研究者詳細 - 宮田　一志

論文 - 宮田　一志

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Negative Impact of High FOXP3 Status in Lymph Nodes of Esophageal Squamous Cell Carcinoma Patients.

Nonaka Y, Baba T, Sugita S, Miyata K, Sunagawa M, Yamaguchi J, Kokuryo T, Yokoyama Y, Ebata T

Anticancer research 45 巻 ( 2 ) 頁： 781 - 787 2025年2月

記述言語：英語出版者・発行元：Anticancer Research

Background/Aim: Available data on the immune profiles of regional lymph nodes in individuals with esophageal squamous cell carcinoma (ESCC) are limited. This study investigated the immune profiles of proximal regional lymph nodes (PLNs) and evaluated the association between PLNs and the outcomes of patients with ESCC. Patients and Methods: This study included 39 patients with ESCC who underwent subtotal esophagectomy with three-field lymph node dissection. The immune profiles of tumor-infiltrating lymphocytes and PLNs were evaluated through immunohistochemistry. Furthermore, the impact of this immune profile on long-term outcomes was analyzed. Results: Cox proportional-hazards analysis for overall survival revealed that ypT ≥3 [hazard ratio (HR)=8.91; 95% confidence interval (CI)=1.59-49.8] and high FOXP3 status in PLNs (HR=4.29; 95%CI=1.06-17.4) are significant independent prognostic factors. Meanwhile, analysis of disease-free survival (DFS) revealed that ypT ≥3 (HR=5.52; 95%CI=1.15-26.6) and ypN ≥1 (HR=7.74; 95%CI=1.58-37.9) are independent prognostic factors. Furthermore, high FOXP3 status in PLNs was associated with low DFS rate, although the association was not statistically significant (HR=1.70; 95%CI=0.58-5.02). Conclusion: High FOXP3 status in PLNs is associated with poor prognosis in patients with ESCC.

DOI： 10.21873/anticanres.17466

特集合併症を起こさない食道癌手術!-ハイボリュームセンターの技を学ぼう各施設における合併症を起こさない技と工夫名古屋大学腫瘍外科の技と工夫

宮田一志, 杉田静紀, 江畑智希

臨床外科 79 巻 ( 8 ) 頁： 914 - 919 2024年8月

TLK1 Inhibition Enhances the Anticancer Effect of Deep UV Irradiation Through CHK1 Activation.

Koike Y, 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 44 巻 ( 7 ) 頁： 2827 - 2836 2024年7月

記述言語：英語出版者・発行元：Anticancer Research

Background/Aim: A deep ultraviolet (DUV) light-emitting diode (LED) is a device that can irradiate electromagnetic waves from 250 nm to 350 nm. Tousled-like kinase 1 (TLK1) encodes a nuclear serine/threonine kinase, which is thought to influence the effects of DUV irradiation in cancer. The aim of this study was to clarify the interaction of TLK1 with DUV irradiation-induced DNA damage in cancer cells. Materials and Methods: Pancreatic cancer cell lines were treated with or without DUV. TLK1 expression and phosphorylation in the two groups were examined. Then, these cancer cell lines were treated with thioridazine (THD), DUV or both. Thereafter, cytomorphology and apoptosis were assessed. Several proteins related to DNA damage, were analyzed in cancer cells treated with DUV and THD. Tumors in a subcutaneous xenograft model were treated with THD, DUV, or both for six weeks. Results: DUV irradiation induced the phosphorylation of TLK1 in pancreatic cancer cell lines. Cytomorphology was significantly changed in pancreatic cancer cells treated with DUV and THD. TLK1 inhibition enhanced DUV irradiation-induced apoptosis in cancer cells. Interestingly, CHK1 and pCHK1 expression was suppressed after TLK1 inhibition. In addition, inhibition of MRE11 led to a decrease in the expression of CHK1 and pCHK1, accompanied by a notable increase in apoptosis. In the subcutaneous xenograft models, the tumor volume in the DUV and THD groups was lower than that in the other groups. Conclusion: TLK1 phosphorylation is an important event in DUV irradiation. DUV irradiation combined with TLK1 inhibition has therapeutic potential in pancreatic cancer cells.

