2024/03/22 更新

写真a

ウエノ ハルシ
上野 陽史
UENO Harushi
所属
医学部附属病院 呼吸器外科 病院助教
職名
病院助教

学位 1

  1. 学士 (医学) ( 2007年3月   山梨大学 ) 

 

論文 38

  1. CHST4 Gene as a Potential Predictor of Clinical Outcome in Malignant Pleural Mesothelioma

    Okado, S; Kato, T; Hanamatsu, Y; Emoto, R; Imamura, Y; Watanabe, H; Kawasumi, Y; Kadomatsu, Y; Ueno, H; Nakamura, S; Mizuno, T; Takeuchi, T; Matsui, S; Chen-Yoshikawa, TF

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   25 巻 ( 4 )   2024年2月

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    記述言語:英語   出版者・発行元:International Journal of Molecular Sciences  

    Malignant pleural mesothelioma (MPM) develops primarily from asbestos exposures and has a poor prognosis. In this study, The Cancer Genome Atlas was used to perform a comprehensive survival analysis, which identified the CHST4 gene as a potential predictor of favorable overall survival for patients with MPM. An enrichment analysis of favorable prognostic genes, including CHST4, showed immune-related ontological terms, whereas an analysis of unfavorable prognostic genes indicated cell-cycle-related terms. CHST4 mRNA expression in MPM was significantly correlated with Bindea immune-gene signatures. To validate the relationship between CHST4 expression and prognosis, we performed an immunohistochemical analysis of CHST4 protein expression in 23 surgical specimens from surgically treated patients with MPM who achieved macroscopic complete resection. The score calculated from the proportion and intensity staining was used to compare the intensity of CHST4 gene expression, which showed that CHST4 expression was stronger in patients with a better postoperative prognosis. The median overall postoperative survival was 107.8 months in the high-expression-score group and 38.0 months in the low-score group (p = 0.044, log-rank test). Survival after recurrence was also significantly improved by CHST4 expression. These results suggest that CHST4 is useful as a prognostic biomarker in MPM.

    DOI: 10.3390/ijms25042270

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  2. Thoracoscopic Wedge Resection for Low-Grade Fibromyxoid Sarcoma (Evans Tumor) with Massive Calcification and Originating from the Lung: A Rare Case in an Unexpected Location.

    Watanabe H, Nakanishi K, Ueno H, Kato T, Shimoyama Y, Chen-Yoshikawa TF

    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia   30 巻 ( 1 ) 頁: n/a   2024年

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    記述言語:英語   出版者・発行元:Annals of Thoracic and Cardiovascular Surgery  

    We encountered a rare case of low-grade fibromyxoid sarcoma, which is generally known as Evans tumor, with massive calcification originating from the lung. The patient was a 22-year-old man with Duchenne muscular dystrophy who was referred for a detailed investigation of an intrathoracic tumor with massive calcification. Although our preoperative diagnosis was a solitary fibrous tumor originating from the mediastinum or diaphragm, intraoperative thoracoscopy revealed the tumor arising from the left lower lobe without adhesion to the other organs. Considering his medical history, we aimed to preserve lung function and chose wedge resection, which completely removed the tumor. Based on the pathological findings, the tumor was diagnosed as low-grade fibromyxoid sarcoma with massive calcification originating from the lung. Although extremely rare, this tumor should be considered as a differential diagnosis for a solitary lung mass with massive calcification in young adults.

    DOI: 10.5761/atcs.cr.23-00170

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  3. Influencing Factors on Intersegmental Identification Adequacy in Segmentectomy with Intraoperative Indocyanine Green (ICG) Intravenous Administration

    Ueno, H; Setogawa, T; Makita, A; Ohara, Y; Imamura, Y; Okado, S; Watanabe, H; Kawasumi, Y; Kadomatsu, Y; Kato, T; Nakamura, S; Mizuno, T; Chen-Yoshikawa, TF

    CANCERS   15 巻 ( 24 )   2023年12月

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    記述言語:英語   出版者・発行元:Cancers  

    Accurate identification of the intersegmental plane is essential in segmentectomy, and Indocyanine Green (ICG) assists in visualizing lung segments. Various factors, including patient-related, intraoperative, and technical issues, can influence boundary delineation. This study aims to assess the rate of unsuccessful intersegmental identification and identify the contributing factors. We analyzed cases of lung segmentectomy from April 2020 to March 2023, where intraoperative ICG was intravenously administered during robot-assisted or video-assisted thoracoscopic surgery. Cases where fluorescence extended beyond expected boundaries within 30 s were classified as the “unclear boundary group”. This group was then compared to the “clear boundary group”. The study encompassed 111 cases, 104 (94%) of which were classified under the “clear boundary group” and 7 (6%) under the “unclear boundary group”. The “unclear boundary group” had a significantly lower DLCO (15.7 vs. 11.8, p = 0.03) and DLCO/VA (4.3 vs. 3.0, p = 0.01) compared to the “clear boundary group”. All cases in the “unclear boundary group” underwent lower lobe segmentectomy. ICG administration effectively outlines pulmonary segments. Challenges in segment demarcation may occur in cases with low DLCO and DLCO/VA values, particularly during lower lobe segmentectomy.

    DOI: 10.3390/cancers15245876

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  4. Complete visualization using indocyanine green in thoracic surgery for pulmonary sequestration

    Nakanishi, K; Kadomatsu, Y; Ueno, H; Kato, T; Nakamura, S; Mizuno, T; Chen-Yoshikawa, TF

    JOURNAL OF THORACIC DISEASE   15 巻 ( 10 ) 頁: 5714 - +   2023年10月

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    記述言語:英語   出版者・発行元:Journal of Thoracic Disease  

    Preoperative three-dimensional computed tomography (CT) facilitates accurate identification of aberrant systemic arteries in thoracic surgery for pulmonary sequestration (PS). Furthermore, the boundary between normal and sequestrated lungs can be visualized using the spread of fluorescent indocyanine green (ICG) when performing surgery for PS. This study aimed to determine how to completely visualize anatomical variations, safely treat aberrant arteries, remove only sequestrated lungs, and perform minimally invasive surgery for PS. Seventeen patients underwent lung resection for intralobar PS at our institution between 2009 and 2022. We retrospectively reviewed the surgical outcomes and intraoperative images using ICG to assess the efficacy and feasibility of near-infrared fluorescence imaging. Since 2019, intraoperative near-infrared fluorescence imaging with ICG has been used in six patients, including four females and two males (median age, 56 years), to visualize the boundary between normal and sequestrated lungs. Aberrant arteries were identified using preoperative three-dimensional CT, and the boundary between sequestrated and normal lungs could be clearly delineated intraoperatively using ICG in all cases. The median operative time was 145 min (range, 88–167 min), and the median blood loss was 5 mL (range, 1–191 mL). The overlay mode using near-infrared thoracoscopy, which merges visible light images with fluorescent images, was safer and more useful than conventional thoracoscopy for delineating boundaries with electrocautery. No intraoperative or postoperative complications occurred. The median postoperative hospital stay was 5 days (range, 3–7 days). Intraoperative identification of the boundary between normal and sequestrated lungs using ICG was simple and feasible. We suggested that this technique was effective for lesion resection and normal lung preservation during surgery for intralobar PS.

