研究者詳細 - 橋川　和信

レックリングハウゼン病の下眼瞼外反に対し耳介軟骨移植とCaraji anchor suture systemで吊上げを行った1例

高須啓之, 橋川和信, 野村正, 寺師浩人

日本頭蓋顎顔面外科学会誌 32 巻 ( 3号 ) 頁： 213 2016年10月

骨盤内臓全摘術後に有茎大網弁及び遊離広背筋皮弁充填術を施行した一例

北川敬之, 野村正, 橋川和信, 寺師浩人, 山下公大

日本形成外科学会会誌 36 巻 ( 10号 ) 頁： 533 2016年10月

Comparison between primary closure and skin grafts of the free fibula osteocutaneous flap donor site. 査読有り

Akashi M, Hashikawa K, Takasu H, Watanabe K, Kusumoto J, Sakakibara A, Hasegawa T, Minamikawa T, Komori T

Oral and maxillofacial surgery 20 巻 ( 3 ) 頁： 233 - 7 2016年9月

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

Purpose: This study aimed to compare the size of skin paddles, the postoperative course, and donor site complications between primary closure and skin grafts of the free fibula flap donor site. Methods: Thirty-five consecutive patients were enrolled. Medical records were retrospectively reviewed for risk factors for delayed healing, size of skin paddles, time to resumption of gait with a mobility aid and self-ambulation, early donor site morbidity, and late donor site complaints. Results: The harvested skin paddles were significantly wider in the skin graft group than in the primary closure group (P = 0.02), with no difference in length (P = 0.1). The difference in time to resuming gait with a mobility aid was also significant (P = 0.01), but not the time to self-ambulation (P = 0.9). Two early donor site morbidities (5.7 %) and 12 late donor site complaints (34.3 %) were found. No significant difference in the incidence of early donor site morbidity was observed between two groups. Occurrence of late donor site complaints was not affected by any risk factors. Conclusions: The width of the harvested skin paddle, but not the length, is one of factors involved in donor site closure. Resumption of gait with a mobility aid, but not self-ambulation, may be delayed in skin graft patients.

DOI： 10.1007/s10006-016-0556-3

The usefulness of a surgical suture attached with a straight needle in lymphaticovenous anastomosis

治療抵抗性毛細血管奇形に対するパルス可変式色素レーザー・Nd:YAGレーザー併用療法の検討

野村正, 江尻浩隆, 榊原俊介, 柳英之, 武川力, 辻依子, 田原真也, 橋川和信, 寺師浩人

日本レーザー医学会誌 37 巻 ( 3号 ) 頁： 366 2016年9月

Hashikawa K.

Japanese Journal of Plastic Surgery 59 巻 ( 8 ) 頁： 819 - 825 2016年8月

記述言語：日本語出版者・発行元：Japanese Journal of Plastic Surgery

Recent advances in microsurgery have enabled surgical anastomosis of small vessels with calibers less than 1 mm. An anastomosis of a small vein and a lymphatic vessel, lymphaticovenous anastomosis (LVA), is an effective surgical treatment for lymphedema. However, because of the particularities of lymphatic vessels such as their small caliber and thin vessel wall, LVA is a difficult treatment to perform. This report presents the usefulness of a surgical suture attached with a straight needle in LVA. Fifty cases where LVAs were carried out with the technique were retrospectively reviewed based on technical viewpoints with medical records including operative reports and videos. The gages of threads used in the procedure were 11-0 and 12-0, and all were made of monofilament nylon. The diameters of the needles were 40um, 50um, 60um and 80um. and the lengths of needles were 3 mm, 4 mm and 5 mm. The calibers of the anastomosed lymphatic vessels were 0.2 mm to 1.0 mm. Both end-to-end and end-to-side anastomoses were performed. All the patients developed no postoperative complications related to the procedure. The review of the cases showed: (1) a back-wall first technique was useful for the anastomosis of vessels with calibers of less than 1 mm; (2) a straight needle was useful for a posterior vessel wall; (3) in particular, direction was easy to control when stabbing a vessel wall with a straight needle; (4) an anterior wall was difficult to stab with a straight needle when the wall was very thick, which was much less frequent in LVA. Some technical refinements are necessary for a reliable procedure in lymphatic microsurgery. The combination of a usual back-wall first technique and a straight needle is an effective alternative in LVA.

