal, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Ishimaru Tetsuya

Journal of the Japanese Society of Pediatric Surgeons Vol. 43 ( 3 ) page： 452 - 452 2007

P-273A Surgical disorders in neonates with trisomy 13 and trisomy 18(Newborn surgery 2/Hepatobiliary, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Gotoh Chikashi

Journal of the Japanese Society of Pediatric Surgeons Vol. 43 ( 3 ) page： 573 - 573 2007

P-274A A rare case of chronic pancreatitis with choledochal cyst and pancreaticobiliary malformation(Newborn surgery 2/Hepatobiliary, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons) Reviewed

Yotsumoto Katsumi

Journal of the Japanese Society of Pediatric Surgeons Vol. 43 ( 3 ) page： 573 - 573 2007

1.新生児期に手術を施行した先天性梨状窩嚢胞の2例(一般演題,第26回日本小児内視鏡外科・手術手技研究会) Reviewed

石丸哲也, 岩中督, 内田広夫, 四本克己, 川嶋寛, 五藤周, 岩中督

日本小児外科学会雑誌 Vol. 43 ( 1 ) page： 104 - 104 2007

65.ターナー症候群の索状性腺に対する腹腔鏡下性腺摘除術の手術経験(一般演題,第26回日本小児内視鏡外科・手術手技研究会) Reviewed

四本克己, 岩中督, 内田広夫, 川嶋寛, 五藤周, 石丸哲也, 岩中督, 会津克哉, 望月弘

日本小児外科学会雑誌 Vol. 43 ( 1 ) page： 121 - 121 2007

3.顎下腺に生じたsialolipomaの1例(一般演題,第41回日本小児外科学会関東甲信越地方会) Reviewed

五藤周, 岩中督, 内田広夫, 四本克己, 川嶋寛, 石丸哲也, 岸本宏志

日本小児外科学会雑誌 Vol. 43 ( 6 ) page： 794 - 794 2007

23.下部空腸に胎便が充満したmeconium diseaseの1例(一般演題,第41回日本小児外科学会関東甲信越地方会) Reviewed

川嶋寛, 岩中督, 内田広夫, 四本克己, 五藤周, 石丸哲也, 藤澤ますみ, 鬼本博文

日本小児外科学会雑誌 Vol. 43 ( 6 ) page： 799 - 799 2007

20.過去10年間のHirschsprung病の検討 : Duhamel池田法と腹腔鏡補助下Soave伝田法の比較(一般演題,第37回日本小児消化管機能研究会) Reviewed

石丸哲也, 北野良博, 内田広夫, 四本克己, 五藤周, 芳田真理子, 岩中督

日本小児外科学会雑誌 Vol. 43 ( 5 ) page： 709 - 709 2007

18.小児内鏡視手術の術中,術後合併症の検討(一般演題,第26回日本小児内視鏡外科・手術手技研究会) Reviewed

五藤周, 岩中督, 内田広夫, 四本克己, 川嶋寛, 石丸哲也

日本小児外科学会雑誌 Vol. 43 ( 1 ) page： 109 - 109 2007

14.小児肺疾患に対する胸腔鏡および胸腔鏡補助下手術症例の検討(第17回日本小児呼吸器外科研究会) Reviewed

内田広夫, 岩中督, 四本克己, 川嶋寛, 石丸哲也, 五藤周

日本小児外科学会雑誌 Vol. 43 ( 4 ) page： 648 - 648 2007

12.Caudal duplicationの2例(II.第63回直腸肛門奇形研究会抄録(主題:重複肛門),第63回直腸肛門奇形研究会) Reviewed

石丸哲也, 岩中督, 内田広夫, 四本克己, 川嶋寛, 五藤周, 多田実, 小林堅一郎, 岩中督

日本小児外科学会雑誌 Vol. 43 ( 1 ) page： 125 - 125 2007

P-62 待機的腹腔鏡下虫垂切除術;その効用と妥当性の検討(示説15 小腸2,第43回日本小児外科学会総会) Reviewed

内田広夫, 岩中督, 岸本宏志, 川嶋寛, 四本克己, 石丸哲也, 五藤周, 浜野志穂

日本小児外科学会雑誌 Vol. 42 ( 3 ) page： 450 - 450 2006

Or-55 腹腔鏡下幽門筋切開術の臨床的検討(口演14 内視鏡,第43回日本小児外科学会総会) Reviewed

浜野志穂, 岩中督, 川嶋寛, 内田広夫, 四本克己, 石丸哲也, 五藤周

日本小児外科学会雑誌 Vol. 42 ( 3 ) page： 414 - 414 2006

Or-56 腹腔鏡下噴門形成術後に再発した6症例 : 再発原因の検討と腹腔鏡下再手術(口演14 内視鏡,第43回日本小児外科学会総会) Reviewed

石丸哲也, 岩中督, 内田広夫, 川嶋寛, 四本克己, 五藤周, 浜野志穂

日本小児外科学会雑誌 Vol. 42 ( 3 ) page： 414 - 414 2006

16. 新生児十二指腸穿孔の1例(第40回日本小児外科学会関東甲信越地方会) Reviewed

石丸哲也, 岩中督, 内田広夫, 川嶋寛, 四本克己, 五藤周, 浜野志穂

日本小児外科学会雑誌 Vol. 42 ( 1 ) page： 111 - 111 2006

7.腹腔鏡下肥厚性幽門狭窄症の手術と消化管機能(一般演題,第36回日本小児消化管機能研究会) Reviewed

浜野志穂, 岩中督, 川嶋寛, 内田広夫, 四本克己, 石丸哲也

日本小児外科学会雑誌 Vol. 42 ( 4 ) page： 546 - 546 2006

49. 超低出生体重児腸重積症の1例(第25回日本小児内視鏡外科・手術手技研究会) Reviewed

川嶋寛, 岩中督, 内田広夫, 四本克己, 五藤周, 浜野志穂, 石丸哲也, 長澤真由美, 鬼本博文

日本小児外科学会雑誌 Vol. 42 ( 1 ) page： 157 - 157 2006

25. 食道狭窄, 胃食道逆流症, 先天性食道裂孔ヘルニアを合併し診断・治療に難渋したBPFMの1例(第25回日本小児内視鏡外科・手術手技研究会) Reviewed

