2023/12/01 更新

写真a

ワタナベ ノブユキ
渡辺 伸元
WATANABE Nobuyuki
所属
医学部附属病院 消化器・腫瘍外科(肝胆膵) 病院講師
職名
病院講師
外部リンク

学位 1

  1. 医学博士 ( 2017年9月   名古屋大学 ) 

研究分野 1

  1. ライフサイエンス / 消化器外科学

学歴 1

  1. 名古屋大学

    2000年4月 - 2006年3月

 

論文 42

  1. A proposal of drain removal criteria in hepatobiliary resection 査読有り 国際誌

    Watanabe Nobuyuki, Mizuno Takashi, Yamaguchi Junpei, Yokoyama Yukihiro, Igami Tsuyoshi, Onoe Shunsuke, Uehara Kay, Sunagawa Masaki, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   29 巻 ( 9 ) 頁: 974 - 982   2022年9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)   出版者・発行元:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: Standardized criteria for drain removal in hepatobiliary resection are lacking. Here, we evaluated the outcomes of delayed removal policy in this extended surgery. Methods: Patients undergoing hepatectomy with biliary reconstruction between 2012 and 2018 were retrospectively reviewed. The drains were removed on postoperative day (POD) 7 when the drainage fluid was grossly serous, biochemically normal, and negative for bacterial contamination as assessed by Gram staining; additionally, no abnormal fluid collection was confirmed by computed tomography. Clinically relevant abdominal complications (CRACs), including biliary leakage, pancreatic fistula or intra-abdominal abscess, served as the primary outcome measure. Results: Among 374 study patients, surgical drains were removed in 166 (44.3%) patients who met the criteria. Of these patients, 16 (9.6%) patients subsequently required additional drainage due to CRAC. Drains were retained and exchanged in 208 (55.6%) patients who did not meet the criteria. Of these, exchanged drains were soon removed in 34 patients due to no signs of CRAC. The diagnostic ability of the criteria revealed 0.916 sensitivity, 0.815 specificity, and 0.866 accuracy. Conclusion: The four findings on POD 7 worked well as criteria for drain removal, and these criteria may be helpful in drain management after hepatobiliary resection.

    DOI: 10.1002/jhbp.1194

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  2. The Impact of Stump Closure Techniques on Pancreatic Fistula Stratified by the Thickness of the Pancreas in Distal Pancreatectomy. 査読有り 国際誌

    Watanabe N, Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R, Uesaka K

    Digestive surgery   37 巻 ( 4 ) 頁: 340 - 347   2020年

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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: 10.1159/000505061

    PubMed

  3. Postoperative Pancreatic Fistula in Surgery for Perihilar Cholangiocarcinoma 査読有り 国際誌

    Watanabe Nobuyuki, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Nagino Masato

    WORLD JOURNAL OF SURGERY   43 巻 ( 12 ) 頁: 3094 - 3100   2019年12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)   出版者・発行元:World Journal of Surgery  

    DOI: 10.1007/s00268-019-05127-3

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  4. A predictive scoring system for insufficient liver hypertrophy after preoperative portal vein embolization. 査読有り 国際誌

    Watanabe N, Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R, Aramaki T, Uesaka K

    Surgery   163 巻 ( 5 ) 頁: 1014 - 1019   2018年5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: 10.1016/j.surg.2017.11.026

    PubMed

  5. 医原性肝門部胆管狭窄を伴う神経内分泌腫瘍残肝再発に対し肝中央二区域・尾状葉切除+肝内胆管空腸吻合を行った1例 査読有り

    中島 悠, 水野 隆史, 尾上 俊介, 渡辺 伸元, 川勝 章司, 山口 淳平, 砂川 真輝, 横山 幸浩, 伊神 剛, 江畑 智希

    胆道   37 巻 ( 1 ) 頁: 108 - 115   2023年3月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本胆道学会  