DOI： 10.21873/anticanres.17095

上部消化管高度進行胃癌に対するコンバージョン手術の個別化治癒切除不能胃癌におけるConversion Surgeryの至適タイミングと予後因子の検討

中西香企, 田中千恵, 神田光郎, 宮田一志, 清水大, 杉田静紀, 藤原道隆, 江畑智希, 小寺泰弘

日本消化器外科学会総会 79回巻頁： 542 - 542 2024年7月

Genetic polymorphisms as predictive biomarkers of adverse events during preoperative chemotherapy in esophageal cancer. 国際誌

Liang Y, Maeda O, Miyata K, Kanda M, Sugita S, Shimizu D, Nishida K, Kodera Y, Ando Y

Cancer chemotherapy and pharmacology 93 巻 ( 2 ) 頁： 121 - 127 2024年2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：Cancer Chemotherapy and Pharmacology

Purpose: This study aimed to explore associations between genetic polymorphisms and adverse effects due to preoperative chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for esophageal cancer. Methods: Preoperative DCF (docetaxel, 70 mg/m2/day, day 1; cisplatin, 70 mg/m2/day, day 1; fluorouracil, 750 mg/m2/day, days 1–5) was repeated every 3 weeks for up to three cycles. Genotyping of nine candidate genetic polymorphisms was conducted using blood samples from the enrolled patients. Results: According to a multivariable analysis evaluating 50 patients, grade 3 or worse neutropenia was more likely to occur in those with the ABCC2-24C/T or T/T genotype (rs717620) (OR, 5.30, P = 0.013). Additionally, patients with the TYMS 3′-UTR 0 bp/0 bp genotype (rs151264360) showed a trend toward grade 3 or worse hyponatremia (OR, 0.16, P = 0.005). Grade 2 or worse thrombocytopenia was more likely to occur in patients with the TNF-α-1031C/T or T/T genotype (rs1799964) (OR, 6.30, P = 0.016) and IL-6-634C/C genotype (rs1800796) (OR, 0.18, P = 0.034), and grade 2 or worse anemia was more likely to occur in patients with the MCP-1-2518G/G genotype (rs1024611) (OR, 0.19, P = 0.027). Conclusions: ABCC2-24C > T (rs717620), TYMS 3′-UTR 6-bp indel (rs151264360), TNF-α-1031T > C (rs1799964) as well as IL-6-634G > C (rs1800796), and MCP-1-2518A > G (rs1024611) polymorphisms might serve as independent and predictive biomarkers for neutropenia, hyponatremia, thrombocytopenia, and anemia, respectively, during preoperative chemotherapy with docetaxel, cisplatin, and fluorouracil for patients with esophageal cancer.

DOI： 10.1007/s00280-023-04607-7

術後合併症の予測と対策ドレーンアミラーゼ値を用いた腹腔内感染症の早期予測法

中西香企, 神田光郎, 田中千恵, 杉田静紀, 清水大, 宮田一志, 藤原道隆, 江畑智希, 小寺泰弘

日本胃癌学会総会記事 96回巻頁： 179 - 179 2024年2月

Protocol of a phase II study investigating the efficacy and safety of trifluridine/tipiracil plus ramucirumab as a third-line or later treatment for advanced gastric cancer.

Nakanishi K, Tanaka C, Kanda M, Miyata K, Machida N, Sakai M, Kobayashi D, Teramoto H, Ishiyama A, Sato B, Oshima T, Kajikawa M, Matsushita H, Ishigure K, Yamashita K, Fujitake S, Sueoka S, Asada T, Shimizu D, Sugita S, Kuwatsuka Y, Maeda O, Furune S, Murotani K, Ando Y, Ebata T, Kodera Y

