研究者詳細 - 宮田　一志

論文 - 宮田　一志

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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

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

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

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

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

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

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

Web of Science

Scopus

PubMed

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

Sakatoku Y, Fukaya M, Miyata K, Nagino M

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

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

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

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

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

Web of Science

Scopus

PubMed

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

Miyata K, Fukaya M, Nagino M

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