2023/04/03 更新

写真a

ミヤタ　カズシ
宮田　一志
MIYATA Kazushi
所属
医学部附属病院 消化器外科一 病院講師
職名
病院講師

学位 1

  1. 医学博士 （ 2018年10月   名古屋大学 ） 

学位の先頭へ▲

経歴 1

  1. 名古屋大学   腫瘍外科   助教

    2015年1月

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    国名：日本国

経歴の先頭へ▲
 

論文 41

  1. Feasibility assessment of global standard chemoradiotherapy followed by surgery in patients with esophageal cancer.

    Liang Y, Maeda O, Miyata K, Kanda M, Shimizu D, Sugita S, Okada T, Ito J, Kawamura M, Ishihara S, Nakatochi M, Ando M, Kodera Y, Ando Y

    Molecular and clinical oncology   18 巻 ( 4 ) 頁： 34   2023年4月

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    記述言語：英語   出版者・発行元：Molecular and Clinical Oncology  

    The present study aimed to assess the feasibility of global standard chemoradiotherapy (CRT) followed by surgery in patients with esophageal cancer. A prospective study was conducted at Nagoya University Hospital (Nagoya, Japan) to evaluate global standard CRT followed by surgery in patients with esophageal cancer. The CRT regimen consisted of 75 mg/m2 cisplatin on day 1 and 1,000 mg/m2 fluorouracil daily on days 1-4 given twice 4 weeks apart together with concurrent esophageal irradiation starting on day 1 (group A). For comparison, 17 patients with esophageal cancer who had received the same chemotherapy regimen but with lower drug doses were retrospectively reviewed: 70 mg/m2 cisplatin on day 1 and 700 mg/m2 fluorouracil daily on days 1-4 given twice 4 weeks apart together with concurrent esophageal irradiation starting on day 1 (group B). Grade 3 or worse adverse events were observed in 9 of the 12 patients (75%) in group A and in 5 of the 17 patients (29%) in group B. The patients in group A were more likely to experience grade 3 or worse neutropenia (50%) than those in group B (6%). No febrile neutropenia or treatment-related deaths occurred in either group. A total of 11 patients (92%) in group A and 16 patients (94%) in group B subsequently underwent an esophagectomy, and 9 (82%) and 14 (88%) of these patients, respectively, achieved microscopically margin-negative resection (R0 resection). In conclusion, global standard CRT was more likely to cause severe but manageable adverse events. There was no apparent difference in the R0 resection rate or postoperative complications between the two treatments. This clinical trial was registered at the Japan Registry of Clinical Trials (trial registration number: jRCT1041180004) on September 11, 2018.

    DOI： 10.3892/mco.2023.2630

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    PubMed

  2. Risk Factors for Muscle Loss During Neoadjuvant Therapy for Esophageal Cancer.

    Shimizu D, Miyata K, Fukaya M, Sugita S, Ebata T

    Anticancer research   43 巻 ( 3 ) 頁： 1309 - 1315   2023年3月

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    記述言語：英語   出版者・発行元：Anticancer research  

    BACKGROUND/AIM: In patients with esophageal cancer, muscle loss induced by neoadjuvant therapy before esophagectomy is correlated with poor prognosis. However, little is known about the causes of muscle loss. Thus, the purpose of this retrospective study was to clarify the risk factors for muscle loss during neoadjuvant therapy. PATIENTS AND METHODS: Patients with esophageal cancer who underwent neoadjuvant therapy before esophagectomy between 2009 and 2020 were investigated (n=132). The patients received either cisplatin plus 5-fluorouracil (CF); docetaxel, cisplatin plus 5-fluorouracil (DCF); or CF with radiotherapy as neoadjuvant therapy. The cross-sectional areas of the bilateral psoas muscles were measured at the level of the third lumbar vertebra using CT, before and after neoadjuvant therapy, and psoas muscle loss was calculated. The patients were divided into the high muscle loss group with 5% or more muscle loss or the low muscle loss group with less than 5% loss. Correlations between muscle loss and clinical factors were evaluated. RESULTS: The median value of psoas muscle loss was 5.30%. Psoas muscle loss was significantly correlated with a poor 3-year overall survival rate (p=0.034). Multivariate analysis showed that the independent factors associated with muscle loss were age ≥70 years [odds ratio (OR)=2.43, p=0.022], treatment with DCF (OR=3.47, p=0.034), and a poor response to neoadjuvant therapy (OR=2.68, p=0.028). CONCLUSION: A regimen of DCF was a major trigger of muscle loss during neoadjuvant therapy.

    DOI： 10.21873/anticanres.16278

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  3. Cyclodextrin Conjugated α-Bisabolol Suppresses FAK Phosphorylation and Induces Apoptosis in Pancreatic Cancer.

    Kano MT, Kokuryo T, Baba T, Yamazaki K, Yamaguchi J, Sunagawa M, Ogura A, Watanabe N, Onoe S, Miyata K, Mizuno T, Uehara K, Igami T, Yokoyama Y, Ebata T, Nagino M

    Anticancer research   43 巻 ( 3 ) 頁： 1009 - 1016   2023年3月

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    記述言語：英語   出版者・発行元：Anticancer research  

    BACKGROUND/AIM: α-Bisabolol is an essential oil component extracted from plants, such as chamomile. We have previously reported that α-bisabolol suppressed proliferation, invasion, and motility of pancreas cancer. Cyclodextrin improved the solubility of α-bisabolol, therefore it enabled to administer intravenously. The aim of this study was to clarify the effect of cyclodextrin conjugated α-bisabolol (CD-BSB) and the signals pathways associated with α-bisabolol for pancreatic cancer. MATERIALS AND METHODS: Human pancreatic cancer cell lines were treated with or without CD-BSB. Cytomorphology and apoptosis were assessed in these treated groups. In addition, several phosphorylated proteins were analyzed to clarify the signal pathway concerning CD-BSB. In subcutaneous xenograft model, tumor volume and Ki-67 expression were evaluated among Control (untreated), CD-BSB, or Gemcitabine (GEM). RESULTS: CD-BSB significantly changed cytomorphology and induced apoptosis in pancreatic cancer cells. CD-BSB suppressed phosphorylation of focal adhesion kinase (FAK). In addition, pFAK 397 was inhibited by CD-BSB in a concentration-dependent manner in cancer cells. In the subcutaneous xenograft models, the tumor volume in the CD-BSB groups was lower than Control groups. Ki67-positive cells in CD-BSB treated group were lower than the GEM-treated groups. CONCLUSION: We clarified the efficiency of CD-BSB in xenograft tumor using intravenous administration. α-Bisabolol suppresses phosphorylation of FAK 397 and impairs cytoskeletal polymerization in a pancreatic cancer cell line. Further investigations are required to reveal the precise mechanisms of the antitumor effects of solubilized α-bisabolol to facilitate its clinical application. Our data indicate that solubilized α-bisabolol has therapeutic potential and could improve the prognosis of cancer patients.