Nagoya journal of medical science 86 巻 ( 1 ) 頁： 43 - 51 2024年2月

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

In Japan, systemic chemotherapy is the standard treatment for unresectable, advanced, or recurrent gastric cancer. However, numerous patients with gastric cancer do not receive late-line treatment because of the rapid progression of gastric cancer. Additionally, late-line treatments, such as nivolumab, trifluridine tipiracil (FTD/TPI), or irinotecan, have limited effects on improving clinical symptoms and delaying the onset of symptoms associated with cancer progression. Recently, a combination of FTD/TPI and ramucirumab was reported to have a high response rate in late-line treatment; however, owing to patient selection bias and a high rate of hematologic toxicity in that previous study, this regimen may not be feasible in real-world clinical applications. Our objective is to conduct a single-arm phase II study to assess the safety and efficacy of FTD/TPI plus ramucirumab combination therapy for gastric cancer after third-line treatment under real-world clinical conditions. This study will recruit 32 patients according to eligibility criteria and administer FTD/TPI (35 mg/m2) and intravenous ramucirumab (8 mg/kg). The primary endpoint will be the time to treatment failure. The secondary endpoints will include the overall survival time, progression-free survival time, overall response rate, disease control rate, relative dose intensity, and incidence of adverse events. The results will add new insights for improving the late-line treatment of advanced gastric cancer.

DOI： 10.18999/nagjms.86.1.43

Risk factors for venous thrombosis after esophagectomy.

Torii N, Miyata K, Fukaya M, Ebata T

Esophagus : official journal of the Japan Esophageal Society 2024年1月

記述言語：英語出版者・発行元：Esophagus

Background: Venous thrombosis (VT) after esophagectomy for esophageal cancer is an important complication, potentially leading to pulmonary embolism. However, there are few available information about the risk for the postsurgical VT. Methods: This study included 271 patients who underwent esophagectomy for esophageal cancer between 2006 and 2019. Contrast-enhanced computed tomography (CT) was performed for all patients on the seventh postoperative day to survey complications, including VT. Results: VT was radiologically visualized in 48 patients (17.7%), 8 of whom (16.7%) had pulmonary embolism. The thrombus disappeared in 42 patients, the thrombus size was unchanged in 5 patients, and 1 patient died. Multivariate analysis was performed on factors clinically considered to have a significant influence on thrombus formation. The analysis showed that CVC insertion via the femoral vein (odds ratio, 7.67; 95% CI, 2.64–22.27; P < 0.001), retrosternal reconstruction route (odds ratio, 3.94; 95% CI, 1.90–8.17; P < 0.001) and intraoperative fluid balance < 5 ml/kg/hr (odds ratio, 0.38; 95% CI, 0.17–0.85; P = 0.019) were independently related to VT. Conclusions: Intraoperative fluid balance < 5 ml/kg/hr, along with CVC insertion via the femoral vein and retrosternal reconstruction may be potential risk factors for VT after esophagectomy.

DOI： 10.1007/s10388-023-01038-4

Docetaxel, cisplatin, and fluorouracil with pegfilgrastim on day 3 as neoadjuvant chemotherapy for esophageal cancer. 国際誌

Maeda O, Furune S, Kanda M, Miyata K, Shimizu D, Sugita S, Nishida K, Ando M, Kodera Y, Ando Y

Cancer medicine 13 巻 ( 2 ) 頁： e6974 2024年1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：Cancer Medicine

Purpose: A high risk of febrile neutropenia (FN) from neoadjuvant chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for esophageal cancer has been reported. The optimal timing of prophylactic use of pegfilgrastim remains to be elucidated. To evaluate the effect of pegfilgrastim administered on day 3, we conducted a feasibility study. Methods: Chemotherapy consisted of intravenous administration of docetaxel (70 mg/m2 per day) and cisplatin (70 mg/m2 per day) on day 1 and continuous infusion of 5-fluorouracil (750 mg/m2 per day) on days 1–5. Pegfilgrastim was given as a single subcutaneous injection at a dose of 3.6 mg on day 3 during each treatment course. This regimen was repeated every 3 weeks for up to a maximum of three courses. Prophylactic antibiotics were not needed but were allowed to be given at the discretion of the physician. The primary endpoint was the incidence of FN. Results: Twenty-six patients were administered DCF in combination with pegfilgrastim on day 3. After the first course of DCF, 10 out of 26 patients (38.5%) experienced grade 4 neutropenia, and two patients (7.7%) experienced FN. Of the 14 patients who did not receive prophylactic antibiotics, four had grade 4 neutropenia, including two who developed FN. On the contrary, of the 12 patients who received prophylactic levofloxacin, six had grade 4 neutropenia, but no cases of FN were observed. Conclusion: Administration of pegfilgrastim on day 3 was not sufficient to prevent FN due to DCF treatment, and prophylactic administration of both pegfilgrastim and antibiotics could be a solution.