    DOI: 10.21037/jtd-23-892

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  5. Cadaver surgical training for brain-dead donor lung procurement: Educational note

    Nakamura, S; Ueno, H; Mutsuga, M; Chen-Yoshikawa, TF

    JTCVS TECHNIQUES   21 巻   頁: 261 - 264   2023年10月

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    記述言語:英語   出版者・発行元:JTCVS Techniques  

    DOI: 10.1016/j.xjtc.2023.07.026

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  6. New method for delineation of the intersegmental line in a deflated lung

    Okado, S; Kadomatsu, Y; Nakao, M; Ueno, H; Fukumoto, K; Nakamura, S; Chen-Yoshikawa, TF

    JOURNAL OF THORACIC DISEASE   15 巻 ( 9 ) 頁: 4736 - 4744   2023年9月

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    記述言語:英語   出版者・発行元:Journal of Thoracic Disease  

    Background: Preoperative three-dimensional (3D) computed tomography (CT) images have been widely used as surgical guides in lung surgery; however, the lungs tend to be deflated during surgery. Discrepancies between the preoperatively constructed 3D image and the intraoperative view of the deflated lungs often require preoperative and/or intraoperative marking methods for sublobar pulmonary resection. We have developed a lung deflation simulation algorithm in which 3D CT images of the deflated lungs can be predicted only based on the preoperative CT taken in an inflated phase of respiration. Using this system, we conducted a preliminary study to retrospectively compare the intersegmental line predicted by our lung deflation simulation algorithm with the intersegmental line delineated by the intravenous administration of indocyanine green. Methods: Sixteen patients who underwent unilateral segmentectomy between January 1, 2020, and June 30, 2022, were included in the study. The identified intersegmental lines were confirmed intraoperatively using indocyanine green. These actual intersegmental lines were compared with those delineated on 3D images using the lung deflation simulation algorithm. Results: Of the 16 patients who underwent pulmonary segmentectomy, the consistency of these intersegmental lines was in complete agreement in twelve patients, partial agreement in three patients, and disagreement in one patient. The concordance rate of the intersegmental lines was 75%. Conclusions: The lung deflation simulation algorithm provides a new surgical guide in addition to the currently utilized ones. Continuous innovation might lead to a less invasive surgical technique for delineating the intersegmental line.

    DOI: 10.21037/jtd-23-421

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  7. Setting a quality indicator for actual surgery time relative to scheduled surgery time in the context of increasing robotic-assisted thoracic surgery cases

    Ozeki, N; Ueno, H; Saeki, J; Kadomatsu, Y; Kato, T; Nakamura, S; Fukumoto, K; Fukui, T; Chen-Yoshikawa, TF

    GENERAL THORACIC AND CARDIOVASCULAR SURGERY   71 巻 ( 7 ) 頁: 396 - 402   2023年7月

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    記述言語:英語   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: This study aimed to demonstrate to the involved departments the goal of increasing the number of robotic-assisted thoracic surgery (RATS) cases/surgeons and acceptable surgery times. Methods: This retrospective study included 1572 patients who underwent thoracic surgery from fiscal year (FY) 2018 to FY 2021. The factors evaluated included the number of surgery cases and actual and scheduled surgery times. Results: The total number of RATS and total surgery cases increased after the quality indicator (QI) setting (n = 363, 360, 417, and 432 in FY 2018, 2019, 2020, and 2021, respectively). In FY 2020, 93.3% of the QI target was achieved, while in FY 2021, 88% was achieved. The number of RATS lobectomy/segmentectomy increased as the FY progressed (n = 31, 47, 58, and 116 in FY 2018, 2019, 2020, and 2021, respectively). The mean surgical time by RATS starters decreased in FY 2020 and 2021 (171.4 min.; 74 cases; seven RATS starters) compared with those in FY 2018 and 2019 (198.0 min.; 57 cases; six RATS starters) (P = 0.002). Conclusions: The goal of increasing the number of surgery cases and RATS cases/surgeons within the given framework was achieved by setting the QI.

    DOI: 10.1007/s11748-022-01903-6

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  8. Lingular-segment torsion after extended left-upper division segmentectomy by video-assisted thoracic surgery with indocyanine green fluorescence imaging

    Kato, T; Ohara, Y; Okado, S; Noritake, O; Nakanishi, K; Kadomatsu, Y; Ueno, H; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY   16 巻 ( 3 ) 頁: 584 - 587   2023年7月

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

    Lingular-segment torsion after left-upper division segmentectomy (LUDS) is a rare complication, and the cause remains unclear. Here we report the case of a patient who developed lingular-segment torsion after LUDS for multiple lung metastases of breast cancer. One lung nodule was located in the S1 + 2 segment and another between the upper lobe and S6 on an incomplete interlobar fissure. The lung metastases were resected by extended LUDS using video-assisted thoracic surgery with indocyanine green fluorescence imaging. The staple line on the lingular segment was vertically tilted against the interlobar line because of the atypical defect of the fluorescence plane and nodule position. Chest X-ray and contrast-enhanced computed tomography indicated ischemia and torsion of the lingular segment on the second postoperative day, and completion of lingular segmentectomy was performed. This case showed the vertical intersegment staple line during LUDS was one of the important causes of postoperative torsion of the lingular segment.

    DOI: 10.1111/ases.13189

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  9. [Robot-assisted Extended Thymectomy via a Bilateral Approach for Patients with Myasthenia Gravis].

    Nakamura S, Nakanishi K, Kadomatsu Y, Ueno H, Kato T, Chen-Yoshikawa TF

    Kyobu geka. The Japanese journal of thoracic surgery   76 巻 ( 7 ) 頁: 523 - 527   2023年7月

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    記述言語:日本語  

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  10. Clinical application of resection process map as a novel surgical guide in thoracic surgery

    Kadomatsu, Y; Nakao, M; Ueno, H; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY   36 巻 ( 4 )   2023年4月

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    記述言語:英語   出版者・発行元:Interdisciplinary cardiovascular and thoracic surgery  

    Resection Process Map (RPM) is a surgical simulation system that uses preoperative three-dimensional computed tomography. Unlike the usual static simulation, this system provides surgeons an individualized dynamic deformation of the lung parenchyma and vessels. RPM was first introduced in 2020. Although the intraoperative usefulness of this system has been evaluated experimentally, there have been no reports on its clinical use. Herein, we presented in detail the first experience on RPM during robot-assisted anatomical lung resection in the real clinical setting.