    DOI： 10.21873/anticanres.16245

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  4. Antitumor Effects of Deep Ultraviolet Irradiation for Pancreatic Cancer.

    Yamazaki K, Kokuryo T, Yamaguchi J, Sunagawa M, Ogura A, Watanabe N, Onoe S, Miyata K, Mizuno T, Uehara K, Igami T, Yokoyama Y, Ebata T, Nagino M

    Anticancer research   43 巻 ( 2 ) 頁： 621 - 630   2023年2月

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    記述言語：英語   出版者・発行元：Anticancer Research  

    Background/Aim: Deep ultraviolet (DUV) light spans within the 250 nm to 350 nm invisible wavelength range. Although it strongly damages various cells, the efficacy of DUV irradiation on pancreatic cancer cells has never been clarified. The purpose of this study was to reveal the antitumor effects of DUV irradiation on pancreatic cancer cells. Materials and Methods: Human pancreatic cancer cell lines were eradicated with DUV or ultraviolet A (UVA) for 5 s. Several angiogenesis-related proteins were studied in cancer cells after DUV irradiation using a protein antibody array. A subcutaneous xenograft model was established by inoculation of pancreatic cancer cells into mice. Tumors in this model were irradiated with DUV or UVA once or twice for two weeks. Tumor volumes in these groups (DUV×1: one irradiation, DUV×2: two irradiations, and untreated) were analyzed one week after the second irradiation. Results: DUV irradiation significantly changed the cytomorphology of pancreatic cancer cells. In addition, DUV irradiation induced apoptosis on pancreatic cancer cells more strongly than UVA irradiation and no irradiation. Interestingly, lower expression of thrombospondin 1 (TSP1) and tissue inhibitor of metalloproteinase 1 (TIMP1) was identified after DUV treatment. The tumor volume in the DUV-treated groups (DUV×1 and DUV×2) was smaller than that in the untreated group. Conclusion: Further investigations are required to reveal the precise mechanisms of the antitumor effects of DUV irradiation and to facilitate its clinical application as a new therapy for pancreatic cancer. Overall, DUV irradiation can be potentially used as a therapeutic option of pancreatic malignancy.

    DOI： 10.21873/anticanres.16198

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  5. Correlation of Brain Metastasis Shrinking and Deviation During 10-Fraction Stereotactic Radiosurgery With Late Sequela: Suggesting Dose Ramification Between Tumor Eradication and Symptomatic Radionecrosis.

    Ohtakara K, Tanahashi K, Kamomae T, Miyata K, Suzuki K

    Cureus   15 巻 ( 1 ) 頁： e33411   2023年1月

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    記述言語：英語  

    DOI： 10.7759/cureus.33411

    PubMed

  6. Preoperative docetaxel, cisplatin, and fluorouracil treatment with pegfilgrastim on day 7 for patients with esophageal cancer: A phase II study.

    Maeda O, Fukaya M, Koike M, Miyata K, Kanda M, Nishida K, Ando M, Kodera Y, Ando Y

    Asia-Pacific journal of clinical oncology   18 巻 ( 6 ) 頁： 578 - 585   2022年12月

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    記述言語：英語   出版者・発行元：Asia-Pacific Journal of Clinical Oncology  

    Aims: The docetaxel and cisplatin plus 5-fluorouracil (5-FU) (DCF) regimen is expected to be superior to cisplatin plus 5-FU for the preoperative treatment of esophageal cancer. However, a high risk of adverse effects, including febrile neutropenia (FN), has been reported. To evaluate the effectiveness and safety of DCF with prophylactic pegfilgrastim, we conducted a phase II study. Methods: The regimen consisted of intravenous administration of docetaxel (70 mg/m2 per day) and cisplatin (70 mg/m2 per day) on day 1 and a continuous infusion of 5-FU (750 mg/m2 per day) on days 1–5. A single 3.6-mg dose of pegfilgrastim was given as a subcutaneous injection on day 7 of each cycle. This regimen was repeated every 3 weeks for a maximum of three cycles. The primary endpoint was the grade-2/3 histopathological response rate. Results: Thirty-seven eligible patients were enrolled and received DCF. Thirty-four patients underwent esophagectomy. Two patients received chemoradiotherapy or radiotherapy without surgery. One patient withdrew consent and ended his hospital visit. One patient received additional radiotherapy before surgery. Histopathological responses of grade 3, grade 2, grade 1b, and grade 1a were observed in two (5.4%), 14 (37.8%), 10 (27.0%), and seven (18.9%) patients, respectively, and the primary endpoint was met. Of the 37 eligible patients, 11 (29.7%) developed FN in the first cycle. Conclusions: Since the histopathological responses were as expected, DCF with prophylactic pegfilgrastim is considered to be effective as preoperative chemotherapy. However, the prophylactic use of pegfilgrastim on day 7 was insufficient to prevent FN.

    DOI： 10.1111/ajco.13755

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  7. Early volume loss of skeletal muscle after esophagectomy: a risk for late-onset postoperative pneumonia.

    Nishimura K, Miyata K, Fukaya M, Yokoyama Y, Uehara K, Yamaguchi J, Mizuno T, Onoe S, Ogura A, Ebata T

    Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus   35 巻 ( 11 )   2022年11月

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    記述言語：英語   出版者・発行元：Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus  

    Late-onset postoperative pneumonia (LOPP) after esophagectomy is poorly understood. This study was designed to clarify the features and risk factors for this event. Patients who underwent esophagectomy for esophageal cancer between 2006 and 2016 were included. LOPP was defined as radiologically proven pneumonia that occurred over 3 months after surgery, and clinically relevant late-onset postoperative pneumonia (CR-LOPP) was defined as LOPP that required administration of oxygen and antibiotics in the hospital and/or more intensive treatment. The total psoas muscle area (TPA) was measured using preoperative and postoperative (at 3 months after surgery) computed tomography scan images. Potential risk factors for CR-LOPP were investigated. Among 175 study patients, 46 (26.3%) had LOPP, 29 (16.6%) of whom exhibited CR-LOPP with a cumulative incidence of 15.6% at 3 years and 22.4% at 5 years. Four (13.8%) of these patients died of LOPP. Univariable analysis showed that clinical stage ≥III (P = 0.005), preoperative prognostic nutritional index (PNI) <45 (P = 0.035), arrhythmia (P = 0.014), postoperative hospital stay ≥40 days (P = 0.003), and percent decrease of TPA more than 5% (P < 0.001) were associated with CR-LOPP but not early onset postoperative pneumonia. Multivariable analysis revealed that clinical stage ≥III (hazard ratio [HR] 3.01, P = 0.004), postoperative hospital stay ≥40 days (HR 2.51, P = 0.015), and percent decrease of TPA >5% (HR 9.93, P < 0.001) were independent risk factors for CR-LOPP. CR-LOPP occurred in over 20% of patients at 5 years, and early postoperative loss of TPA was a potential trigger for this delayed complication.