四本克己, 岩中督, 内田広夫, 川嶋寛, 石丸哲也, 五藤周, 浜野志穂, 岸本宏志

日本小児外科学会雑誌 Vol. 42 ( 1 ) page： 151 - 151 2006

18. 小児慢性排便障害に対する結腸瘻ボタンを用いた腹腔鏡下順行性浣腸路の経験(第25回日本小児内視鏡外科・手術手技研究会) Reviewed

浜野志穂, 岩中督, 四本克己, 内田広夫, 川嶋寛, 五藤周, 石丸哲也

日本小児外科学会雑誌 Vol. 42 ( 1 ) page： 149 - 149 2006

Midterm follow-up study of high-type imperforate anus after laparoscopically assisted anorectoplasty. Reviewed

Kudou S, Iwanaka T, Kawashima H, Uchida H, Nishi A, Yotsumoto K, Kaneko M

Journal of pediatric surgery Vol. 40 ( 12 ) page： 1923-6 2005.12

B-51 食道閉鎖症long gap症例の術後長期予後について(食道) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 3 ) page： 455 - 455 2005

A-21 小児内視鏡下手術における術中合併症予防の工夫(鏡視下手術の合併症予防の工夫) Reviewed

川嶋寛, 岩中督, 内田広夫, 四本克己, 西明, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 3 ) page： 375 - 375 2005

B-32 腹腔鏡下噴門形成術の手術適応と合併症 : 当センター78例の検討(内視鏡・内視鏡手術) Reviewed

内田広夫, 岩中督, 川嶋寛, 西明, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 3 ) page： 450 - 450 2005

22. 胆道閉鎖症疑診例に対する腹腔鏡下肝門部観察および胆道造影の適応と有用性(第31回胆道閉鎖症研究会) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 4 ) page： 706 - 706 2005

40. 食道閉鎖症術後のGER手術適応について(コンセンサスカンファレンス(GERDの手術適応): 食道閉鎖症術後, 第35回日本小児消化管機能研究会) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 6 ) page： 839 - 839 2005

38.交通外傷により肛門から結腸の脱出がみられた小児の1例(第39回日本小児外科学会関東甲信越地方会) Reviewed

内田広夫, 岩中督, 西明, 川嶋寛, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 1 ) page： 90 - 91 2005

33. 重症心身障害児の胃食道逆流症に対する手術適応(コンセンサスカンファレンス(GERDの手術適応): 重症心身障害児(者), 第35回日本小児消化管機能研究会) Reviewed

内田広夫, 岩中督, 川嶋寛, 西明, 四本克己, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 6 ) page： 837 - 837 2005

32.吐血, 腹腔内遊離ガス像を認めた急性虫垂炎の1例(第39回日本小児外科学会関東甲信越地方会) Reviewed

川嶋寛, 岩中督, 内田広夫, 四本克己, 西明, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 1 ) page： 89 - 89 2005

27. 呼吸障害を合併する胃食道逆流症に対する腹腔鏡下噴門形成術の手術適応(コンセンサスカンファレンス(GERDの手術適応): 呼吸器症状, 第35回日本小児消化管機能研究会) Reviewed

川嶋寛, 岩中督, 内田広夫, 四本克己, 西明, 佐竹亮介

日本小児外科学会雑誌 Vol. 41 ( 6 ) page： 836 - 836 2005

Complications of laparoscopic surgery in neonates and small infants. Reviewed

Iwanaka T, Uchida H, Kawashima H, Nishi A, Kudou S, Satake R

Journal of pediatric surgery Vol. 39 ( 12 ) page： 1838-41 2004.12

Infantile intestinal leiomyosarcoma is prognostically favorable despite histologic aggressiveness: case report and literature review. Reviewed

Yamamoto H, Tsuchiya T, Ishimaru Y, Kisaki Y, Fujino J, Uchida H, Yoshida M, Mori Y, Ikeda H

Journal of pediatric surgery Vol. 39 ( 8 ) page： 1257-60 2004.8

D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics. Reviewed

Uchida H, Yamamoto H, Kisaki Y, Fujino J, Ishimaru Y, Ikeda H

Journal of pediatric surgery Vol. 39 ( 4 ) page： 634-6 2004.4

Umbilicoplasty for large protruding umbilicus accompanying umbilical hernia: a simple and effective technique. Reviewed

Ikeda H, Yamamoto H, Fujino J, Kisaki Y, Uchida H, Ishimaru Y, Hasumi T, Hamajima A

Pediatric surgery international Vol. 20 ( 2 ) page： 105-7 2004.2

Epidermoid cyst: rare testicular tumor in children. Reviewed

Fujino J, Yamamoto H, Kisaki Y, Ishimaru Y, Uchida H, Mori Y, Nozaki M, Ikeda H

Pediatric radiology Vol. 34 ( 2 ) page： 172-4 2004.2

P-177 当センターにおける鎖肛根治術の変遷と周術期の問題点(示説直腸肛門奇形) Reviewed

工藤寿美, 岩中督, 内田広夫, 西明, 川嶋寛, 佐竹亮介

日本小児外科学会雑誌 Vol. 40 ( 3 ) page： 526 - 526 2004

P-143 突然の小腸穿孔で発症したクロストリディウム腸炎の1例(示説十二指腸・小腸1) Reviewed

川嶋寛, 岩中督, 内田広夫, 西明, 工藤寿美, 佐竹亮介, 岸本宏志

日本小児外科学会雑誌 Vol. 40 ( 3 ) page： 509 - 509 2004

1. 腹腔鏡下噴門形成術の再発症例に対する腹腔鏡下手術(セッション8 ミニシンポジウム1 : 内視鏡手術における合併症の予防と対処法)(第23回日本小児外科手術手技・小児内視鏡手術研究会) Reviewed

