Research activity information

• 2023 膵臓学会, Best paper in 2023

  Yoshihide Nanno


• 2018 Japanese Society of Parenteral and Enteral Nutrition, Young Doctors Award

  International academic award


• 2015 Asia Pacific Digestive Week, Young Investigator’s Award

  International academic award


• 2015 International Association of Pancreatology, International Association of Pancreatology Grant

  International academic award

• Preoperative level of serum transthyretin as a novel biomarker predicting survival in resected pancreatic ductal adenocarcinoma with neoadjuvant therapy.

  Yoshihide Nanno, Hirochika Toyama, Takuya Mizumoto, Jun Ishida, Takeshi Urade, Kenji Fukushima, Hidetoshi Gon, Daisuke Tsugawa, Shohei Komatsu, Sadaki Asari, Hiroaki Yanagimoto, Masahiro Kido, Takumi Fukumoto

  BACKGROUND: Systemic inflammation and altered metabolism are essential hallmarks of cancer. We hypothesized that the rapid turnover protein transthyretin (TTR) (half-life: 2-3 days), compared with the conventional marker albumin (21 days), better reflects the inflammatory/metabolic dynamics of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT) and is a useful prognostic marker. METHODS: Serum TTR and albumin levels were measured in 104 consecutive post-NAT PDAC patients before curative resection. The associations of preoperative TTR and albumin levels with overall survival (OS) after pancreatectomy were retrospectively analyzed. RESULTS: The mean (SD) TTR and albumin levels were 21.6 (6.4) mg/dL (normal range: ≥22.0 mg/dL) and 3.9 (0.55) g/dL. A low (<22.0 mg/dL) post-NAT TTR level was associated with an advanced tumor stage and higher CEA and CRP levels. Patients with low TTR levels showed significantly worse OS compared with normal levels (3-year OS 39 % vs. 54 %, P = 0.037), although albumin levels did not. We modified prognostic biomarkers of systemic inflammation/metabolism, such as GPS, PNI, and CONUT scores, using the serum TTR instead of albumin level and successfully showed that modified scores were better associated with OS compared with original scores using serum albumin level. CONCLUSIONS: Our data suggest that the TTR level is a promising prognostic biomarker for PDAC patients after NAT.

  Sep. 2024, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 24(6) (6), 917 - 924, English, International magazine

  Scientific journal


• Comparison of laparoscopic liver resection for the ventral versus the dorsal areas of segment 8.

  Kentaro Oji, Takeshi Urade, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Nobuaki Yamasaki, Kenji Fukushima, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Masayuki Akita, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Sadaki Asari, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  PURPOSE: The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear. METHODS: We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023. RESULTS: Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences. CONCLUSION: The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss. THE TRIAL REGISTRATION NUMBER: B230165 (approved at December 26, 2023).

  Aug. 2024, Langenbeck's archives of surgery, 409(1) (1), 243 - 243, English, International magazine

  Scientific journal


• 膵・胆管合流異常に合併した2型IPNBに相当する胆嚢内乳頭状腫瘍の1例

  吉田 道彦, 柳本 泰明, 津川 大介, 秋田 真之, 藤田 千佳, 吉田 俊彦, 宗 慎一, 石田 潤, 南野 佳英, 浦出 剛史, 福島 健司, 権 英寿, 小松 昇平, 浅利 貞毅, 児玉 貴之, 木戸 正浩, 外山 博近, 神保 直江, 伊藤 智雄, 福本 巧

  日本膵・胆管合流異常研究会, Aug. 2024, 日本膵・胆管合流異常研究会プロシーディングス, 47, 16 - 16, Japanese


• Impact of bile leak on the prognosis of patients with hepatocellular carcinoma who have undergone liver resection.

  Hidetoshi Gon, Shohei Komatsu, Hirotoshi Soyama, Motofumi Tanaka, Kenji Fukushima, Takeshi Urade, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto

  PURPOSE: The impact of postoperative bile leak on the prognosis of patients with hepatocellular carcinoma who underwent liver resection is controversial. This study aimed to investigate the prognostic impact of bile leak for patients with hepatocellular carcinoma who underwent liver resection. METHODS: Patients with hepatocellular carcinoma who underwent liver resection between 2009 and 2019 at Kobe University Hospital and Hyogo Cancer Center were included. After propensity score matching between the bile leak and no bile leak groups, differences in 5-year recurrence-free and overall survival rates were evaluated using the Kaplan-Meier method. RESULTS: A total of 781 patients, including 43 with postoperative bile leak, were analyzed. In the matched cohort, 40 patients were included in each group. The 5-year recurrence-free survival rates after liver resection were 35% and 32% for the bile leak and no bile leak groups, respectively (P = 0.857). The 5-year overall survival rates were 44% and 54% for the bile leak and no bile leak groups, respectively (P = 0.216). CONCLUSION: Overall, bile leak may not have a profound negative impact on the prognosis of patients with hepatocellular carcinoma who have undergone liver resection.

  Jul. 2024, Langenbeck's archives of surgery, 409(1) (1), 233 - 233, English, International magazine

  Scientific journal


• The Albumin-bilirubin Grade as Prognostic Indicator for Recurrent Hepatocellular Carcinoma Needing Repeat Liver Resection.

  Hidetoshi Gon, Shohei Komatsu, Satoshi Omiya, Masahiro Kido, Kenji Fukushima, Takeshi Urade, Toshihiko Yoshida, Keisuke Arai, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND/AIM: This study aimed to evaluate the utility of the albumin-bilirubin grade for predicting the prognosis after repeat liver resection for patients with recurrent hepatocellular carcinoma. PATIENTS AND METHODS: Ninety patients with intrahepatic recurrent hepatocellular carcinoma who underwent repeat liver resection at our institution between 2005 and 2019 were retrospectively analyzed. Cox proportional-hazards regression models evaluated independent preoperative prognostic factors, including the albumin-bilirubin grade. Prognosis differences between patients with albumin-bilirubin grades 1 and 2 were analyzed using the Kaplan-Meier method. RESULTS: Cox proportional-hazards regression analysis revealed that albumin-bilirubin grade 2 (p=0.003) and early recurrence within one year from the initial surgery (p=0.001) were independently associated with poor recurrence-free survival, and albumin-bilirubin grade 2 (p=0.020) was independently associated with poor overall survival. The five-year recurrence-free (31% and 17%, respectively) and overall (86% and 60%, respectively) survival rates after repeat liver resection for patients with albumin-bilirubin grades 1 and 2 were significantly different between groups (both p=0.003). CONCLUSION: The albumin-bilirubin grade is useful for preoperatively predicting favorable survival rates after repeat liver resection for patients with recurrent hepatocellular carcinoma. Patients with an albumin-bilirubin grade 1 are better candidates for surgical treatment of recurrent hepatocellular carcinoma.

  May 2024, Anticancer research, 44(5) (5), 2031 - 2038, English, International magazine

  Scientific journal


• 開腹および腹腔鏡下膵体尾部切除後のドレーンアミラーゼ値による適切なドレーン管理の検討

  外山 博近, 石田 潤, 南野 佳英, 大川 大資, 福岡 裕貴, 阿見 勝也, 後藤 直大, 浅利 貞毅, 吉田 俊彦, 浦出 剛, 権 英寿, 福島 健司, 津川 大介, 小松 昇平, 柳本 泰明, 木戸 正浩, 福本 巧

  (一社)日本外科学会, Apr. 2024, 日本外科学会定期学術集会抄録集, 124回, SF - 1, Japanese


• Optimal cutoff values of drain amylase for predicting pancreatic fistula are different between open and laparoscopic distal pancreatectomy.

  Jun Ishida, Hirochika Toyama, Sadaki Asari, Tadahiro Goto, Yoshihide Nanno, Toshihiko Yoshida, Shinichi So, Takeshi Urade, Kenji Fukushima, Hidetoshi Gon, Daisuke Tsugawa, Shohei Komatsu, Hiroaki Yanagimoto, Masahiro Kido, Takumi Fukumoto

  BACKGROUND: Drainage fluid amylase (DFA) is useful for predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy (DP). However, difference in optimal cutoff value of DFA for predicting CR-POPF between open DP (ODP) and laparoscopic DP (LDP) has not been investigated. This study aimed to identify the optimal cutoff values of DFA for predicting CR-POPF after ODP and LDP. METHODS: Data for 294 patients (ODP, n = 127; LDP, n = 167) undergoing DP at Kobe University Hospital between 2010 and 2021 were reviewed. Propensity score matching was performed to minimize treatment selection bias. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff values of DFA for predicting CR-POPF for ODP and LDP. Logistic regression analysis for CR-POPF was performed to investigate the diagnostic value of DFA on postoperative day (POD) three with identified cutoff value. RESULTS: In the matched cohort, CR-POPF rates were 24.7% and 7.9% after ODP and LDP, respectively. DFA on POD one was significantly lower after ODP than after LDP (2263 U/L vs 4243 U/L, p < 0.001), while the difference was not significant on POD three (543 U/L vs 1221 U/L, p = 0.171). ROC analysis revealed that the optimal cutoff value of DFA on POD one and three for predicting CR-POPF were different between ODP and LDP (ODP, 3697 U/L on POD one, 1114 U/L on POD three; LDP, 10564 U/L on POD one, 6020 U/L on POD three). Multivariate analysis showed that DFA on POD three with identified cutoff value was the independent predictor for CR-POPF both for ODP and LDP. CONCLUSIONS: DFA on POD three is an independent predictor for CR-POPF after both ODP and LDP. However, the optimal cutoff value for it is significantly higher after LDP than after ODP. Optimal threshold of DFA for drain removal may be different between ODP and LDP.

  Mar. 2024, Surgical endoscopy, 38(5) (5), 2699 - 2708, English, International magazine

  Scientific journal


• 【必携 消化器・一般外科医のための外科解剖アトラス】肝胆膵 脾温存膵体尾部切除に必要な局所解剖

  外山 博近, 南野 佳英, 石田 潤, 大川 太資, 阿見 勝也, 福本 巧

  金原出版(株), Mar. 2024, 手術, 78(4) (4), 535 - 544, Japanese


• Efficacy of S-1 Adjuvant Chemotherapy for Resected Biliary Tract Cancer: A Retrospective Propensity-Matched Analysis.