    DOI： 10.1093/dote/doac019

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  8. Trefoil factor 1 inhibits the development of esophageal adenocarcinoma from Barrett's epithelium.

    Hasebe K, Yamazaki K, Yamaguchi J, Kokuryo T, Yokoyama Y, Miyata K, Fukaya M, Nagino M, Ebata T

    Laboratory investigation; a journal of technical methods and pathology   102 巻 ( 8 ) 頁： 885 - 895   2022年8月

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    記述言語：英語   出版者・発行元：Laboratory Investigation  

    Trefoil factor family 1 (TFF1) is one of three members of the trefoil factor family that are abundantly expressed in the gastrointestinal mucosal epithelium. Recent studies have shown that TFF1 acts as a tumor suppressor in gastric, pancreatic and hepatocellular carcinogenesis; however, little is known about its function in esophageal carcinogenesis, especially in esophageal adenocarcinoma (EAC). Barrett’s epithelium is the metaplastic columnar epithelium of the esophagus and a known premalignant lesion of EAC. To investigate the role of TFF1 in EAC development, a mouse model of Barrett’s epithelium was employed, and human specimens of EAC were assessed by immunohistochemistry (IHC) and methylation-specific PCR. Wild-type (WT) mice underwent gastrojejunostomy on the forestomach, resulting in the development of Barrett’s epithelium-like (BE-like) epithelium adjacent to the anastomotic site. BE-like epithelium in these mice expressed TFF1, indicating the association of TFF1 with esophageal adenocarcinoma. TFF1-knockout (TFF1KO) mice underwent the same procedure as well, revealing that a deficiency in TFF1 resulted in the development of adenocarcinoma in the anastomotic site, presumably from BE-like epithelium. IHC of human samples revealed strong TFF1 expression in Barrett’s epithelium, which was lost in some EACs, confirming the association between TFF1 and EAC development. Aberrant DNA hypermethylation in TFF1 promoter lesions was detected in TFF1-negative human EAC samples, further confirming not only the role of TFF1 in EAC but also the underlying mechanisms of TFF1 regulation. In addition, IHC revealed the nuclear translocation of β-catenin in human and mouse EAC, suggesting that activation of the Wnt/β-catenin pathway was induced by the loss of TFF1. In conclusion, these results indicate that TFF1 functions as a tumor suppressor to inhibit the development of esophageal carcinogenesis from Barrett’s epithelium.

    DOI： 10.1038/s41374-022-00771-1

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  9. 特集 直腸癌局所再発に挑む-最新の治療戦略と手術手技 総論 局所再発直腸癌の治療方針-臓器温存手術や遠隔転移併存症例の手術適応も含めて

    村田 悠記, 上原 圭, 小倉 淳司, 杉田 静紀, 渡辺 伸元, 砂川 真輝, 尾上 俊介, 宮田 一志, 山口 淳平, 水野 隆史, 伊神 剛, 國料 俊男, 横山 幸浩, 江畑 智希

    臨床外科   77 巻 ( 5 ) 頁： 514 - 519   2022年5月

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    出版者・発行元：株式会社医学書院  

    DOI： 10.11477/mf.1407213704

    CiNii Research

  10. 小細胞癌成分を含む胆管癌の2切除例

    南 貴之, 水野 隆史, 山口 淳平, 尾上 俊介, 渡辺 伸元, 伊神 剛, 上原 圭, 宮田 一志, 横山 幸浩, 江畑 智希

    日本消化器外科学会雑誌   55 巻 ( 4 ) 頁： 240 - 250   2022年4月

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    記述言語：日本語   出版者・発行元：一般社団法人 日本消化器外科学会  

    <p>外科的切除後に対照的な経過を呈した胆管小細胞癌の2例を経験した．症例1は70歳の男性で，肝門部領域胆管癌に対して肝左葉尾状葉切除，肝外胆管切除を施行した．病理組織学的に乳頭腺癌と小細胞癌が混在する腺神経内分泌癌を認め，小細胞癌成分の静脈侵襲を認めた．進行度はpT2N0M0，fStage IIであった．術後にゲムシタビン単独療法を行ったが，術後4か月目に多発肝再発を認め，5か月目に原病死した．症例2は65歳の男性で，遠位胆管癌に対して亜全胃温存膵頭十二指腸切除を施行した．病理組織学的に神経内分泌癌（小細胞癌）を認め，進行度はpT2N1M0，fStage IIIと診断された．術後に，肺小細胞癌に準じてシスプラチン+エトポシド併用療法を4コース投与した．現在，術後8年無再発生存中である．胆管小細胞癌は根治切除後も早期再発する例が多く，肺小細胞癌に準じた薬物治療を含む集学的治療が必要である．</p>

    DOI： 10.5833/jjgs.2021.0083

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  11. 特集 胆道癌治療の最前線 II. 各論 4.肝外胆管癌に対する手術術式と適応

    尾上 俊介, 水野 隆史, 渡辺 伸元, 横山 幸浩, 國料 俊男, 伊神 剛, 上原 圭, 山口 淳平, 宮田 一志, 砂川 真輝, 小倉 淳司, 江畑 智希

    外科   84 巻 ( 2 ) 頁： 136 - 141   2022年2月

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    出版者・発行元：南江堂  

    DOI： 10.15106/j_geka84_136

    CiNii Research

  12. Impact of synbiotics treatment on bacteremia induced during neoadjuvant chemotherapy for esophageal cancer: A randomised controlled trial.

    Fukaya M, Yokoyama Y, Usui H, Fujieda H, Sakatoku Y, Takahashi T, Miyata K, Niikura M, Sugimoto T, Asahara T, Nagino M, Ebata T

    Clinical nutrition (Edinburgh, Scotland)   40 巻 ( 12 ) 頁： 5781 - 5791   2021年12月

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    記述言語：英語   出版者・発行元：Clinical Nutrition  

    Background & aims: To elucidate the impact of synbiotics on bacterial translocation and subsequent bacteremia during neoadjuvant chemotherapy for esophageal cancer. Methods: Patients requiring neoadjuvant chemotherapy for esophageal cancer were randomized to receive synbiotics (synbiotics group) or no synbiotics (control group) during chemotherapy. Blood and fecal samples were taken before and after every chemotherapy cycle, and 1 day before surgery. Mesenteric lymph nodes (MLNs) were harvested at laparotomy (MLN-1) and after resection of the tumor (MLN-2). Bacteria in each sample were detected. Fecal microbiota and organic acid concentrations were also determined. The primary endpoint was the detection of bacteria in the blood samples, as well as the incidence of side effects during chemotherapy. The secondary endpoint was the detection rate of bacteria in the MLN samples collected during surgery. Results: The study recruited a total of 42 patients (22 in the control group, 20 in the synbiotics group). Bacteria were detected in 16 of 101 blood samples in the control group, whereas those were detected only 2 of 100 blood samples in the synbiotics group (p < 0.001) during neoadjuvant chemotherapy. Additionally, bacteria were detected in 12 of 34 MLN samples in the control group, whereas no bacteria were detected in 38 MLN samples in the synbiotics group (p < 0.001). Suppression of bacterial translocation was at least partly associated with an increased fecal acetic acid concentration as well as a lowered fecal pH by synbiotics. The incidence rate of grade 3 gastrointestinal toxicity during chemotherapy was lower in the synbiotics group compared to the control group (8/22 vs. 1/20, p = 0.022). Conclusions: Neoadjuvant chemotherapy for esophageal cancer may induce bacterial translocation and subsequent bacteremia, which can be prevented by synbiotics administration. Trial registration: The University Hospital Medical Information Network (http://www.umin.ac.jp; registration number ID 000007651).