川嶋寛, 岩中督, 内田広夫, 西明, 工藤寿美, 佐竹亮介

日本小児外科学会雑誌 Vol. 40 ( 1 ) page： 160 - 160 2004

2. 腹腔鏡下造肛術時の膣,尿道の同定の工夫(セッション9 腹腔鏡,手術手技 : 直腸肛門・泌尿生殖器1)(第23回日本小児外科手術手技・小児内視鏡手術研究会) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 工藤寿美, 佐竹亮介

日本小児外科学会雑誌 Vol. 40 ( 1 ) page： 162 - 162 2004

14. 術後直腸狭窄に対する経肛門的狭窄切開術の経験(第30回日本小児内視鏡研究会) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 工藤寿美, 佐竹亮介

日本小児外科学会雑誌 Vol. 40 ( 2 ) page： 223 - 224 2004

11. ITPに対する腹腔鏡下脾摘術中の血小板数の変動について(第17回日本小児脾臓研究会) Reviewed

西明, 岩中督, 内田広夫, 川嶋寛, 工藤寿美, 佐竹亮介

日本小児外科学会雑誌 Vol. 40 ( 2 ) page： 231 - 231 2004

Impact of graft length on surgical damage after intestinal transplantation in rats. Reviewed

Inoue S, Tahara K, Sakuma Y, Hori T, Uchida H, Hakamada Y, Murakami T, Takahashi M, Kawarasaki H, Hashizume K, Kaneko M, Kobayashi E

Transplant immunology Vol. 11 ( 2 ) page： 207-14 2003.4

Impact of graft length on surgical damage after intestinal transplantation in rats Reviewed

S Inoue, K Tahara, Y Sakuma, T Hori, H Uchida, Y Hakamada, T Murakami, M Takahashi, H Kawarasaki, K Hashizume, M Kaneko, E Kobayashi

TRANSPLANT IMMUNOLOGY Vol. 11 ( 2 ) page： 207 - 214 2003.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Background: Intestinal grafts greatly affect nutrition and immunology in the host. The growth of the recipient and incidence of graft-versus-host disease depend on graft length. A larger graft may affect the host immune system, but little is known about how the length of the intestinal graft severely affects surgical intervention. We developed a cervical small bowel transplantation (SBT) rat model that minimized technical variations using a cuff method and studied the effects of graft length on surgical damage in SBT. Materials and methods: We transplanted a whole (70 cm) or partial (15 cm) intestine into a syngeneic rat combination of LEW (MHC haplotype: RT1(1)) to LEW and evaluated changes in perioperative hemodynamics and the endogenous endotoxin level. Natural killer (NK) cell activity in the peripheral blood and the immunologic response of the recipient spleen were also studied. Results: In the whole SBT model, body weight loss was more severe than in the segmental SBT model; the rats in the former model often died, while all in the latter survived indefinitely. The systemic blood pressure markedly decreased in the whole SBT group immediately after reperfusion. The proliferative activity of splenic lymphocytes stimulated by concanavalin A was also more severely inhibited in the former model than in the latter postoperatively. NK cell activity in the whole SBT rats declined more severely than the segmental SBT rats 3 days postoperatively. Conclusion: The longer graft severely induced surgical intervention; and influenced host immunosuppression, resulting in the higher mortality in rats undergoing whole SBT. (C) 2003 Elsevier Science B.V. All rights reserved.

V-026 ブタ部分小腸移植モデル : VCS クリップを用いた血管吻合法 Reviewed

Increase of bile acid production by tacrolimus in the rat liver. Reviewed

Mizuta K, Kobayashi E, Uchida H, Hishikawa S, Kawarasaki H

Transplantation proceedings Vol. 35 ( 1 ) page： 437-8 2003.2

Increase of bile acid production by tacrolimus in the rat liver Reviewed

K Mizuta, E Kobayashi, H Uchida, S Hishikawa, H Kawarasaki

TRANSPLANTATION PROCEEDINGS Vol. 35 ( 1 ) page： 437 - 438 2003.2

吉野浩之, 山内仁, 井上成一朗, 田原和典, 内田広夫, 宇野武治, 水田耕一, 河原秀雄, 橋都浩平, 小林英司

日本小児外科学会雑誌 Vol. 39 ( 3 ) page： 241 - 241 2003

4. 極低出生体重児のC型食道閉鎖症に対する新しい治療法の試み(セッションIV 低出生体重児)(第19回日本小児外科学会秋季シンポジウム : 先天性食道閉鎖症) Reviewed

岩中督, 内田広夫, 川嶋寛, 西明, 工藤寿美, 佐竹亮介

日本小児外科学会雑誌 Vol. 39 ( 6 ) page： 738 - 739 2003

Short-course methotrexate and long-term acceptance of fully allogeneic rat cardiac grafts: a possible mechanism of tolerance. Reviewed

Sakuma Y, Xiu D, Uchida H, Hakamata Y, Takahashi M, Murakami T, Nagai H, Kobayashi E

Transplant immunology Vol. 10 ( 1 ) page： 49-54 2002.6

Short-course methotrexate and long-term acceptance of fully allogeneic rat cardiac grafts: a possible mechanism of tolerance Reviewed

Sakuma Y, Xiu D, Uchida H, Hakamata Y, Takahashi M, Murakami T, Nagai H, Kobayashi E

TRANSPLANT IMMUNOLOGY Vol. 10 ( 1 ) page： 49 - 54 2002.6

Combined cuff and suture technique for orthotopic whole intestinal transplantation in rats. Reviewed

Nakao A, Tahara K, Inoue S, Mizuta K, Takeichi T, Uchida H, Tanaka N, Kobayashi E

Microsurgery Vol. 22 ( 3 ) page： 85-90 2002

Chronotherapy of sublethal doses of methotrexate on rats allogeneic heart grafts Reviewed International journal

Xiu, D.R., Sakuma, Y., Nagai, H., To, H., Sugimoto, K., Fujimura, A., Uchida, H., Kobayashi, E.

