|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Significance of functional hepatic resection rate calculated using 3D CT/^(99m)Tc-galactosyl human serum albumin singlephoton emission computed tomography fusion imaging显示文摘AIM: To evaluate the usefulness of the functional hepatic resection rate(FHRR) calculated using 3D computed tomography(CT)/^(99m)Tc-galactosyl-human serum albumin(GSA) single-photon emission computed tomography(SPECT) fusion imaging for surgical decision making. METHODS: We enrolled 57 patients who underwent bi- or trisectionectomy at our institution between October 2013 and March 2015. Of these, 26 patients presented with hepatocellular carcinoma, 12 with hilar cholangiocarcinoma, six with intrahepatic cholangiocarcinoma, four with liver metastasis, and nine with other diseases. All patients preoperatively underwent three-phase dynamic multidetector CT and ^(99m)Tc-GSA scintigraphy. We compared the parenchymal hepatic resection rate(PHRR) with the FHRR, which was defined as the resection volume counts per total liver volume counts on 3D CT/^(99m)Tc-GSA SPECT fusion images.RESULTS: In total, 50 patients underwent bisectionectomy and seven underwent trisectionectomy.Biliary reconstruction was performed in 15 patients, including hepatopancreatoduodenectomy in two. FHRR and PHRR were 38.6 ± 19.9 and 44.5 ± 16.0, respectively; FHRR was strongly correlated with PHRR. The regression coefficient for FHRR on PHRR was 1.16(P < 0.0001). The ratio of FHRR to PHRR for patients with preoperative therapies(transcatheter arterial chemoembolization, radiation, radiofrequency ablation, etc.), large tumors with a volume of > 1000 m L, and/or macroscopic vascular invasion was significantly smaller than that for patients without these factors(0.73 ± 0.19 vs 0.82 ± 0.18, P < 0.05). Postoperative hyperbilirubinemia was observed in six patients. Major morbidities(Clavien-Dindo grade ≥ 3) occurred in 17 patients(29.8%). There was no case of surgeryrelated death.CONCLUSION: Our results suggest that FHRR is an important deciding factor for major hepatectomy, because FHRR and PHRR may be discrepant owing to insufficient hepatic inflow and congestion in patients with preoperative therapies, macroscopic vascular invasion, and/or a tumor volume of > 1000 m L. | Yosuke Tsuruga Toshiya Kamiyama Hirofumi Kamachi Shingo Shimada Kenji Wakayama Tatsuya Orimo Tatsuhiko Kakisaka Hideki Yokoo Akinobu Taketomi | 2016 | World Journal of Gastroenterology2016，22，17： | 6 |
| 2 | High HbA1c is a risk factor for complications after hepatectomy and influences for hepatocellular carcinoma without HBV and HCV infection显示文摘Background:Currently,the population with type 2 diabetes mellitus(DM)is increasing worldwide.However,the influence of DM or hyperglycemia on the outcome of resected hepatocellular carcinoma(HCC)is unclear.Methods:We analyzed 756 patients with HCC who underwent hepatectomy.These patients were assigned to an HbA1c≥7.0%(H-A1c;n=100)or HbA1c<7.0%(L-A1c;n=656)group depending on their HbA1c level at admission.We investigated prognoses,clinicopathological characteristics and surgical outcomes including morbidities of HCC patients with high HbA1c,prognoses according to the treatment for DM were also investigated.Results:Among all patients and those with hepatitis B virus(HBV)and hepatitis C virus(HCV)infection,overall survival(OS)and relapse-free survival(RFS)did not differ significantly between the H-A1c and L-A1c groups.In contrast,the 5-year OS rate of the H-A1c group was 55%and that of the L-A1c group 71%among patients without HBV and HCV(NBNC patients)(P=0.03).Among NBNC