    DOI: 10.1093/icvts/ivad059

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  11. Video-assisted thoracoscopic surgery for pleuroperitoneal communication

    Tsubouchi, H; Nakamura, S; Fukui, T; Kadomatsu, Y; Ueno, H; Ozeki, N; Fukumoto, K; Mizuno, M; Chen-Yoshikawa, TF

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY   16 巻 ( 2 ) 頁: 262 - 265   2023年4月

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

    Here we report the cases of five patients on continuous ambulatory peritoneal dialysis (CAPD) who developed hydrothorax because of pleuroperitoneal communication. Preoperative computed tomography (CT) peritoneography revealed penetrated sites on the diaphragm in all patients. All patients underwent video-assisted thoracoscopic surgery (VATS), and a dialysate containing indigo carmine was injected intraperitoneally through a CAPD catheter to confirm the fistula. In all patients, a thinned bleb was found at the center of the diaphragmatic tendon consistent with that noted on preoperative CT peritoneography. The bleb was resected using a surgical stapler in four patients, and the pleuroperitoneal communication did not recur. However, in one patient, the bleb was only covered with reinforcement agents and the hydrothorax recurred after CAPD. This study demonstrates that VATS treatment for pleuroperitoneal communication is safe and effective but that lesion resection would be more useful for preventing hydrothorax recurrence in patients undergoing CAPD.

    DOI: 10.1111/ases.13127

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  12. Real-world evidence of safety and influence for lung cancer surgery under COVID-19 pandemic in Japan

    Kato, T; Katsuya, R; Okado, S; Sato, K; Noritake, O; Nakanishi, K; Noguchi, M; Kadomatsu, Y; Ueno, H; Ozeki, N; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    JOURNAL OF THORACIC DISEASE   15 巻 ( 2 ) 頁: 542 - +   2023年2月

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    記述言語:英語   出版者・発行元:Journal of Thoracic Disease  

    Background: The COVID-19 pandemic has affected the clinical practice of lung cancer surgery in Japan, but few studies have revealed the real situation of surgical practice for lung cancer in this country. This latest information will help us to decide the future direction of lung cancer surgery under pandemic circumstances. Methods: We collected data from patients with primary lung cancer who underwent thoracic surgery between 2018 and 2021. To investigate the impact of the COVID-19 pandemic on lung cancer surgery, we compared between 2018–2019 (prepandemic group) and 2020–2021 (pandemic group) in the respect of patient characteristics, pathological findings, and short-term outcome after lung cancer resection by Mann-Whitney and Fisher’s exact tests. Moreover, the monthly number of surgeries for lung cancer in our institution during 2020–2021 was compared with the number of newly diagnosed COVID-19 patients in Japan by Spearman correlation analysis. Results: From 2018 through 2021, 936 patients with primary lung cancer underwent surgical intervention in our institute and were included in this study. The number of surgeries did not decrease in the pandemic group (n=443) compared with that in the prepandemic group (n=493). Tumor and invasive size in stage I which was measured by pathologist were significantly larger in the pandemic group than in the prepandemic group (tumor size: P=0.031, invasive size: P<0.001). In terms of postoperative short-term outcome, the median hospital stay was 6 days, 30-day mortality was 2, and morbidity was around 20% in both groups. Only one patient suffered from COVID-19 infection 5 months after right upper lobectomy. An increased ratio of newly diagnosed COVID-19 cases in Japan was negatively correlated with the number of surgeries for lung cancer in our institution in the next month (r=−0.393, P=0.007), although there was no correlation in the present or the month after next. Conclusions: Even during the COVID-19 pandemic period, lung cancer surgery could be performed safely and in a sustainable manner. However, pathological findings of lung cancer tended to be progressive in early-stage lung cancer.

    DOI: 10.21037/jtd-22-1289

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  13. ASO Visual Abstract: Impact of Pleural Thickness on the Occurrence of Postoperative Complications in Patients with Malignant Pleural Mesothelioma

    Ito Toshinari, Nakamura Shota, Kadomatsu Yuka, Ueno Harushi, Kato Taketo, Ozeki Naoki, Fukumoto Koichi, Chen-Yoshikawa Toyofumi Fengshi

    ANNALS OF SURGICAL ONCOLOGY   30 巻 ( 3 ) 頁: 1586   2022年11月

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    記述言語:英語   出版者・発行元:Annals of surgical oncology  

    DOI: 10.1245/s10434-022-12860-y

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  14. Impact of Pleural Thickness on Occurrence of Postoperative Complications in Patients with Malignant Pleural Mesothelioma

    Ito Toshinari, Nakamura Shota, Kadomatsu Yuka, Ueno Harushi, Kato Taketo, Ozeki Naoki, Fukumoto Koichi, Chen-Yoshikawa Toyofumi Fengshi

    ANNALS OF SURGICAL ONCOLOGY   30 巻 ( 3 ) 頁: 1574 - 1583   2022年11月

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    記述言語:英語   出版者・発行元:Annals of Surgical Oncology  

    Objectives: The rates of postoperative mortality and morbidity are high in patients with malignant pleural mesothelioma (MPM). Therefore, it is important to identify variables that increase the risk of postoperative complications. Pleural thickness has recently been identified as a prognostic indicator in patients with MPM. The aim of this study was to investigate clinical variables, including pleural thickness, that contribute to postoperative complications in patients with MPM. Patients and Methods: A total of 47 patients who underwent surgical excision of MPM between 2005 and 2021 were enrolled in this study. Correlations between postoperative complications within 90 days of surgery and preoperative clinical factors were investigated. Results: A total of 27 patients underwent extrapleural pneumonectomy (EPP), and the remaining 20 underwent pleurectomy/decortication (P/D). Macroscopic complete resections were obtained in all but three patients. Of the 47 patients, 23 (49%) experienced postoperative complications of grade 3 or worse. The major complication in patients with EPP was respiratory failure (n = 6), whereas the major complication in patients with P/D was prolonged air leakage (n = 7). Univariate logistic regression analysis found a correlation between postoperative complications and age, surgical side, and pleural thickness, while multivariate logistic regression analysis found surgical side (p = 0.04, 95% Cl 1.10–21.71, OR 4.90) and pleural thickness (p = 0.03, 95% Cl 1.21–23.00, OR 5.26) to significantly influence the occurrence of postoperative complications. Conclusions: Pleural thickness has a significant effect on the occurrence of postoperative complications. Patients with thick pleura on the right side are at greater risk of postoperative complications.