Research Communications in Pharmacology and Toxicology Vol. 7 ( 1-2 ) page： 77 - 85 2002

Comparison of efficacy and toxicity between Sandimmune® and Neoral® in the cyclosporine-resistant rat allo-pancreas transplantation Reviewed International journal

Sakuma, Y., Nagai, H., Sugimoto, K.-I., Fujimura, A., Murakami, T., Uchida, H., Hakamata, Y., Takahashi, M., Kobayashi, E.

Research Communications in Pharmacology and Toxicology Vol. 7 ( 1-2 ) page： 86 - 94 2002

Blunt Abdominal Injury and Pediatric Trauma Score in Children Reviewed

Fujino Junko, Ishimaru Yuki, Yamamoto Hideki, Uchida Hiroo, Ikeda Hitoshi

Journal of the Japanese Society of Pediatric Surgeons Vol. 38 ( 6 ) page： 826 - 832 2002

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Pediatric Surgeons

Purpose : To investigate whether the Pediatric Trauma Score (PTS) correlates with the need for surgery in patients with blunt abdominal injury, a retrospective study was done. Methods : There were 39 injuries of solid organs (liver, spleen and kidneys) and 9 injuries of other organs (duodenum, jejunum and diaphragm). These 48 organ injuries in 42 patients were classified according to the classifications of each organ injury and PTS, treatment and outcome were reviewed. Results and Conclusion : Surgery was done to manage 5 out of the 39 solid organ injuries. PTSs in patients who needed surgery ranged from 1 to 10 (median, 7) and were significantly lower than those with nonoperative management, 4-12 (median, 11)(p=0.004). In the 9 injuries of other organs, PTSs were 4-12 (median, 12) in patients who needed surgery and were not significantly different from the scores 10-12 (median, 10) in patients who were treated nonoperatively. These results indicate that surgical procedures may be necessary in patients with injuries of the liver, the spleen and the kidneys whose PTSs are low. PTS may be important in triage in children with abdominal blunt trauma, although an organspecific grading system should be developed to diagnose the extent of the injury and determine the treatment approach.

DOI： 10.11164/jjsps.38.6_826

CiNii Books

Other Link： http://search.jamas.or.jp/link/ui/2008346366

Vascularized composite tissue transfers for open fractures with massive soft-tissue defects in the lower extremities Reviewed

Nakao, A., Tahara, K., Inoue, S., Mizuta, K., Takeichi, T., Uchida, H., Tanaka, N., Kobayashi, E.

Microsurgery Vol. 22 ( 4 ) page： 131 - 132 2002

A-16 新生児小腸を用いた移植治療のための基礎的研究 Reviewed

内田広夫, 田原和典, 井上成一朗, 石丸由紀, 小林英司, 池田均

日本小児外科学会雑誌 Vol. 38 ( 3 ) page： 422 - 422 2002

Experimental small bowel transplantation using a newborn intestine in rats: IV. Effect of cold preservation on graft neovascularization. Reviewed

Uchida H, Tahara K, Takizawa T, Inose K, Yashiro T, Hashizume K, Ikeda H, Takahashi M, Kobayashi E

Journal of pediatric surgery Vol. 36 ( 12 ) page： 1805-10 2001.12

Experimental small bowel transplantation using a newborn intestine in rats: IV. Effect of cold preservation on graft neovascularization Reviewed

H Uchida, K Tahara, T Takizawa, K Inose, T Yashiro, K Hashizume, H Ikeda, M Takahashi, E Kobayashi

JOURNAL OF PEDIATRIC SURGERY Vol. 36 ( 12 ) page： 1805 - 1810 2001.12

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO

Background/Purpose: University of Wisconsin (UW) solution is one of the most superior organ preservation solutions for liver, kidney, and pancreas; however, it still is controversial for intestinal preservation. Here, the authors studied the efficacy of preservation with 2 kinds of solutions, UW and modified TOM (m-TOM) solutions in our experimental newborn intestinal transplantation model. UW solution was used as a standard intracellular and m-TOM solution as an extracellular preservation solution. Lactated ringer (LR) solution was used as a control.
Methods. Newborn intestine, which were preserved in these solutions for 24 or 48 hours, were transplanted in the subcutaneous spaces of the syngeneic recipients without surgical vascular anastomosis and histologically examined 14 days after grafting. The preserved grafts were evaluated histologically by use of light and electron microscopy just after preservation. The biochemical parameters such as LDH and serotonin also were measured in the supernatants of preservation solutions.
Results: Fresh newborn grafts were revascularized successfully at a rate of 80% (16 of 20). After 24 hours of preservation, 65% (13 of 20), 75% (15 of 20), and 85% (17 of 20) of the grafts were observed to be revascularized in LR, m-TOM, and UW solutions, respectively. After 48 hours of preservation, 60% (12 of 20), 80% (16 of 20), and 80% (16 of 20) of the grafts also were revascularized in the respective solutions (no statistic difference among the groups). The cold-preservation did not affect the neovascularization of newborn intestine until 48 hours. Histologic findings of the preserved intestine and biochemical analyses showed that UW and m-TOM solutions kept villous architectures of the preserved grafts, however, might be harmful to enterochromaffin cells.
Conclusion: Long-time preservation of newborn intestine did not interfere with neovascularization and maturation. Copyright (C) 2001 by W.B. Saunders Company.