  Michihiko Yoshida, Hiroaki Yanagimoto, Daisuke Tsugawa, Masayuki Akita, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Sadaki Asari, Masahiro Kido, Hirochika Toyama, Tetsuo Ajiki, Takumi Fukumoto

  INTRODUCTION: Surgical resection is considered an effective cure for biliary tract cancer (BTC); however, the prognosis is unsatisfactory despite improved surgical techniques and perioperative management. The recurrence rate remains high even after curative resection. The efficacy of adjuvant chemotherapy in pancreatic and gastric cancers has been previously reported, and the feasibility of adjuvant therapy with S-1 has recently been reported in patients with resected BTC. We aimed to retrospectively investigate the effects of adjuvant chemotherapy with S-1 on resected advanced BTC. METHODS: We included data from 438 BTC patients who underwent resection between 2001 and 2020. After excluding patients with pTis-pT1 (n = 112) and other exclusion criteria, 266 patients were included in the analysis. RESULTS: After propensity score matching, 48 patients received S-1 adjuvant chemotherapy (S-1 group), and 48 patients received non-S1 adjuvant chemotherapy or underwent surgery alone (Non-S-1 group). The patients in the S-1 group had significantly better overall survival (OS) than those in the non-S-1 group (MST 51 vs 37 months, hazard ratio [HR]:.54, 95% confidence interval [CI]:.30-.98, P = .04). The S-1 group had a significantly better recurrence-free survival (RFS) than the non-S-1 group (94 vs 21 months, HR: .57, 95% CI: .33-.97, P = .03). Subgroup analyses for OS and RFS exhibited the benefits of S-1 in patients aged <75 years and in patients with primary sites of extrahepatic and perineural invasion and curability of R0. DISCUSSION: S-1 adjuvant therapy is promising for improving the postoperative survival of patients with resected advanced BTC, positive nerve invasion, and R0 resection.

  Jan. 2024, The American surgeon, 90(6) (6), 31348241227188 - 31348241227188, English, International magazine

  Scientific journal


• Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy.

  Taiichiro Miyake, Hiroaki Yanagimoto, Daisuke Tsugawa, Masayuki Akita, Riki Asakura, Keisuke Arai, Toshihiko Yoshida, Shinichi So, Jun Ishida, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of hepatectomy. The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding. Therefore, we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy. AIM: To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy. METHODS: The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed. Patients were divided into two groups according to whether or not they developed VTE after hepatectomy, as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities. Clinicopathological factors, including demographic data and perioperative D-dimer values, were compared between the two groups. Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value. Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors. RESULTS: In total, 234 patients who underwent hepatectomy were, of whom (5.6%) were diagnosed with VTE following hepatectomy. A comparison between the two groups showed significant differences in operative time (529 vs 403 min, P = 0.0274) and blood loss (530 vs 138 mL, P = 0.0067). The D-dimer levels on postoperative days (POD) 1, 3, 5, 7 were significantly higher in the VTE group than in the non-VTE group. In the multivariate analysis, intraoperative blood loss of > 275 mL [odds ratio (OR) = 5.32, 95% confidence interval (CI): 1.05-27.0, P = 0.044] and plasma D-dimer levels on POD 5 ≥ 21 μg/mL (OR = 10.1, 95%CI: 2.04-50.1, P = 0.0046) were independent risk factors for VTE after hepatectomy. CONCLUSION: Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.

  Jan. 2024, World journal of clinical cases, 12(2) (2), 276 - 284, English, International magazine

  Scientific journal


• Early Metabolic Measures Predict Long-term Insulin Independence in Recipients of Total Pancreatectomy and Islet Autotransplantation.

  Yoshihide Nanno, James S Hodges, Martin L Freeman, Guru Trikudanathan, Sarah J Schwarzenberg, Elissa M Downs, Karthik Ramanathan, Timothy L Pruett, Gregory J Beilman, Srinath Chinnakotla, Bernhard J Hering, Melena D Bellin

  BACKGROUND: Although diabetes after total pancreatectomy and islet autotransplantation (TP-IAT) is one of the biggest concerns for TP-IAT recipients and physicians, reliable prediction of post-TP-IAT glycemic control remains unestablished. This study was conducted to identify early predictors of insulin independence and goal glycemic control by hemoglobin A1c (HbA1c) ≤ 6.5% after TP-IAT. METHODS: In this single-center, retrospective study, patients who underwent TP-IAT (n = 227) were reviewed for simple metabolic markers or surrogate indices of β-cell function obtained 3 mo after TP-IAT as part of standard clinical testing. Long-term metabolic success was defined as (1) insulin independence and (2) HbA1c ≤ 6.5% 1, 3, and 5 y after TP-IAT. Single- and multivariate modeling used 3-mo markers to predict successful outcomes. RESULTS: Of the 227 recipients, median age 31 y, 30% male, 1 y after TP-IAT insulin independence, and HbA1c ≤ 6.5% were present in 39.6% and 72.5%, respectively. In single-predictor analyses, most of the metabolic markers successfully discriminated between those attaining and not attaining metabolic goals. Using the best model selected by random forests analysis, we accurately predicted 1-y insulin independence and goal HbA1c control in 77.3% and 86.4% of the patients, respectively. A simpler "clinically feasible" model using only transplanted islet dose and BETA-2 score allowed easier prediction at a small accuracy loss (74.1% and 82.9%, respectively). CONCLUSIONS: Metabolic testing measures performed 3 mo after TP-IAT were highly associated with later diabetes outcomes and provided a reliable prediction model, giving valuable prognostic insight early after TP-IAT and help to identify recipients who require early intervention.

  Jan. 2024, Transplantation direct, 10(1) (1), e1561, English, International magazine

  Scientific journal


• Allogeneic Islet Transplantation and Future

  Shinichi Matsumoto, Sadaki Asari, Yoshihide Nanno, Takumi Fukumoto

  Pancreatic islets contain beta cells which produce insulin based on the blood glucose levels resulting in tight control of blood glucose levels. In type 1 diabetic patients, most of the beta cells are destroyed, therefore, pharmaceutical insulin injection is mandatory to avoid diabetes-related illness and death. Even with recent advanced insulin therapy, hypoglycemia is a critical limiting factor to control blood glucose levels. There is no doubt that hypoglycemia can be fatal. Allogeneic islet transplantation can prevent severe hypoglycemia and provide excellent blood glucose control. On the other hand, allograft donor shortage is the major issue. To overcome donor shortage, xenograft has been used and shown safety and efficacy. Recently stem-cell-derived beta cells are clinically applied. In this chapter, the history and current status of allogenic islet transplantation and future scope are described.

  IntechOpen, Dec. 2023, Allogeneic Islet Transplantation and Future, English

  In book


• 腹腔動脈起始部狭窄を伴う十二指腸乳頭部癌に対し膵頭十二指腸切除術および動脈血行再建を施行した1例

  岡副 佑城, 津川 大介, 柳本 泰明, 秋田 真之, 宗 慎一, 石田 潤, 南野 佳英, 浦出 剛史, 福島 健司, 権 英寿, 小松 昇平, 浅利 貞毅, 外山 博近, 木戸 正浩, 福本 巧

  症例は72歳,男性。閉塞性黄疸で発症し,精査にて十二指腸乳頭部癌と診断した。造影CTにて腹腔動脈起始部狭窄による総肝動脈狭窄および膵頭部アーケード(PDA)拡張を認め,肝動脈血流は上腸間膜動脈からPDAを介して供給されていると推察した。正中弓状靱帯圧迫症候群を示唆する所見はなく,腹腔動脈(CA)起始部に石灰化を認めたため,成因は動脈硬化性と診断した。術中の胃十二指腸動脈(GDA)クランプテストにて明らかな肝動脈血流の低下を認めなかったが,CAの術後の開存性を懸念し,左大伏在静脈グラフトにて下膵十二指腸動脈-GDAバイパス術および亜全胃温存膵頭十二指腸切除術を施行した。術後経過は良好で,術後24日目に退院となった。自験例と同様の病態下では,本再建法は一つの選択肢として考慮できる再建法である。(著者抄録)

  (株)癌と化学療法社, Dec. 2023, 癌と化学療法, 50(13) (13), 1534 - 1536, Japanese


• Risk Factors for Recurrence of Cholangitis After Pancreaticoduodenectomy and Comparison of Stents in Hepaticojejunostomy.

  Hirotaka Fukuoka, Hirochika Toyama, Takuya Mizumoto, Jun Ishida, Sadaki Asari, Tadahiro Goto, Yoshihide Nanno, Takeshi Urade, Kenji Fukushima, Hidetoshi Gon, Daisuke Tsugawa, Shohei Komatsu, Kaori Kuramitsu, Hiroaki Yanagimoto, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Postoperative cholangitis is a common complication of pancreaticoduodenectomy. Frequent cholangitis impairs patients' quality of life after pancreaticoduodenectomy. However, the risk factors for recurrence of cholangitis remain unclear. Hence, this retrospective study aimed to identify risk factors for recurrence of cholangitis after pancreaticoduodenectomy. METHODS: The medical records of patients who underwent pancreaticoduodenectomy between 2015 and 2019 in our institution were retrospectively reviewed. At least two episodes of cholangitis a year after pancreaticoduodenectomy were defined as 'recurrence of cholangitis' in the present study. Univariate and multivariate analyses were performed. RESULTS: The recurrence of cholangitis occurred in 40 of 207 patients (19.3%). Multivariate analysis revealed that internal stent (external, RR: 2.16, P = 0.026; none, RR: 4.76, P = 0.011), firm pancreas (RR: 2.61, P = 0.021), constipation (RR: 3.49, P = 0.008), and postoperative total bilirubin>1.7 mg/dL (RR: 2.94, P = 0.006) were risk factors of recurrence of cholangitis. Among patients with internal stents (n = 54), those with remnant stents beyond 5 months had more frequent recurrence of cholangitis (≥5 months, 75%; <5 months, 30%). CONCLUSIONS: Internal stents, firm pancreas, constipation, and postoperative high bilirubin levels are risk factors for cholangitis recurrence after pancreaticoduodenectomy. In addition, the long-term implantation of internal stents may trigger cholangitis recurrence.

  Oct. 2023, World journal of surgery, 47(10) (10), 2499 - 2506, English, International magazine

  Scientific journal


• 膵・胆管合流異常に発生した膵管内乳頭粘液性腺癌の1切除例

  上田 泰弘, 柳本 泰明, 津川 大介, 秋田 真之, 吉田 俊彦, 宗 慎一, 石田 潤, 南野 佳英, 浦出 剛史, 福島 健司, 権 英寿, 小松 昇平, 浅利 貞毅, 外山 博近, 木戸 正浩, 福本 巧

  日本膵・胆管合流異常研究会, Sep. 2023, 日本膵・胆管合流異常研究会プロシーディングス, 46, 30 - 30, Japanese


• Proton radiotherapy as a treatment strategy to increase survival in locally advanced pancreatic cancer in the body and tail: a retrospective study.