    DOI: 10.1245/s10434-022-12790-9

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  15. Neoadjuvant Therapy for Patients With Non-small Cell Lung Cancer Complicated With Chest Wall Invasion

    Sato, K; Nakamura, S; Kadomatsu, Y; Ueno, H; Kato, T; Ozeki, N; Fukumoto, K; Chen-Yoshikawa, TF

    ANTICANCER RESEARCH   42 巻 ( 11 ) 頁: 5539 - 5546   2022年11月

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

    Background/Aim: Multidisciplinary treatment including anatomical pulmonary and chest wall resection is recommended for lung cancer complicated by chest wall invasion. The present study aimed to investigate the survival benefit and safety of preoperative therapy followed by surgery for non-small cell lung cancer with chest wall invasion. Patients and Methods: Sixty-five patients who underwent surgical excision of lung cancer complicated with chest wall invasion between 2009 and 2020 were enrolled in this study. Results: The median age was 65 (37-81) years old, with 59 males and 6 females. Histological types included squamous cell carcinoma (n=32) and adenocarcinoma (n=21). The median tumor diameter was 5.5 cm (2.3-12.5 cm). The clinical nodal status was N0 in 49 cases and N positive in 16 cases. Of the 65 eligible patients, 5- and 10-year overall survival (OS) rates were 58.4% and 46.0%, respectively, and 5- and 10-year progression-free survival (PFS) rates were 54.2% and 41.7%, respectively. For patients receiving preoperative therapy followed by surgery (Pre-Tx), 5- and 10-year OS survival rates were 69.2% and 62.9%, and among patients receiving up-front surgery (UFS) were 48.5% and 29.1%, respectively (p=0.03). The 5- and 10-year PFS rates for pre-Tx were 65.8% and 59.2%, respectively, and 44.7% and 26.8% for UFS, respectively (p=0.02). Cox regression analysis preoperative therapy was significantly associated with OS and PFS. Conclusion: We demonstrate the survival benefit of preoperative therapy followed by surgery for patients with lung cancer and chest wall invasion.

    DOI: 10.21873/anticanres.16059

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  16. Prognostic Value of Uncertain Resection for Overall Survival in Non-small Cell Lung Cancer

    Kadomatsu, Y; Nakamura, S; Ueno, H; Goto, M; Ozeki, N; Fukumoto, K; Fukui, T; Suzuki, Y; Chen-Yoshikawa, TF

    ANNALS OF THORACIC SURGERY   114 巻 ( 4 ) 頁: 1262 - 1268   2022年10月

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    記述言語:英語   出版者・発行元:Annals of Thoracic Surgery  

    Background: In this study we evaluated the R(un) category proposed by the International Association for the Study of Lung Cancer (IASLC) for non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the medical records of patients with NSCLC who underwent segmentectomy or lobectomy between 2014 and 2015 at our institution. Residual tumor (R) status was reclassified from the Union for International Cancer Control designation to the IASLC-proposed R classification of R0 and R(un). The underlying reasons for the R(un) reclassification were analyzed according to pathologic stage, lymph node status, and resected lobe. A Cox proportional hazard model was used to evaluate the impacts of R(un) categorization on overall survival. Results: Of 355 patients, 44.5% were reclassified as R(un). The most common reason for the reclassification was insufficient number of harvested lymph nodes or no station 7 lymph nodes. When stratified by tumor location, the absence of station 7 lymph nodes was especially prominent in both the right and left upper lung resections. In the multivariate Cox regression model, the IASLC R classification was associated with poor overall survival in node-positive patients (hazard ratio, 2.657; P = .016). Conclusions: Various factors resulted in reclassification to R(un) because the R(un) group was highly heterogeneous. Careful consideration is required to determine whether the R(un) classification can be used as an indicator of lymph node dissection quality. For advanced cases, the R(un) definition may be useful in predicting poor prognosis.

    DOI: 10.1016/j.athoracsur.2021.07.087

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  17. A novel system applying artificial intelligence in the identification of air leak sites

    Kadomatsu, Y; Nakao, M; Ueno, H; Nakamura, S; Chen-Yoshikawa, TF

    JTCVS TECHNIQUES   15 巻   頁: 181 - 191   2022年10月

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    記述言語:英語   出版者・発行元:JTCVS Techniques  

    Objective: Prolonged air leak is the most common complication of thoracic surgery. Intraoperative leak site detection is the first step in decreasing the risk of leak-related postoperative complications. Methods: We retrospectively reviewed the surgical videos of patients who underwent lung resection at our institution. In the training phase, deep learning-based air leak detection software was developed using leak-positive endoscopic images. In the testing phase, a different data set was used to evaluate our proposed application for each predicted box. Results: A total of 110 originally captured and labeled images obtained from 70 surgeries were preprocessed for the training data set. The testing data set contained 64 leak-positive and 45 leak-negative sites. The testing data set was obtained from 93 operations, including 58 patients in whom an air leak was present and 35 patients in whom an air leak was absent. In the testing phase, our software detected leak sites with a sensitivity and specificity of 81.3% and 68.9%, respectively. Conclusions: We have successfully developed a deep learning-based leak site detection application, which can be used in deflated lungs. Although the current version is still a prototype with a limited training data set, it is a novel concept of leak detection based entirely on visual information.

    DOI: 10.1016/j.xjtc.2022.06.011

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  18. Computer-Aided Volumetry by Multidetector Computed Tomography is Efficient for Prognostic Prediction of Early-Stage Solid Lung Cancers

    Kato, T; Iwano, S; Katsuya, R; Okado, S; Ito, T; Sato, K; Nakanishi, K; Kadomatsu, Y; Ueno, H; Ozeki, N; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    JOURNAL OF THORACIC ONCOLOGY   17 巻 ( 9 ) 頁: S206 - S207   2022年9月

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  19. Skeletal muscle and related protein expression as prognostic factors in thymic squamous cell carcinoma

    Nakanishi, K; Ozeki, N; Tateyama, H; Kadomatsu, Y; Ueno, H; Goto, M; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    JOURNAL OF THORACIC DISEASE   14 巻 ( 9 ) 頁: 3245 - 3254   2022年9月

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    記述言語:英語   出版者・発行元:Journal of Thoracic Disease  

    Background: Sarcopenia and its marker, the psoas muscle index (PMI), have attracted attention as prognostic factors for various types of cancers. The fragile X-related 1 (FXR1) gene is highly expressed in myocytes, and FXR1 overexpression is a candidate biomarker for poor survival in several types of cancers. Thymic squamous cell carcinoma (TSQCC) is rare, and no studies assessing its prognostic factors, particularly in terms of skeletal muscle mass and FXR1 expression, are available. Methods: We retrospectively investigated the prognostic significance of PMI in 34 patients who underwent TSQCC resection, considering the status of FXR1 and tumor programmed death-ligand 1 (PD-L1). PMI was calculated from the bilateral psoas muscle using preoperative computed tomography (CT). Patients were divided into two groups: low PMI (<58.2%, n=17) and normal PMI (≥58.2%, n=17). Immunohistochemical analysis was performed to determine the FXR1 and PD-L1 expression levels. Results: Low PMI was significantly associated with worse overall survival (OS) (5-year survival rate; 86% vs. 100%; P=0.026) and marginally associated with worse disease-free survival (DFS) (5-year survival rate; 39% vs. 66%; P=0.090) compared with normal PMI. The immunohistochemical analysis revealed that the FXR1 intensity score (0–1+: 6% vs. 0%; 2+–3+: 94% vs. 100%; P=0.31), median FXR1 distribution (95% vs. 90%; P=0.63), and PD-L1 status (high: 47% vs. 59%; P=0.49) were not significantly different between the two groups. Conclusions: Our findings suggest that PMI might be considered as a potential prognostic factor in TSQCC and that FXR1 is widely expressed regardless of the PMI status. Skeletal muscle mass may play a role in the prognosis of TSQCC.