DOI： 10.1002/cam4.6974

徐々に適応を拡大したロボット支援胃切除の短期成績

杉田静紀, 田中千恵, 宮田一志, 中西香企, 稲田亘佑, 田根雄一郎, 神田光郎, 清水大, 小寺泰弘, 江畑智希

日本内視鏡外科学会雑誌 28 巻 ( 7 ) 頁： 1969 - 1969 2023年12月

Low Expectancy of Conversion Surgery with R0 Resection in Patients with CEA > 5.0 ng/mL at the Initial RECIST Evaluation for Metastatic Gastric Cancer.

Nakanishi K, Tanaka C, Kanda M, Miyata K, Furukawa K, Maeda O, Shimizu D, Sugita S, Kakushima N, Furune S, Kawashima H, Ando Y, Ebata T, Kodera Y

Cancers 15 巻 ( 21 ) 2023年10月

記述言語：英語出版者・発行元：Cancers

This retrospective study examined early the predictive factors for successful conversion surgery (CS) with R0 resection in patients with metastatic gastric cancer (MGC) who underwent systemic chemotherapy. This study included 204 patients diagnosed with metastatic gastric adenocarcinoma, who received chemotherapy between 2009 and 2019. Of these patients, 31 (15%) underwent CS with R0 resection. The incidence of CS with R0 resection was not affected by the volume of metastatic lesions or the presence of peritoneal metastasis. The overall survival time of the CS with R0 resection group was significantly longer than that of the non-CS group (hazard ratio, 0.12; 95% confidence interval, 0.07–0.23; p < 0.0001), with a 5 year overall survival rate of 50.2%. Multivariate analysis of 150 patients, excluding those with disease progression until the initial Response Evaluation Criteria in Solid Tumors (RECIST) evaluation, showed that carcinoembryonic antigen > 5.0 ng/mL at the initial RECIST evaluation was an independent, significant, and unfavorable predictor of CS with R0 resection (odds ratio, 0.21; p = 0.0108), whereas systemic chemotherapy with trastuzumab for HER2-positive cancer was a favorable factor (odds ratio, 4.20; p = 0.0119). Monitoring serum carcinoembryonic antigen levels during chemotherapy may be a useful predictor of the CS implementation in patients with MGC.

DOI： 10.3390/cancers15215197

A risk scoring system for early diagnosis of anastomotic leakage after subtotal esophagectomy for esophageal cancer. 国際誌

Sugita S, Miyata K, Shimizu D, Ebata T, Yokoyama Y

Japanese journal of clinical oncology 53 巻 ( 10 ) 頁： 936 - 941 2023年10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：Japanese Journal of Clinical Oncology

Background: Anastomotic leakage (AL) is one of the most critical postoperative complications after subtotal esophagectomy in patients with esophageal cancer. This study attempted to develop an optimal scoring system for stratifying the risk for AL. Methods: The study included 171 patients who underwent subtotal esophagectomy for esophageal cancer followed by esophagogastrostomy in the cervical region from January 2011 to April 2021 at Nagoya University Hospital. AL was defined by radiologic or endoscopic evidence of anastomotic breakdown using some modalities. A risk scoring system for an early diagnosis of AL was established using factors determined in the multivariate analysis. A score was calculated for each patient, and the patients were classified into three categories according to the risk for AL: low-, intermediate- and high-risk. The trend of the risk for AL among the categories was evaluated. Results: Twenty-nine patients (17%) developed AL. Multivariate analysis demonstrated that sinistrous gross features of drain fluid (P < 0.001; odds ratio (OR), 10.2), radiologic air bubble sign (P < 0.001; OR, 15.0) and the level of drain amylase ≥280 U/L on postoperative Day 7 (P < 0.001; OR, 9.0) were significantly associated with AL. According to the matching number of the above three risk factors and categorization into three risk groups, the incidence of AL was 6.1% (8/131) in the low-risk group, 45.5% (15/33) in the intermediate-risk group and 85.7% (6/7) in the high-risk group (area under curve, 0.81; 95% confidence interval, 0.72-0.90). Conclusions: The present AL-risk scoring system may be useful in postoperative patient care after subtotal esophagectomy.