    <p>症例は78歳男性.前医で直腸神経内分泌腫瘍(G1)異時性肝転移に対し肝左内側区域部分切除を施行.術中の胆道損傷による医原性肝門部胆管閉塞に対し総胆管―右肝管磁石圧迫吻合(山内法)が施行された.肝切除44カ月後に胆管再狭窄及び残肝再発を指摘され当科紹介.腹部造影CTで肝門部近傍の左内側区域/尾状葉に13mm大の腫瘤を認め,胆道造影では左右肝管合流部に高度狭窄を認めた.転移性肝腫瘍および医原性胆管狭窄の再燃と診断し,肝中央二区域尾状葉切除+胆道再建にて双方の治療を企図した.安全性を考慮し狭窄して肝門部胆管を温存し肝切除を施行した後,左外側下枝と右後区域枝を術前に挿入したカテーテルを目印に同定し,それぞれに胆管空腸側々吻合を行った.複雑な良性胆道狭窄を伴う肝転移再々発例に対し,肝門部血管損傷を回避しつつ腫瘍切除と胆道再建を一期的に施行し得た症例を経験したので文献的考察を含めて報告する.</p>

    DOI: 10.11210/tando.37.108

    CiNii Research

  6. Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean-Japanese joint cohort and the SEER database 査読有り 国際誌

    Kwon Wooil, Heo Jin Seok, Han In Woong, Kang Chang Moo, Hwang Ho Kyoung, Kim Song Cheol, Park Sang-Jae, Yoon Yoo-Seok, Kim Yong Hoon, Lim Chang-Sup, Lee Seung Yeoun, Park Taesung, Takami Hideki, Watanabe Nobuyuki, Shimizu Yasuhiro, Okuno Masataka, Yamaue Hiroki, Kawai Manabu, Seiko Hirono, Nagakawa Yuichi, Osakabe Hiroaki, Sugiura Teiichi, Toyama Hirochika, Ohtsuka Masayuki, Unno Michiaki, Endo Itaru, Kitago Minoru, Jang Jin-Young

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES     2023年3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:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background/Purpose: Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition. Method: Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database. Results: The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p <.001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database. Conclusion: Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.

    DOI: 10.1002/jhbp.1316

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  7. Impact of skeletal muscle mass on the prognosis of patients undergoing neoadjuvant chemotherapy for resectable or borderline resectable pancreatic cancer 査読有り 国際誌

    Nakajima Hiroki, Yamaguchi Junpei, Takami Hideki, Hayashi Masamichi, Kodera Yasuhiro, Nishida Yoshihiro, Watanabe Nobuyuki, Onoe Shunsuke, Mizuno Takashi, Yokoyama Yukihiro, Ebata Tomoki

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY     2023年3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:International Journal of Clinical Oncology  

    Background: Neoadjuvant chemotherapy is a common therapeutic procedure for patients with pancreatic cancer. This study aimed to investigate the association between the total psoas area (TPA) and prognosis in patients undergoing neoadjuvant chemotherapy for resectable or borderline resectable pancreatic cancer. Study design: This retrospective study included patients who underwent neoadjuvant chemotherapy for pancreatic cancer. TPA was measured at the level of the L3 vertebra using computed tomography. The patients were divided into low-TPA and normal-TPA groups. These dichotomizations were separately performed in patients with resectable and those with borderline resectable pancreatic cancer. Results: In total, 44 patients had resectable pancreatic cancer and 71 patients had borderline resectable pancreatic cancer. Overall survival among patients with resectable pancreatic cancer did not differ between the normal- and low-TPA groups (median, 19.8 vs. 21.8 months, p = 0.447), whereas among patients with borderline resectable pancreatic cancer, the low-TPA group had shorter overall survival than the normal-TPA group (median, 21.8 vs. 32.9 months, p = 0.006). Among patients with borderline resectable pancreatic cancer, the low-TPA group was predictive of poor overall survival (adjusted hazard ratio, 2.57, p = 0.037). Conclusion: Low TPA is a risk factor of poor survival in patients undergoing neoadjuvant chemotherapy for borderline resectable pancreatic cancer. TPA evaluation could potentially suggest the treatment strategy in this disease.

