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所属 |
附属病院 第二外科 |
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生年 |
1982年 |
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研究室住所 |
秋田市本道1-1-1 |
職務経歴（学内） 【 表示 ／ 非表示 】
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2021年04月-継続中
秋田大学 附属病院 第二外科 講師
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2019年04月-2021年03月
秋田大学 大学院医学系研究科（医学専攻等） 医学専攻 腫瘍制御医学系 助教
研究経歴 【 表示 ／ 非表示 】
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非小細胞肺がん術後補助化学療法としての カルボプラチン+ゲムシタビンの効果と安全性に関しての検討
（選択しない）
研究期間：
2019年04月-継続中研究態様：機関内共同研究
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Cyclin B2 mRNAの発現と非小細胞肺癌予後との関連性の検討
（選択しない）
研究期間：
2013年04月-2014年03月研究態様：機関内共同研究
学位論文 【 表示 ／ 非表示 】
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Strong expression of cyclin B2 mRNA correlates with a poor prognosis in patients with non-small cell lung cancer
Takashima S, Saito H, Takahashi N, Imai K, Kudo S, Atari M, Saito Y, Motoyama S, Minamiya Y
Tumor Biology 35 ( 5 ) 4257 - 4265 2014年03月 [査読有り]
国内共著
研究等業績 【 表示 ／ 非表示 】
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Tracheal bifurcation repair for blunt thoracic trauma in a patient with COVID-19.
Shoji Kuriyama, Kazuhiro Imai, Kasumi Tozawa, Shinogu Takashima, Ryo Demura, Haruka Suzuki, Yuzu Harata, Tatsuki Fujibayashi, Sumire Shibano, Yoshihiro Minamiya
Surgical case reports 9 ( 1 ) 108 - 108 2023年06月
研究論文（学術雑誌）
BACKGROUND: Tracheobronchial injury (TBI) is a rare but potentially life-threatening trauma that requires prompt diagnosis and treatment. We present a case in which a patient with COVID-19 infection was successfully treated for a TBI through surgical repair and intensive care with extracorporeal membrane oxygenation (ECMO) support. CASE PRESENTATION: This is the case of a 31-year-old man transported to a peripheral hospital following a car crash. Tracheal intubation was performed for severe hypoxia and subcutaneous emphysema. Chest computed tomography showed bilateral lung contusion, hemopneumothorax, and penetration of the endotracheal tube beyond the tracheal bifurcation. A TBI was suspected; moreover, his COVID-19 polymerase chain reaction screening test was positive. Requiring emergency surgery, the patient was transferred to a private negative pressure room in our intensive care unit. Due to persistent hypoxia and in preparation for repair, the patient was started on veno-venous ECMO. With ECMO support, tracheobronchial injury repair was performed without intraoperative ventilation. In accordance with the surgery manual for COVID-19 patients in our hospital, all medical staff who treated this patient used personal protective equipment. Partial transection of the tracheal bifurcation membranous wall was detected and repaired using 4-0 monofilament absorbable sutures. The patient was discharged on the 29th postoperative day without postoperative complications. CONCLUSIONS: ECMO support for traumatic TBI in this patient with COVID-19 reduced mortality risk while preventing aerosol exposure to the virus.
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Inferior pulmonary ligament division during left upper lobectomy causes pulmonary dysfunction.