High-dose tacrolimus and lengthy survival of the combined rat pancreas/spleen graft in a high-responder combination Reviewed

High-dose tacrolimus and lengthy survival of the combined rat pancreas/spleen graft in a high-responder combination. Reviewed

Sakuma Y, Uchida H, Nagai H, Kobayashi E

Transplant immunology Vol. 9 ( 1 ) page： 37-42 2001.10

Y Sakuma, H Uchida, H Nagai, E Kobayashi

TRANSPLANT IMMUNOLOGY Vol. 9 ( 1 ) page： 37 - 42 2001.10

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Pancreas grafts do not survive for lengthy periods, especially in a high-responder rat combination. Recent data indicated that a combined spleen/pancreas graft protects against acute graft rejection and induces donor-specific tolerance. In this study, we performed a combination spleen/pancreas transplantation using high-dose tacrolimus in a high-responder rat combination of DA (RTla) to LEW(RT1(l)) and induced permanent survival in the few recipient rats. In these recipients, there was no difference in the mixed lymphocyte reaction (MLR) of the recipients when compared with that of the naive LEW splenic cells, but MLR inhibition by the serum from the recipients was significantly decreased. We also performed immunoblotting and detected a protein that has an affinity for the anti-DA class antibody. This protein may be an anti-idiotypic antibody and contribute to donor- and tissue-specific tolerance. (C) 2001 Elsevier Science BN. All rights reserved.

DOI： 10.1016/S0966-3274(01)00049-1

Green fluorescent protein-transgenic rat: a tool for organ transplantation research. Reviewed

Hakamata Y, Tahara K, Uchida H, Sakuma Y, Nakamura M, Kume A, Murakami T, Takahashi M, Takahashi R, Hirabayashi M, Ueda M, Miyoshi I, Kasai N, Kobayashi E

Biochemical and biophysical research communications Vol. 286 ( 4 ) page： 779-85 2001.8

Experimental small bowel transplantation using newborn intestine in rats: III. Long-term cryopreservation of rat newborn intestine. Reviewed

Tahara K, Uchida H, Kawarasaki H, Hasizume K, Kobayashi E

Journal of pediatric surgery Vol. 36 ( 4 ) page： 602-4 2001.4

Experimental small bowel transplantation using newborn intestine in rats: III. Long-term cryopreservation of rat newborn intestine Reviewed

K Tahara, H Uchida, H Kawarasaki, K Hasizume, E Kobayashi

JOURNAL OF PEDIATRIC SURGERY Vol. 36 ( 4 ) page： 602 - 604 2001.4

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO

Background: If long-term organ cryopreservation can be attained, a significant achievement will have been made to address the problem for donor shortage. Fetal intestine has been known to revascularize naturally without vascular anastmosis. The authors have confirmed previously that the newborn intestine also could develop to maturity in the host omentum. Here, the authors examined whether the cryopreserved newborn intestine could revascularize in the syngeneic combination using the 2 different solutions and whether cryopreservation affect their antigenicity in the allogeneic combination.
Methods: Inbred rat strains of LEW (MHC haplotype; RT1(1)) and BN (RT1(n)) were used. LEW newborn intestinal grafts were stored in RPMI-1640 or University of Wisconsin solution with 10% DEMSO (n = 10 in each group). The grafts were placed into a cold (4 degreesC) preservation solution for 30 minutes and then placed into a freezing chamber and cooled to -80 degreesC at -1 degreesC/min after 12 hours quenched to -180 degreesC in liquid nitrogen for longer than 30 days. Then, the cryopreserved grafts under the 2 different solutions were transplanted syngenicaly (LEW to LEW). The cryopreserved BN grafts also were implanted into the LEW omentum pouch. The allotransplantation was received with a 14-day high-dose course of tacrolimus (0.64 mg/kg, intramuscularly). The grafts were evaluated histologically at 4 weeks after transplantation. Fresh newborn intestines implanted in this syngeneic and allogeneic combination were evaluated as each control group.
Result: In the syngeneic combination, more than 90% of the mature intestine were obtained. There was no significant difference among the different solution and the fresh group. However, in the allogeneic combination, both fresh and cryo preserved grafts were histologically poor.
Conclusions: This is the first report showing that long-term cryopreservation was not harmful for neovascularization of newborn intestine. Long-term cryopreservation did not reduce the antigenicity of the newborn intestine.

Rat auxiliary liver transplantation without portal vein reconstruction: comparison with the portal vein-arterialized model. Reviewed

Rong Xiu D, Hishikawa S, Sato M, Nagai H, Uchida H, Kobayashi E

Microsurgery Vol. 21 ( 5 ) page： 189-95 2001

Dosing time-dependent pharmacological effects of anti-metabolites for rat cardiac graft. Reviewed

To H, Xiu DR, Hishikawa S, Uchida H, Sudoh T, Sunaga K, Sugimoto K, Higuchi S, Fujimura A, Kobayashi E

Research communications in molecular pathology and pharmacology Vol. 110 ( 5-6 ) page： 319-32 2001

Orthotopic intestinal transplantation using the cuff method in rats: a histopathological evaluation of the anastomosis. Reviewed

Nakao A, Ogino Y, Tahara K, Uchida H, Kobayashi E

Microsurgery Vol. 21 ( 1 ) page： 12-5 2001

Simplified method of heterotopic rat heart transplantation using the cuff technique: application to sublethal dose protocol of methotrexate on allograft survival. Reviewed

Xiu D, Uchida H, To H, Sugimoto K, Kasahara K, Nagai H, Fujimura A, Kobayashi E

Microsurgery Vol. 21 ( 1 ) page： 16-21 2001

Chronopharmacology of oral prednisolone in rats. Reviewed

Tomizawa N, Uchida H, Xiu DR, To H, Fujimura A, Kobayashi E

Journal of medicine Vol. 32 ( 3-4 ) page： 135-51 2001

Simplified method of heterotopic rat heart transplantation using the cuff technique: Application to sublethal dose protocol of methotrexate on allograft survival Reviewed