    DOI： 10.1016/j.clnu.2021.10.004

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  13. Neoadjuvant docetaxel, oxaliplatin plus S-1 for treating clinical stage III squamous cell carcinoma of the esophagus: Study protocol of an open-label phase II trial.

    Kanda M, Shimizu D, Miyata K, Maeda O, Tanaka C, Inokawa Y, Hattori N, Hayashi M, Ando M, Kuwatsuka Y, Murotani K, Nakayama G, Koike M, Ando Y, Ebata T, Kodera Y

    Contemporary clinical trials communications   24 巻   頁： 100853   2021年12月

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    記述言語：英語   出版者・発行元：Contemporary Clinical Trials Communications  

    In Japan, esophagectomy after two courses of 5-fluorouracil plus cisplatin is regarded a standard strategy for treating resectable stage II or III esophageal squamous cell carcinoma (ESCC). However, 5-fluorouracil plus cisplatin does not benefit cohorts with clinical stage III ESCC, suggesting the requirement for a more effective regimen. We are conducting a single-arm phase II study to assess the safety and efficacy of neoadjuvant docetaxel, oxaliplatin plus S-1 (DOS) for treating patients with clinical stage III ESCC. The primary endpoint is the pathological response rate, and the target number is 45 patients. Safety, response rate, R0 resection rate, and survival are secondary endpoints. This trial is registered in the Japan Registry of Clinical Trials as jRCTs041210023. We are conducting a prospective phase II trial to evaluate the safety and efficacy of three courses of neoadjuvant DOS treatment followed by radical esophagectomy for clinical stage III ESCC.

    DOI： 10.1016/j.conctc.2021.100853

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  14. 増刊号 Stepごとに要点解説 標準術式アトラス最新版-特別付録Web動画 4.大腸 直腸癌-骨盤内臓全摘術

    小倉 淳司, 上原 圭, 村田 悠記, 三品 拓也, 伊神 剛, 水野 隆史, 山口 淳平, 宮田 一志, 尾上 俊介, 渡辺 伸元, 横山 幸浩, 江畑 智希

    臨床外科   76 巻 ( 11 ) 頁： 128 - 137   2021年10月

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    出版者・発行元：株式会社医学書院  

    DOI： 10.11477/mf.1407213500

    CiNii Research

  15. II. Treatment for Recurrent Cholangiocarcinoma

    Watanabe N., Yokoyama Y., Igami T., Uehara K., Mizuno T., Yamaguchi J., Miyata K., Onoe S., Ogura A., Ebata T.

    Japanese Journal of Cancer and Chemotherapy   48 巻 ( 10 ) 頁： 1223 - 1226   2021年10月

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    記述言語：日本語   出版者・発行元：Japanese Journal of Cancer and Chemotherapy  

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  16. [Ⅱ.Treatment for Recurrent Cholangiocarcinoma].

    Watanabe N, Yokoyama Y, Igami T, Uehara K, Mizuno T, Yamaguchi J, Miyata K, Onoe S, Ogura A, Ebata T

    Gan to kagaku ryoho. Cancer & chemotherapy   48 巻 ( 10 ) 頁： 1223 - 1226   2021年10月

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    記述言語：日本語  

    PubMed

  17. 特集 側方リンパ節郭清のすべて-開腹からロボット手術まで 手技の実際 経肛門的アプローチによる側方リンパ節郭清

    相場 利貞, 上原 圭, 小倉 淳司, 村田 悠記, 三品 拓也, 横山 幸浩, 國料 俊男, 伊神 剛, 水野 隆史, 山口 淳平, 宮田 一志, 尾上 俊介, 渡辺 伸元, 江畑 智希

    臨床外科   76 巻 ( 5 ) 頁： 596 - 602   2021年5月

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    出版者・発行元：株式会社医学書院  

    DOI： 10.11477/mf.1407213349

    CiNii Research

  18. 手術症例報告 下咽頭癌術後の腹臥位胸腔鏡下食道癌手術─永久気管孔,両側DP(deltopectoral)皮弁の取り扱いに注意を要した1例

    川上 次郎, 深谷 昌秀, 宮田 一志, 富永 健太, 丸尾 貴志, 江畑 智希

    手術   75 巻 ( 5 ) 頁： 905 - 910   2021年4月

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    出版者・発行元：金原出版  

    DOI： 10.18888/op.0000002217

    CiNii Research

  19. 頸部リンパ節転移再発に対し二次治療が著効し病理学的完全奏効を得たRAS/BRAF V600E変異型横行結腸癌の1例

    村田 悠記, 上原 圭, 相場 利貞, 小倉 淳司, 深谷 昌秀, 宮田 一志, 田中 綾, 大原 規彰, 神野 孝徳, 江畑 智希

    日本消化器外科学会雑誌   54 巻 ( 4 ) 頁： 278 - 284   2021年4月

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    記述言語：日本語   出版者・発行元：一般社団法人 日本消化器外科学会  

    <p>今日，進行再発大腸癌治療において遺伝子検査は必要不可欠なものとなっている．中でもBRAF V600E変異症例の予後は極めて不良と報告され，その治療選択に悩むことは少なくない．今回，オキサリプラチンベースの術後補助化学療法が終了した直後の術後9か月の早期に，頸部リンパ節再発を来し，BRAF V600E変異型で予後不良が予測された症例に対し，二次治療としてのFOLFIRI+aflibercept療法が著効し，切除により病理学的完全奏効を確認した1例を経験した．術後経過観察期間は9か月とまだ短いが，外来で無再発，無治療で経過観察中である．予後不良とされるBRAF V600E変異型であっても野生型と同様に一定の全身コントロールが可能であれば，転移巣切除を考慮する意義はあると考えられた．</p>

    DOI： 10.5833/jjgs.2020.0057

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    CiNii Research

  20. Repair of gastro-tracheobronchial fistula after esophagectomy for esophageal cancer using intercostal muscle and latissimus dorsi muscle flaps: a case report.