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  20. Relationship of smoking cessation period with the incidence of complications in lung cancer surgery

    Kadomatsu, Y; Sugiyama, T; Sato, K; Nakanishi, K; Ueno, H; Goto, M; Ozeki, N; Nakamura, S; Fukumoto, K; Chen-Yoshikawa, TF

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   62 巻 ( 3 )   2022年8月

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    記述言語:英語   出版者・発行元:European Journal of Cardio-thoracic Surgery  

    OBJECTIVES: The incidence of postoperative complications is relatively high in smokers. Although 4-week smoking cessation before surgery is generally recommended, it has not been sufficiently studied in lung cancer surgery. This study investigated whether smoking cessation for a short period of time significantly reduced complications after lung cancer surgery. METHODS: This was a retrospective, observational study that investigated the relationship between the smoking cessation period and the incidence of complications in lung cancer surgery. Patients who underwent curative-intent surgery for lung cancer at our institution between January 2014 and December 2017 were included. The smokers were classified into the following 4 categories of smoking cessation period before surgery: current (<4 weeks), recent (4 weeks to 12 months), distant (12 months to 5 years) and ex-smokers (>5 years). RESULTS: A total of 911 patients were included in this study. The incidence of pulmonary complications was 5 times higher in the smoker group than in the never smoker group (12.9% vs 2.5%, P < 0.001). On multivariable analysis in both models, the odds ratio for complications was significantly higher in distant smokers than in recent smokers and never smokers. Across all models, low lung function significantly predicted the development of postoperative complications. CONCLUSIONS: The evidence-based smoking cessation duration that reduces the incidence of complications after thoracic surgery remains unclear. The incidence of postoperative complications was more strongly affected by low pulmonary function than by the duration of preoperative smoking cessation. For patients with marginal indications for surgery, postponing surgery to accommodate a smoking cessation period seemed unnecessary.

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  21. Postoperative empyema complicated with descending necrotizing fasciitis: a case report

    Kadomatsu, Y; Ueno, H; Goto, M; Ozeki, N; Nakamura, S; Chen-Yoshikawa, TF

    SURGICAL CASE REPORTS   8 巻 ( 1 ) 頁: 133   2022年7月

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  22. Pleural Invasion Depth of Disseminated Nodules in Patients with Stage IVa or Recurrent Thymoma: Assessment, Curative Impact, and Surgical Outcomes

    Nakamura, S; Tateyama, H; Nakanishi, K; Sugiyama, T; Kadomatsu, Y; Ueno, H; Goto, M; Ozeki, N; Fukui, T; Yokoi, K; Chen-Yoshikawa, TF

    ANNALS OF SURGICAL ONCOLOGY   29 巻 ( 3 ) 頁: 1829 - 1837   2022年3月

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    記述言語:英語   出版者・発行元:Annals of Surgical Oncology  

    Background: Thymoma patients with pleural dissemination are difficult to manage, and their treatment strategy remains undefined. This study aimed to investigate the clinicopathologic features of these patients, focusing on the association between the depth of pleural invasion and prognosis. Methods: Between 2003 and 2019, the study identified 120 disseminated lesions in 20 thymoma patients. Seven patients had de novo stage IVa thymoma and 13 were recurrent cases. Extrapleural pneumonectomy was performed for 8 patients and debulking surgery for 12 patients. Invasion depth of pleural tumors was classified into two groups: when the disseminated tumors invaded the pleura beneath the elastic layer, the tumor was diagnosed as Da, and when the disseminated tumors invaded the pleura beyond the elastic layer, the tumor was diagnosed as Db. Results: Of 120 nodules, 31 (26%), found in eight patients with recurrent malignancies, were classified as Db. The pathologic status of the surgical margin (PSM) was positive in eight patients, seven of whom had Db nodules. The 5-year overall survival (OS) rate was 100% in the Da group and 75% in the Db group (P = 0.02). The 5-year progression-free survival (PFS) rate was 66.7% in the Da group and 25% in the Db group (P = 0.02). Cox univariate analysis showed that PFS was significantly influenced by the depth of invasion (P = 0.04) and PSM (P = 0.03). Conclusion: Depth of pleural invasion may influence survival outcomes for thymoma patients with pleural dissemination. The patients in this study with Da-disseminated nodules had an increased probability of a longer OS and PFS and tended to achieve negative PSM compared with the patients with Db.

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  23. ASO Visual Abstract: Pleural Invasion Depth of Disseminated Nodules in Patients with Stage IVa or Recurrent Thymoma: Assessment, Curative Impact, and Surgical Outcomes

    Nakamura, S; Tateyama, H; Nakanishi, K; Sugiyama, T; Kadomatsu, Y; Ueno, H; Goto, M; Ozeki, N; Fukui, T; Yokoi, K; Chen-Yoshikawa, TF

    ANNALS OF SURGICAL ONCOLOGY   29 巻 ( 3 ) 頁: 1838 - 1838   2022年3月

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    記述言語:日本語   出版者・発行元:Annals of surgical oncology  

    DOI: 10.1245/s10434-021-10969-0

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  24. Removal of hematoma due to massive hemoptysis after transbronchial biopsy: a case report

    Ueno, H; Tsubouchi, H; Nakanishi, K; Sugiyama, T; Kadomatsu, Y; Goto, M; Ozeki, N; Nakamura, S; Fukui, T; Chen-Yoshikawa, TF

    SURGICAL CASE REPORTS   7 巻 ( 1 ) 頁: 237   2021年11月

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  25. Diagnostic utility of metabolic parameters on FDG PET/CT for lymph node metastasis in patients with cN2 non-small cell lung cancer

    Nakanishi, K; Nakamura, S; Sugiyama, T; Kadomatsu, Y; Ueno, H; Goto, M; Ozeki, N; Fukui, T; Iwano, S; Chen-Yoshikawa, TF

    BMC CANCER   21 巻 ( 1 ) 頁: 983   2021年9月

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    記述言語:英語   出版者・発行元:BMC Cancer  