Xiu DR, Uchida H, To H, Sugimoto K, Kasahara K, Nagai H, Fujimura A, Kobayashi E

MICROSURGERY Vol. 21 ( 1 ) page： 16 - 21 2001

Rat auxiliary liver transplantation without portal vein reconstruction: Comparison with the portal vein-arterialized model Reviewed

Xiu DR, Hishikawa S, Sato M, Nagai H, Uchida H, Kobayashi E

MICROSURGERY Vol. 21 ( 5 ) page： 189 - 195 2001

Orthotopic intestinal transplantation using the cuff method in rats: A histopathological evaluation of the anastomosis Reviewed

A Nakao, Y Ogino, K Tahara, H Uchida, E Kobayashi

MICROSURGERY Vol. 21 ( 1 ) page： 12 - 15 2001

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Segmental small intestine transplantation (SIT) in rats, using a cuff technique, has achieved a high success rate. However, there have been few reports on the influence of the foreign body reaction to polyethylene cuff on vessel anastomoses and graft after SIT. This study involves the histopathological examination of the site of cuff anastomosis and grafts in the short- and long-term survival of segmental SIT. The data obtained from the suture anastomosis model also served as a control. One week after heterotopic segmental SIT using the cuff technique, orthotopic continuations were carried out in syngeneic combination. Twenty-five of 30 rats surviving >200 days (83.3%) were examined for vessel anastomosis. All arterial anastomoses were patent, but the portovenous anastomoses in 10 grafts (33%) were totally occluded and were associated with the formation of collateral vessels. Histopathological examination demonstrated good patency of the artery and vein anastomotic site in the short term, but granulation, fibrosis, and neovascularization at the anastomosis site surrounding the cuffs in the long-surviving group. However, the grafts appeared to be intact, with normal features of the villi. On the contrary, the site of the sutured anastomosis in the long-survival rats showed no inflammatory reaction. Although a polyethylene cuff caused foreign body reaction, the graft blood supplies were maintained by collateral vessels. Considering the low mortality and high success rate, polyethylene cuff is good for short-term study and an alternative method for long-term SIT experiments. (C) 2001 Wiley-Liss, Inc.

Rat auxiliary liver transplantation without portal vein reconstruction: Comparison with the portal vein-arterialized model Reviewed

DR Xiu, S Hishikawa, M Sato, H Nagai, H Uchida, E Kobayashi

MICROSURGERY Vol. 21 ( 5 ) page： 189 - 195 2001

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Auxiliary liver transplantation (ALT) has been reintroduced in clinical cases recently and is now believed to be a viable alternative to orthotopic liver transplantation. To provide a simple rat ALT model for studying the physiological and immunological aspects of the ALT graft, a new ALT was performed, and the comparison between this new model and the portal arterialized one that was reported by other investigators was carried out. At first, we confirmed that liver could tolerate the deprivation of its portal flow well, using a portosystemic shunted rat model. The new rat ALT model, in which the ALT graft obtained its blood inflow only from the hepatic artery, was then performed. Our results demonstrated that 50% of the hepatic artery-alone ALT graft showed almost normal structure histologically at 1 month after grafting, with bile secretion preserved. By contrast, only 8% 1-month graft survival was noted in the portal arterialized group, and all grafts stopped bile secretion 1 week after operation. In conclusion, with arterial blood supply-alone, the ALT graft survived and demonstrated normal bile secretion function for more than 1 month. Portal vein arterialization is not an appropriate way to establish the graft's blood supply if no pressure adjustment measures were taken in advance. (C) 2001 Wiley-Liss, Inc.

22. 新生仔小腸を用いた実験的小腸移植の可能性(Session 2. 長期栄養管理のコツ : ここがポイントだ, 小児外科と代謝・栄養, 第 17 回日本小児外科学会秋季シンポジウム) Reviewed

内田広夫, 池田均, 田原和典, 小林英司

日本小児外科学会雑誌 Vol. 37 ( 6 ) page： 885 - 886 2001

[Characterization of humoral immunosuppressive factors induced after allogeneic blood transfusion and their application for organ transplantation]. Reviewed

Uchida H, Tanaka H, Tahara K, Kobayashi E

Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology Vol. 23 ( 6 ) page： 627-9 2000.12

Hepatic lymphocyte transplantation in hyperbilirubinemic Gunn rats Reviewed

Y Yoshida, E Kobayashi, M Nozawa, H Uchida, A Fujimura, T Yamanaka, M Miyata

EUROPEAN SURGICAL RESEARCH Vol. 32 ( 4 ) page： 223 - 227 2000.7

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

Hepatic lymphomyeloid cells (HLCs) are thought to contain liver stem cells. We investigated whether HLCs generated enzyme-producing cells in vivo. HLCs from normal Wistar/Shi rats and rats in which liver ischemia was induced using a portal clamp 4 days previously were studed histopathologically and characterized using flow cytometry. Splenic lymphocytes obtained from these animals were compared as a control. The proliferative activity of HLCs and splenic cells from both groups was also tested by stimulation with concanavalin A. HLCs contained a significantly higher number of NK-T cells and OV6+ cells compared with the splenic cells. The HLCs from rats in which liver ischemia was induced tended to have greater proliferative activity than those from normal rats, while the proliferative activity of splenic lymphocytes was impaired by liver ischemia. The HLCs obtained from Wistar/Shi rats with liver ischemia were then injected into hereditary hyperbilirubinemic Gunn rats to determine whether the HLCs generated enzyme-producing cells. After injection of these stimulated HLCs, the titer of serum bilirubin in the recipient rats was markedly reduced over a long time course (6.80 +/- 0.93 to 4.87 +/- 0.22 mg/dl after 1 month and 3.52 +/- 1.33 mg/dl after 6 months). The results of the present study indicate that HLCs have different populations than splenic cells, and ischemia-reperfusion of the liver increased their proliferative activity. HLC transplantation successfully reduced high bilirubin levels over a long time course. Copyright (C) 2000 S. Karger AG, Basel.