patients,the median RFS of the H-A1c group was 13 months,and that of the L-A1c group was 26 months(P=0.02).In addition,metformin use was an independent favorable factor for both OS and RFS.The H-A1c group had significantly higher rates of hyperbilirubinemia,wound infection,and pneumonia.Conclusions:HCC patients with high HbA1c might have poor prognoses for both survival and recurrence in NBNC-HCC.High HbA1c may also be a risk factor for morbidities after hepatectomy.Metformin use may constitute a good option for NBNC patients with HCC. | Shingo Shimada Toshiya Kamiyama Tatsuya Orimo Akihisa Nagatsu Hirofumi Kamachi Akinobu Taketomi | 2021 | Hepatobiliary Surgery and Nutrition2021，10，4： | 2 |
| 3 | Enhan- cing the generalization ability of neural networks through con- trolling the hidden layers显示文摘 | Wan Weishui Shingo Mabu Kaoru Shimada | 2009 | Applied Soft Computing2009，9，1： | 1 |
| 4 | Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus显示文摘 | Kazunari Ishii Tomonori Kanda Aya Harada Naokazu Miyamoto Tetsuro Kawaguchi Kenichi Shimada Shingo Ohkawa Takafumi Uemura Toshiki Yoshikawa Etsuro Mori | 2008 | European Radiology2008，，11： | 1 |
| 5 | Impact of comorbid renal dysfunction in patients with hepatocellular carcinoma on long-term outcomes after curative resection显示文摘BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common malignancies worldwide.However,the number of patients with chronic kidney disease(CKD)is on the rise because of the increase in lifestyle-related diseases.AIM To establish a tailored management strategy for HCC patients,we evaluated the impact of comorbid renal dysfunction(RD),as stratified by using the estimated glomerular filtration rate(EGFR),and assessed the oncologic validity of hepatectomy for HCC patients with RD.METHODS We enrolled 800 HCC patients who underwent hepatectomy between 1997 and 2015 at our university hospital.We categorized patients into two(RD,EGFR<60 mL/min/1.73 m^(2);non-RD,EGFR≥60 mL/min/1.73 m^(2))and three groups(severe CKD,EGFR<30 mL/min/1.73 m^(2);mild CKD,30≤EGFR<60 mL/min/1.73 m2;control,EGFR≥60 mL/min/1.73 m^(2))according to renal function as defined by the EGFR.Overall survival(OS)and recurrence-free survival(RFS)were compared among these groups with the log-rank test,and we also analyzed survival by using a propensity score matching(PSM)model to exclude the influence of patient characteristics.The mean postoperative observation period was 64.7±53.0 mo.RESULTS The RD patients were significantly older and had lower serum total bilirubin,aspartate aminotransferase,and aspartate aminotransferase levels than the non-RD patients(P<0.0001,P<0.001,P<0.05,and P<0.01,respectively).No patient received maintenance hemodialysis after surgery.Although the overall postoperative complication rates were similar between the RD and non-RD patients,the proportions of postoperative bleeding and surgical site infection were significantly higher in the RD patients(5.5%vs 1.8%;P<0.05,3.9%vs 1.8%;P<0.05,respectively),and postoperative bleeding was the highest in the severe CKD group(P<0.05).Regardless of the degree of comorbid RD,OS and RFS were comparable,even after PSM between the RD and non-RD groups to exclude the influence of patient characteristics,liver function,and other causes of death.CONCLUSION Comorbid mild RD had a negligible impact on the prognosis of HCC patients who underwent curative hepatectomy with appropriate perioperative management,and close attention to severe CKD is necessary to prevent postoperative bleeding and surgical site infection. | Yuzuru Sakamoto Shingo Shimada Toshiya Kamiyama Ko Sugiyama Yoh Asahi Akihisa Nagatsu Tatsuya Orimo Tatsuhiko Kakisaka Hirofumi Kamachi Yoichi M Ito Akinobu Taketomi | 2022 | World Journal of Gastrointestinal Surgery2022，14，7： | 0 |