    DOI: 10.1007/s10147-023-02321-1

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  8. Cyclodextrin Conjugated alpha-Bisabolol Suppresses FAK Phosphorylation and Induces Apoptosis in Pancreatic Cancer 査読有り 国際誌

    Kano Mikiko takebayashi, Kokuryo Toshio, Baba Taisuke, Yamazaki Kimitoshi, Yamaguchi Junpei, Sunagawa Masaki, Ogura Atsushi, Watanabe Nobuyuki, Onoe Shunsuke, Miyata Kazushi, Mizuno Takashi, Uehara Kay, Igami Tsuyoshi, Yokoyama Yukihiro, Ebata Tomoki, Nagino Masato

    ANTICANCER RESEARCH   43 巻 ( 3 ) 頁: 1009 - 1016   2023年3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: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

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  9. 特集 血管再建を伴う高難度肝胆膵外科手術 6.肝門部領域胆管癌に対する肝動脈合併切除再建を伴う左側肝切除

    尾上 俊介, 水野 隆史, 渡辺 伸元, 川勝 章司, 横山 幸浩, 伊神 剛, 山口 淳平, 砂川 真輝, 馬場 泰輔, 江畑 智希

    外科   85 巻 ( 2 ) 頁: 145 - 154   2023年2月

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    記述言語:日本語   出版者・発行元:南江堂  

    DOI: 10.15106/j_geka85_145

    CiNii Research

  10. Impact of preoperative muscle mass and quality on surgical outcomes in patients undergoing major hepatectomy for perihilar cholangiocarcinoma 査読有り 国際誌

    Asai Yuichi, Yamaguchi Junpei, Mizuno Takashi, Onoe Shunsuke, Watanabe Nobuyuki, Igami Tsuyoshi, Uehara Kay, Yokoyama Yukihiro, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   30 巻 ( 2 ) 頁: 202 - 211   2023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:Journal of Hepato-Biliary-Pancreatic Sciences  

    Purposes: This study sought to define the impact of skeletal muscle mass and quality on postoperative outcomes in patients with perihilar cholangiocarcinoma. Methods: Patients who underwent major hepatectomy for perihilar cholangiocarcinoma were included. The normalized total psoas area (TPA) (psoas muscle index [PMI]) and average Hounsfield units of the TPA (psoas muscle density [PMD]) were measured using preoperative computed tomography images. The cohort was dichotomized using the following indices: sex-specific lowest tertile (low PMI and low PMD) and other (normal PMI and normal PMD). Intraoperative and postoperative outcomes were compared, focusing on PMI and PMD. Results: A total of 456 patients were analyzed. The intraoperative blood loss (IBL) was 21.3 ml/kg in the low PMI group and 17.2 ml/kg in the normal PMI group (P =.008). Patients in the low PMI or PMD group experienced postoperative infectious complications more frequently than those in the other groups. The median survival time was 37.8 months in the low PMI group and 54.2 months in the normal PMI group (P =.027). Conclusions: PMI and PMD were closely associated with IBL and postoperative infectious complications. Additionally, PMI impacted long-term survival. These results suggest an importance of improving muscle mass and quality before surgery.

    DOI: 10.1002/jhbp.1220

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  11. Antitumor Effects of Deep Ultraviolet Irradiation for Pancreatic Cancer. 査読有り 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

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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: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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  12. Is a specific T classification needed for extrahepatic intraductal papillary neoplasm of the bile duct (IPNB) type 2 associated with invasive carcinoma? 査読有り 国際誌

    Mitake Yasuhiro, Onoe Shunsuke, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Sunagawa Masaki, Watanabe Nobuyuki, Kawakatsu Shoji, Shimoyama Yoshie, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES     2022年11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:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: The necessity of a specific T classification for extrahepatic intraductal papillary neoplasm of the bile duct (IPNB) type 2, one of the precursors of cholangiocarcinoma (CC), remains unclear. Methods: Patients who underwent resection for extrahepatic biliary tumors were reviewed. Relapse-free survival (RFS) was compared between IPNB type 2 and CC, stratified by T classification. Results: The cohort involved 443 patients with IPNB type 2 (n = 57) and CC (n = 386). In 342 patients with perihilar tumors, 5-year RFS of IPNB type 2 and CC group was 49.8% versus 34.5% (p =.012), respectively. The RFS was 54.6% versus 47.2% (p =.110) for pT1-2 tumors and 28.6% versus 22.7% (p =.436) for pT3-4 tumors, respectively. In 92 patients with distal tumors, 5-year RFS was 47.4% versus 42.1% (p =.678). The RFS was 68.2% versus 49.6% (p =.422) for pT1 tumors and 18.8% versus 38.3% (p =.626) for pT2-3 tumors, respectively. Multivariate analysis identified that poor histologic grade (HR, 2.105; p <.001), microscopic venous invasion (HR, 1.568; p =.002), and nodal metastasis (HR, 1.547; p <.001) were independent prognostic deteriorators, while tumor type (IPNB type 2 vs. CC) was not. Conclusions: Prognostic impact of IPNB type 2 was limited, suggesting unnecessity of a specific T classification for IPNB type 2 with invasive carcinoma.