DOI： 10.1159/000008768

Mechanisms of immunomodulation induced by blood transfusion: Identification of humoral factors Reviewed

Effect of erythromycin on ischemia-reperfusion injury of liver in rats. Reviewed

Ohmori M, Miyashita F, Uchida H, Kitoh Y, Tsuruoka S, Harada K, Sugimoto K, Fujimura A, Kobayashi E

Transplantation proceedings Vol. 32 ( 4 ) page： 811-4 2000.6

Effect of erythromycin on ischemia-reperfusion injury of liver in rats Reviewed

Ohmori M, Miyashita F, Uchida H, Kitoh Y, Tsuruoka S, Harada K, Sugimoto K, Fujimura A, Kobayashi E

TRANSPLANTATION PROCEEDINGS Vol. 32 ( 4 ) page： 811 - 814 2000.6

Mechanisms of immunomodulation induced by blood transfusion: identification of humoral factors. Reviewed

Uchida H, Tanaka H, Kitoh Y, Yanagisawa K, To H, Tago K, Mizuta K, Fujimura A, Tominaga S, Hashizume K, Kobayashi E

Transplantation proceedings Vol. 32 ( 2 ) page： 255-6 2000.3

H Uchida, H Tanaka, Y Kitoh, K Yanagisawa, H To, K Tago, K Mizuta, A Fujimura, S Tominaga, K Hashizume, E Kobayashi

TRANSPLANTATION PROCEEDINGS Vol. 32 ( 2 ) page： 255 - 256 2000.3

プレドニゾロンの時間薬理学的研究 : 投与時刻による毒性および薬効の検討 Reviewed

冨沢直子, 小林英司, 内田広夫, 藤秀人, XIU Dian Rong, 藤村昭夫

臨床薬理 Vol. 31 ( 2 ) page： 261 - 262 2000.2

Hepatic lymphocyte transplantation in hyperbilirubinemic gunn rats. Reviewed

Yoshida Y, Kobayashi E, Nozawa M, Uchida H, Fujimura A, Yamanaka T, Miyata M

European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes Vol. 32 ( 4 ) page： 223-7 2000

Detection of membrane-bound and soluble-form MHC class I antigen from rat pancreas/spleen grafts during ongoing rejection. Reviewed

Kobayashi E, Lord R, Green M, Walker NI, Kamada N, Uchida H, Fujimura A

Transplantation proceedings Vol. 31 ( 8 ) page： 3409-13 1999.12

Detection of membrane-bound and soluble-form MHC class I antigen from rat pancreas/spleen grafts during ongoing rejection Reviewed

E Kobayashi, R Lord, M Green, NI Walker, N Kamada, H Uchida, A Fujimura

TRANSPLANTATION PROCEEDINGS Vol. 31 ( 8 ) page： 3409 - 3413 1999.12

Survival of rats undergoing continuous bile drainage depends on maintenance of circadian rhythm of bile secretion. Reviewed

Mizuta K, Hishikawa S, Yoshida T, Kobayashi E, Uchida H, Fujimura A, Kawarasaki H, Hashizume K

Chronobiology international Vol. 16 ( 6 ) page： 759-65 1999.11

Chronopharmacology of tacrolimus in rats: toxicity and efficacy in a mouse-to-rat intestinal transplant model and its pharmacokinetic profile. Reviewed

Uchida H, Kobayashi E, Ogino Y, Mizuta K, To H, Okabe R, Hashizume K, Fujimura A

Transplantation proceedings Vol. 31 ( 7 ) page： 2751-3 1999.11

Cyclosporine inhibits transport of bile acid in rats: comparison of bile acid composition between liver and bile. Reviewed

Mizuta K, Kobayashi E, Uchida H, Ogino Y, Fujimura A, Kawarasaki H, Hashizume K

Transplantation proceedings Vol. 31 ( 7 ) page： 2755-6 1999.11

Chronotoxicity of mizoribine under repeated administration in the rat. Reviewed

Hishikawa S, To H, Kobayashi E, Uchida H, Fujimura A

Transplantation proceedings Vol. 31 ( 7 ) page： 2765-6 1999.11

Experimental intestinal transplantation using mouse fetal intestine in the rat: combination effect of FK 506 with cyclophosphamide. Reviewed

Uchida H, Kobayashi E, Ogino Y, Mizuta K, Hashizume K, Fujimura A

Transplantation proceedings Vol. 31 ( 7 ) page： 2799-800 1999.11

Experimental intestinal transplantation using mouse fetal intestine in the rat: Combination effect of FK 506 with cyclophosphamide Reviewed

Uchida H, Kobayashi E, Ogino Y, Mizuta K, Hashizume K, Fujimura A

TRANSPLANTATION PROCEEDINGS Vol. 31 ( 7 ) page： 2799 - 2800 1999.11

Chronopharmacology of tacrolimus in rats: Toxicity and efficacy in a mouse-to-rat intestinal transplant model and its pharmacokinetic profile Reviewed

Uchida H, Kobayashi E, Ogino Y, Mizuta K, To H, Okabe R, Hashizume K, Fujimura A

TRANSPLANTATION PROCEEDINGS Vol. 31 ( 7 ) page： 2751 - 2753 1999.11

Chronotoxicity of mizoribine under repeated administration in the rat Reviewed

Hishikawa S, To H, Kobayashi E, Uchida H, Fujimura A

TRANSPLANTATION PROCEEDINGS Vol. 31 ( 7 ) page： 2765 - 2766 1999.11

Cyclosporine inhibits transport of bile acid in rats: Comparison of bile acid composition between liver and bile Reviewed