    Background: The aim of this study was to assess the diagnostic utility of metabolic parameters on fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) for predicting lymph node (LN) metastasis in patients with cN2 non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed patients who underwent surgery for cN2 NSCLC between 2007 and 2020. Those who had clinically diagnosed positive hilar and mediastinal LNs by routine CT and PET/CT imaging were investigated. To measure the metabolic parameters of LNs, the data according to maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN-to-primary tumor ratio of SUVmax (LPR) were examined. The diagnosis of each retrieved LN was confirmed based on histopathological examination of surgical tissue specimens. Receiver operating characteristics (ROC) curves with area under the curve (AUC) calculations and multivariate analysis by logistic regression were performed. Results: Forty-five patients with 84 clinically diagnosed positive hilar or mediastinal LNs were enrolled in the present study. Of the 84 LNs, 63 LNs were pathologically proven as positive (75%). The SUVmax, MTV, TLG, and LPR of LN metastasis were significantly higher than those of benign nodes. In the ROC analysis, the AUC value of LPR [AUC, 0.776; 95% confidence interval (CI), 0.640–0.913] was higher than that of LN SUVmax (AUC, 0.753; 95% CI, 0.626–0.880) or LN TLG3.5 (AUC, 0.746; 95% CI, 0.607–0.885). Using the optimal LPR cutoff value of 0.47, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.1, 66.7, 88.3, 58.3, and 79.8%, respectively. Multivariate analysis by logistic regression showed that LPR was an independent predictor for LN metastasis (odds ratio, 6.45; 95% CI, 1.785–23.301; P = 0.004). In the subgroup analysis of adenocarcinoma patients (n = 18; 32 LNs), TLG3.5 was a better predictor (AUC, 0.816; 95% CI, 0.639–0.985) than LPR (AUC, 0.792; 95% CI, 0.599–0.986) or LN SUVmax (AUC, 0.792; 95% CI, 0.625–0.959). Conclusions: Our findings suggest that LPR on FDG-PET is a useful predictor for LN metastasis in patients with cN2 NSCLC. TLG can be a good predictor for LN metastasis in patients with adenocarcinoma.

    DOI: 10.1186/s12885-021-08688-6

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  26. Differential impacts of postoperative complications on patients' survival in completely resected non-small-cell lung cancer

    Kadomatsu, Y; Tsubouchi, H; Nakanishi, K; Sugiyama, T; Ueno, H; Goto, M; Ozeki, N; Nakamura, S; Fukui, T; Chen-Yoshikawa, TF

    GENERAL THORACIC AND CARDIOVASCULAR SURGERY   69 巻 ( 9 ) 頁: 1283 - 1290   2021年9月

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    記述言語:英語   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. Methods: Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan–Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. Results: Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41–4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70–2.70). Conclusions: Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.

    DOI: 10.1007/s11748-021-01619-z

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  27. Robotic open-thoracotomy-view approach using vertical port placement and confronting monitor setting.

    Sakakura N, Nakada T, Shirai S, Takahara H, Nakanishi K, Matsui T, Ueno H, Takahashi Y, Kuroda H

    Interactive cardiovascular and thoracic surgery   33 巻 ( 1 ) 頁: 60 - 67   2021年6月

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    記述言語:英語  

    DOI: 10.1093/icvts/ivab033

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  28. Learning curve of robotic lobectomy for lung malignancies by certified thoracic surgeons

    Fukui, T; Kawaguchi, K; Tsubouchi, H; Ueno, H; Sugiyama, T; Mori, S; Goto, M; Ozeki, N; Hakiri, S; Nakamura, S; Chen-Yoshikawa, TF

    NAGOYA JOURNAL OF MEDICAL SCIENCE   83 巻 ( 2 ) 頁: 227 - 237   2021年5月

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

    Video-assisted thoracic surgery (VATS) has become widespread in the last 20 years, followed by robot-assisted thoracic surgery (RATS). Few studies compared the learning curve between RATS lobectomy and conventional VATS. This study included 79 RATS lobectomy cases performed in our hospital from November 2015 to October 2019. To estimate the required number for learning, the cumulative sum method, which is to plot a value obtained by sequentially accumulating a difference from a mean value was applied. As a result, the median total operative time and the median console time for all cases were 167 minutes and 138 minutes, respectively. Firstly, for our team, 28 cases were estimated to be required for learning curve for RATS lobectomy. For individual, each surgeon might be learned in only 5 to 6 cases. By contrast, the number of cases for learning VATS lobectomy which was underwent by a ‘single' surgeon from 2009 was estimated to be 35 cases. The time to dock from start operation (median 14 minutes) reached plateau in 18 cases, but the time after rollout was median of 18 minutes and there was no significant change from the beginning. In conclusion, RATS lobectomy might be a technique that could be learned in a small number of cases compared to VATS. The results of this study might be helpful for certified surgeons who tried to get started with RATS and for establishing a learning program.

    DOI: 10.18999/nagjms.83.2.227

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  29. Left brachiocephalic vein aneurysm: a case report

    Ueno, H; Yazawa, M; Tsubouchi, H; Nakanishi, K; Sugiyama, T; Kadomatsu, Y; Goto, M; Ozeki, N; Nakamura, S; Fukui, T; Mutsuga, M; Yoshikawa, TFC

    SURGICAL CASE REPORTS   7 巻 ( 1 ) 頁: 66   2021年3月

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  30. Prognostic factors of stage I thymic epithelial tumors

    Fukui, T; Kadomatsu, Y; Tsubouchi, H; Nakanishi, K; Ueno, H; Sugiyama, T; Goto, M; Ozeki, N; Nakamura, S; Chen-Yoshikawa, TF

    GENERAL THORACIC AND CARDIOVASCULAR SURGERY   69 巻 ( 1 ) 頁: 59 - 66   2021年1月

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    記述言語:英語   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: According to the tumor-node-metastasis classification for thymic malignancies, the proportion of patients diagnosed with stage I is expected to increase significantly. However, whether those patients have homogenous clinicopathological features and survival has not been fully evaluated. Methods: We reviewed 153 consecutive patients with stage I thymic epithelial tumors (133 thymomas, 15 thymic carcinomas, and 5 neuroendocrine tumors) who underwent complete resection at our institution between 2001 and 2016 and evaluated the prognostic significance of their clinicopathological factors. Results: The stage I patients accounted for 78% of all thymic epithelial tumors. The 5-year overall survival and recurrence-free survival rates of the 153 patients were 94% and 80%, respectively. The patients with the histology of thymic carcinoma or neuroendocrine tumor and with a tumor larger than 5.0 cm showed significantly worse recurrence-free survival in multivariate analysis (p = 0.027 and 0.038, respectively). Only the tumor size was revealed as a significant prognostic factor for recurrence-free survival when limited in the 133 cases of thymoma (p = 0.048). Conclusions: Patients with large tumors showed significantly worse recurrence-free survival than those with small tumors both in stage I thymic epithelial tumors and thymomas.