  Katsuya Ami, Kazuki Terashima, Jun Ishida, Masaki Suga, Taisuke Okawa, Daiki Takahashi, SungChul Park, Yoshiro Matsuo, Yoshihide Nanno, Sunao Tokumaru, Tomoaki Okimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Long-term outcomes and prognostic factors of proton radiotherapy for locally advanced pancreatic cancer (LAPC) in the body and tail are still unknown. The aim of this study was to determine the prognostic factors after proton radiotherapy in a large group of patients with LAPC in the body and tail. METHODS: The medical records of 200 patients with LAPC in the body and tail who underwent proton radiotherapy between February 2009 and January 2021 at the Hyogo Ion Beam Medical Center were retrospectively reviewed to identify prognostic factors that contribute to long-term survival. RESULTS: The overall survival rate at 1- and 2-year after PT was 69.6% and 35.4% with a median overall survival of 18.4 months. The 1- and 2-year local progression-free, and progression-free survival rates were 84.3% and 68.0%, and 44.3% and 19.4%, respectively. In multivariate analysis, superior mesenteric artery (SMA) invasion (SMA only invasion vs. celiac artery only invasion; P = 0.049: SMA and celiac artery invasion vs. celiac artery only invasion; P = 0.017), carbohydrate antigen 19-9 (CA 19-9) level ≥ 231.9 U/mL (P = 0.001), anterior peripancreatic invasion (P = 0.006), and incomplete scheduled concurrent chemotherapy (P = 0.009) were statistically significant prognostic factors for overall survival. There was no significant difference in local progression-free survival; however, distant metastasis-free survival was statistically worse in patients with prognostic factors than in those without. CONCLUSIONS: Proton radiotherapy for LAPC in the body and tail may be a valuable multidisciplinary treatment option. Patients with SMA invasion, higher pre-proton radiotherapy serum CA 19-9 level, anterior peripancreatic invasion, or incomplete scheduled concurrent chemotherapy had worse overall survival because of worse distant metastasis-free survival, suggesting that distant metastases have a significant impact on overall survival in such patients. TRIAL REGISTRATION: Retrospectively registered.

  Aug. 2023, Radiation oncology (London, England), 18(1) (1), 131 - 131, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 膵頭十二指腸切除術前後の血中必須脂肪酸の推移

  福岡 裕貴, 南野 佳英, 外山 博近, 後藤 直大, 津川 大介, 小松 昇平, 蔵満 薫, 柳本 泰明, 木戸 正浩, 福本 巧

  (一社)日本消化器外科学会, Jul. 2023, 日本消化器外科学会総会, 78回, P270 - 6, Japanese


• Transarterial chemoembolization for liver metastases of a pancreatic neuroendocrine neoplasm: a single-center experience.

  Yoshihide Nanno, Hirochika Toyama, Eisuke Ueshima, Keitaro Sofue, Ippei Matsumoto, Jun Ishida, Takeshi Urade, Kenji Fukushima, Hidetoshi Gon, Daisuke Tsugawa, Shohei Komatsu, Kaori Kuramitsu, Tadahiro Goto, Sadaki Asari, Hiroaki Yanagimoto, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  Transarterial chemoembolization (TACE) is performed for pancreatic neuroendocrine tumor (PanNEN) liver metastases; however, the safety and efficacy of TACE procedures, especially for patients who have undergone previous pancreatic surgery, have not been established. We reviewed 48 TACE procedures (1-6 procedures/patient) performed on 11 patients with PanNEN liver metastases, including 16 TACE procedures (4-6 procedures/patient) for 3 patients with a history of biliary-enteric anastomosis. The overall tumor objective response rate was 94%. The incidence of Clavien‒Dindo grade ≥ 2 complications was 1/16 (6%) and 1/32 (3%), and the median time to untreatable progression was 31 (14-41) and 27 (2-60) months among patients with and without a history of biliary-enteric anastomosis, respectively. Although validation is needed in future studies, our experiences have shown that TACE treatment is a viable treatment option for PanNEN liver metastases, even after biliary-enteric anastomosis with experienced teams and careful patient follow-up.

  Jun. 2023, Surgery today, 53(12) (12), 1396 - 1400, English, Domestic magazine

  Scientific journal


• Advantages of the Laparoscopic Approach for the Initial Operation in Patients who Underwent Repeat Hepatectomy.

  Hidetoshi Gon, Shohei Komatsu, Masahiro Kido, Kenji Fukushima, Takeshi Urade, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Less intra-abdominal adhesions are expected following laparoscopic surgery. Although an initial laparoscopic approach for primary liver tumors may have advantages in patients who require repeat hepatectomies for recurrent liver tumors, this has not been sufficiently investigated. METHODS: Patients who underwent repeat hepatectomies for recurrent liver tumors at our hospital between 2010 and 2022 were retrospectively analyzed. Of 127 patients, 76 underwent laparoscopic repeat hepatectomy (LRH), of whom 34 patients initially underwent laparoscopic hepatectomy (L-LRH) and 42, open hepatectomy (O-LRH). Fifty-one patients underwent open hepatectomy as both the initial and second operation (O-ORH). We analyzed surgical outcomes between L-LRH and O-LRH groups and between L-LRH and O-ORH groups using propensity-matching analysis for each pattern. RESULTS: Twenty-one patients each were included in L-LRH and O-LRH propensity-matched cohorts. The L-LRH group had a lower rate of postoperative complications than the O-LRH group (0 vs 19%, P = 0.036). When we compared surgical outcomes between L-LRH and O-ORH groups in another matched cohort with 18 patients in each group, in addition to the lower rate of postoperative complications, the L-LRH group had additional favorable surgical outcomes including shorter operation time and lower blood loss volume than the O-ORH group (291 vs 368 min, P = 0.037 and 10 vs 485 mL, P < 0.0001). CONCLUSIONS: An initial laparoscopic approach would be favorable for patients undergoing repeat hepatectomies, as it leads to lower risk of postoperative complications. Compared with O-ORH, the advantage of the laparoscopic approach may be enhanced when it is repeatedly adopted.

  Jun. 2023, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 27(8) (8), 1621 - 1631, English, International magazine

  Scientific journal


• ASO Visual Abstract: Association of Sarcopenia with a Poor Prognosis and Decreased Tumor-Infiltrating CD8-Positive T Cells in Pancreatic Ductal Adenocarcinoma-A Retrospective Analysis.

  Shigeto Masuda, Kohei Yamakawa, Atsuhiro Masuda, Hirochika Toyama, Keitaro Sofue, Yoshihide Nanno, Shohei Komatsu, Satoshi Omiya, Arata Sakai, Takashi Kobayashi, Takeshi Tanaka, Masahiro Tsujimae, Shigeto Ashina, Masanori Gonda, Shohei Abe, Hisahiro Uemura, Shinya Kohashi, Noriko Inomata, Kae Nagao, Yoshiyuki Harada, Mika Miki, Yosuke Irie, Noriko Juri, Maki Kanzawa, Tomoo Itoh, Takumi Fukumoto, Yuzo Kodama

  Jun. 2023, Annals of surgical oncology, 30(9) (9), 5790 - 5791, English, International magazine

  Scientific journal


• ASO Author Reflections: Preoperative Malignant Risk Assessment for Small (≤ 20 mm) Nonfunctioning Pancreatic Neuroendocrine Tumors.

  Yoshihide Nanno, Hirochika Toyama

  Jun. 2023, Annals of surgical oncology, 30(6) (6), 3501 - 3502, English, International magazine

  Scientific journal


• Association of Sarcopenia with a Poor Prognosis and Decreased Tumor-Infiltrating CD8-Positive T Cells in Pancreatic Ductal Adenocarcinoma: A Retrospective Analysis.

  Shigeto Masuda, Kohei Yamakawa, Atsuhiro Masuda, Hirochika Toyama, Keitaro Sofue, Yoshihide Nanno, Shohei Komatsu, Satoshi Omiya, Arata Sakai, Takashi Kobayashi, Takeshi Tanaka, Masahiro Tsujimae, Shigeto Ashina, Masanori Gonda, Shohei Abe, Hisahiro Uemura, Shinya Kohashi, Noriko Inomata, Kae Nagao, Yoshiyuki Harada, Mika Miki, Yosuke Irie, Noriko Juri, Maki Kanzawa, Tomoo Itoh, Takumi Fukumoto, Yuzo Kodama

  BACKGROUND: Sarcopenia, defined as a loss of skeletal muscle mass and quality, is found in 30-65% of patients with pancreatic ductal adenocarcinoma (PDAC) at diagnosis, and is a poor prognostic factor. However, it is yet to be evaluated why sarcopenia is associated with poor prognosis. Therefore, this study elucidated the tumor characteristics of PDAC with sarcopenia, including driver gene alterations and tumor microenvironment. PATIENTS AND METHODS: We retrospectively analyzed 162 patients with PDAC who underwent pancreatic surgery between 2008 and 2017. We defined sarcopenia by measuring the skeletal muscle mass at the L3 level using preoperative computed tomography images and evaluated driver gene alteration (KRAS, TP53, CDKN2A/p16, and SMAD4) and tumor immune (CD4+, CD8+, and FOXP3+) and fibrosis status (stromal collagen). RESULTS: In localized-stage PDAC (stage ≤ IIa), overall survival (OS) and recurrence-free survival were significantly shorter in the sarcopenia group than in the non-sarcopenia group (2-year OS 89.7% versus 59.1%, P = 0.03; 2-year RFS 74.9% versus 50.0%, P = 0.02). Multivariate analysis revealed that sarcopenia was an independent poor prognostic factor in localized-stage PDAC. Additionally, tumor-infiltrating CD8+ T cells in the sarcopenia group were significantly less than in the non-sarcopenia group (P = 0.02). However, no difference was observed in driver gene alteration and fib.rotic status. These findings were not observed in advanced-stage PDAC (stage ≥ IIb). CONCLUSIONS: Sarcopenia was associated with a worse prognosis and decreased tumor-infiltrating CD8+ T cells in localized-stage PDAC. Sarcopenia may worsen a patient's prognosis by suppressing local tumor immunity.

  May 2023, Annals of surgical oncology, 30(9) (9), 5776 - 5787, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Prognostic Impact of Malnutrition Diagnosed by the GLIM Criteria for Resected Extrahepatic Cholangiocarcinoma.