Mizuta K, Kobayashi E, Uchida H, Ogino Y, Fujimura A, Kawarasaki H, Hashizume K

TRANSPLANTATION PROCEEDINGS Vol. 31 ( 7 ) page： 2755 - 2756 1999.11

Influence of tacrolimus on bile acid and lipid composition in continuously drained bile using a rat model - Comparative study with cyclosporine Reviewed International journal

K Mizuta, E Kobayashi, H Uchida, A Fujimura, H Kawarasaki, K Hashizume

TRANSPLANT INTERNATIONAL Vol. 12 ( 5 ) page： 316 - 322 1999.10

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER VERLAG

Cholestatic effects have been reported for cyclosporine (CsA), but information is still limited for tacrolimus (TCR). The purpose of this study was to investigate the influence of TCR on biliary bile acid and lipid composition as compared with CsA, using a continuously bile-drained rat model. Adult male Wistar rats received TCR (0.4 mg/kg, 1 mg/kg, and 4 mg/kg) or CsA (2.5 mg/kg, 10 mg/kg, and 25 mg/kg) by intramuscular injection (i.m.) daily for 10 days,On day 7, the common bile duct of all rats was cannulated, then bile was continuously collected for the following 3 days. Bile flow, bile acid secretion rate (BASR), and biliary lipids secretion were measured for each of the groups. TCR increased bile acid-dependent flow (BADF) but with no statistical significance. However this agent did not influence total bile flow and biliary lipids secretion, while bile acid-independent flow (BAIF) was significantly reduced and bile acid synthesis (mainly cholic acid, CA, synthesis) was increased. In contrast, CsA was cholestatic, showing a tendency to reduce both BADF and BAIF. BASR was dose-dependently suppressed, especially in chenodeoxycholic acid (CDCA). Furthermore biliary lipids secretions were also significantly decreased under a higher dose of CsA, TCR increased BADF with no influence on total bile Row, having a stimulating effect on CA production, although CsA dose-dependently diminishes CDCA production and consequently reduced bile secretion. Our results suggest that TCR is a less effective agent on cholestasis as compared to CsA.

DOI： 10.1111/j.1432-2277.1999.tb00616.x

Experimental small bowel transplantation using newborn intestine in rats: II. Revascularization of newborn intestine is independent of vascular endothelial growth factor. Reviewed

Uchida H, Kobayashi E, Yanagisawa K, Mizuta K, Kitoh Y, Fujimura A, Tominaga S, Kawarasaki H, Hashizume K

Journal of pediatric surgery Vol. 34 ( 9 ) page： 1396-400 1999.9

Experimental small bowel transplantation using newborn intestine in rats: II. Revascularization of newborn intestine is independent of vascular endothelial growth factor Reviewed

Uchida H, Kobayashi E, Yanagisawa K, Mizuta K, Kitoh Y, Fujimura A, Tominaga S, Kawarasaki H, Hashizume K

JOURNAL OF PEDIATRIC SURGERY Vol. 34 ( 9 ) page： 1396 - 1400 1999.9

Experimental small bowel transplantation using newborn intestine in rats: I. Lipid absorption restored after transplantation of nonvascularized graft. Reviewed

Uchida H, Yoshida T, Kobayashi E, Mizuta K, Fujimura A, Miyata M, Kawarasaki H, Hashizume K

Journal of pediatric surgery Vol. 34 ( 6 ) page： 1007-11 1999.6

Experimental small bowel transplantation using newborn intestine in rats: I. Lipid absorption restored after transplantation of nonvascularized graft Reviewed

Uchida H, Yoshida T, Kobayashi E, Mizuta K, Fujimura A, Miyata M, Kawarasaki H, Hashizume K

JOURNAL OF PEDIATRIC SURGERY Vol. 34 ( 6 ) page： 1007 - 1011 1999.6

Chronopharmacology for deoxyspergualin: toxicity and efficacy in the rat. Reviewed

Uchida H, Kobayashi E, Matsuda K, Mizuta K, Sugimoto K, Kawarasaki H, Hashizume K, Fujimura A

Transplantation Vol. 67 ( 9 ) page： 1269-74 1999.5

Chronopharmacology for deoxyspergualin - Toxicity and efficacy in the rat Reviewed

Uchida H, Kobayashi E, Matsuda K, Mizuta K, Sugimoto K, Kawarasaki H, Hashizume K, Fujimura A

TRANSPLANTATION Vol. 67 ( 9 ) page： 1269 - 1274 1999.5

Chronopharmacology for deoxyspergualin - Toxicity and efficacy in the rat Reviewed International journal

H Uchida, E Kobayashi, K Matsuda, K Mizuta, K Sugimoto, H Kawarasaki, K Hashizume, A Fujimura

TRANSPLANTATION Vol. 67 ( 9 ) page： 1269 - 1274 1999.5

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background Deoxyspergualin (DSG), a potent immunosuppressive drug, has been clinically used as a rescue therapy for acute graft rejection. However, DSG has severe adverse effects that limits its use. Here, we examined the optimized therapeutic protocol for DSG using chronopharmacological profiles of it.
Methods. First, a dosing time-dependent difference in the toxicity and efficacy of DSG was determined using a heterotopic heart transplantation model. Second, chronokinetics of DSG were examined to reveal the mechanism for dosing time-dependent differences in the effect.
Results. In rats treated with DSG at the active period, bone marrow suppression and damage of small intestine were significantly severe. However, no significant difference was found in cardiac allograft survival and pharmacokinetics according to the timing of drug administration.
Conclusions. The toxicity of DSG varied with the dosing time, whereas its efficacy did not. The chronopharmacological approach may provide merits for immunosuppressive therapy with DSG in clinical organ transplantation.

DOI： 10.1097/00007890-199905150-00012