    DOI: 10.1007/s11748-020-01427-x

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  31. 多職種チームで行う「献体を用いた臓器摘出トレーニング」in Clinical Anatomy Laboratory Nagoya (CALNA)

    中村 彰太, 六鹿 雅登, 後藤 和大, 仲西 慶太, 杉山 燈人, 門松 由佳, 上野 陽史, 後藤 真輝, 尾関 直樹, 福本 紘一, 伊藤 英樹, 小山 富生, 碓氷 章彦, 芳川 豊史

    移植   56 巻 ( Supplement ) 頁: s105 - s105   2021年

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    記述言語:日本語   出版者・発行元:一般社団法人 日本移植学会  

    <p>【背景】脳死ドナー臓器摘出では、外科医だけでなく臨床工学技士(ME)・看護師・コーディネーター等多職種が関わる医療で、実際の手技を知っていればよりよい連携が可能かもしれない。献体されたご遺体の固定方法は進化しており、特殊な保存液で固定された状態は生体と類似しているため、手術トレーニングに用いることが可能となった。肺移植実施施設でない当院での実施施設へのとり組みの一貫として、心臓外科医・ME・医学生と合同で臓器摘出トレーニングを実行したので報告する。</p><p>【トレーニング概要】開胸・心嚢切開し臓器評価方法を全員で確認した後、心灌流液注入用と肺灌流液ドレナージ用のカテーテルを各留置し、大血管を遮断し心臓摘出、続いて肺摘出を行った。続いてバックテーブルにて肺の植え込みができる状態にまで処理を行いトレーニング終了とした。心肺摘出に際して重要となる左房の処理については、操作を止め指導医にポイントを解説してもらいつつ、心臓外科・呼吸器外科の双方の考えを伝え、解剖を確認しながら行った。また、MEと肺灌流液ドレナージ経路の方法や肺灌流のタイミングなど細やかな部分まで共有できた。</p><p>【結語】本トレーニングは多職種での手技と順序の確認に有用で、臓器摘出の際互いに心がけているポイントや考えも共有・理解できた。今後はプログラムを定型化し、実践に対応できるレベルに質を高めつつ、看護師やコーディネーターも含めて行う予定である。</p>

    DOI: 10.11386/jst.56.supplement_s105

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  32. Landscape of driver mutations and their clinical impacts in pediatric B-cell precursor acute lymphoblastic leukemia

    Ueno H., Yoshida K., Shiozawa Y., Nannya Y., Iijima-Yamashita Y., Kiyokawa N., Shiraishi Y., Chiba K., Tanaka H., Isobe T., Seki M., Kimura S., Makishima H., Nakagawa M.M., Kakiuchi N., Kataoka K., Yoshizato T., Nishijima D., Deguchi T., Ohki K., Sato A., Takahashi H., Hashii Y., Tokimasa S., Hara J., Kosaka Y., Kato K., Inukai T., Takita J., Imamura T., Miyano S., Manabe A., Horibe K., Ogawa S., Sanada M.

    Blood Advances   4 巻 ( 20 ) 頁: 5165 - 5173   2020年10月

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    記述言語:日本語   出版者・発行元:Blood Advances  

    Recent genetic studies using high-throughput sequencing have disclosed genetic alterations in B-cell precursor acute lymphoblastic leukemia (B-ALL). However, their effects on clinical outcomes have not been fully investigated. To address this, we comprehensively examined genetic alterations and their prognostic impact in a large series of pediatric B-ALL cases. We performed targeted capture sequencing in a total of 1003 pediatric patients with B-ALL from 2 Japanese cohorts. Transcriptome sequencing (n 5 116) and/or array-based gene expression analysis (n 5 120) were also performed in 203 (84%) of 243 patients who were not categorized into any disease subgroup by panel sequencing or routine reverse transcription polymerase chain reaction analysis for major fusions in B-ALL. Our panel sequencing identified novel recurrent mutations in 2 genes (CCND3 and CIC), and both had positive correlations with ETV6-RUNX1 and hypodiploid ALL, respectively. In addition, positive correlations were also newly reported between TCF3-PBX1 ALL with PHF6 mutations. In multivariate Cox proportional hazards regression models for overall survival, TP53 mutation/deletion, hypodiploid, and MEF2D fusions were selected in both cohorts. For TP53 mutations, the negative effect on overall survival was confirmed in an independent external cohort (n 5 466). TP53 mutation was frequently found in IGH-DUX4 (5 of 57 [9%]) ALL, with 4 cases having 17p LOH and negatively affecting overall survival therein, whereas TP53 mutation was not associated with poor outcomes among NCI (National Cancer Institute) standard risk (SR) patients. A conventional treatment approach might be enough, and further treatment intensification might not be necessary, for patients with TP53 mutations if they are categorized into NCI SR.

    DOI: 10.1182/BLOODADVANCES.2019001307

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  33. Current trends in thoracic surgery

    Chen-Yoshikawa, TF; Fukui, T; Nakamura, S; Ito, T; Kadomatsu, Y; Tsubouchi, H; Ueno, H; Sugiyama, T; Goto, M; Mori, S; Ozeki, N; Hakiri, S; Kawaguchi, K

    NAGOYA JOURNAL OF MEDICAL SCIENCE   82 巻 ( 2 ) 頁: 161 - 174   2020年5月

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

    Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, imageguided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and ex vivo lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

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  34. Clinicopathological Features, Surgical Outcomes, Oncogenic Status and PD-L1 Expression of Pulmonary Pleomorphic Carcinoma.

    Nakanishi K, Sakakura N, Matsui T, Ueno H, Nakada T, Oya Y, Shimizu J, Hida T, Hosoda W, Kuroda H

    Anticancer research   39 巻 ( 10 ) 頁: 5789 - 5795   2019年10月

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    記述言語:英語  

    DOI: 10.21873/anticanres.13782

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  35. Thoracoscopic lobectomy using indocyanine green fluorescence to detect the interlobar fissure in a patient with displaced B3 and absence of fissure: A case report.

    Nakanishi K, Kuroda H, Nakada T, Ueno H, Sakakura N

    Thoracic cancer   10 巻 ( 7 ) 頁: 1654 - 1656   2019年7月

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    記述言語:英語  

    DOI: 10.1111/1759-7714.13104

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  36. Comparison of the analgesic effects of modified continuous intercostal block and paravertebral block under surgeon's direct vision after video-assisted thoracic surgery: a randomized clinical trial

    Kadomatsu, Y; Mori, S; Ueno, H; Uchiyama, M; Wakai, K

    GENERAL THORACIC AND CARDIOVASCULAR SURGERY   66 巻 ( 7 ) 頁: 425 - 431   2018年7月

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    記述言語:英語   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: Clinical evidence comparing paravertebral (PVB) and continuous intercostal nerve (ICB) blocks for pain management post video-assisted thoracic surgery (VATS) is limited. This study confirms the analgesic effect of ICB using two catheters is not inferior to that of PVB under direct vision. Methods: Fifty patients who underwent VATS lobectomy from July 2015 to March 2016 were prospectively recruited and randomly assigned to PVB and ICB groups. Postoperative pain was assessed using the visual analog scale (VAS). VAS score at rest at 24 h was the primary endpoint. Data on time required for catheter insertion, adverse effects, and frequency of additional analgesics as secondary endpoints were also collected. Noninferiority was assessed by adding a VAS margin of 15 mm to the PVB group. Results: No significant differences were observed between the VAS scores of the two groups except at 48 h after surgery, with a margin noted for the PVB group. No significant differences were detected in the frequency of additional analgesics and occurrence of adverse effects. Conclusions: Our results could not clearly establish noninferiority of ICB to PVB. Improvements in ICB may be necessary for it to be used as an alternative method to PVB.