  Yuki Okazoe, Hiroaki Yanagimoto, Daisuke Tsugawa, Masayuki Akita, Riki Asakura, Satoshi Omiya, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Kaori Kuramitsu, Tadahiro Goto, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND/AIM: Recently, the Global Leadership Initiative on Malnutrition (GLIM), which includes the world's leading clinical nutrition societies, proposed the first global diagnostic criteria for malnutrition. However, the association between malnutrition diagnosed by the GLIM criteria and prognosis in patients with resected extrahepatic cholangiocarcinoma (ECC) remains unknown. This study aimed to investigate the predictive validity of the GLIM criteria for the prognosis of patients with resected ECC. PATIENTS AND METHODS: Between 2000 and 2020, 166 patients who underwent curative-intent resection for ECC were retrospectively analyzed. Prognostic significance of preoperative malnutrition diagnosed by the GLIM criteria was investigated using a multivariate Cox proportional hazards model. RESULTS: Eighty-five (51.2%) and 46 (27.7%) patients were diagnosed with moderate and severe malnutrition, respectively. Increased malnutrition severity tended to be correlated with increased lymph node metastasis rate (p-for-trend=0.0381). The severe malnutrition group had worse 1-, 3-, and 5-year overall survival rates than the normal (without malnutrition) group (82.2% vs. 91.2%, 45.6% vs. 65.1%, 29.3% vs. 61.5%, respectively, p=0.0159). In multivariate analysis, preoperative severe malnutrition was an independent predictor for poor prognosis (hazard ratio=1.68, 95% confidence interval=1.06-2.66, p=0.0282), along with intraoperative blood loss >1,000 ml, lymph node metastasis, perineural invasion, and curability. CONCLUSION: Severe preoperative malnutrition diagnosed by the GLIM criteria was associated with poor prognosis in patients who underwent curative-intent resection for ECC.

  May 2023, Anticancer research, 43(5) (5), 2299 - 2308, English, International magazine

  Scientific journal


• ASO Visual Abstract: Reappraisal of Malignant Risk Assessment for Small (≤20 mm) Non-functioning Pancreatic Neuroendocrine Tumors.

  Yoshihide Nanno, Hirochika Toyama, Ippei Matsumoto, Jun Uemura, Sadaki Asari, Tadahiro Goto, Dongha Lee, Tomomasa Murakami, Shohei Komatsu, Hiroaki Yanagimoto, Masahiro Kido, Tetsuo Ajiki, Keiichi Okano, Yoshifumi Takeyama, Takumi Fukumoto

  Mar. 2023, Annals of surgical oncology, 30(6) (6), 3503 - 3504, English, International magazine

  Scientific journal


• 横隔膜腹腔側に発生したsolitary fibrous tumorの1例

  上田 泰弘, 味木 徹夫, 浅利 貞毅, 柳本 泰明, 津川 大介, 秋田 真之, 朝倉 力, 三宅 泰一郎, 南野 佳英, 浦出 剛史, 福島 健司, 権 英寿, 小松 昇平, 蔵満 薫, 後藤 直大, 外山 博近, 木戸 正浩, 福本 巧

  72歳女性。右季肋部痛を主訴に前医を受診し、右横隔膜原発の腫瘍を指摘され、精査加療目的で当院へ紹介となった。腹部CT検査では右横隔膜と連続した9cm大で、不均一な造影効果を伴う境界明瞭な腫瘤が認められた。また、腹部MRI検査ではT1強調画像にて筋組織と同程度の低信号ほか、T2強調画像にて高信号を呈する腫瘤が認められた。以上、これらの所見を踏まえて、針生検を施行したところ、採取されたのは壊死組織のみで、診断には困難であった。そこで、右横隔膜原発の腫瘍とみなし、開腹下に腫瘍を切除した結果、病理組織学的に右横隔膜腹腔側に発生したsolitary fibrous tumorと確定診断された。術後1年経過現在、無再発生存中である。

  兵庫県外科医会, Mar. 2023, 兵庫県外科医会会誌, 57, 13 - 15, Japanese


• Reappraisal of Malignant Risk Assessment for Small (≤20 mm) Non-functioning Pancreatic Neuroendocrine Tumors.

  Yoshihide Nanno, Hirochika Toyama, Ippei Matsumoto, Jun Uemura, Sadaki Asari, Tadahiro Goto, Dongha Lee, Tomomasa Murakami, Shohei Komatsu, Hiroaki Yanagimoto, Masahiro Kido, Tetsuo Ajiki, Keiichi Okano, Yoshifumi Takeyama, Takumi Fukumoto

  BACKGROUND: Optimal management of non-functioning pancreatic neuroendocrine tumors (PanNETs) ≤20 mm is controversial. The biological heterogeneity of these tumors poses challenges when deciding between resection and observation. METHODS: In this multicenter, retrospective cohort study, we analyzed all patients (n = 78) who underwent resection of non-functioning PanNETs ≤20 mm at three tertiary medical centers from 2004 to 2020 to assess the utility of preoperatively available radiological features and serological biomarkers of non-functioning PanNETs in choosing an optimal surgical indication. The radiological features included non-hyper-attenuation pattern on enhancement computed tomography (CT; hetero/hypo-attenuation) and main pancreatic duct (MPD) involvement, and serological biomarkers included elevation of serum elastase 1 and plasma chromogranin A (CgA) levels. RESULTS: Of all small non-functioning PanNETs, 5/78 (6%) had lymph node metastasis, 11/76 (14%) were WHO grade II, and 9/66 (14%) had microvascular invasion; 20/78 (26%) had at least one of these high-risk pathological factors. In the preoperative assessment, hetero/hypo-attenuation and MPD involvement were observed in 25/69 (36%) and 8/76 (11%), respectively. Elevated serum elastase 1 and plasma CgA levels were observed in 1/33 (3%) and 0/11 (0%) patients, respectively. On multivariate logistic regression analysis, hetero/hypo-attenuation (odds ratio [OR] 6.1, 95% confidence interval [CI] 1.7-22.2) and MPD involvement (OR 16.8, 95% CI 1.6-174.3) were significantly associated with the high-risk pathological factors. The combination of the two radiological worrisome features correctly predicted non-functioning PanNETs with high-risk pathological factors, with about 75% sensitivity, 79% specificity, and 78% accuracy. CONCLUSIONS: This combination of radiological worrisome features can accurately predict non-functioning PanNETs that may require resection.

  Feb. 2023, Annals of surgical oncology, 30(6) (6), 3493 - 3500, English, International magazine

  Scientific journal


• Assessment of serum and drain fluid bilirubin concentrations in liver transplantation patients.

  Hirotoshi Soyama, Kaori Kuramitsu, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Takeshi Urade, Shinichi So, Yoshihide Nanno, Daisuke Tsugawa, Tadahiro Goto, Hiroaki Yanagimoto, Sadaki Asari, Hirochika Toyama, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Bile leakage is a major complication after liver transplantation and remains as a significant source of morbidity and mortality. In 2011, the International Study Group of Liver Surgery (ISGLS) defined bile leakage as a drain/serum bilirubin ratio ≥3. However, to our knowledge there is no literature assessing serum and drain bilirubin concentrations after liver transplantation. The aim of this study was to describe the natural postoperative changes in serum and drain fluid bilirubin concentrations in patients after liver transplantation. METHODS: We included 32 patients who underwent liver transplantation at Kobe University Hospital from January 2007 to December 2020. We enrolled 34 living donors who had no complications as the control group. RESULTS: The recipient serum total/direct bilirubin concentration were higher compared with the donors from postoperative day (POD) 1 to 5 with a statistical difference (P < .05). The recipient drain/serum total bilirubin ratio was lower than donors on POD 3 (0.89 ± 0.07 vs 1.53 ± 0.07: P < .0001), which was also confirmed by the recipient drain/serum direct bilirubin ratio (0.64 ± 0.10 vs 1.18 ± 0.09: P < .0001). On POD 3, the drain fluid volume (647.38 ± 89.47 vs 113.43 ± 86.8 mL: P < .001) and serum total bilirubin concentration (6.73 ± 0.61 vs 1.23 ± 0.60 mg/dL: P < .001) was higher in the recipients than in donors. Categorized in 2 groups, the higher drain fluid volume and bilirubin concentration recipients showed lower drain/serum total bilirubin ratio compared with the other group (P = .03) CONCLUSION: The drain/serum bilirubin ratio in the transplanted patients could be calculated lower compared with the hepatectomy patients because of high drain fluid volume and hyperbilirubinemia. Great care should be taken when assessing the bile leakage in liver transplant recipients using the ISGLS definition.

  Jan. 2023, Transplantation proceedings, 55(1) (1), 184 - 190, English, International magazine

  Scientific journal


• Laparoscopic Medial-to-Lateral Approach for the Resection of Hepatocellular Carcinoma Located at the Spiegel Lobe of the Liver.

  Hidetoshi Gon, Masahiro Kido, Shohei Komatsu, Kenji Fukushima, Takeshi Urade, Yoshihide Nanno, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Laparoscopic caudate lobe resection is a challenging procedure. Several researchers have reported the safety of laparoscopic liver resections;1.Transl Gastroenterol Hepatol. 1:56;2.Asian J Endosc Surg. 12:232-236;3.Ann Surg Oncol. 26:2980; however, a standardized procedure has not yet been established. Herein, we present a video showing laparoscopic Spiegel lobectomy in a patient with 6-cm hepatocellular carcinoma (HCC) using a novel approach. PATIENT AND METHODS: A 63-year-old man with a caudate lobe HCC was referred to our hospital. Computed tomography showed a 5 × 6 cm2 HCC located in the Spiegel lobe, which profoundly displaced the inferior vena cava (IVC) to the lower right side, and mobilization of the Spiegel lobe was considered difficult. To perform the dissection between the Siegel lobe and IVC safely, we performed parenchymal transection along the ventral side of the IVC initially. The Spiegel lobe was then dislocated to the left side of the IVC. We dissected the left lateral side of the IVC, including the proper hepatic vein draining the caudate lobe and the left IVC ligament with a safe operative field, and successfully removed the Spiegel lobe with large HCC. RESULTS: The operation time was 383 min. The blood loss was 10 mL. The patient was discharged on the seventh postoperative day without any complications. Histopathological examination revealed well-differentiated HCC with a negative surgical margin. CONCLUSIONS: Laparoscopic medial-to-lateral approach with initial parenchymal transection at the medial side of the Spiegel lobe followed by dissection of the left lateral side of the IVC is considered as a safe and effective procedure for large tumors in the Spiegel lobe.

  Jan. 2023, Annals of surgical oncology, 30(1) (1), 381 - 382, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Safe Laparoscopic Resection of Hepatocellular Carcinoma in the Spiegel Lobe of the Liver Using a Medial-to-Lateral Approach.

  Hidetoshi Gon, Masahiro Kido, Shohei Komatsu, Kenji Fukushima, Takeshi Urade, Yoshihide Nanno, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  Jan. 2023, Annals of surgical oncology, 30(1) (1), 383 - 383, English, International magazine

  Scientific journal


• Potential Role of Surgical Resection for Gallbladder Cancer in Elderly Patients.

