研究者詳細 - 城田　千代栄

Urinary N1,N12-diacetylspermine as a biomarker for pediatric cancer: a case-control study

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

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

記述言語：英語出版者・発行元：Pediatric Surgery International

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

DOI： 10.1007/s00383-021-04987-y

Long-term outcomes of the partial splenectomy for hypersplenism after portoenterostomy of patients with biliary atresia

Tainaka, T; Hinoki, A; Tanaka, Y; Shirota, C; Sumida, W; Yokota, K; Makita, S; Oshima, K; Amano, H; Takimoto, A; Kano, Y; Uchida, H

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

記述言語：英語出版者・発行元：Nagoya Journal of Medical Science

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

Factors associated with bleeding after endoscopic variceal ligation in children

Yokoyama, S; Ishizu, Y; Ishigami, M; Honda, T; Kuzuya, T; Ito, T; Hinoki, A; Sumida, W; Shirota, C; Tainaka, T; Makita, S; Yokota, K; Uchida, H; Fujishiro, M

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

記述言語：英語出版者・発行元：Pediatrics International

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

DOI： 10.1111/ped.14614

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

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

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

記述言語：日本語出版者・発行元：特定非営利活動法人日本小児外科学会

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

DOI： 10.11164/jjsps.57.5_855

CiNii Research

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

Amano, H; Hinoki, A; Uchida, H; Yokota, K; Ishigaki, T; Sakairi, M; Abe, M; Terui, Y; Oda, H; Tainaka, T; Shirota, C; Sumida, W; Makita, S; Takimoto, A; Okamoto, M; Yasui, A; Nakagawa, Y

CANCER RESEARCH 81 巻 ( 13 ) 2021年7月

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

Takimoto, A; Sumida, W; Amano, H; Shirota, C; Tainaka, T; Yokota, K; Makita, S; Yasui, A; Kanou, Y; Hinoki, A; Uchida, H

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

特集シミュレーションとナビゲーション精索静脈瘤

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 53 巻 ( 5 ) 頁： 560 - 563 2021年5月

Urinary biomarkers for monitoring treatment response in neuroblastoma patients.

Amano, H; Hinoki, A; Uchida, H; Yokota, K; Ishigaki, T; Sakairi, M; Abe, M; Takahashi, Y; Narita, A; Tainaka, T; Shirota, C; Sumida, W; Makita, S; Takimoto, A; Kano, Y; Yasui, A; Okamoto, M; Nakagawa, Y

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

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

千馬耕亮, 田中裕次郎, 城田千代栄, 田井中貴久, 住田亙, 横田一樹, 大島一夫, 牧田智, 内田広夫

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

記述言語：日本語出版者・発行元：特定非営利活動法人日本小児外科学会

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

DOI： 10.11164/jjsps.57.1_22

CiNii Research

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

Shirota, C; Tainaka, T; Sumida, W; Yokota, K; Makita, S; Takimoto, A; Amano, H; Hinoki, A; Ono, Y; Uchida, H

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

記述言語：英語出版者・発行元：Pediatric Surgery International

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

DOI： 10.1007/s00383-020-04793-y

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

Tanaka, Y; Tainaka, T; Hinoki, A; Shirota, C; Sumida, W; Yokota, K; Oshima, K; Makita, S; Amano, H; Takimoto, A; Kano, Y; Uchida, H

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

記述言語：英語出版者・発行元：Pediatric Surgery International

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

DOI： 10.1007/s00383-020-04791-0

Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation

Takimoto, A; Sumida, W; Amano, H; Shirota, C; Tainaka, T; Yokota, K; Makita, S; Yasui, A; Kanou, Y; Hinoki, A; Uchida, H

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

記述言語：英語出版者・発行元：Pediatric Surgery International

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

DOI： 10.1007/s00383-020-04807-9

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

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

中川洋一, 内田広夫, 檜顕成, 城田千代栄, 住田亙, 横田一樹, 牧田智, 岡本眞宗, 滝本愛太朗, 安井昭洋, 高田舜也, 前田拓也

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

先天性胆道拡張症の晩期合併症についての検討

城田千代栄, 天野日出, 檜顕成, 住田亙, 横田一樹, 牧田智, 岡本眞宗, 滝本愛太朗, 安井昭洋, 高田瞬也, 中川洋一, 前田拓也, 内田広夫

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

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 52 巻 ( 12 ) 頁： 1331 - 1335 2020年12月

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

Yokota, K; Amano, H; Kudo, T; Yamamura, T; Tanaka, Y; Tainaka, T; Shirota, C; Sumida, W; Makita, S; Takimoto, A; Nakamura, M; Fujishiro, M; Hinoki, A; Uchida, H

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

記述言語：英語出版者・発行元：BMC Surgery

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

DOI： 10.1186/s12893-020-00986-3

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

Tanaka, T; Amano, H; Tanaka, Y; Takahashi, Y; Tajiri, T; Tainaka, T; Shirota, C; Sumida, W; Yokota, K; Makita, S; Tani, Y; Hinoki, A; Uchida, H

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

記述言語：英語出版者・発行元：BMC Pediatrics

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

DOI： 10.1186/s12887-020-02183-w