Shoji Kuriyama, Kazuhiro Imai, Hajime Saito, Shinogu Takashima, Nobuyasu Kurihara, Ryo Demura, Haruka Suzuki, Yuzu Harata, Yusuke Sato, Katsutoshi Nakayama, Kyoko Nomura, Yoshihiro Minamiya
Interdisciplinary cardiovascular and thoracic surgery 36 ( 5 ) 2023年05月
研究論文（学術雑誌）
OBJECTIVES: The division of inferior pulmonary ligament (IPL) during upper lobectomy (UL) was believed to be mandatory to dilate the remaining lung sufficiently. However, the benefits, especially postoperative pulmonary function, remain controversial. This study aimed to evaluate whether IPL division leads to pulmonary dysfunction. METHODS: This retrospective study included 213 patients who underwent UL between 2005 and 2018. They were categorized into an IPL division group (D group, n = 106) and a preservation group (P group, n = 107). Postoperative dead space at the lung apex, pulmonary function and complications were assessed using chest X-rays and spirometry. Changes in bronchial angle, cross-sectional area and circumference of the narrowed bronchus on the excised side were measured on three-dimensional computed tomography. RESULTS: There was no significant difference in the postoperative complication rate, the dead space area, forced vital capacity (FVC), or forced expiratory volume in 1 s (FEV1) between the 2 groups after right UL (FVC; P = 0.838, FEV1; P = 0.693). By contrast, after left UL pulmonary function was significantly better in the P than in the D group (FVC; P = 0.038, FEV1; P = 0.027). Changes in bronchial angle did not significantly differ between the 2 groups. The narrowed bronchus's cross-sectional area (P = 0.021) and circumference (P = 0.009) were significantly smaller in the D group than in the P group after left UL. CONCLUSIONS: IPL division during left UL caused postoperative pulmonary dysfunction and airflow limitation due to bronchial kinking. IPL preservation may have a beneficial impact on postoperative pulmonary function.
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Matsuo T.
Thoracic Cancer ( Thoracic Cancer ) 14 ( 9 ) 827 - 833 2023年 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND: Sleeve lobectomy is recommended to avoid pneumonectomy and preserve pulmonary function in patients with central lung cancer. However, the relationship between postoperative pulmonary functional loss and resected lung parenchyma volume has not been fully characterized. The aim of this study was to evaluate the relationship between pulmonary function and lung volume in patients undergoing sleeve lobectomy or pneumonectomy. METHODS: A total of 61 lung cancer patients who had undergone pneumonectomy or sleeve lobectomy were analyzed retrospectively. Among them, 20 patients performed pulmonary function tests, including vital capacity (VC) and forced expiratory volume in 1 s (FEV1) tests, preoperatively and then about 6 months after surgery. VC and FEV1 ratios were calculated (measured postoperative respiratory function/predicted postoperative respiratory function) as the standardized pulmonary functional loss ratio. RESULTS: Thirty-day operation-related mortality was significantly lower after sleeve lobectomy (3.2%) than pneumonectomy (9.6%). The 5-year relapse-free survival rate was 46.67% versus 29.03%, and the 5-year overall survival rate was 63.33% versus 38.71% in patients receiving sleeve lobectomy versus pneumonectomy. The VC ratio in the pneumonectomy group was better than in the sleeve lobectomy group (1.003 ± 0.117 vs. 0.779 ± 0.12; p = 0.0008), as was the FEV1 ratio (1.132 ± 0.226 vs. 0.851 ± 0.063; p = 0.0038). CONCLUSIONS: Both short-term and long-term outcomes were better with sleeve lobectomy than pneumonectomy. However, actual postoperative pulmonary function after pneumonectomy may be better than clinicians expect, and pneumonectomy should still be considered a treatment option for patients with sufficient pulmonary reserve and in whom sleeve lobectomy is less likely to be curative.
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Changes in Serum Trace Element Concentrations before and after Surgery in Resectable Breast Cancer
Takahashi E.
Anticancer Research ( Anticancer Research ) 42 ( 11 ) 5323 - 5334 2022年11月 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND/AIM: Minerals and trace elements (TEs) play vital roles in normal biological functions and in all cancers. Breast carcinoma is the most commonly occurring cancer in women. The aim of this study was to evaluate changes in TE levels before and after breast cancer surgery and the clinical utility and reliability of TE levels assayed using inductively coupled plasma mass spectrometry (ICP-MS). PATIENTS AND METHODS: Thirteen patients with ductal carcinoma in situ (DCIS) and 34 with invasive ductal carcinoma (IDC) treated with planned surgery were enrolled between August 2017 and February 2019. Blood samples were collected before and the day after resection of the primary tumor. All enrolled patients received mastectomy or quadrantectomy and axillary lymph node dissection/biopsy. Serum TE concentrations were determined using ICP-MS. RESULTS: Changes in boron, titanium, vanadium, chromium, copper, zinc, and selenium levels from before to after surgery differed between IDC and DCIS patients. Boron and copper levels before surgery and changes in titanium, vanadium, and chromium before and after surgery are potential predictors distinguishing DCIS from IDC. Subset analysis showed that chromium is a potential biomarker for luminal subtype, while titanium and chromium are potential biomarkers for pathological staging. CONCLUSION: Changes in serum TEs before and after surgery may help with diagnosis and staging of breast cancer and in establishing TE supplementation protocols.