    Miyata K, Fukaya M, Nagino M

    Surgical case reports   6 巻 ( 1 ) 頁： 172   2020年7月

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  21. Successful two-stage operation for esophageal necrosis due to proton beam therapy followed by sorafenib in a case of large hepatocellular carcinoma.

    Higaki E, Fukaya M, Miyata K, Kawai R, Abe T

    Surgical case reports   6 巻 ( 1 ) 頁： 138   2020年6月

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  22. 特集 進行直腸癌のベストプラクティス II. 各論 5.局所再発直腸癌の再発部位を意識した治療戦略

    小倉 淳司, 上原 圭介, 相場 利貞, 江畑 智希, 横山 幸浩, 國料 俊男, 伊神 剛, 深谷 昌秀, 水野 隆史, 山口 淳平, 宮田 一志, 尾上 俊介, 渡辺 伸元, 梛野 正人

    外科   82 巻 ( 7 ) 頁： 742 - 748   2020年6月

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    出版者・発行元：南江堂  

    DOI： 10.15106/j_geka82_742

    CiNii Research

  23. A prospective trial to evaluate treatment effects of a β-hydroxy-β-methylbutyrate containing nutrient for leakage at the anastomotic site after esophagectomy.

    Kanda M, Koike M, Fukaya M, Miyata K, Tanaka C, Kobayashi D, Hayashi M, Yamada S, Nakayama G, Murotani K, Fujiwara M, Nagino M, Kodera Y

    Nagoya journal of medical science   82 巻 ( 1 ) 頁： 33 - 37   2020年2月

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

    Anastomotic leakage after esophagectomy is associated with prolonged hospitalization and increased medical cost. Additionally, it sometimes leads to a fatal condition and impaired postoperative quality of life. During the process of wound healing, β-hydroxy-β-methylbutyrate (HMB) is important for collagen biosynthesis. An open-label prospective intervention trial has been designed to evaluate the treatment effect of an enteral nutrient containing HMB with arginine and glutamine (Abound, Abbott Japan Co., Ltd.) for leakage at the anastomotic site after esophagectomy. Patients in whom leakage at the anastomotic site developed within 14 days after esophagectomy are eligible and Abound (24 g) is administered for 14 days through an enteral feeding tube. The target sample size is 10. The primary endpoint is duration between diagnosis and cure of leakage. Surgical procedure, safety, length of fasting, drainage placement and hospital stay, and nutritional status are determined as secondary endpoints. A historical control consisting of 20 patients who had leakage at the anastomotic site after esophagectomy between 2005 and 2018 at Nagoya University Hospital is compared with enrolled patients.

    DOI： 10.18999/nagjms.82.1.33

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    PubMed

  24. The impact of cervical lymph node dissection on acid and duodenogastroesophageal reflux after intrathoracic esophagogastrostomy following transthoracic esophagectomy.

    Asai S, Fukaya M, Miyata K, Itatsu K, Miyahara R, Furukawa K, Ebata T, Nagino M

    Surgery today   49 巻 ( 12 ) 頁： 1029 - 1034   2019年12月

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    記述言語：英語   出版者・発行元：Surgery Today  

    Purpose: The aim of this study was to evaluate the impact of cervical lymph node dissection on acid reflux and duodenogastroesophageal reflux (DGER) in patients undergoing transthoracic esophagectomy with gastric tube reconstruction and intrathoracic esophagogastrostomy. Methods: Thirty-one patients receiving transthoracic esophagectomy with gastric tube reconstruction by intrathoracic esophagogastrostomy were divided into the following two groups: a two-field lymph node dissection group (2F group) and a three-field lymph node dissection group (3F group). All patients underwent 24-h pH and bilirubin monitoring and gastrointestinal endoscopy at 1 year after surgery. The 24-h pH and bilirubin monitoring results, endoscopic findings, and reflux symptoms were compared between the 2 groups. Results: No acid reflux was observed in the 2F group, whereas it was observed in 6 (40%) patients in the 3F group (p = 0.007). DGER was found in 2 patients (13%) in the 2F group and in 8 (53%) in the 3F group (p = 0.023). Four patients (25%) in the 2F group and 9 (60%) in the 3F group (p = 0.048) had reflux esophagitis. Conclusion: Cervical lymph node dissection increases acid reflux and DGER and can lead to an increase in the incidence of reflux esophagitis in patients undergoing intrathoracic esophagogastrostomy.

    DOI： 10.1007/s00595-019-01835-4

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    PubMed

  25. Esophageal reconstruction using a pedicled jejunum following esophagectomy for metastatic esophageal stricture from breast cancer in a patient with previous pancreatoduodenectomy

    Asai Soichiro, Fukaya Masahide, Fujieda Hironori, Igami Tsuyoshi, Tsunoda Nobuyuki, Salcatoku Yayoi, Kamei Yuzuru, Miyata Kazushi, Nagino Masato

    NAGOYA JOURNAL OF MEDICAL SCIENCE   81 巻 ( 4 ) 頁： 679 - 685   2019年11月

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  26. Repeated episodes of thoracic empyema after spontaneous esophageal rupture

    Sakatoku Yayoi, Fukaya Masahide, Kawaguchi Koji, Fujieda Hironori, Miyata Kazushi, Nagino Masato

    NAGOYA JOURNAL OF MEDICAL SCIENCE   81 巻 ( 4 ) 頁： 693 - 699   2019年11月

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  27. 画像診断と病理 食道平滑筋腫

    兵藤 良太, 岩野 信吾, 長縄 慎二, 宮田 一志, 島田 聡子

    画像診断   39 巻 ( 7 ) 頁： 662 - 663   2019年5月

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    出版者・発行元：学研メディカル秀潤社  

    DOI： 10.15105/gz.0000001162

    CiNii Research

  28. 胸腔鏡下に切除した初診時血中CA19-9高値食道duplication cystの1例

    浅井 宗一郎, 深谷 昌秀, 檜垣 栄治, 宮田 一志, 三浦 泰智, 梛野 正人

    日本臨床外科学会雑誌   80 巻 ( 4 ) 頁： 700 - 706   2019年

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    記述言語：日本語   出版者・発行元：日本臨床外科学会  

    <p>症例は41歳，男性．2017年2月，胸痛があり近医を受診．精査で後縦隔嚢胞性病変が疑われ当院紹介となった．血液検査ではCA19-9 5,960U/mlと高値を呈し，上部消化管内視鏡検査では門歯より24-41cmにわたり粘膜が青紫色を呈した半周性の粘膜下隆起がみられた．また，超音波内視鏡で病変部は腫瘤として描出され，内部はモザイクパターンを呈し血腫の存在が考えられた．CTでは食道前面に83×41×115mm大の二房性の嚢胞性病変がみられ，食道を圧排して狭窄していた．食道嚢胞と診断したが，胸痛と食道狭窄による症状があるため3月に胸腔鏡下に嚢胞切除術を施行した．術後経過は良好で，術後10日目に退院した．組織学的に嚢胞内面に多列上皮を認め，また嚢胞壁に2層の筋層を有することからduplication cystと診断した．</p>