Four-dimensional computed tomography evaluation of jaw movement following mandibular reconstruction: A pilot study 査読有り

Akashi Masaya, Shibuya Yasuyuki, Takahashi Satoru, Hashikawa Kazunobu, Hasegawa Takumi, Kakei Yasumasa, Negi Noriyuki, Sekitani Toshinori, Komori Takahide

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY 44 巻 ( 5 ) 頁： 637 - 641 2016年5月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cranio-Maxillofacial Surgery

Purpose The purpose of this study was to analyze jaw movement during mastication in patients who underwent mandibular reconstruction following segmental mandibulectomy, including mouth opening and mastication time, based on four-dimensional computed tomography (4D CT) images. Material and methods This study included six surgical patients, who underwent segmental mandibulectomy and simultaneous reconstruction with a free fibula osteocutaneous flap, and four controls. 4D CT was performed during mastication of a cookie to evaluate the movement of the jaw during natural function. The maximum mouth opening, mastication time, and movement of the mandibular angle during mastication were evaluated from the 4D CT images. Results 4D CT images enabled visualization of jaw movement during mastication. When compared with the controls, the maximum mouth opening during mastication and excursion of the mandibular angle, especially on the diseased side, tended to decrease in surgical patients; however, this did not occur with mastication time. The numerical differences between the diseased and nondiseased side in surgical patients tended to be higher than the crosswise differences in controls. Conclusion 4D CT images revealed differences in jaw function between patients who underwent mandibular reconstruction and controls. 4D CT could be used to evaluate postoperative outcomes following mandibular reconstruction.

DOI： 10.1016/j.jcms.2016.01.027

Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone 査読有り国際誌

Shinomiya Hirotaka, Hasegawa Shingo, Yamashita Daisuke, Ejima Yasuo, Kenji Yoshida, Otsuki Naoki, Kiyota Naomi, Sakakibara Shunsuke, Nomura Tadashi, Hashikawa Kazunobu, Kohmura Eiji, Sasaki Ryohei, Nibu Ken-ichi

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 38 巻頁： E949 - E953 2016年4月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Head and Neck

Background The purpose of this study was to analyze outcomes for the treatment of locally advanced temporal bone cancer by means of concomitant chemoradiotherapy (CCRT) with a combination of cisplatin (CDDP), 5-fluorouracil (5-FU), and docetaxel (TPF). Methods Between 2006 and 2011, 34 patients with squamous cell carcinoma of the temporal bone were treated at Kobe University Hospital. Medical records were retrospectively reviewed to obtain information concerning patient characteristics, extent of disease, treatment, adverse events, and oncologic results. Results Ten patients were treated with CCRT using TPF regimen. The 5-year overall survival rate and disease-free survival rate were both 60%. Of special interest is that even for patients with unresectable T4 disease, the 5-year overall survival rate was 56%. Conclusion The results of our study indicate that CCRT with TPF for locally advanced temporal bone cancer is an effective and promising regimen.

DOI： 10.1002/hed.24133

創内持続陰圧洗浄療法を用いた下腿コンパートメント症候群後皮膚潰瘍の治療

高須啓之, 森脇綾, 橋川和信, 野村正, 寺師浩人

日本形成外科学会会誌 36 巻 ( 3号 ) 頁： 144 2016年3月

A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography 査読有り

OkumuraK, HashikawaK, SakakibaraS, OnishiH, TerashiH

Eplasty 16 巻頁： e11 2016年2月

A comparison of radial forearm free-flap reconstruction and non-reconstruction after partial maxillectomy. 査読有り

Akashi M, Shibuya Y, Takahashi Y, Kusumoto J, Sakakibara A, Hasegawa T, Minamikawa T, Hashikawa K, Komori T