    DOI: 10.1002/jhbp.1269

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  13. 手術手技 肝外胆管癌に対する肝門部胆管高位切除─肝切除を避けるために

    尾上 俊介, 水野 隆史, 渡辺 伸元, 川勝 章司, 伊神 剛, 江畑 智希

    手術   76 巻 ( 11 ) 頁: 1729 - 1734   2022年10月

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    記述言語:日本語   掲載種別:論文集(書籍)内論文   出版者・発行元:金原出版  

    DOI: 10.18888/op.0000003012

    CiNii Research

  14. 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

  15. 特集 Borderline resectableとは? II. 各論 8.肝門部領域胆管癌におけるborderline resectableとは?

    水野 隆史, 尾上 俊介, 渡辺 伸元, 山口 淳平, 砂川 正輝, 上原 圭, 江畑 智希

    外科   84 巻 ( 6 ) 頁: 670 - 678   2022年5月

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    出版者・発行元:南江堂  

    DOI: 10.15106/j_geka84_670

    CiNii Research

  16. 特集 高難度肝胆膵外科手術アトラス2022 Ⅱ 各論 B 胆道 3 血管合併切除を伴う胆道癌手術

    水野 隆史, 尾上 俊介, 渡辺 伸元, 江畑 智希

    手術   76 巻 ( 4 ) 頁: 561 - 569   2022年4月

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    出版者・発行元:金原出版  

    DOI: 10.18888/op.0000002718

    CiNii Research

  17. 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  

    DOI: 10.5833/jjgs.2021.0083

    CiNii Research

  18. 第1回 拡大切除術式,周術期管理,周術期薬物療法,minimum invasive surgeryによる胆道癌外科治療の進歩

    水野 隆史, 尾上 俊介, 渡辺 伸元, 伊神 剛, 横山 幸浩, 江畑 智希

    胆道   36 巻 ( 1 ) 頁: 66 - 76   2022年3月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本胆道学会  

    DOI: 10.11210/tando.36.66

    CiNii Research

  19. 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

  20. A long-term survivor of advanced retroperitoneal dedifferentiated liposarcoma: a successful multimodal approach with extended resection and chemotherapy 査読有り

    Nakahashi Koichi, Yokoyama Yukihiro, Fukaya Masahide, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Ebata Tomoki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   84 巻 ( 1 ) 頁: 200 - 207   2022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:Nagoya Journal of Medical Science  

    Surgical resection is the mainstay of treatment for retroperitoneal liposarcoma (RPLS). Herein, we describe a case of dedifferentiated RPLS successfully treated with an extended surgical approach with adjuvant chemotherapy. A 61-year-old male was referred to our hospital with a chief complaint of chest tightness. Abdominal computed tomography revealed a large retroperitoneal tumor, 11 cm in diameter, extensively invading the surrounding organs: the celiac axis, the splenic artery, the pancreatic body and tail, the lesser curvature of the stomach and the left adrenal gland. Endoscopic ultrasound-guided fine-needle aspiration biopsy confirmed dedifferentiated liposarcoma, suggesting aggressive tumor biology. We performed total gastrectomy combined with distal pancreatectomy with celiac axis and left adrenal gland resection with a curative intent. The postoperative course was almost uneventful. As the pathological findings indicated a positive margin with a well-differentiated liposarcoma component, we added adjuvant chemotherapy with four cycles of doxorubicin and ifosfamide (AI). Five years after primary surgery, regular follow-up CT demonstrated a pulmonary hilar lymph node enlargement and a tumor at paraesophageal locations. After downsizing chemotherapy with eribulin followed by pazopanib, he underwent partial esophagectomy with dissection of the paraesophageal tumor. The pathological findings indicated recurrence of dedifferentiated liposarcoma with a tumor-free surgical margin. He is currently alive without any evidence of recurrence almost 7 years after the first surgery and 15 months after the second surgery. The long-term survival gained in this patient indicates that extended resections and adjuvant chemotherapy could prolong survival in patients even with RPLS with dedifferentiated tumor histology