    DOI： 10.3919/jjsa.80.700

    CiNii Research

  29. Docetaxel, cisplatin and fluorouracil as neoadjuvant chemotherapy for esophageal cancer with prophylactic pegfilgrastim

    Maeda Osamu, Koike Masahiko, Fukaya Masahide, Miyata Kazushi, Iwata Naoki, Nagino Masato, Kodera Yasuhiro, Ando Yuichi

    ANNALS OF ONCOLOGY   29 巻   2018年10月

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  30. 特集 消化器癌に対する最新の集学的治療戦略 II. 各論 6.胆道癌の集学的治療戦略

    江畑 智希, 水野 隆史, 横山 幸浩, 伊神 剛, 山口 淳平, 尾上 俊介, 深谷 昌秀, 上原 圭介, 宮田 一志, 相場 利貞, 梛野 正人

    外科   80 巻 ( 8 ) 頁： 851 - 858   2018年7月

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    出版者・発行元：南江堂  

    DOI： 10.15106/j_geka80_851

    CiNii Research

  31. 胆道再建を伴う肝切除後の Clavien-Dindo Grade Ⅲ・Ⅳ症例に対する感染管理

    菅原 元, 横山 幸浩, 江畑 智希, 伊神 剛, 山口 淳平, 尾上 俊介, 國料 俊男, 角田 伸行, 深谷 昌秀, 上原 圭介, 宮田 一志, 相場 利貞, 梛野 正人

    日本外科感染症学会雑誌   15 巻 ( 3 ) 頁： 201 - 208   2018年6月

    　詳細を見る

    記述言語：日本語   出版者・発行元：一般社団法人 日本外科感染症学会  

    <p>【目的】胆道再建を伴う肝切除術後の Clavien-Dindo Grade Ⅲ・Ⅳ症例の経過について検討すること。【対象と方法】2009年から 2015年の 7年間における胆道再建を伴う肝切除施行例 428例を対象として，Grade Ⅲ・Ⅳ症例の患者背景・術式・術後合併症および治療経過について比較検討した。肝不全発症の危険因子についても検討した。【結果】Grade Ⅳ症例はⅢ症例に比較して，右肝切除施行および血管合併切除併施症例が多く，出血量が多かった。術後合併症では肺炎・敗血症の発症が多く，平均在院期間は長かった。肝不全発症の危険因子は出血量 1,500mL以上，肺炎・敗血症の発症であった。Grade Ⅲ・Ⅳ症例ともに治療法は，腹腔内のドレナージ状況を良好に保つこと，全身性の感染症が疑われる際は抗菌薬を追加投与することが基本となる。【結論】Clavien-Dindo Grade Ⅲ症例に対する感染管理を徹底することが，Clavien-Dindo Grade Ⅳ症例の発症予防につながる。</p>

    DOI： 10.24679/gekakansen.15.3_201

    CiNii Research

  32. Peritonitis after percutaneous endoscopic gastrojejunostomy for levodopa-carbidopa intestinal gel treatment despite concomitant use of gastropexy

    Tsuboi Takashi, Watanabe Hirohisa, Funasaka Kouhei, Takebayashi Mikiko, Miyata Kazushi, Katsuno Masahisa

    NEUROLOGY AND CLINICAL NEUROSCIENCE   6 巻 ( 2 ) 頁： 64 - 66   2018年3月

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  33. The Impact of the Location of Esophagogastrostomy on Acid and Duodenogastroesophageal Reflux After Transthoracic Esophagectomy with Gastric Tube Reconstruction and Intrathoracic Esophagogastrostomy.

    Usui H, Fukaya M, Itatsu K, Miyata K, Miyahara R, Funasaka K, Nagino M

    World journal of surgery   42 巻 ( 2 ) 頁： 599 - 605   2018年2月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Journal of Surgery  

    Background: The aim of this study was to evaluate the impact of the location of esophagogastrostomy on acid and duodenogastroesophageal reflux (DGER) in patients undergoing gastric tube reconstruction and intrathoracic esophagogastrostomy. Methods: Thirty patients receiving transthoracic esophagectomy without cervical lymph node dissection and gastric tube reconstruction by intrathoracic anastomosis were enrolled. All patients underwent 24-h pH and bilirubin monitoring and gastrointestinal endoscopy one year after surgery. Patients were divided into three groups according to esophagogastrostomy location: group A (n = 9), above the top of the aortic arch; group B (n = 15), between the top and bottom of the aortic arch; and group C (n = 6), below the bottom of the aortic arch. The relations among the esophagogastrostomy location, 24-h pH and bilirubin monitoring results, endoscopic findings, and reflux symptoms were investigated. Results: No acid reflux into the remnant esophagus was observed in group A, whereas it was observed in three of 15 patients (20%) in group B and in two of six patients (33%) in group C (P = 0.139). No DGER was found in group A, whereas DGER was observed in eight (53%) patients in group B and all patients in group C (P < 0.001). Reflux esophagitis was observed in one patient (11%) in group A, five patients (33%) in group B, and all patients in group C (P = 0.002). Conclusion: In gastric tube reconstruction via intrathoracic anastomosis, esophagogastrostomy should be performed above the top of the aortic arch to prevent postoperative DGER and reduce the incidence of reflux esophagitis.

    DOI： 10.1007/s00268-017-4186-1

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  34. 根治的化学放射線療法後3度の再発と二次原発癌をきたした食道癌の1例

    酒徳 弥生, 深谷 昌秀, 宮田 一志, 高橋 崇真, 梛野 正人

    日本臨床外科学会雑誌   79 巻 ( 1 ) 頁： 84 - 89   2018年

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    記述言語：日本語   出版者・発行元：日本臨床外科学会  

    症例は50歳，女性．2008年7月に胸部中部食道，cT4 N1 M0 : cStage III Cに対し根治的化学放射線療法およびFP療法を2コース行いCRが得られた．半年後に#104L，#16a2interに転移を認めた．FP療法を5コース，5-FU+CDGP療法を3コース施行し，#16a2interはCRとなったが，#104LはSDであった．2010年7月に左頸部リンパ節郭清を行った．2011年2月に#105・#3に転移を認め，5-FU+CDGP療法を5コース行いCRとなった．2012年2月に再度#105の腫大と切歯列23cmにT1b病変を認めた．R0切除が見込めると判断し，2012年3月に右開胸開腹食道亜全摘術，3領域リンパ節郭清，後縦隔経路胃管再建を行った．以後，化学療法は行わず，初回治療から7年3カ月無再発生存中である．

    DOI： 10.3919/jjsa.79.84

    CiNii Research

  35. 特集 最新の胆道癌診療トピックス-新たな治療戦略の可能性を探る 術前治療と切除適応 胆道癌の予後不良因子とは-手術適応のborderlineはどこか? 肝門部領域胆管癌

    尾上 俊介, 江畑 智希, 横山 幸浩, 國料 俊男, 角田 伸行, 伊神 剛, 菅原 元, 深谷 昌秀, 上原 圭介, 水野 隆史, 山口 淳平, 宮田 一志, 相場 利貞, 梛野 正人

    臨床外科   72 巻 ( 13 ) 頁： 1419 - 1422   2017年12月

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    出版者・発行元：株式会社医学書院  

    DOI： 10.11477/mf.1407211870

    CiNii Research

  36. Clinical value of a prophylactic minitracheostomy after esophagectomy: analysis in patients at high risk for postoperative pulmonary complications.