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. 28 巻 ( 2 ) 頁： 111 - 117 2016年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Objective: This study aimed to compare postoperative outcomes between free-flap reconstruction and prosthesis after secondary healing for moderate-sized maxillectomy defects. Methods: We enrolled patients who underwent tumor ablation extending to the alveolus, antral walls, masticatory space, and surrounding soft tissue but not the orbital floor with either radial forearm free-flap reconstruction (RFFF) or no reconstruction (NR) and compared the extent of cheek concavity on the resected side, evaluated using axial computed tomography images, and time to prosthesis insertion between the RFFF and NR groups. Results: There was a significant difference between the RFFF and NR groups in operative duration (P = 0.010) but not blood loss. The postoperative cheek concavity was significantly smaller in the RFFF group (P = 0.037). Although the between group difference in time to prosthesis insertion was not significant, prostheses tended to be inserted earlier in the RFFF group; median time to prosthesis insertion was 49 days in the RFFF group and 67 days in the NR group. Conclusions: Reconstruction of a moderate-sized maxillectomy defect with radial forearm free-flap transfer can improve postoperative outcome.

DOI： 10.1016/j.ajoms.2015.08.007

A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography.

Okumura K, Hashikawa K, Sakakibara S, Onishi H, Terashi H

Eplasty 16 巻頁： e11 2016年

常勤形成外科医不在施設における乳房一次再建症例の検討査読有り

野村正, 榊原俊介, 西藤勝, 河野範男, 橋川和信, 寺師浩人

Oncoplastic Breast Surgery 1 巻 ( 2 ) 頁： 1 - 6 2016年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本乳房オンコプラスティックサージャリー学会

<p>　常勤形成外科医が不在の施設で, 形成外科医が非常勤として乳房一次再建に取り組んだわれわれの方法を紹介するとともに, 連携における問題点について検討し, 報告する。連携方法としては, 常勤形成外科が不在の2施設において, 乳腺外科の診察時に, 患者がある程度再建手術に関心があれば, おもに電子メールによりその情報が非常勤の形成外科医に伝えられ, 手術日程の候補日を検討した。術前に当該施設で全患者の診察を形成外科医が行った。再建手術を行ったのは28例30側で, 平均年齢は46.1歳, 再建術式は自家組織による再建19例19側 (有茎広背筋皮弁18例, 有茎横軸型腹直筋皮弁1例) , ティッシュエキスパンダー挿入が9例11側であった。形成外科の初診から手術までの日数は, 平均26.0±14.9日であった。電子メールの利用により連携は比較的スムーズであった。本連携では再建術式が限定されるため, 術式決定には, 形成外科医の診察およびインフォームド・コンセントが必須である。</p>

DOI： 10.20699/jopbs.1.2_82

CiNii Research

"Sensory Switching" in Elbow Reconstruction. 査読有り

Sakakibara S, Hashikawa K, Terashi H

Journal of brachial plexus and peripheral nerve injury 10 巻 ( 1 ) 頁： e30 - e33 2015年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Brachial Plexus and Peripheral Nerve Injury

In the treatment of the soft tissue defect of the elbow, flap reconstruction is necessitated in many cases because of thinness of soft tissue at this region. In addition, reacquirement of tactile sensation is desirable because of the anatomical and specific functions of the elbow. Of three cases treated for elbow defects, one was reconstructed with a pedicled island forearm flap containing the lateral cutaneous nerve of the forearm, another was reconstructed with a venoneuro-accompanying artery fasciocutaneous flap (VNAF flap) containing the basilic vein, and the third with the VNAF flap containing the cephalic vein. The three cases demonstrated a sudden change of sensory territory 4 to 6 months after surgery, which was confirmed by touching the reconstructed region with patients' eye-closed: from its original territory to the elbow in a "switching"-like action. Here we describe and discuss the concept of "sensory switching".

DOI： 10.1055/s-0035-1549369

CT Evaluation of Morphology of Transferred Fibula for Implant Placement in Reconstructed Mandible 査読有り

Akashi Masaya, Shibuya Yasuyuki, Wanifuchi Satoshi, Kusumoto Junya, Sakakibara Akiko, Kimoto Akira, Hasegawa Takumi, Suzuki Hiroaki, Hashikawa Kazunobu, Komori Takahide

IMPLANT DENTISTRY 24 巻 ( 5 ) 頁： 541 - 546 2015年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Implant Dentistry