DOI： 10.1093/jjco/hyad072

A cell wall-localized cytokinin/purine riboside nucleosidase is involved in apoplastic cytokinin metabolism in Oryza sativa.

Kojima M, Makita N, Miyata K, Yoshino M, Iwase A, Ohashi M, Surjana A, Kudo T, Takeda-Kamiya N, Toyooka K, Miyao A, Hirochika H, Ando T, Shomura A, Yano M, Yamamoto T, Hobo T, Sakakibara H

Proceedings of the National Academy of Sciences of the United States of America 120 巻 ( 36 ) 頁： e2217708120 2023年9月

記述言語：英語出版者・発行元：Proceedings of the National Academy of Sciences of the United States of America

In the final step of cytokinin biosynthesis, the main pathway is the elimination of a ribose-phosphate moiety from the cytokinin nucleotide precursor by phosphoribohydrolase, an enzyme encoded by a gene named LONELY GUY (LOG). This reaction accounts for most of the cytokinin supply needed for regulating plant growth and development. In contrast, the LOG-independent pathway, in which dephosphorylation and deribosylation sequentially occur, is also thought to play a role in cytokinin biosynthesis, but the gene entity and physiological contribution have been elusive. In this study, we profiled the phytohormone content of chromosome segment substitution lines of Oryza sativa and searched for genes affecting the endogenous levels of cytokinin ribosides by quantitative trait loci analysis. Our approach identified a gene encoding an enzyme that catalyzes the deribosylation of cytokinin nucleoside precursors and other purine nucleosides. The cytokinin/purine riboside nucleosidase 1 (CPN1) we identified is a cell wall-localized protein. Loss-of-function mutations (cpn1) were created by inserting a Tos17-retrotransposon that altered the cytokinin composition in seedling shoots and leaf apoplastic fluid. The cpn1 mutation also abolished cytokinin riboside nucleosidase activity in leaf extracts and attenuated the trans-zeatin riboside-responsive expression of cytokinin marker genes. Grain yield of the mutants declined due to altered panicle morphology under field-grown conditions. These results suggest that the cell wall-localized LOG-independent cytokinin activating pathway catalyzed by CPN1 plays a role in cytokinin control of rice growth. Our finding broadens our spatial perspective of the cytokinin metabolic system.

DOI： 10.1073/pnas.2217708120

TUG1-mediated R-loop resolution at microsatellite loci as a prerequisite for cancer cell proliferation.

Suzuki MM, Iijima K, Ogami K, Shinjo K, Murofushi Y, Xie J, Wang X, Kitano Y, Mamiya A, Kibe Y, Nishimura T, Ohka F, Saito R, Sato S, Kobayashi J, Yao R, Miyata K, Kataoka K, Suzuki HI, Kondo Y

Nature communications 14 巻 ( 1 ) 頁： 4521 2023年8月

記述言語：英語出版者・発行元：Nature Communications

Oncogene-induced DNA replication stress (RS) and consequent pathogenic R-loop formation are known to impede S phase progression. Nonetheless, cancer cells continuously proliferate under such high-stressed conditions through incompletely understood mechanisms. Here, we report taurine upregulated gene 1 (TUG1) long noncoding RNA (lncRNA), which is highly expressed in many types of cancers, as an important regulator of intrinsic R-loop in cancer cells. Under RS conditions, TUG1 is rapidly upregulated via activation of the ATR-CHK1 signaling pathway, interacts with RPA and DHX9, and engages in resolving R-loops at certain loci, particularly at the CA repeat microsatellite loci. Depletion of TUG1 leads to overabundant R-loops and enhanced RS, leading to substantial inhibition of tumor growth. Our data reveal a role of TUG1 as molecule important for resolving R-loop accumulation in cancer cells and suggest targeting TUG1 as a potent therapeutic approach for cancer treatment.