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Atari M.
Lung Cancer ( Lung Cancer ) 173 75 - 82 2022年11月 [査読有り]
研究論文（学術雑誌） 国内共著
OBJECTIVES: Locoregional recurrence of non-small cell lung cancer (NSCLC) occurs even among patients with stage I disease, as a result of tumor proliferative activity. The aim of this study was to evaluate the clinical reliability of a new rapid immunohistochemistry (IHC) technique for assessing malignant potential through detection of tumoral Ki-67 expression. MATERIALS AND METHODS: The rapid IHC method uses non-contact alternating current (AC) mixing to achieve more rapid/stable staining within 20 min during surgery. First, to investigate the association between clinical outcomes and tumoral Ki-67 labeling with rapid IHC, 21 pairs of surgical patients treated between 2012 and 2020 for pStage IA1-3 NSCLC with/without recurrence were retrospectively reviewed. Second, 40 frozen section (FS) samples in patients with NSCLC for whom radical surgery was planned between April 2021 and February 2022 were deemed eligible for comparison of the clinical performance of conventional IHC and intraoperative rapid Ki-67 IHC with FS. RESULTS: Detection of tumoral Ki-67 expression using rapid IHC with formalin-fixed, paraffin-embedded (FFPE) blocks was significantly associated with clinical outcomes in R0 pStage IA NSCLC surgical patients, including overall and recurrence-free survival (P = 0.0043 and P < 0.0001, respectively). Levels of Ki-67 expression among resectable NSCLC patients detected using rapid IHC with FS significantly correlated with those detected using conventional FFPE-IHC (p < 0.001). An intraoperative cut-off of > 7.5 % tumor cell Ki-67 positivity accurately predicted pathological stage more advanced than IA3 [P = 0.0185, Odds ratio = 20.477, 95 % confidence interval (CI): 1.660-252.55]. CONCLUSION: Rapid Ki-67 IHC with AC mixing could potentially serve as a clinical tool for intraoperative determination of tumor malignancy status. The present study suggests that segmentectomy for early small NSCLCs is oncologically safe and a reasonable alternative to lobectomy, but only when there is adequate intraoperative selection for primary tumors with low-grade malignancy, which could be verified using intraoperative rapid Ki-67 IHC with FS.