  Yasuhiro Ueda, Hiroaki Yanagimoto, Tetsuo Ajiki, Daisuke Tsugawa, Riki Asakura, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Kaori Kuramitsu, Tadahiro Goto, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto

  INTRODUCTION: With the aging of the population in Japan, gallbladder cancer (GBC) in the elderly is increasing. However, the available clinical data are limited, and the optimal treatment is still controversial. The aim of this study was to evaluate the benefit of surgical resection in GBC patients ≥75 years of age. METHODS: A retrospective single center analysis of patients who had undergone surgical resection for GBC between 2000 and 2019 was carried out. Patients aged ≥75 years (elderly group, n = 24) or <75 years (younger group, n = 50) were compared. RESULTS: Both younger and elderly patients exhibited similar clinicopathological characteristics, but comorbidity in the latter was significantly greater, as was the frequency of less invasive surgery. Nonetheless, the incidence of postoperative complications was similar in elderly and younger patients. The proportion of patients receiving adjuvant chemotherapy was lower in the elderly. Overall survival of elderly and younger patients was not significantly different (65.0 vs 62.4% at 5 years, P = .600). In multivariate analysis, residual tumor status but not age was an independent prognostic factor. DISCUSSION: This study demonstrated that appropriate surgical treatment of elderly GBC patients was safe and effective, despite their having more comorbidities and lower rates of adjuvant chemotherapy than younger patients.

  Nov. 2022, The American surgeon, 89(12) (12), 31348221136570 - 31348221136570, English, International magazine

  Scientific journal


• Standardization of laparoscopic anatomic liver resection of segment 2 by the Glissonean approach.

  Takeshi Urade, Masahiro Kido, Kaori Kuramitsu, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Shinichi So, Takuya Mizumoto, Yoshihide Nanno, Daisuke Tsugawa, Tadahiro Goto, Sadaki Asari, Hiroaki Yanagimoto, Hirochika Toyama, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Anatomic liver resection (ALR) has been established to eliminate the tumor-bearing hepatic region with preservation of the remnant liver volume for liver malignancies. Recently, laparoscopic ALR has been widely applied; however, there are few reports on laparoscopic segmentectomy 2. This study aimed to present the standardization of laparoscopic segmentectomy 2 with surgical outcomes. METHODS: This study included seven patients who underwent pure laparoscopic segmentectomy 2 by the Glissonean approach from January 2020 to December 2021. Four of them had hepatocellular carcinoma, two had colorectal liver metastasis, and one had hepatic angiomyolipoma, which was preoperatively diagnosed with hepatocellular carcinoma. In all patients, preoperative three-dimensional (3D) simulation images from dynamic CT were reconstructed using a 3D workstation. The layer between the hepatic parenchyma and the Glissonean pedicle of segment 2 (G2) was dissected to encircle the root of G2. After clamping or ligation of the G2, 2.5 mg of indocyanine green was injected intravenously to identify the boundaries between segments 2 and 3 with a negative staining method under near-infrared light. Parenchymal transection was performed from the caudal side to the cranial side according to the demarcation on the liver surface, and the left hepatic vein was exposed on the cut surface if possible. RESULTS: The mean operative time for all patients was 281 min. The mean blood loss was 37 mL, and no transfusion was necessary. Estimated liver resection volumes significantly correlated with actual liver resection volumes (r = 0.61, P = 0.035). After the operation, one patient presented with asymptomatic deep venous and pulmonary thrombosis, which was treated with anticoagulant therapy. The mean length of hospital stay was 8.9 days. CONCLUSION: Laparoscopic segmentectomy 2 by the Glissonean approach is a feasible and safe procedure with the preservation of the nontumor-bearing segment 3 for liver tumors in segment 2.

  Nov. 2022, Surgical endoscopy, 36(11) (11), 8600 - 8606, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Correction to: Use of a short cartridge stapler is beneficial in pancreatic transection at the neck during laparoscopic distal pancreatectomy.

  Jun Ishida, Hirochika Toyama, Sadaki Asari, Tadahiro Goto, Yoshihide Nanno, Takuya Mizumoto, Daisuke Tsugawa, Shohei Komatsu, Kaori Kuramitsu, Hiroaki Yanagimoto, Masahiro Kido, Takumi Fukumoto

  Sep. 2022, Surgery today, 53(1) (1), 158 - 158, English, Domestic magazine


• がん化学療法中の急性胆嚢炎症例の検討

  上田 泰弘, 味木 徹夫, 柳本 泰明, 津川 大介, 秋田 真之, 朝倉 力, 三宅 泰一郎, 南野 佳英, 浦出 剛史, 福島 健司, 権 英寿, 小松 昇平, 蔵満 薫, 後藤 直大, 浅利 貞毅, 外山 博近, 木戸 正浩, 福本 巧

  (一社)日本Acute Care Surgery学会, Sep. 2022, Japanese Journal of Acute Care Surgery, 12(Suppl.) (Suppl.), 149 - 149, Japanese


• Use of a short cartridge stapler is beneficial in pancreatic transection at the neck during laparoscopic distal pancreatectomy.

  Jun Ishida, Hirochika Toyama, Sadaki Asdari, Tadahiro Goto, Yoshihide Nanno, Takuya Mizumoto, Daisuke Tsugawa, Shohei Komatsu, Kaori Kuramitsu, Hiroaki Yanagimoto, Masahiro Kido, Takumi Fukumoto

  Stapling is the standard method for pancreatic transection during laparoscopic distal pancreatectomy. Although most surgeons use a 60 mm cartridge stapler, space limitations created by laparoscopic surgery make the instrument difficult to handle, especially during pancreatic transection at the neck. Therefore, we currently use a 45 mm cartridge stapler for laparoscopic pancreatic transection at the neck. Between October 2019 and December 2020, we performed pancreatic transection using a 45 mm cartridge stapler in 27 patients. Fifteen patients experienced biochemical leakage, but no patients developed clinically relevant pancreatic fistula. The compactness of the 45 mm cartridge has several benefits: (1) less space is required for flexing, opening, and closing the device; (2) it enables easy insertion of the lower jaw behind the pancreas, even if the dissected space behind the pancreas is narrow; (3) less obstruction of the surgeons' view prevents accidental injury to the surrounding tissues and vessels. These benefits may enable safe pancreatic transection.

  Jul. 2022, Surgery today, 53(1) (1), 153 - 157, English, Domestic magazine

  Scientific journal


• Suitability of Laparoscopic Liver Resection of Segment VII: a Retrospective Two-Center Study.

  Hidetoshi Gon, Hisoka Yamane, Toshihiko Yoshida, Masahiro Kido, Motofumi Tanaka, Kaori Kuramitsu, Shohei Komatsu, Kenji Fukushima, Takeshi Urade, Shinichi So, Yoshihide Nanno, Daisuke Tsugawa, Tadahiro Goto, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Resecting liver tumors located in Couinaud's segment VII is challenging; the efficacy and safety of laparoscopic liver resection for segment VII lesions compared to open liver resection remain unclear. METHODS: Medical records of 84 patients who underwent liver resection of segment VII at Kobe University Hospital and Hyogo Cancer Center between 2010 and 2021 were retrospectively analyzed. Surgical outcomes were compared between laparoscopic liver resection and open liver resection groups using propensity matching analysis. RESULTS: Thirty-one and 53 patients underwent laparoscopic liver resection and open liver resection, respectively. After propensity matching, 29 patients were included in each group. The laparoscopic liver resection group had a significantly longer operation time (407 vs. 305 min, P = 0.002), lower blood loss (100 vs. 230 mL, P = 0.004), and higher postoperative alanine aminotransferase levels (436 vs. 252 IU/L, P = 0.008) than the open liver resection group. In patients with liver cirrhosis, the proportion of patients with postoperative liver-specific complications was higher in the laparoscopic liver resection group than in the open liver resection group (57% vs 11%, P = 0.049), although there was no significant difference in postoperative liver-specific complication rates between the groups in patients without liver cirrhosis. CONCLUSIONS: For liver resection of segment VII, laparoscopic liver resection led to higher postoperative liver damage than open liver resection. Open liver resection may be better for patients with liver cirrhosis to avoid postoperative liver-specific complications. Laparoscopic liver resection could be an acceptable procedure for patients without liver cirrhosis, with some merits such as less blood loss.

  Jun. 2022, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 26(11) (11), 2274 - 2281, English, International magazine

  Scientific journal


• Editorial Comment to "High Expression of Bloom Syndrome Helicase is a Key Factor for Poor Prognosis and Advanced Malignancy in Patients with Pancreatic Cancer: A Retrospective Study".

  Yoshihide Nanno, Hirochika Toyama

  Jun. 2022, Annals of surgical oncology, 29(6) (6), 3373 - 3374, English, International magazine


• 膵頭十二指腸切除術後の早期胆管炎リスク因子の検討

  福岡 裕貴, 外山 博近, 浅利 貞毅, 後藤 直大, 南野 佳英, 水本 拓也, 宗 慎一, 浦出 剛史, 福島 健司, 権 英寿, 津川 大介, 小松 昇平, 蔵満 薫, 柳本 泰明, 木戸 正浩, 味木 徹夫, 福本 巧

  (一社)日本外科学会, Apr. 2022, 日本外科学会定期学術集会抄録集, 122回, SF - 2, Japanese


• Factors associated with long-term survival in gemcitabine-concurrent proton radiotherapy for non-metastatic locally advanced pancreatic cancer: a single-center retrospective study.

  Yuta Ogura, Kazuki Terashima, Yoshihide Nanno, SungChul Park, Masaki Suga, Daiki Takahashi, Yoshiro Matsuo, Nor Shazrina Sulaiman, Sunao Tokumaru, Tomoaki Okimoto, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Factors associated with long-term survival in gemcitabine-concurrent proton radiotherapy (GPT) for non-metastatic, locally advanced pancreatic cancer (LAPC) remain unclear. This study aimed to determine the factors associated with long-term survival in GPT for non-metastatic LAPC. METHODS: The medical records of 123 patients with LAPC treated with GPT between February 2009 and December 2019 at Hyogo Ion Beam Medical Center were retrospectively reviewed to assess the factors associated with long-term survival outcomes. RESULTS: The median overall survival of the total cohort treated with GPT was 18.7 months. The 1- and 2-year overall, local progression-free, and progression-free survival rates were 70.4% and 35.7%, 78.2% and 59.0%, and 38.6% and 20.8%, respectively. Multivariate analysis revealed that LAPCs at the pancreatic body-tail and those without anterior peripancreatic invasion were independently associated with longer overall survival (P = 0.040 and P = 0.015, respectively). The median overall survival of patients with LAPC at the pancreatic body-tail and those with LAPC without anterior peripancreatic invasion were 24.1 and 28.1 months, respectively. LAPCs at the pancreatic body-tail had a higher volume ratio irradiated over 60 Gy equivalents at gross tumor volume than those at the pancreatic head (P < 0.001). LAPCs with anterior peripancreatic invasion had more peritoneal recurrence within 6 months after GTP than those without anterior peripancreatic invasion (P = 0.039). CONCLUSIONS: GPT is a promising treatment option for patients with LAPC at the pancreatic body-tail and those with LAPC without anterior peripancreatic invasion.