DOI： 10.1038/s41467-023-40243-8

A feasibility study of modified docetaxel, cisplatin, and capecitabine for advanced gastric cancer followed by gastrectomy. 国際誌

Liang Y, Maeda O, Miyata K, Tanaka C, Kanda M, Shimizu D, Fukaya M, Koike M, Kodera Y, Ando Y

Asia-Pacific journal of clinical oncology 2023年7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：Asia-Pacific Journal of Clinical Oncology

Aims: To explore the feasibility of modified docetaxel, cisplatin, and capecitabine (mDCX) chemotherapy with a lower dose of docetaxel than previously reported for stage III resectable gastric cancer patients with a high risk of recurrence or for stage IV gastric cancer patients aiming for conversion surgery. Methods: Patients with stage III resectable HER2-negative gastric cancer with large type 3 or type 4 tumors or extensive lymph node metastasis (bulky N or cN3) and those who had stage IV HER2-negative gastric cancer with distant metastasis were enrolled to receive 30 mg/m2 docetaxel and 60 mg/m2 cisplatin on day 1, followed by 2000 mg/m2 capecitabine per day for 2 weeks every 3 weeks. Results: Five patients with stage III gastric cancer with a high risk of recurrence received three courses of mDCX, and four patients with stage IV gastric cancer received three or four courses of mDCX. In terms of grade 3 or worse adverse events, leukopenia was observed in one (11%) patient, neutropenia in two (22%) patients, anemia in one (11%) patient, anorexia in two (22%) patients and nausea in two (22%) patients. All six patients with measurable lesions achieved a partial response. All nine patients underwent subsequent surgeries. The histological responses of the nine patients revealed grade 3 in one (11%) patient, grade 2 in five (56%) patients, and grade 1a in three (33%) patients. Three of the nine patients survived without recurrence, and two of them survived for more than four years. Conclusions: mDCX seems to be feasible and may be helpful as neoadjuvant chemotherapy for patients at high risk of recurrence or as chemotherapy for patients who are likely to undergo conversion surgery.

DOI： 10.1111/ajco.13995

【上部】【Challenges beyond borders】高度進行胃癌に対するconversion surgeryの現状と新たな治療戦略高齢者における治癒切除不能胃癌に対するconversion surgeryの治療成績

中西香企, 田中千恵, 神田光郎, 宮田一志, 清水大, 杉田静紀, 藤原道隆, 江畑智希, 小寺泰弘

日本消化器外科学会総会 78回巻頁： PD3 - 9 2023年7月

病理学的T3N0,T1N2,3を含むpStageII胃癌の治療成績の検討

杉田静紀, 宮田一志, 田中千恵, 中西香企, 清水大輔, 小倉淳司, 村田悠記, 水野隆史, 小寺泰弘, 江畑智希

日本消化器外科学会総会 78回巻頁： P062 - 3 2023年7月

免疫チェックポイント阻害薬治療後に病理学的完全奏効が確認できた高頻度マイクロサテライト不安定性大腸癌限局性腹壁再発の1切除例

西村元伸, 上原圭, 小倉淳司, 村田悠記, 小林龍太朗, 水野隆史, 宮田一志, 横山幸浩, 江畑智希

日本消化器外科学会雑誌 56 巻 ( 4 ) 頁： 221 - 228 2023年4月

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>近年，高頻度マイクロサテライト不安定性（microsatellite instability-high；以下，MSI-Hと略記）切除不能大腸癌に対し，免疫チェックポイント阻害薬（immune checkpoint inhibitors；以下，ICIと略記）使用が推奨されている．今回，ICI投与後に根治切除を行ったborderline resectableの1例を経験したため報告する．S状結腸癌術後1年，前医で左下腹壁に浸潤する限局性腹壁再発を指摘された．RAS/BRAF野生型であり，一次治療としてFOLFIRI+panitumumabを施行し，縮小を認めたため切除の可能性を求めて当科を受診した．MSI-Hを呈しており，さらなる病勢制御のためにipilimumab+nivolumab併用療法を導入した．中間画像評価では5%の増大を示したため，3コースで終了し根治手術（腹壁腫瘍切除+リンパ節郭清+大腿筋膜腹壁再建）を施行した．病理結果は完全奏効で，術後補助療法は施行せず，無再発経過観察中である．</p>

DOI： 10.5833/jjgs.2022.0056

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

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 - 34 2023年4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：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

治癒切除不能胃癌におけるconversion surgery対象選択の客観的指標とはなにか?