    DOI: 10.18999/nagjms.84.1.200

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  21. Combined Vascular Resection for Locally Advanced Perihilar Cholangiocarcinoma 査読有り

    Mizuno Takashi, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Kamei Yuzuru, Nagino Masato

    ANNALS OF SURGERY   275 巻 ( 2 ) 頁: 382 - 390   2022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:Annals of Surgery  

    Objective:To evaluate the efficacy and safety of combined vascular resection (VR) in advanced perihilar cholangiocarcinoma (PHC).Summary of Background Data:Hepatectomy combined with portal vein resection (PVR) and/or hepatic artery resection (HAR) is technically demanding but an option only for tumor eradication against PHC involving the hilar hepatic inflow vessels; however, its efficacy and safety have not been well evaluated.Methods:Patients diagnosed with PHC during 2001-2018 were included. Patients who underwent resection were divided according to combined VR. Patients undergoing VR were subdivided according to type of VR. Postoperative outcomes and OS were compared between patient groups.Results:Among the 1055 consecutive patients, 787 (75%) underwent resection (without VR: N = 484, PVR: N = 157, HAR: N = 146). The incidences of postoperative complications and mortality were 49% (without VR vs with VR, 48% vs 50%; P= 0.715) and 2.1% (without VR vs with VR, 1.2% vs 3.6%; P= 0.040), respectively. The OS of patients who underwent resection with VR (median, 30 months) was shorter than that of those who underwent resection without VR (median, 61 months; P < 0.0001); however, it was longer than that of those who did not undergo resection (median, 10 months; P < 0.0001). OS was not significantly different between those who underwent PVR and those who underwent HAR (median, 29 months vs 34 months; P = 0.517).Conclusion:VR salvages a large number of patients from having locally advanced PHC that is otherwise unresectable and is recommended if the hilar hepatic inflow vessels are reconstructable, providing acceptable surgical outcomes and substantial survival benefits.

    DOI: 10.1097/SLA.0000000000004322

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  22. Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma 国際誌

    Yamada Mihoko, Mizuno Takashi, Yamaguchi Junpei, Yokoyama Yukihiro, Igami Tsuyoshi, Onoe Shunsuke, Watanabe Nobuyuki, Uehara Kay, Matsuo Keitaro, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES     2021年11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:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma. Methods: Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter-based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell’s concordance index (C-index). Results: Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P <.001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P =.002, cT2 vs cT3; P =.008 and cT3 vs cT4; P <.001). The AJCC system had the largest C-index of 0.627. Conclusions: The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.

    DOI: 10.1002/jhbp.1066

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  23. 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

  24. Efficacy of Extended Modification in Left Hemihepatectomy for Advanced Perihilar Cholangiocarcinoma: Comparison Between H12345'8'-B-MHV and H1234-B.

    Otsuka S, Mizuno T, Yamaguchi J, Onoe S, Watanabe N, Shimoyama Y, Igami T, Uehara K, Yokoyama Y, Nagino M, Ebata T

    Annals of surgery     2021年10月

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    記述言語:英語  

    DOI: 10.1097/SLA.0000000000005248

    PubMed

  25. 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 &amp; chemotherapy   48 巻 ( 10 ) 頁: 1223 - 1226   2021年10月

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    担当区分:筆頭著者   記述言語:日本語   掲載種別:論文集(書籍)内論文   出版者・発行元:Gan to kagaku ryoho. Cancer &amp; chemotherapy  

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  26. [Ⅱ.Treatment for Recurrent Cholangiocarcinoma]. 招待有り

    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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    担当区分:筆頭著者   記述言語:日本語   掲載種別:論文集(書籍)内論文  

    PubMed

  27. A clinicopathological reappraisal of intraductal papillary neoplasm of the bile duct (IPNB): a continuous spectrum with papillary cholangiocarcinoma in 181 curatively resected cases 国際誌

    Onoe Shunsuke, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Watanabe Nobuyuki, Otsuka Shinpei, Nakamura Shigeo, Shimoyama Yoshie, Nagino Masato

    HPB   23 巻 ( 10 ) 頁: 1525 - 1532   2021年10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:HPB  