    Sakatoku Y, Fukaya M, Miyata K, Itatsu K, Nagino M

    BMC surgery   17 巻 ( 1 ) 頁： 120   2017年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Surgery  

    Background: The aim of this study is to evaluate the clinical value of a prophylactic minitracheostomy (PMT) in patients undergoing an esophagectomy for esophageal cancer and to clarify the indications for a PMT. Methods: Ninety-four patients who underwent right transthoracic esophagectomy for esophageal cancer between January 2009 and December 2013 were studied. Short surgical outcomes were retrospectively compared between 30 patients at high risk for postoperative pulmonary complications who underwent a PMT (PMT group) and 64 patients at standard risk without a PMT (non-PMT group). Furthermore, 12 patients who required a delayed minitracheostomy (DMT) due to postoperative sputum retention were reviewed in detail, and risk factors related to a DMT were also analyzed to assess the indications for a PMT. Results: Preoperative pulmonary function was lower in the PMT group than in the non-PMT group: FEV1.0 (2.41 vs. 2.68 L, p = 0.035), and the proportion of patients with FEV1.0% <60 (13.3% vs. 0%, p = 0.009). No between-group differences were observed in the proportion of patients who suffered from postoperative pneumonia, atelectasis, or re-intubation due to respiratory failure. Of the 12 patients with a DMT, 11 developed postoperative pneumonia, and three required re-intubation due to severe pneumonia. Multivariate analysis revealed FEV1.0% <70% and vocal cord palsy were independent risk factors related to a DMT. Conclusion: A PMT for high-risk patients may prevent an increase in the incidence of postoperative pneumonia and re-intubation. The PMT indications should be expanded for patients with vocal cord palsy or mild obstructive respiratory disturbances.

    DOI： 10.1186/s12893-017-0321-z

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  37. Gradually shrinking intra-abdominal desmoid tumor derived from the stomach in a young boy: a case report.

    Miyata K, Fukaya M, Nagino M

    Surgical case reports   3 巻 ( 1 ) 頁： 54   2017年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1186/s40792-017-0330-2

    Web of Science

    PubMed

  38. Successful bypass operation for esophageal obstruction after acute esophageal necrosis: a case report.

    Sakatoku Y, Fukaya M, Miyata K, Nagino M

    Surgical case reports   3 巻 ( 1 ) 頁： 4   2017年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1186/s40792-016-0277-8

    Web of Science

    PubMed

  39. Retrosternal Reconstruction Can be a Risk Factor for Upper Extremity Deep Vein Thrombosis After Esophagectomy.

    Takahashi T, Fukaya M, Miyata K, Sakatoku Y, Nagino M

    World journal of surgery   41 巻 ( 12 ) 頁： 3154 - 3163   2017年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Journal of Surgery  

    Background: Upper extremity deep vein thrombosis (UEDVT) is a rare but important complication because it can cause pulmonary embolism. The aim of this study was to investigate the incidence of UEDVT after esophagectomy and the risk factors related to UEDVT. Methods: This study included 88 patients who underwent esophagectomy with retrosternal or posterior mediastinal reconstruction using gastric tube. The incidence of UEDVT and the diameter of left brachiocephalic vein were measured using postoperative contrast-enhanced computed tomography (CT). (a) The distance from sternum to brachiocephalic artery and (b) the distance from sternum to vertebra were measured by preoperative CT, and the ratio of (a) to (b) was defined as the width of the retrosternal space. Results: Among the patients, 14 (15.9%) suffered from UEDVT. All UEDVTs were found in left-side upper extremity deep veins. Twelve of the 14 patients (85.7%) underwent retrosternal reconstruction. In a multivariate analysis, retrosternal reconstruction was an independent risk factor for UEDVT (odds ratio 5.48). The diameter of the left brachiocephalic vein in patients with retrosternal reconstruction was significantly smaller than that in patients with posterior mediastinal reconstruction (4.3 vs 6.9 mm; P < 0.001) due to compression of left brachiocephalic vein by the gastric tube. Among patients with retrosternal reconstruction, the width of the retrosternal space in patients with UEDVT was significantly smaller than that in patients without UEDVT (0.21 vs 0.27; P = 0.001). Conclusion: Retrosternal reconstruction can be a risk factor for UEDVT. In patients with small width of the retrosternal space, retrosternal reconstruction might be inappropriate.

    DOI： 10.1007/s00268-017-4120-6

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  40. 外科におけるcontroversy-誌上ディベート 肝門部領域癌の取り扱い　肝癌として扱うべきか胆管癌として扱うべきか　胆管癌として

    江畑 智希, 横山 幸浩, 國料 俊男, 菅原 元, 伊神 剛, 水野 隆史, 山口 淳平, 深谷 昌秀, 上原 圭介, 宮田 一志, 相場 利貞, 梛野 正人

    外科   79 巻 ( 5 ) 頁： 437 - 440   2017年5月

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    出版者・発行元：南江堂  

    DOI： 10.15106/j00393.2017258593

    CiNii Research

  41. Muscle sparing thoracotomy for esophageal cancer: a comparison with posterolateral thoracotomy 査読有り

    Miyata K, Fukaya M, Itatsu K, Abe T, Nagino M

    Surg Today     2015年8月

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    担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1007/s00595-015-1240-1

    PubMed

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論文の先頭へ▲

書籍等出版物 2

  1. 消化器外科ナーシング2020春季増刊

    宮田一志（ 担当： 単著 ,  範囲: 第2章　開胸・開腹手術　1食道亜全摘術（胃管再建））

    メディカ出版  2020年 

    　詳細を見る

    担当ページ：34-37   記述言語：日本語

  2. 消化器外科ナーシング2020春季増刊

    宮田一志（ 担当： 単著 ,  範囲: 第2章　開胸・開腹手術　2頸部食道切除術）

    メディカ出版  2020年 

    　詳細を見る

    担当ページ：38-41   記述言語：日本語 著書種別：教科書・概説・概論

書籍等出版物の先頭へ▲

MISC 3

  1. 不治の病とどう戦えば？患者さんが望んだ「無治療という医療」 招待有り

    宮田一志  

    消化器外科ナーシング25 巻 ( 4 ) 頁： 1 - 1   2020年4月

    　詳細を見る

    担当区分：筆頭著者   記述言語：日本語   掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）  

  2. Esophageal reconstruction using a pedicled jejunum following esophagectomy for metastatic esophageal stricture from breast cancer in a patient with previous pancreatoduodenectomy.