  Feb. 2022, Radiation oncology (London, England), 17(1) (1), 32 - 32, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma.

  Riki Asakura, Hiroaki Yanagimoto, Tetsuo Ajiki, Daisuke Tsugawa, Takuya Mizumoto, Shinichi So, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Kaori Kuramitsu, Tadahiro Goto, Sadaki Asari, Masahiro Kido, Hirochika Toyama, Takumi Fukumoto

  INTRODUCTION: Although the relationship between systemic inflammatory responses and prognosis has been known in various cancers, it remains unclear which scores are most valuable for determining the prognosis of extrahepatic cholangiocarcinoma. We aimed to verify the usefulness of various inflammation-based scores as prognostic factors in patients with resected extrahepatic cholangiocarcinoma. METHODS: We analyzed consecutive patients undergoing surgical resection for extrahepatic cholangiocarcinoma at our institution between January 2000 and December 2019. The usefulness of the following inflammation-based scores as prognostic factor was investigated: Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), prognostic nutrition index (PNI), C-reactive protein to albumin ratio (CAR), controlling nutritional status (CONUT), and prognostic index (PI). RESULTS: A total of 169 patients were enrolled in this study. Of the nine scores, CAR and CONUT indicated prognostic value. Furthermore, multivariate analysis for overall survival revealed that high CAR (>0.23) was an independent prognostic factor (HR: 1.816, 95%CI: 1.135-2.906, p=0.0129), along with lymph node metastasis and curability. There was no difference in tumor staging and short-term outcomes between the low CAR (≤ 0.23) and high CAR groups. CONCLUSIONS: CAR was the most valuable prognostic score in patients with resected extrahepatic cholangiocarcinoma.

  Jan. 2022, Digestive surgery, 39(2-3) (2-3), 65 - 74, English, International magazine

  Scientific journal


• 腹腔鏡下膵頭十二指腸切除導入の経験

  外山 博近, 後藤 直大, 山下 博成, 石田 潤, 南野 佳英, 水本 拓也, 浅利 貞毅, 小倉 佑太, 福岡 裕貴, 阿見 勝也, 小松 昇平, 津川 大介, 柳本 泰明, 木戸 正浩, 福本 巧

  (一社)日本内視鏡外科学会, Dec. 2021, 日本内視鏡外科学会雑誌, 26(7) (7), MO091 - 1, Japanese


• Immunohistochemically Detected Expression of ATRX, TSC2, and PTEN Predicts Clinical Outcomes in Patients With Grade 1 and 2 Pancreatic Neuroendocrine Tumors.

  Jun Uemura, Keiichi Okano, Minoru Oshima, Hironobu Suto, Yasuhisa Ando, Kensuke Kumamoto, Kyuichi Kadota, Shuji Ichihara, Yasutaka Kokudo, Takashi Maeba, Yoshihide Nanno, Hirochika Toyama, Yasutsugu Takada, Mitsuo Shimada, Kazuhiro Hanazaki, Tsutomu Masaki, Yasuyuki Suzuki

  OBJECTIVE: The goal of this retrospective study was to clarify the clinical implications of immunohistochemically detected protein expression for genes that are frequently mutated in pancreatic neuroendocrine tumors (PNETs). BACKGROUND: The clinical management of PNETs is hindered by their heterogenous biological behavior. Whole-exome sequencing recently showed that 5 genes (DAXX/ATRX, MEN1, TSC2, and PTEN) are frequently mutated in PNETs. However, the clinical implications of the associated alterations in protein expression remain unclear. METHODS: We collected Grade 1 and 2 (World Health Organization 2017 Classification) primary PNETs samples from 100 patients who underwent surgical resection. ATRX, DAXX, MEN1, TSC2, and PTEN expression were determined immunohistochemically to clarify their relationships with prognosis and clinicopathological findings. RESULTS: Kaplan-Meier analysis indicated that loss of TSC2 (n = 58) or PTEN (n = 37) was associated with significantly shorter overall survival, and that loss of TSC2 or ATRX (n = 41) was associated with significantly shorter recurrence-free survival. Additionally, loss of ATRX or TSC2 was significantly associated with nodal metastasis. In a multivariate analysis, combined loss of TSC2 and ATRX (n = 31) was an independent prognostic factor for shorter recurrence-free survival (hazard ratio 10.1, 95% confidence interval 2.1-66.9, P = 0.003) in G2 PNETs. CONCLUSIONS: Loss of ATRX, TSC2, and PTEN expression might be useful as a method of clarifying the behavior and clinical outcomes of Grade 1 and 2 PNETs in routine clinical practice. Combined loss of TSC2 and ATRX had an especially strong, independent association with shorter recurrence-free survival in patients with G2 PNETs. Loss of pairs in ATRX, TSC2, or PTEN would be useful for selecting the candidate for postoperative adjuvant therapy.

  Dec. 2021, Annals of surgery, 274(6) (6), e949-e956, English, International magazine

  Scientific journal


• Indocyanine green (ICG) fluorography and digital subtraction angiography (DSA) of vessels supplying the remnant stomach that were performed during distal pancreatectomy in a patient with a history of distal gastrectomy: a case report.

  Sadaki Asari, Hirochika Toyama, Tadahiro Goto, Hironori Yamashita, Yoshihide Nanno, Jun Ishida, Takuya Mizumoto, Hiroaki Yanagimoto, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  A 68-year-old man who had undergone distal gastrectomy for gastric cancer 3 years previously, presented to our hospital for examination of dilatation of the main pancreatic duct on follow-up computed tomography and magnetic resonance cholangiopancreatography. After examination, he was diagnosed with early-stage pancreatic cancer and distal pancreatectomy (DP) was planned. With informed consent, we performed indocyanine green (ICG) fluorography during DP and digital subtraction angiography (DSA) of vessels supplying the remnant stomach immediately before and after DP. On ICG fluorography, the remnant stomach gradually became fluoresced starting at the area of the lesser curvature, and the fluorescence eventually intensified over the entire area of the remnant stomach to the same brightness as that of the liver and duodenum. On DSA following DP, the terminal branches of the left inferior phrenic artery (LIPA) were distributed to more than half of the area of the remnant stomach, centering around the proximal area. It is useful to confirm blood flows to the remnant stomach by ICG fluorography using a near-infrared imaging camera during DP. We found that the LIPA played an important role in maintaining the blood supply to the remnant stomach in the absence of the left gastric artery and splenic artery.

  Dec. 2021, Clinical journal of gastroenterology, 14(6) (6), 1749 - 1755, English, Domestic magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Standardization of the Side-to-Side Cavo-Caval Anastomosis in Orthotopic Liver Transplantation Based on the Causal Analysis of Outflow Obstruction.

  Kaori Kuramitsu, Masahiro Kido, Shohei Komatsu, Daisuke Tsugawa, Hidetoshi Gon, Kenji Fukushima, Takeshi Urade, Shinichi So, Takuya Mizumoto, Yoshihide Nanno, Hironori Yamashita, Tadahiro Goto, Hiroaki Yanagimoto, Sadaki Asari, Tetsuo Ajiki, Hirochika Toyama, Takumi Fukumoto

  BACKGROUND: Although liver transplantation is widely accepted as the therapeutic strategy for end-stage liver failure, complication of hepatic venous outflow obstruction remains lethal. Currently, ensuring a single wide orifice in both the graft and recipient inferior vena cava has been proposed to avoid hepatic venous outflow obstruction with no theoretical concept. METHODS: We herein report a standardization technique for the reconstruction of the hepatic vein based on the causal analysis. RESULTS: During the put-in process, the graft must be positioned in contact with the recipient diaphragm and slightly pushed to the cranial direction to simulate the state after abdominal closure. Because there is no extra space between the graft and diaphragm, the graft could not rotate about the anastomotic site of the inferior vena cava toward the diaphragm after abdominal closure as the intestinal pressure increases, and accordingly hepatic venous outflow obstruction does not develop. CONCLUSIONS: With this concept, all transplant surgeons can successfully and easily perform hepatic vein reconstruction without total clamping of the inferior vena cava and without outflow block.

  Dec. 2021, Transplantation proceedings, 53(10) (10), 2934 - 2938, English, International magazine

  Scientific journal


• Metabolic measures before surgery and long-term diabetes outcomes in recipients of total pancreatectomy and islet autotransplantation.

  Yoshihide Nanno, Solvejg Wastvedt, Martin L Freeman, Guru Trikudanathan, Sarah J Schwarzenberg, Elissa M Downs, Varvara A Kirchner, Timothy L Pruett, Gregory J Beilman, Srinath Chinnakotla, Bernhard J Hering, Melena D Bellin

  In this single-center, retrospective cohort study, we aimed to elucidate simple metabolic markers or surrogate indices of β-cell function that best predict long-term insulin independence and goal glycemic HbA1c control (HbA1c ≤ 6.5%) after total pancreatectomy with islet autotransplantation (TP-IAT). Patients who underwent TP-IAT (n = 371) were reviewed for metabolic measures before TP-IAT and for insulin independence and glycemic control at 1, 3, and 5 years after TP-IAT. Insulin independence and goal glycemic control were achieved in 33% and 68% at 1 year, respectively. Although the groups who were insulin independent and dependent overlap substantially on baseline measures, an individual who has abnormal glycemia (prediabetes HbA1c or fasting glucose) or estimated IEQs/kg < 2500 has a very high likelihood of remaining insulin dependent after surgery. In multivariate logistic regression modelling, metabolic measures correctly predicted insulin independence in about 70% of patients at 1, 3, and 5 years after TP-IAT. In conclusion, metabolic testing measures before surgery are highly associated with diabetes outcomes after TP-IAT at a population level and correctly predict outcomes in approximately two out of three patients. These findings may aid in prognostic counseling for chronic pancreatitis patients who are likely to eventually need TP-IAT.

  Oct. 2021, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 21(10) (10), 3411 - 3420, English, International magazine

  Scientific journal


• Carbohydrate antigen microarray analysis of serum IgG and IgM antibodies before and after adult porcine islet xenotransplantation in cynomolgus macaques.