    Background: Intraductal papillary neoplasm of the bile-duct (IPNB) has recently been further subclassified into “so-called IPNBs” (Type-1) and “narrow-sense papillary cholangiocarcinomas” (Type-2), but their differential diagnosis is challenging. This study aimed to reevaluate Type-1 and Type-2 IPNBs. Methods: Consecutive patients who underwent papillary bile-duct tumor resection were included. Using six pathological features (location, mucin secretion, histological architecture, histological type, presence of a low/intermediate-dysplasia component, and proportion of the invasive component), all papillary tumors were scored. Tumors scoring 5–6 were classified as Type-1, 0–1 as Type-2, and 2–4 as Type-Unclassifiable. Results: The 181 papillary bile-duct tumor patients were divided into three groups, consisting of 12 Type-1, 46 Type-2, and 123 Type-Unclassifiable—gray-zone lesions between Type-1 and Type-2 that constituted the largest proportion of papillary tumors. Type-1 tumors were pathologically the least advanced, while the other types showed gradual advancement. The 5-year survival rate was better for patients with Type-1 tumors than for those with Type-Unclassifiable or Type-2 tumors. Conclusion: The scoring system worked well to delineate a continuous spectrum of pathologic features ranging from Type-1, through Type-Unclassifiable, to Type-2, the latter two being challenging to differentially diagnose. Type-1 is regarded as an early neoplasm of Type-Unclassifiable and Type-2.

    DOI: 10.1016/j.hpb.2021.03.004

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  28. Adjuvant S-1 vs gemcitabine for node-positive perihilar cholangiocarcinoma: A propensity score-adjusted analysis

    Takahashi Daigoro, Mizuno Takashi, Yokoyama Yukihiro, Igami Tsuyoshi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Maeda Osamu, Ando Masahiko, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   28 巻 ( 9 ) 頁: 716 - 726   2021年9月

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    記述言語:日本語   出版者・発行元:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: The efficacy of adjuvant chemotherapy for biliary cancers remains controversial because of conflicting results from previous phase 3 studies that used different key drugs and enrolled patients with heterogeneous tumor sites and disease stages. Fluoropyrimidine seems more beneficial than gemcitabine (GEM) combination regimens in the adjuvant setting; however, data comparing the survival benefit between GEM- and fluoropyrimidine-based regimens are lacking. Methods: Patients who underwent resection for node-positive perihilar cholangiocarcinoma were included. The patients who underwent adjuvant chemotherapy were divided into the S-1 and GEM groups according to the regimen. The recurrence-free survival (RFS) and the overall survival (OS) were compared between the groups and adjusted with propensity scores generated from 14 potentially confounding clinicopathological factors. Results: In total, 186 patients (Surgery alone, n = 71; S-1, n = 60; GEM, n = 55) were included. The S-1 and GEM completion rates were 75% and 65%, respectively. Among the patients who underwent adjuvant therapy, the RFS was longer in the S-1 group patients than the GEM group patients (median, 24.4 months vs 14.9 months; P =.044) whereas the OS was not significantly different between the groups (median, 48.5 months vs 35.0 months; P =.324). After propensity score adjustment, the differences in RFS and OS between the groups were more evident (HR: 2.696, 95% CI: 1.739-4.180 P <.001; HR: 1.988, 95% CI: 1.221-3.238, P <.001, respectively). Conclusions: Compared with adjuvant GEM monotherapy, adjuvant S-1 monotherapy may improve survival in node-positive perihilar cholangiocarcinoma patients.

    DOI: 10.1002/jhbp.1005

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  29. Early Prediction of a Serious Postoperative Course in Perihilar Cholangiocarcinoma: Trajectory Analysis of the Comprehensive Complication Index. 査読有り 国際誌

    Kawakatsu S, Yamaguchi J, Mizuno T, Watanabe N, Onoe S, Igami T, Yokoyama Y, Uehara K, Nagino M, Matsuo K, Ebata T

    Annals of surgery     2021年8月

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    記述言語:英語  

    DOI: 10.1097/SLA.0000000000005162

    PubMed

  30. 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

  31. Hepatopancreatoduodenectomy with simultaneous resection of the portal vein and hepatic artery for locally advanced cholangiocarcinoma: Short- and long-term outcomes of superextended surgery 査読有り

    Nagino Masato, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   28 巻 ( 4 ) 頁: 376 - 386   2021年4月