    Asai S, Fukaya M, Fujieda H, Igami T, Tsunoda N, Sakatoku Y, Kamei Y, Miyata K, Nagino M  

    Nagoya journal of medical science81 巻 ( 4 ) 頁： 679 - 685   2019年11月

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

    A 71-year-old woman with dysphagia was diagnosed with thoracic esophageal squamous cell carcinoma by endoscopic biopsy at another hospital. She had previously undergone partial breast excision with axillary lymph node dissection for right breast cancer eleven years earlier and subtotal stomach-preserving pancreatoduodenectomy with Child's reconstruction for ampullary cancer ten years earlier. Gastrointestinal endoscopy showed a stricture due to a bulging submucosal tumor in the mid-thoracic esophagus. The tumor was diagnosed as an esophageal metastasis from breast cancer by endoscopic ultrasound-guided fine-needle aspiration biopsy. After six courses of fulvestrant, the tumor progressed, completely impeding her ability to swallow. An esophagectomy was planned in a one-stage operation because of the expectation of a prolonged survival and her strong hope of regaining oral intake. Unfortunately, she underwent emergent omental patch repair for perforation of the gastrojejunostomy site due to an anastomotic ulcer one day before the scheduled operation. Due to postoperative impairment of her performance status, she subsequently underwent a two-stage esophageal operation. In the first surgical stage, prone position thoracoscopic esophagectomy and cervical esophagostomy were performed and she was discharged with enteral nutrition on postoperative day 15. Sixty-one days after the first surgical stage, esophageal reconstruction was performed using a pedicled jejunum with microvascular anastomosis via the subcutaneous route. She was discharged without any complications 20 days after the second operation.

    DOI： 10.18999/nagjms.81.4.679

    Scopus

    PubMed

  3. Repeated episodes of thoracic empyema after spontaneous esophageal rupture.

    Sakatoku Y, Fukaya M, Kawaguchi K, Fujieda H, Miyata K, Nagino M  

    Nagoya journal of medical science81 巻 ( 4 ) 頁： 693 - 699   2019年11月

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

    A 52-year-old man with a cough, high fever, and inappetence was diagnosed with thoracic empyema on computed tomography at a local hospital. He had undergone continuous thoracic drainage for a spontaneous esophageal rupture that occurred 17 years earlier. He developed left thoracic empyema 2, 14 and 17 years following the initial esophageal rupture that improved with conservative therapy each time. The most recent episode of thoracic empyema also resolved with conservative therapy. However, he was referred to our hospital for further examination and more complete surgical treatment for recurrent thoracic empyema. Gastrointestinal endoscopy showed a scar from the previous esophageal rupture in the lower esophagus. We considered that recurrent esophageal rupture may have caused repeated episodes of thoracic empyema based on endoscopic findings and his past history and elected to perform subtotal esophagectomy to provide a complete cure. A left transthoracic esophagectomy with a left lower lung lobectomy and gastric tube reconstruction via a retrosternal route were performed. A latissimus dorsi muscle flap was used to eliminate the dead space after lower lung lobectomy to prevent recurrent thoracic empyema. The bronchial stump was covered with a pedicled intercostal muscle flap to prevent leakage from the stump. Minor leakage from the esophagogastrostomy site developed during the postoperative course but resolved with conservative therapy. The patient was transferred to the previous hospital on the 36th postoperative day. Four years after surgery, he had good oral intake and nutritional status without any evidence of recurrent thoracic empyema.

    DOI： 10.18999/nagjms.81.4.693

    Scopus

    PubMed

MISCの先頭へ▲

講演・口頭発表等 3

  1. 当院でのダビンチシステムを用いた食道手術の現状

    宮田一志

    日本外科系連合学会学術集会  2020年12月 

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    開催年月日： 2020年12月

    記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

    開催地：久留米   国名：日本国  

  2. 局所進行食道癌とくにBorderline Resectable症例に対する当科の治療方針とその成績

    宮田一志

    日本食道学会  2020年12月 

    　詳細を見る

    開催年月日： 2020年12月

    記述言語：日本語   会議種別：ポスター発表  

    開催地：徳島   国名：日本国  

  3. 当院における消化器外科領域のCALNA参入と現状について 国際会議

    宮田一志

    日本外科学会定期学術集会  2020年8月 

    　詳細を見る

    開催年月日： 2020年8月

    記述言語：日本語   会議種別：口頭発表（一般）  

    開催地：横浜   国名：日本国  

講演・口頭発表等の先頭へ▲

科研費 1

  1. 深紫外線による新規癌治療法の開発

    研究課題/研究課題番号：18K08673  2018年4月 - 2021年3月

    科学研究費助成事業  基盤研究(C)

    宮田 一志, 梛野 正人, 江畑 智希, 國料 俊男, 山口 淳平

    　 詳細を見る

    担当区分：研究代表者 

    配分額：4420000円 （ 直接経費：3400000円 、 間接経費：1020000円 ）

    深紫外線照射は、癌細胞株において細胞形態を変化させ、アポトーシスを誘導した。作用機序としてCHK1、TLK1、MRE11が関与しており、TLK1 およびMRE11の抑制により、深紫外線照射によるアポトーシス誘導能が増強した。担癌動物モデルにおいて、深紫外線照射は腫瘍の増殖を抑制した。TLK1阻害剤の投与は、深紫外線照射による抗腫瘍効果を増強させ、腫瘍におけるKi67の発現は低下していた。ブタの胃粘膜に対して、照射により生じた粘膜面の欠損は、1週間後は治癒していた病理学的検査、血液生化学検査において異常を認めなかった。臨床応用のために更なる研究は必要であるが、新規治療法開発の可能性が示唆された。
    深紫外線によるアポトーシスの作用機序に関連するシグナルを明らかにした。またDNA修復遺伝子の抑制により深紫外線の抗腫瘍効果の増強が可能であることを明らかにした。これらは深紫外線による細胞障害作用を癌治療に応用するための重要な知見であり学術的意義が大きい。また本研究により新規治療法開発の可能性が示唆され、深紫外線による治療法が可能になれば、生存率を含めた治療成績の向上が期待され社会的意義は大きい。

科研費の先頭へ▲
 

担当経験のある科目 (本学) 2

  1. 選択特別授業

    2020

  2. チュートリアル講義

    2020

担当経験のある科目 (本学)の先頭へ▲