  Yoshihide Nanno, Eric Sterner, Jeffrey C Gildersleeve, Bernhard J Hering, Christopher Burlak

  Understanding the anti-carbohydrate antibody response toward epitopes expressed on porcine cells, tissues, and organs is critical to advancing xenotransplantation toward clinical application. In this study, we determined IgM and IgG antibody specificities and relative concentrations in five cynomolgus monkeys at baseline and at intervals following intraportal xenotransplantation of adult porcine islets. This study utilized a carbohydrate antigen microarray that comprised more than 400 glycoconjugates, including historically reported α-Gal and non-α-Gal carbohydrate antigens with various modifications. The elicited anti-carbohydrate antibody responses were predominantly IgM compared to IgG in 4 out of 5 monkeys. Patterns of elicited antibody responses greater than 1.5 difference (log2 base units; 2.8-fold on a linear scale) from pre-serum to post-serum sampling specific for carbohydrate antigens were heterogeneous and recipient-specific. Increases in the elicited antibody response to α-Gal, Sda, GM2 antigens, or Lexis X antigen were found in individual monkeys. The novel carbohydrate structures Galβ1-4GlcNAcβ1-3Galβ1 and N-linked glycans with Manα1-6(GlcNAcβ1-2Manα1-3)Manβ1-4GlcNAcβ structure were common targets of elicited IgM antibodies. These results provide important insights into the carbohydrate epitopes that elicit antibodies following pig-to-monkey islet xenotransplantation and reveal possible targets for gene editing.

  2021, PloS one, 16(6) (6), e0253029, English, International magazine

  Scientific journal


• Xenotransplantation literature update, July/August 2020.

  Yoshihide Nanno, Christopher Burlak

  Nov. 2020, Xenotransplantation, 27(6) (6), e12653, English, International magazine

  Scientific journal


• Combination of pancreas volume and HbA1c level predicts islet yield in patients undergoing total pancreatectomy and islet autotransplantation.

  Yoshihide Nanno, Joshua J Wilhelm, David Heller, Robben Schat, Martin L Freeman, Guru Trikudanathan, Varvara A Kirchner, Timothy L Pruett, Gregory J Beilman, Bernhard J Hering, Melena D Bellin

  Islet yield is an important predictor of acceptable glucose control after total pancreatectomy with islet autotransplantation (TP-IAT). We assessed if pancreas volume calculated with preoperative MRI could assess islet yield and postoperative outcomes. We reviewed dynamic MRI studies from 154 adult TP-IAT patients (2009-2016), and associations between calculated volumes and digest islet equivalents (IEQs) were tested. In multivariate regression analysis, pancreas volume (P < .001) and preoperative HbA1c levels (P = .009) were independently associated with digest IEQs. The IEQ prediction formula was calculated according to each preoperative HbA1c level, (a) pancreas volume × 5800 for HbA1c ≥ 6.5, (b) pancreas volume × 10 000 for HbA1c ≥5.7/<6.5 and (iii) pancreas volume × 11 400 for HbA1c < 5.7. The formula was internally validated with 28 TP-IAT patients between 2017 and 2018 (r2  = .657 and r2  = .710 when restricted to 24 patients without prior pancreatectomy). An estimated IEQs/Body Weight (kg) ≥3700 predicted HbA1c ≤6.5 and insulin independence at 1 year after TP-IAT with 77% and 88% sensitivity and 55% and 43% specificity, respectively. The combination of pancreas volume and preoperative HbA1c levels may be useful to estimate islet yield. Estimated IEQs were reasonably sensitive to predict acceptable glucose control at 1 year.

  Aug. 2020, Clinical transplantation, 34(8) (8), e14008, English, International magazine

  Scientific journal


• Profiling natural serum antibodies of non-human primates with a carbohydrate antigen microarray.

  Yoshihide Nanno, Eric Sterner, Jeffrey C Gildersleeve, Bernhard J Hering, Christopher Burlak

  BACKGROUND: Engineering of α-Galactosyltransferase gene-knockout pigs circumvented hyperacute rejection of pig organs after xenotransplantation in non-human primates. Overcoming this hurdle revealed the importance of non-α-Gal carbohydrate antigens in the immunobiology of acute humoral xenograft rejection. METHODS: This study analyzed serum from seven naïve cynomolgus monkeys (blood type O/B/AB = 3/2/2) for the intensity of natural IgM and IgG signals using carbohydrate antigen microarray, which included historically reported α-Gal and non-α-Gal carbohydrate antigens with various modifications. RESULTS: The median (range) of IgM and IgG signals were 12.71 (7.23-16.38) and 9.05 (7.23-15.90), respectively. The highest IgM and IgG signals with narrowest distribution were from mono- and disaccharides, followed by modified structures. Natural anti-α-Gal antibody signals were medium to high in IgM (11.2-15.9) and medium in IgG (8.5-11.6) spectra, and was highest with Lac core structure (Galα1-3Galβ1-4Glc, iGb3) and lowest with LacNAc core structure (Galα1-3Galβ1-4GlcNAc). Similar signal intensities (up to 15.8 in IgM and up to 11.8 in IgG) were observed for historically detected natural non-α-Gal antigens, which included Tn antigen, T antigen, GM2 glycolipid, and Sda antigen. The hierarchical clustering analysis revealed the presence of clusters of anti-A antibodies and was capable of distinguishing between the blood group B and AB non-human primates. CONCLUSIONS: The results presented here provide the most comprehensive evaluation of natural antibodies present in cynomolgus monkeys.

  Mar. 2020, Xenotransplantation, 27(2) (2), e12567, English, International magazine

  Scientific journal


• High-mannose type N-glycans with core fucosylation and complex-type N-glycans with terminal neuraminic acid residues are unique to porcine islets.

  Yoshihide Nanno, Asif Shajahan, Roberto N Sonon, Parastoo Azadi, Bernhard J Hering, Christopher Burlak

  OBJECTIVES: Islet transplantation is an emerging treatment option for type 1 diabetes but its application is limited by the shortage of human pancreas donors. Characterization of the N- and O-glycan surface antigens that vary between human and genetically engineered porcine islet donors could shed light on targets of antibody mediated rejection. METHODS: N- and O-glycans were isolated from human and adult porcine islets and analyzed using matrix-assisted laser-desorption time-of-flight mass spectrometry (MALDI-TOF-MS) and electrospray ionization mass spectrometry (ESI-MS/MS). RESULTS: A total of 57 porcine and 34 human N-glycans and 21 porcine and 14 human O-glycans were detected from cultured islets. Twenty-eight of which were detected only from porcine islets, which include novel xenoantigens such as high-mannose type N-glycans with core fucosylation and complex-type N-glycans with terminal neuraminic acid residues. Porcine islets have terminal N-glycolylneuraminic acid (NeuGc) residue in bi-antennary N-glycans and sialyl-Tn O-glycans. No galactose-α-1,3-galactose (α-Gal) or Sda epitope were detected on any of the islets. CONCLUSIONS: These results provide important insights into the potential antigenic differences of N- and O-glycan profiles between human and porcine islets. Glycan differences may identify novel gene targets for genetic engineering to generate superior porcine islet donors.

  2020, PloS one, 15(11) (11), e0241249, English, International magazine

  Scientific journal


• Preoperative Oral Branched-Chain Amino Acid Supplementation Suppresses Intraoperative and Postoperative Blood Lactate Levels in Patients Undergoing Major Hepatectomy.

  Yoshihide Nanno, Hirochika Toyama, Sachio Terai, Takuya Mizumoto, Motofumi Tanaka, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Lactate production is exacerbated by surgical stress. We sought to determine whether branched-chain amino acid (BCAA) supplementation could decrease blood lactate levels in patients undergoing hepatectomy. METHODS: A total of 275 consecutive patients who underwent hepatectomy of ≥2 segments were retrospectively reviewed. Blood lactate levels in patients treated with BCAA supplementation before hepatectomy (December 2011 to December 2016) were compared with levels in patients who were not pretreated (January 2008 to November 2011). RESULTS: Postoperative lactate levels were significantly lower in patients who received preoperative BCAA supplementation than in those who did not (2.6 vs 3.4 mmol/L; P < .001). Intraoperative blood lactate levels, which were evaluated after induction of general anesthesia, were also lower in those who received BCAA supplementation than in those who did not (1.1 vs 1.5 mmol/L, respectively; P < .001). A multiple regression analysis revealed that preoperative BCAA supplementation was independently associated with decreased postoperative and intraoperative lactate levels (P = .030 and P < .001, respectively). CONCLUSION: Preoperative BCAA supplementation decreased intraoperative and postoperative blood lactate levels in patients undergoing major hepatectomy.

  Feb. 2019, JPEN. Journal of parenteral and enteral nutrition, 43(2) (2), 220 - 225, English, International magazine

  Scientific journal


• 【膵神経内分泌腫瘍-診断と治療のパラダイムシフト-】外科治療 膵神経内分泌腫瘍の外科治療前にわかる予後予測因子

  南野 佳英, 外山 博近, 松本 逸平, 福本 巧

  (株)アークメディア, Jan. 2019, 肝胆膵, 78(1) (1), 79 - 86, Japanese


• ASO Author Reflections: Serum Elastase 1 Level as a Risk Factor for Postoperative Recurrence in Patients with Well-Differentiated Pancreatic Neuroendocrine Neoplasms.

  Yoshihide Nanno, Hirochika Toyama

  Dec. 2018, Annals of surgical oncology, 25(Suppl 3) (Suppl 3), 800 - 801, English, International magazine

  Scientific journal


• Serum Elastase 1 Level as a Risk Factor for Postoperative Recurrence in Patients with Well-Differentiated Pancreatic Neuroendocrine Neoplasms.

  Yoshihide Nanno, Hirochika Toyama, Yoh Zen, Masayuki Akita, Yasuhisa Ando, Takuya Mizumoto, Yuki Ueda, Tetsuo Ajiki, Keiichi Okano, Yasuyuki Suzuki, Takumi Fukumoto

  PURPOSE: This study was designed to assess the potential role of the preoperative serum level of elastase 1 as a risk factor for recurrence in patients with resectable well-differentiated pancreatic neuroendocrine neoplasms (PanNETs). METHODS: Preoperative serum elastase 1 levels were measured in 53 patients with PanNETs who underwent complete tumor resection in two tertiary referral centers between January 2004 and June 2017. The preoperative elastase 1 levels were correlated with clinicopathological characteristics, including tumor recurrence and recurrence-free survival. RESULTS: The median elastase 1 level was 96 ng/dL (range: 21-990 ng/dL). Preoperative serum elastase 1 levels were significantly higher in those with tumors ≥ 20 mm in diameter (vs. < 20 mm, P = 0.018), WHO grade 2 (vs. grade 1, P = 0.035), and microscopic venous invasion (vs. without venous invasion, P = 0.039). The median preoperative serum level of elastase 1 was higher in patients with recurrence than in those without recurrence (251 vs. 80 ng/dL, P = 0.004). Receiver operating characteristic analysis of elastase 1 levels showed that a cutoff level of 250 ng/dL was associated with postoperative recurrence, with 63% sensitivity, 100% specificity, and 94% overall accuracy. Patients with higher elastase 1 levels showed significantly worse recurrence-free survival than that of those with lower levels (2-year recurrence-free survival rate: 25% and 92%, respectively, P < 0.001). CONCLUSIONS: Our data provide the first evidence that high preoperative elastase 1 levels may be a risk factor for postoperative recurrence in patients with resectable PanNETs.