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    記述言語:英語   出版者・発行元:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: Only a few authors have reported negative results for hepatopancreatoduodenectomy (HPD) with simultaneous resection of the portal vein and hepatic artery in a limited number of patients. The aim of the current study was to outline our experience with this superextended surgery and to discuss its clinical value. Methods: Medical records of consecutive patients who underwent resection of perihilar cholangiocarcinoma between 2007 and 2020 were retrospectively reviewed. Results: During the study interval, 650 patients with perihilar cholangiocarcinoma underwent resection. The superextended surgery was performed in only nine (1.4%) patients. Left or right trisectionectomy was primarily performed. For portal vein reconstruction, external iliac vein graft was required in seven patients. For hepatic artery reconstruction, rotating left gastric artery was often used. The median operative time was 870 minutes and blood loss was 2,598 mL. Postoperatively, pancreatic fistula and liver failure occurred in all patients, followed by intraabdominal abscess (n = 8), and bacteremia (n = 4). One patient died on day 86 due to multiple organ failure. Two patients survived for more than 7 years. Conclusions: HPD with simultaneous resection of the portal vein and hepatic artery is demanding but worth performing as the last option, with careful patient selection in experienced centers.

    DOI: 10.1002/jhbp.914

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  32. 特集 肝胆膵外科における再切除と再手術─最新の治療戦略 肝外胆管切除後の胆管癌再発に対する再切除

    渡辺 伸元, 江畑 智希

    手術   75 巻 ( 3 ) 頁: 297 - 302   2021年3月

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    担当区分:筆頭著者   出版者・発行元:金原出版  

    DOI: 10.18888/op.0000002097

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  33. Application of fluorescent cholangiography during single-incision laparoscopic cholecystectomy in the cystohepatic duct without preoperative diagnosis 国際誌

    Asai Yuichi, Igami Tsuyoshi, Ebata Tomoki, Yokoyama Yukihiro, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Nagino Masato

    ANZ JOURNAL OF SURGERY   91 巻 ( 3 ) 頁: 470 - 472   2021年3月

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    記述言語:英語   出版者・発行元:ANZ Journal of Surgery  

    DOI: 10.1111/ans.16162

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  34. The influence of the preoperative thickness of the abdominal cavity on the gastrojejunal anatomic position and delayed gastric emptying after pancreatoduodenectomy 査読有り 国際誌

    Watanabe Nobuyuki, Yokoyama Yukihiro, Ebata Tomoki, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Nagino Masato

    HPB   22 巻 ( 12 ) 頁: 1695 - 1702   2020年12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)   出版者・発行元:HPB  

    DOI: 10.1016/j.hpb.2020.03.016

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  35. 第3回 術前の胆道ドレナージ方法―外科医の立場から

    江畑 智希, 水野 隆史, 尾上 俊介, 渡辺 伸元, 伊神 剛, 横山 幸浩

    胆道   34 巻 ( 4 ) 頁: 781 - 789   2020年10月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本胆道学会  

    <p>術前胆道ドレナージに関して,ルーチンに採用する本邦と不要であると考える海外の間で対立があった.しかし,右葉切除以上の肝切除では胆道ドレナージは肝不全率や死亡率を低下させることが判明した.このため,肝切除量に応じて胆道ドレナージの適応を考えるようになった.過去には胆道ドレナージの主な方法であった経皮的胆道ドレナージは,術後に瘻孔再発や腹膜播種を増加させ,予後を悪化させることが判明した.この結果と内視鏡的な技術の進歩とも関係し,本邦では内視鏡的な胆道ドレナージが第一選択となった.また,術後死亡率の危険因子の一つが術前胆管炎であるため,術前胆道ドレナージは術前胆管炎が少ない方法が望ましい.本邦では内視鏡的経鼻胆道ドレナージを第一選択とし,海外では内視鏡的胆管ステントを第一選択とすることが多い.後方視的研究に基づくため,施設や地域間格差は現在でも認められる.</p>

    DOI: 10.11210/tando.34.781

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  36. Mild Prognostic Impact of Postoperative Complications on Long-Term Survival of Perihilar Cholangiocarcinoma. 査読有り

    Kawakatsu S, Ebata T, Watanabe N, Onoe S, Yamaguchi J, Mizuno T, Igami T, Yokoyama Y, Matsuo K, Nagino M

    Annals of surgery     2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/SLA.0000000000004465