中西香企, 田中千恵, 神田光郎, 宮田一志, 清水大, 杉田静紀, 藤原道隆, 江畑智希, 小寺泰弘

日本外科学会定期学術集会抄録集 123回巻頁： SF - 5 2023年4月

Risk Factors for Muscle Loss During Neoadjuvant Therapy for Esophageal Cancer. 国際誌

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

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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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 CDBSB groups was lower than Control groups. Ki67-positive cells in CD-BSB treated group were lower than the GEMtreated groups. Conclusion: We clarified the efficiency of CDBSB 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

Antitumor Effects of Deep Ultraviolet Irradiation for Pancreatic Cancer. 国際誌

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

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

Cureus 15 巻 ( 1 ) 頁： e33411 2023年1月

Proposal for Shape Memory Alloy Positioning Actuator using Electric Parameter Based Controller

Miyata K., Kawazoe Y., Hara S.

IEEJ Journal of Industry Applications 12 巻 ( 2 ) 頁： 153 - 154 2023年

出版者・発行元：IEEJ Journal of Industry Applications

This paper proposes the controller design for a shape memory alloy (SMA) positioning actuator system. The system utilizes spiral-formed SMA wire as the driving power source. SMA generates force via temperature-based crystalline phase transitions. The wire is deformed in the spiral form under low temperature and heated by applying direct current, it recovers to the original form and generates the recovering force, which rotates the attached load. This paper proposes using the electric resistance of the SMA, which is related to its crystalline phase status, for designing the controller of the actuator system. The feasibility of the proposed system and controller design are evaluated experimentally with a sample test device, manufactured using a 3D printer, and the device achieves the designed rotation.

DOI： 10.1541/ieejjia.L22000583

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

【本邦の大腸癌治療の現状と展望-海外における標準治療と比較して】局所再発に対する治療選択と実践

上原圭, 小倉淳司, 村田悠記, 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

日本外科学会雑誌 123 巻 ( 3 ) 頁： 255 - 261 2022年5月

【本邦の大腸癌治療の現状と展望-海外における標準治療と比較して】局所再発に対する治療選択と実践

上原圭, 小倉淳司, 村田悠記, 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

日本外科学会雑誌 123 巻 ( 3 ) 頁： 255 - 261 2022年5月

記述言語：日本語出版者・発行元：(一社)日本外科学会

局所再発直腸癌に対する治療戦略はその病態の不均一性から治療は個々の症例に応じて選択すべきである.そのためには,手術技術を磨くことは当然のことであるが,近年発達著しい集学的治療の知識を身に着け,経験を積むことが必要不可欠である.性質上,無作為化比較試験からの情報を得ることが難しく,多くがセンター施設での経験に基づく指針ではあるが,本稿では,本邦および海外での局所再発直腸癌治療の現状と展望を述べる.(著者抄録)

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

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

切除可能同時性肝転移症例の治療戦略肝実質温存術式の有用性

三品拓也, 水野隆史, 上原圭, 小倉淳司, 村田悠記, 小池佳勇, 神原祐一, 西村元伸, 小林龍太朗, 服部憲史, 中山吾郎, 國料俊男, 伊神剛, 山口淳平, 宮田一志, 尾上俊介, 砂川真輝, 渡辺伸元, 横山幸浩, 江畑智希