Background: Dental rehabilitation with osseointegrated implants in reconstructed mandibles remains one of the most challenging procedures for oral and maxillofacial surgeons. Satisfactory outcome requires appropriate assessment of graft morphology. There are few analyses of the morphology of fibulae in reconstructed mandibles, although cadaver studies on fibular shape have been performed. Materials and Methods: In this study, we used postoperative computed tomography to retrospectively evaluate the shape, height, and orientation of fibulae transferred after mandibulectomy in 19 patients. Results: The average height of transferred fibulae was 14.3 mm (range, 10.8'20.5 mm). The crosssectional morphology of transferred fibulae could be classified into 2 types: apex and nonapex. The former type included knife-edged and triangular shapes; the latter included square and circular shapes. Conclusion: When implant insertion is planned in a reconstructed mandible, the orientation of the apex of transferred fibula should be evaluated preoperatively to allow for adjustments in implant procedure because the ridge at the apex of the fibula is narrow.

DOI： 10.1097/ID.0000000000000290

Sequential evaluation for bone union of transferred fibula flaps in reconstructed mandibles: panoramic X-ray versus computed tomography 査読有り

難治性下腿潰瘍の1例

北川敬之, 野村正, 橋川和信, 寺師浩人, 柳沢曜

日本形成外科学会会誌 35 巻 ( 10号 ) 頁： 626 2015年10月

Akashi M., Hashikawa K., Kakei Y., Sakakibara A., Hasegawa T., Minamikawa T., Komori T.

INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY 44 巻 ( 8 ) 頁： 942 - 947 2015年8月

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

The purpose of this study was to sequentially evaluate bone union of fibular grafts in mandibular reconstruction. Patients who underwent routine follow-up computed tomography (CT) and panoramic X-ray imaging during a period of ≥2 years were enrolled. On panoramic X-ray images, bone union was scored as 0 (absent callus formation) or 1 (complete callus formation). On CT images, a scale of 0 to 2 was used (0, absent callus formation; 1, complete callus formation only on the labial side; 2, complete callus formation on both the labial and lingual side). A total of 56 bone junctions were evaluated in 20 patients. Five of 56 junctions (9%) in four of 20 patients (20%) showed radiological non-union (panoramic X-ray score = 0, CT score = 0 or 1) at 2 years after surgery. All bone junctions with radiological non-union were located at the mandibular angle. No categorical values, including diabetes mellitus and radiation therapy, were significantly associated with radiological non-union. In conclusion, assessing at least two sides (i.e. labial and lingual sides) on CT images is adequate to evaluate bone union in transferred fibula flaps. Careful fixation at the mandibular angle may improve the rate of bone union.

DOI： 10.1016/j.ijom.2015.04.014

Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report 査読有り

SakakibaraS, TokiyoshiT, HashikawaK, TerashiH

Eplasty 15 巻頁： e23 2015年6月

Does Salivary Duct Repositioning Prevent Complications After Tumor Resection or Salivary Gland Surgery? 査読有り

Sakakibara Akiko, Minamikawa Tsutomu, Hashikawa Kazunobu, Sakakibara Shunsuke, Hasegawa Takumi, Akashi Masaya, Furudoi Shungo, Komori Takahide

JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY 73 巻 ( 5 ) 頁： 1003 - 1007 2015年5月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Oral and Maxillofacial Surgery

Purpose: Tissue that is resected for the treatment of oral tumors often includes salivary gland ducts. At their institution, the authors conserve and transfer as much of the salivary duct as possible during these procedures to avoid obstructive complications. Differentiating these obstructive complications from a metastatic node can be challenging and can confound subsequent oncologic management. This study compared and examined the effectiveness of salivary duct repositioning in decreasing the incidence of obstructive complications. Materials and Methods: Cases of oromandibular disease treated with salivary duct resection at Kobe University Graduate School of Medicine from 2008 to 2013 were retrospectively analyzed. Thirty-two cases (25 patients) of Wharton duct resection and 31 cases (31 patients) of Stensen duct resection were included. The incidence of complications after salivary duct repositioning, duct ligation, and retention of the sublingual gland around the Wharton duct was compared. Results: Wharton ducts were repositioned in 30 cases and ligated in 2 cases. Complications, including oral swelling at the Wharton duct, were observed in 5 cases of repositioning and 2 cases of ligation. Stensen ducts were repositioned in 9 cases and ligated in 22 cases. The only complication reported was a single case of salivary fistula after ligation. Conclusions: Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct.

DOI： 10.1016/j.joms.2014.12.006