    DOI: 10.1007/s11748-018-0936-8

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  37. 荒蕪肺を伴う続発性気管支動脈蔓状血管腫に対して左肺全摘術を施行した一例

    門松 由佳, 川角 佑太, 上野 陽史, 宇佐 美範恭, 内山 美佳, 森 正一

    日本呼吸器外科学会雑誌   32 巻 ( 4 ) 頁: 458 - 463   2018年5月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    <p>症例は60歳男性.繰り返す喀血を主訴に前医を受診した.重症肺炎の既往があり,左肺機能の低下を指摘されていた.胸部CTで左肺全体の囊胞状変化と容積低下,気管支拡張を認めた.複数の気管支動脈が高度に拡張し大動脈弓下と左肺門部を蛇行していた.標的血管が多く著明な拡張を伴っていたため気管支動脈塞栓術は不可能と判断し手術を施行した.手術は肺動静脈の処理を先行し,異常血管の集簇切離を行うことで時間を短縮し出血を最小限にとどめた.左肺全摘術後,広背筋弁にて気管支断端を被覆した.出血量は1,040 mLであった.術後経過は良好で以降は喀血を認めていない.気管支動脈蔓状血管腫の手術では異常血管の脆弱性と易出血性のため出血コントロールに苦慮する事がある.我々は,手術時の異常血管切離の手順と方法に工夫を加えることで高度に拡張した続発性気管支動脈蔓状血管腫の手術を比較的少ない出血量で手術を終えることができた.</p>

    DOI: 10.2995/jacsurg.32.458

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  38. 上大静脈および腕頭静脈合併切除を施行した胸部悪性腫瘍症例における血行再建術式と周術期管理の検討

    門松 由佳, 森 正一, 上野 陽史, 福本 紘一, 内山 美佳, 重光 希公生, 吉岡 洋, 横井 香平

    日本呼吸器外科学会雑誌   31 巻 ( 4 ) 頁: 446 - 452   2017年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    <p>目的:呼吸器外科手術において上大静脈や腕頭静脈の合併切除と血行再建を行った症例について,手術方法,周術期管理および再建血管の開存性について検討した.</p><p>方法:2005年から2014年までに上大静脈および腕頭静脈の切除と再建を施行した15例を対象とした.患者背景,再建術式,使用した人工血管の種類,抗凝固療法および再建血管の閉塞の有無および閉塞時の症状等を調査した.</p><p>結果:対象疾患は胸腺上皮性腫瘍11例,胚細胞性腫瘍2例,肺癌・悪性リンパ腫各1例で,切除した血管は上大静脈13例,右腕頭静脈12例,左腕頭静脈14例であった.全例で,血行再建には径10 mm以上の人工血管が使用され,周術期に抗凝固療法が行われていた.再建血管の閉塞が確認されたのは6例で,左右腕頭静脈再建例では人工血管閉塞時の症状出現が少なかった.</p><p>結論:大血管の切除を伴う手術は現在においても困難な術式であるが,今回検討した症例では周術期死亡や術後急性期の人工血管閉塞は認められなかった.また,人工血管閉塞に伴う症状が出現しない場合には血管閉塞時にも経過観察が可能であると考えられた.</p>

    DOI: 10.2995/jacsurg.31.446

    CiNii Research

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MISC 1

  1. Immunosuppressive treatment for myasthenia gravis crises improve the taste disorder in patients with thymoma: two case reports.

    Fukumoto K, Ohara Y, Okado S, Watanabe H, Noritake O, Nakanishi K, Kadomatsu Y, Ueno H, Kato T, Nakamura S, Chen-Yoshikawa TF  

    Mediastinum (Hong Kong, China)7 巻   頁: 40   2023年

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    記述言語:英語   出版者・発行元:Mediastinum  

    Background: Taste disorders in patients with thymoma accompanied by myasthenia gravis (MG) is rare. Case Description: The first case was a male in his 50s who underwent surgery for Masaoka stage III type B3 thymoma. He experienced a loss of taste before surgery, which showed no improvement after surgery. Due to a MG crisis 44 days after surgery, the patient underwent intensive treatment with mechanical ventilation, steroid pulse therapy, and intravenous immunoglobulin (IVIG) therapy. The patient recovered taste when he started oral food intake after the treatment for the MG crisis (about 3 months after surgery). Despite the recovery of taste after steroid pulse therapy and IVIG therapy, taste disorder gradually worsened about 1 year and 9 months after surgery, resulting in an almost complete loss of sweet taste 2 years after surgery. The second case was a male in his 60s who underwent surgery for Masaoka stage II type B1 thymoma. He experienced loss of taste before surgery, which showed no improvement after surgery. Five years and two months after surgery, the patient was diagnosed with a MG crisis and underwent steroid pulse therapy. Along with improvements in MG symptoms, taste disorders gradually improved. After 6 years and 10 months of surgery, the patient is still alive without MG symptoms (only pyridostigmine, 180 mg/body/day), taste disorder, and thymoma recurrence. Conclusions: The autoimmune mechanism may contribute to taste disorders in patients with thymoma, which can be recovered by immunosuppressive treatment in our cases.

    DOI: 10.21037/med-23-8

    Scopus

    PubMed

講演・口頭発表等 4

  1. Intraoperative and Postoperative air leak of RATS and VATS

    2022年10月6日 

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    開催年月日: 2022年10月

    国名:日本国  

  2. ICGによる肺区域間同定法を利用した肺区域切除の検討

    上野陽史

    第5回日本蛍光ガイド手術研究会  2022年9月17日 

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    開催年月日: 2022年9月

    国名:日本国  

  3. 【アプローチ別の術中および術後肺瘻発生頻度の比較】 -RATS vs VATS-

    上野陽史

    第122回日本外科学会定期学術集会  2022年4月15日 

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    開催年月日: 2022年4月

    記述言語:日本語   会議種別:口頭発表(一般)  

    国名:日本国  

  4. TBLB後の気道出血による右気管支閉塞に対し緊急手術にて救命した肺癌の1例

    Harushi ueno

    中部肺癌学会  2021年2月6日  日本肺癌学会

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    開催年月日: 2021年2月

    記述言語:日本語   会議種別:口頭発表(一般)  

    国名:日本国