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体外式膜型人工肺（extracorporeal membrane oxygenation：ECMO）導入下に緊急で気管分岐部切除再建を行った1症例
中 麻衣子, 河合 秀樹, 石井 良明, 髙嶋 祉之具, 今井 一博, 南谷 佳弘
日本呼吸器外科学会雑誌 ( 一般社団法人 日本呼吸器外科学会 ) 37 ( 5 ) 493 - 499 2023年07月
<p>呼吸器外科手術の中でも気管分岐部切除再建は非常に稀な術式である．また高度な技術を要することから特に麻酔科との連携を図りながら手術に臨むことが多い．今回我々は気管分岐部再建を伴う手術を救命目的に緊急で施行せざるを得なかった気管癌の症例を経験したので報告する．</p><p>症例は76歳男性．気管癌の診断で当科に転院搬送後，術前精査中に左側の完全無気肺を認めたため救命目的に緊急手術の方針となった．手術は体外式膜型人工肺導入下に施行した．右開胸にて気管分岐部切除を施行し，double barrel型にて再建を行った．術後は誤嚥性肺炎や間質性肺炎，気管分岐部の吻合部離開など術後合併症を引き起こし，周術期管理は決して容易ではなかったが，術後約4ヵ月後に無事転院となった．緊急で気管分岐部再建まで要した手術は稀であり，文献を交えて検討する．</p>
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肺癌臨床病期IA期における区域切除から肺葉切除に術中術式変更された症例の検討
原田 柚子, 今井 一博, 高嶋 祉之具, 中 麻衣子, 松尾 翼, 南谷 佳弘
日本呼吸器外科学会雑誌 ( (NPO)日本呼吸器外科学会 ) 36 ( 6 ) 621 - 626 2022年09月
研究発表要旨（全国大会，その他学術会議）
区域切除はIA期の非小細胞肺癌(NSCLC)に対する標準的治療の一つであるが,根治を目的として区域切除を行う際は適切なリンパ節転移の評価と,切除断端の確保が必須である.本研究の目的は,術中判断で区域切除から肺葉切除に移行した症例の頻度と理由,予後を検討することである.当院で2014年から2020年までに臨床病期IA期のNSCLCに対して区域切除が予定された121名の転帰を検討した.121例中8例が術中診断と術者の判断により区域切除から葉切除に変更されていた.4例が術中迅速診断でリンパ節転移陽性の診断,4例は手術手技に関する問題が変更の主な要因となっていた.リンパ節転移の評価には迅速免疫組織化学染色も併用した.区域切除を完遂した患者(n=113)と肺葉切除術に変更した患者(n=8)の間で,全生存期間に有意差はなかった(P=0.5828).適切な術中の判断がなされれば,術前に区域切除の適応と考えられた症例のうち,肺葉切除すべき症例を発見することができる.(著者抄録)
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Extracorporeal membrane oxygenation(ECMO)併用下で安全に切除し得た気管炎症性筋線維芽細胞性腫瘍の1例
高橋 秀悟, 今井 一博, 高嶋 祉之具, 中 麻衣子, 栗山 章司, 南谷 佳弘
日本呼吸器外科学会雑誌 ( (NPO)日本呼吸器外科学会 ) 36 ( 4 ) 441 - 447 2022年05月
研究発表要旨（全国大会，その他学術会議）
気管腫瘍に対する外科的治療は,症例に合わせた術式および術中管理の工夫が必要である.今回我々は,原発性気管腫瘍に対してVV-ECMO併用下での1切除例を経験した.症例は55歳女性.慢性咳嗽を主訴に前医を受診し,精査で声帯より2cm末梢の気管膜様部に有茎性の腫瘍を認め,手術目的に当院へ紹介となった.VV-ECMO併用下(脱血:右大腿静脈,送血:右鎖骨下静脈),頸部襟状切開での気管環状切除(第1-2気管軟骨輪),気管端々吻合を行った.病理組織診断は,炎症性筋線維芽細胞性腫瘍(inflammatory myofibroblastic tumor,IMT)の診断であった.気道閉塞リスクが高い気管腫瘍手術において,覚醒下でのECMO導入は有用と考えられる.また,出血量増加などの術中合併症リスクを回避しつつ,術野確保などの安全性を向上できる可能性がある.(著者抄録)
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呼吸器外科における働き方改革への準備状況
南谷 佳弘, 今井 一博, 高嶋 祉之具, 中 麻衣子, 石井 良明, 小林 昭仁, 原田 柚子, 小林 未来
日本外科系連合学会誌 ( 日本外科系連合学会 ) 47 ( 3 ) 285 - 285 2022年05月
研究発表要旨（全国大会，その他学術会議）
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肺全摘術と気管支形成術における呼吸機能を含めた術後成績の検討
松尾 翼, 今井 一博, 高嶋 祉之具, 中 麻衣子, 栗山 章司, 石井 良明, 小林 昭仁, 高橋 秀悟, 原田 柚子, 木村 大輔, 南谷 佳弘
日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 ) 122回 DP - 2 2022年04月
研究発表要旨（全国大会，その他学術会議）