| 6 | Identification of telomere maintenance gene variations related to lung adenocarcinoma risk by genome-wide association and whole genome sequencing analyses显示文摘Dear editor,Lung carcinoma is responsible for the highest fatal-ity rate among cancer-related deaths globally,with lung adenocarcinoma(LADC)emerging as the prevailing sub-type. | Kouya Shiraishi Atsushi Takahashi Yukihide Momozawa Yataro Daigo Syuzo Kaneko Takahisa Kawaguchi Hideo Kunitoh Shingo Matsumoto Hidehito Horinouchi Akiteru Goto Takayuki Honda Kimihiro Shimizu Masahiro Torasawa Daisuke Takayanagi Motonobu Saito Akira Saito Yuichiro Ohe Shun-ichi Watanabe Koichi Goto Masahiro Tsuboi Katsuya Tsuchihara Sadaaki Takata Tomomi Aoi Atsushi Takano Masashi Kobayashi Yohei Miyagi Kazumi Tanaka Hiroyuki Suzuki Daichi Maeda Takumi Yamaura Maiko Matsuda Yoko Shimada Takaaki Mizuno Hiromi Sakamoto Teruhiko Yoshida Yasushi Goto Tatsuya Yoshida Taiki Yamaji Makoto Sonobe Shinichi Toyooka Kazue Yoneda Katsuhiro Masago Fumihiro Tanaka Megumi Hara Nobuo Fuse Satoshi S.Nishizuka Noriko Motoi Norie Sawada Yuichiro Nishida Kazuki Kumada Kenji Takeuchi Kozo Tanno Yasushi Yatabe Kuniko Sunami Tomoyuki Hishida Yasunari Miyazaki Hidemi Ito Mitsuhiro Amemiya Hirohiko Totsuka Haruhiko Nakayama Tomoyuki Yokose Kazuyoshi Ishigaki Toshiteru Nagashima Yoichi Ohtaki Kazuhiro Imai Ken Takasawa Yoshihiro Minamiya Kazuma Kobayashi Kenichi Okubo Kenji Wakai Atsushi Shimizu Masayuki Yamamoto Motoki Iwasaki Koichi Matsuda Johji Inazawa Yuichi Shiraishi Hiroyoshi Nishikawa Yoshinori Murakami Michiaki Kubo Fumihiko Matsuda Yoichiro Kamatani Ryuji Hamamoto Keitaro Matsuo Takashi Kohno | 2024 | Cancer Communications2024，44，2： | 0 |
| 7 | Functional transition:Inconsistently parallel to the increase in future liver remnant volume after preoperative portal vein embolization显示文摘BACKGROUND Preoperative portal vein embolization(PVE)is a widely used strategy to enable major hepatectomy in patients with insufficient liver remnant.PVE induces hypertrophy of the future liver remnant(FLR)and a shift of the functional reserve to the FLR.However,whether the increase of the FLR volume(FLRV)corresponds to the functional transition after PVE remains unclear.AIM To investigate the sequential relationship between the increase in FLRV and functional transition after preoperative PVE using 3-dimensional(3D)computed tomography(CT)and 99mTc-galactosyl-human serum albumin(99mTc-GSA)singlephoton emission computed tomography(SPECT)fusion images.METHODS Thirty-three patients who underwent major hepatectomy following PVE at the Department of Gastroenterological Surgery I,Hokkaido University Hospital between October 2013 and March 2018 were enrolled.Three-phase dynamic multidetector CT and 99mTc-GSA SPECT scintigraphy were performed at pre-PVE,and at 1 and 2 wk after PVE;3D 99mTc-GSA SPECT CT-fused images were constructed from the Digital Imaging and Communications in Medicine data using 3D image analysis system.Functional FLRV(FFLRV)was defined as the total liver volume×(FLR volume counts/total liver volume counts)on the 3D 99m Tc-GSA SPECT CT-fused images.The calculated FFLRV was compared with FLRV.RESULTS FFLRV increased by a significantly larger extent than FLRV at 1 and 2 wk after PVE(P<0.01).The increase in FFLRV and FLRV was 55.1%±41.6%and 26.7%±17.8%(P<0.001),respectively,at 1 wk after PVE,and 64.2%±33.3%and 36.8%±18.9%(P<0.001),respectively,at 2 wk after PVE.In 3 of the 33 patients,FFLRV levels