日本外科学会定期学術集会抄録集 122回巻頁： SF - 7 2022年4月

悪性転化した仙尾部奇形腫の2例

西村元伸, 上原圭, 小倉淳司, 村田悠記, 三品拓也, 小池佳勇, 神原祐一, 小林龍太朗, 神野孝徳, 國料俊男, 伊神剛, 水野隆史, 山口淳平, 宮田一志, 尾上俊介, 砂川真輝, 渡辺伸元, 杉田静紀, 横山幸浩, 江畑智希

日本外科学会定期学術集会抄録集 122回巻頁： DP - 8 2022年4月

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

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. 国際誌

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 - 100853 2021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：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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

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

[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

Liver、Pancreas、Biliary Tract Cancer 肝・胆・膵癌再発肝胆膵がんへの新たな挑戦 II.胆管癌切除後再発への治療方針

渡辺伸元, 横山幸浩, 伊神剛, 上原圭, 水野隆史, 山口淳平, 宮田一志, 尾上俊介, 小倉淳司, 江畑智希

癌と化学療法 48 巻 ( 10 ) 頁： 1223 - 1226 2021年10月

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

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

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

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

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

記述言語：日本語出版者・発行元：金原出版(株)

症例は60歳代男性で、下咽頭癌術後7年の上部消化管内視鏡検査で中咽頭癌と胸部上部表在食道癌が指摘された。中咽頭癌に対するELPS(endoscopic laryngopharyngeal surgery)を先行し、その後、食道癌に対するESD(endoscopic submucosal dissection)を予定した。下咽頭癌に対する手術時、術後に永久気管孔壊死と皮弁壊死を繰り返し、右DP(deltopectoral)皮弁再建、さらに左DP皮弁再建が追加された。気管血流を温存することに配慮して術式を立案した。気管支動脈、奇静脈弓のほか、伴走する右気管支動脈の上行枝と下行枝を温存し、大動脈弓から直接分岐する左気管枝動脈も温存し、気管分岐部の郭清を省略した。さらに、腹腔鏡用手補助下胃管を作製、後縦隔経路で胃管を挙上した。頸部は皮弁からの気管孔血流を温存するため、左DP皮弁外縁で切開、遊離空腸-食道吻合部で離断し、残食道を全摘した。その後、吻合部狭窄に対しバルーン拡張を、嚥下機能低下に対し嚥下訓練を行い、術後101日から食事を開始し術後138日に退院した。

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00620&link_issn=&doc_id=20210428180019&doc_link_id=10.18888%2Fop.0000002217&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fop.0000002217&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

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

Miyata K, Fukaya M, Nagino M

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

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

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

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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

記述言語：英語掲載種別：研究論文（学術雑誌）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

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

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

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

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

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

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

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

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

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

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

記述言語：日本語出版者・発行元：(一社)日本外科感染症学会

【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。(著者抄録)

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2018&ichushi_jid=J04188&link_issn=&doc_id=20180925370001&doc_link_id=%2Fdg9srgif%2F2018%2F001503%2F001%2F0201-0208%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg9srgif%2F2018%2F001503%2F001%2F0201-0208%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

Tsuboi T., Watanabe H., Funasaka K., Takebayashi M., Miyata K., Katsuno M.

Neurology and Clinical Neuroscience 6 巻 ( 2 ) 頁： 64 - 66 2018年3月

出版者・発行元：Neurology and Clinical Neuroscience

A 58-year-old man with Parkinson's disease experienced peritonitis after percutaneous endoscopic gastrojejunostomy (PEG-J) for levodopa–carbidopa intestinal gel treatment despite concomitant use of gastropexy. Although gastropexy reduces complications including peritonitis, clinicians should consider structural characteristics of PEG-J devices and patients’ anatomical differences. We recommend that suture threads are removed 2–4 weeks after PEG-J and that the PEG-J tube length outside the body is routinely recorded to assess tube dislocation.

DOI： 10.1111/ncn3.12183

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

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

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

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

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

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

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

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

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

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

腹腔内を占拠する婦人科系巨大腫瘍に対して切除手術を施行した3例

神谷忠宏, 上原圭介, 向井俊貴, 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, 水野隆史, 山口淳平, 宮田一志, 梛野正人

日本臨床外科学会雑誌 78 巻 ( 2 ) 頁： 410 - 411 2017年2月

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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