    PubMed

  37. 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

  38. 特集 実践! 手術が上達するトレーニング法-Off the Job Trainingの最新動向 手術シミュレーションの実際 患者データに基づく手術シミュレーション:肝胆膵

    伊神 剛, 江畑 智希, 横山 幸浩, 水野 隆史, 山口 淳平, 尾上 俊介, 渡辺 伸元, 梛野 正人

    臨床外科   75 巻 ( 4 ) 頁: 466 - 475   2020年4月

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    出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.1407212912

    CiNii Research

  39. A case of small in situ perihilar cholangiocarcinoma incidentally accompanied by benign bile duct stricture after open cholecystectomy 査読有り

    Maeda Takashi, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Nagino Masato

    SURGICAL CASE REPORTS   5 巻 ( 1 ) 頁: 177   2019年12月

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  40. A case of duodenal hemorrhage due to arteriovenous malformation around a serous cystic neoplasm. 査読有り

    Tamura S, Yamamoto Y, Okamura Y, Sugiura T, Ito T, Ashida R, Ohgi K, Watanabe N, Sasaki K, Sugino T, Uesaka K

    Surgical case reports   4 巻 ( 1 ) 頁: 140   2018年12月

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    記述言語:英語  

    DOI: 10.1186/s40792-018-0547-8

    PubMed

  41. Clinical influence of preoperative factor XIII activity in patients undergoing pancreatoduodenectomy 査読有り 国際誌

    Watanabe Nobuyuki, Yokoyama Yukihiro, Ebata Tomoki, Sugawara Gen, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Nagino Masato

    HPB   19 巻 ( 11 ) 頁: 972 - 977   2017年11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)   出版者・発行元:HPB  

    DOI: 10.1016/j.hpb.2017.07.002

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  42. Anatomic features of independent right posterior portal vein variants: Implications for left hepatic trisectionectomy 査読有り 国際誌

    Watanabe Nobuyuki, Ebata Tomoki, Yokoyama Yukihiro, Igami Tsuyoshi, Sugawara Gen, Mizuno Takashi, Yamaguchi Junpei, Nagino Masato

    SURGERY   161 巻 ( 2 ) 頁: 347 - 354   2017年2月

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    担当区分:筆頭著者   記述言語:英語   出版者・発行元:Surgery (United States)  

    DOI: 10.1016/j.surg.2016.08.024

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▼全件表示

科研費 2

  1. 消化器外科手術後感染性合併症を予防するプロバイオティクス製剤の開発

    研究課題/研究課題番号:21K08731  2021年4月 - 2024年3月

    科学研究費助成事業  基盤研究(C)

    横山 幸浩, 山口 淳平, 渡辺 伸元, 江畑 智希, 國料 俊男

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    担当区分:研究分担者 

    われわれは先行研究で、周術期にプロバイオティクスを使用することにより、術後感染性合併症発生が抑制されることを確認してきた。われわれがプロバイオティクスとして使用したものはLactobacillus casei ShirotaおよびBifidobacterium breve Yakultであったが、これらがプロバイオティクス製剤として最善のものであるかについては不明である。ヒトの腸内には術後感染性合併症をより強く抑制する菌が存在する可能性がある。本研究では、高度侵襲外科手術後の合併症を最も強力に抑制する腸内細菌種を、無菌マウスにヒトの腸内細菌叢を移植したモデルを用いて探索することを目的にする。

  2. Invisible膵癌に対する新規診断治療法の開発

    研究課題/研究課題番号:19K09168  2019年4月 - 2022年3月

    渡辺 伸元

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    担当区分:研究代表者  資金種別:競争的資金

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

    画像診断に基づく膵癌治療には限界があり、画像では診断できないinvisible膵癌(目に見えない膵癌)を診断し治療を行うことが必要である。本研究の目的は原発巣が膵癌と診断できる膵癌特異的なエクソソームの同定およびその機能を解明することにより、invisible膵癌の診断治療法を開発することである。膵液より回収した膵癌特異的なエクソソームを用いて網羅的遺伝子解析を行う。同定した膵癌特異的エクソソームに関連するマイクロRNAおよび遺伝子に対する標的治療法を開発し、その有効性の検討を行なう。また臨床病理学的検討を行い、バイオマーカーとしての有効性についても検討する。