decreased below FLRV at 2 wk.One of the three patients showed rapidly progressive fatty changes in FLR.The biopsy at 4 wk after PVE showed macroand micro-vesicular steatosis of more than 40%,which improved to 10%.Radical resection was performed at 13 wk after PVE.The patient recovered uneventfully without any symptoms of pos-toperative liver failure.CONCLUSION The functional transition lagged behind the increase in FLRV after PVE in some cases.Evaluating both volume and function is needed to determine the optimal timing of hepatectomy after PVE. | Yosuke Tsuruga Toshiya Kamiyama Hirofumi Kamachi Tatsuya Orimo Shingo Shimada Akihisa Nagatsu Yoh Asahi Yuzuru Sakamoto Tatsuhiko Kakisaka Akinobu Taketomi | 2021 | World Journal of Gastrointestinal Surgery2021，13，2： | 0 |
| 8 | Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma显示文摘BACKGROUND The prognosis of advanced hepatocellular carcinoma(HCC)that is not indicated for curative hepatectomy remains poor,despite advances in the treatment of HCC,including the development of tyrosine kinase inhibitors(TKIs).The outcomes of reduction hepatectomy and multidisciplinary postoperative treatment for advanced HCC that is not indicated for curative hepatectomy,including those of recently treated cases,should be investigated.AIM To examine the outcomes of combination treatment with reduction hepatectomy and multidisciplinary postoperative treatment for advanced HCC that is not indicated for curative hepatectomy.METHODS Thirty cases of advanced HCC that were not indicated for curative hepatectomy,in which reduction hepatectomy was performed between 2000 and 2018 at the Department of Gastroenterological Surgery I,Hokkaido University Graduate School of Medicine,were divided into postoperative complete remission(POCR)(+)and POCR(-)groups,depending on whether POCR of all evaluable lesions was achieved through postoperative treatment.The cases in the POCR(-)group were subdivided into POCR(-)TKI(+)and POCR(-)TKI(-)groups,depending on whether TKIs were administered postoperatively.RESULTS The 5-year overall survival rate and mean survival time(MST)after reduction hepatectomy were 15.7%and 28.40 mo,respectively,for all cases;37.5%and 56.55 mo,respectively,in the POCR(+)group;and 6.3%and 14.84 mo,respectively,in the POCR(-)group(P=0.0041).Tumor size,major vascular invasion,and the number of tumors in the remnant liver after the reduction hepatectomy were also found to be related to survival outcomes.The number of tumors in the remnant liver was the only factor that differed significantly between the POCR(+)and POCR(-)groups,and POCR was achieved significantly more frequently when≤3 tumors remained in the remnant liver(P=0.0025).The MST was 33.52 mo in the POCR(-)TKI(+)group,which was superior to the MST of 10.74 mo seen in the POCR(-)TKI(-)group(P=0.0473).CONCLUSION Reduction hepatectomy combined with multidisciplinary postoperative treatment for unresectable advanced HCC that was not indicated for curative hepatectomy was effective when POCR was achieved via multidisciplinary postoperative therapy.To achieve POCR,reduction hepatectomy should aim to ensure that≤3 tumors remain in the remnant liver.Even in cases in which POCR is not achieved,combined treatment with reduction hepatectomy and multidisciplinary therapy can improve survival outcomes when TKIs are administered. | Yoh Asahi Toshiya Kamiyama Tatsuhiko Kakisaka Tatsuya Orimo Shingo Shimada Akihisa Nagatsu Takeshi Aiyama Yuzuru Sakamoto Hirofumi Kamachi Akinobu Taketomi | 2021 | World Journal of Gastrointestinal Surgery2021，13，10： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员