  Oct. 2018, Annals of surgical oncology, 25(11) (11), 3358 - 3364, English, International magazine

  Scientific journal


• 膵臓移植後の急性移植片対宿主病(GVHD)の検討

  南野 佳英, 外山 博近, 浅利 貞毅, 後藤 直大, 寺井 祥雄, 椋棒 英世, 白川 幸代, 水本 拓也, 上田 悠貴, 津川 大介, 小松 昇平, 木下 秘我, 田中 基文, 木戸 正浩, 福本 巧

  固形臓器移植後の急性移植片対宿主病(GVHD)は、造血幹細胞移植後に比べ頻度が低く、病態や危険因子について未だ不明な点が多い。膵臓移植後GVHDの報告例について著者らの経験を踏まえて考察し、特にHLA一方向性0ミスマッチと言われる特殊な危険因子との関係について報告した。HLA型一方向性0ミスマッチ症例は、必ずしも全例がGVHDを起こすわけではないが、一度発症すると予後不良であることが示唆された。

  (一社)日本移植学会, May 2018, 移植, 53(1) (1), 71 - 77, Japanese

  Link to Kobe Univ. Repository (Kernel)


• Pathological and Radiological Splenic Vein Involvement are Predictors of Poor Prognosis and Early Liver Metastasis After Surgery in Patients with Pancreatic Adenocarcinoma of the Body and Tail.

  Takuya Mizumoto, Hirochika Toyama, Sadaki Asari, Sachio Terai, Hideyo Mukubo, Hironori Yamashita, Sachiyo Shirakawa, Yoshihide Nanno, Yuki Ueda, Keitaro Sofue, Motofumi Tanaka, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: The prognostic impact of pancreatic ductal adenocarcinoma (PDAC) invasion to the splenic vessel is controversial. OBJECTIVE: The aim of this study was to assess the clinical value of pathological and radiological splenic vessel invasion in PDACs of the body and tail. METHODS: Medical records of patients with resectable PDAC of the body and tail who underwent distal pancreatectomy between 2003 and 2016 at the Kobe University Hospital were retrospectively analyzed. RESULTS: Overall, 68 patients (29 female and 39 male patients) were enrolled. Pathologically determined splenic vein invasion (p-SV) and splenic artery invasion (p-SA) were identified in 21 (30.9%) and 5 (7.4%) patients, respectively. The p-SV (but not p-SA) was an independent prognostic factor in multivariate analysis (p = 0.009). On analysis of recurrence patterns, patients with PDAC positive for p-SV were at a higher risk for liver metastasis (p = 0.022); however, the associations were not significant for other recurrence patterns. Liver metastasis occurred earlier in patients who were positive for p-SV (p = 0.015). Preoperative computed tomography effectively diagnosed pathological vessel invasion (SV: sensitivity, 95.2%, specificity, 72.3%; SA: sensitivity, 100%, specificity, 84.1%). Radiological SV invasion remained significant in multivariate analysis regarding postoperative survival (p = 0.007), and was also associated with early liver metastases (p = 0.008). CONCLUSIONS: Pathological/radiological SV invasion were independent adverse prognostic factors associated with early liver metastasis in patients with PDAC of the body/tail. Assessment of these findings may be useful in determining optimal therapeutic options in these patients.

  Mar. 2018, Annals of surgical oncology, 25(3) (3), 638 - 646, English, International magazine

  Scientific journal


• Prediction of lymph node metastasis in pancreatic neuroendocrine tumors by contrast enhancement characteristics

  Takuya Mizumoto, Hirochika Toyama, Sachio Terai, Hideyo Mukubou, Hironori Yamashita, Sachiyo Shirakawa, Yoshihide Nanno, Keitaro Sofue, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  Background: Iso- or hypo-attenuating areas in the arterial phase on contrast-enhanced computed tomography (CE-CT) have been reported to be negative prognostic features in pancreatic neuroendocrine tumors (PNETs). Given that the optimal indication for lymph node dissection in patients with PNET remains unclear, we sought to utilize enhancement characteristics on CE-CT as a preoperative predictor of regional lymph node metastasis in PNETs. Methods: The medical records of patients with well-differentiated PNETs who underwent pancreatectomy along with lymphadenectomy were retrospectively analyzed. We divided PNETs into two groups based on the extent of attenuation in the late arterial phase on CE-CT imaging. PNETs that showed hyper-attenuation over the entire area compared to the adjacent normal pancreas were categorized as hyper-PNETs. PNETs that contained both hyper and iso- or hypo-attenuation regions as well as those that showed only iso- or hypo-attenuation over the entire area were categorized as hetero/hypo-PNETs. Results: Forty-one patients with a median age of 64 years were enrolled, including 11 with hyper-PNETs and 30 with hetero/hypo-PNETs. Hetero/hypo-PNETs were significantly larger than hyper-PNETs (P = 0.022), and the former group more frequently comprised G2 tumors, according to the World Health Organization 2010 classification (P < 0.001). On univariate and multivariate analyses, hetero/hypo-PNETs were independently associated with regional lymph node metastasis. Conclusions: The presence of iso- or hypo-attenuating regions appears to be associated with regional lymph node metastasis in PNETs. Tumor enhancement characteristics should be assessed in patients with PNET so as not to miss those at high risk of lymph node metastasis. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  ELSEVIER SCIENCE BV, Nov. 2017, PANCREATOLOGY, 17(6) (6), 956 - 961, English, International magazine

  [Refereed]

  Scientific journal


• 術前術後のリンパ節転移診断で苦慮したサルコイドーシス併存膵癌の1例

  後藤 直大, 外山 博近, 浅利 貞毅, 寺井 祥雄, 椋棒 英世, 白川 幸代, 南野 佳英, 水本 拓也, 木下 秘我, 田中 基文, 木戸 正浩, 味木 徹夫, 福本 巧, 具 英成

  症例は69歳、女性。乳癌術後の定期検査CTで膵尾部腫瘍を指摘され、精査で傍大動脈リンパ節転移を伴う膵尾部癌と診断された。セカンドオピニオン目的で前医を受診、3年前から肺門部、傍大動脈リンパ節腫大がある点、ぶどう膜炎の既往を有する点からリンパ節腫大はサルコイドーシスが原因と判断した。手術加療目的で当院へ紹介された。2014年3月に膵体尾部切除術を施行した。No.16リンパ節サンプリングは癌陰性であったが、膵周囲リンパ節は転移陽性であった。術後9ヵ月目のCTで腹腔内リンパ節再発を指摘され、EUS-FNAによる確定診断を勧めたが、本人が検査を拒否した。その後定期フォロー中であるが、術後39ヵ月を経過した現在も生存中である。悪性腫瘍に併存したサルコイドーシスではリンパ節転移診断が難しく、治療方針決定の判断に苦慮することも少なくない。文献的考察を加え報告する。(著者抄録)

  (株)癌と化学療法社, Nov. 2017, 癌と化学療法, 44(12) (12), 1886 - 1888, Japanese


• 傍大動脈リンパ節転移を伴う膵VIP産生腫瘍の切除例

  上田 悠貴, 外山 博近, 寺井 祥雄, 椋棒 英世, 白川 幸代, 山下 博成, 南野 佳英, 水本 拓也, 李 東河, 木下 秘我, 田中 基文, 上野 公彦, 味木 徹夫, 木戸 正浩, 福本 巧

  症例は72歳、女性。主訴は8ヵ月前から続く1日7、8回の水様性下痢、体重減少。CT検査にて、膵尾部に55mm大の腫瘤を認めた。膵周囲、傍大動脈に腫大リンパ節を認めたが、肝転移は認めなかった。EUSでは境界明瞭で内部不均一な腫瘤であり、EUS-FNAによる組織診にて膵神経内分泌腫瘍と診断した。傍大動脈リンパ節転移を伴うVIP産生腫瘍を疑い、膵体尾部切除および大動脈周囲のリンパ節郭清術を施行した。切除標本の免疫染色にてVIP産生腫瘍と診断した。術後速やかに下痢は軽快し、切除後11ヵ月現在、症状の再燃や腫瘍の再発は認めていない。(著者抄録)

  (株)癌と化学療法社, Nov. 2017, 癌と化学療法, 44(12) (12), 1976 - 1978, Japanese


• Effect of Oral Branched-Chain Amino Acid Supplementation on Postoperative Blood Lactate Levels in Patients Undergoing Pancreatoduodenectomy.

  Yoshihide Nanno, Hirochika Toyama, Sachio Terai, Takuya Mizumoto, Motofumi Tanaka, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

  BACKGROUND: Elevations in blood lactate levels have been associated with poor postoperative outcome. The aim of the present study was to determine if preoperative supplementation with branched-chain amino acids (BCAA) decreases postoperative blood lactate levels in patients undergoing pancreatoduodenectomy. METHODS: The cases of 223 consecutive patients who underwent pancreatoduodenectomy were retrospectively reviewed. Postoperative blood lactate levels in patients who were treated with BCAA supplementation before pancreatoduodenectomy (December 2011-December 2014) were compared with levels in patients who were not pretreated (January 2008-November 2011). RESULTS: Postoperative lactate levels were significantly lower in patients who received preoperative BCAA supplementation than in patients who did not (2.6 vs 3.1 mmol/L, P = .005), although preoperative blood lactate levels were statistically equivalent between the groups. In the univariate analysis, preoperative BCAA supplementation, preoperative lactate levels, operation time, and postoperative glucose levels were associated with postoperative lactate levels. A multiple regression analysis was performed among the 4 factors, and the preoperative use of BCAA supplementation was independently correlated with postoperative lactate levels ( P = .046). CONCLUSIONS: Preoperative BCAA supplementation decreased postoperative blood lactate levels. These results suggest that preoperative BCAA supplementation may help patients recover after surgery.

  Jun. 2017, JPEN. Journal of parenteral and enteral nutrition, 148607117718494 - 148607117718494, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Internal hernia through a transverse mesocolon defect after laparoscopic distal pancreatectomy: Report of a case.

  Yoshihide Nanno, Tadahiro Goto, Hirochika Toyama, Sadaki Asari, Sachio Terai, Sachiyo Shirakawa, Takuya Mizumoto, Yuki Ueda, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku

  We report a case of an internal hernia through a transverse mesocolon defect after laparoscopic distal pancreatectomy. The patient was a 58-year-old man with an intraductal papillary mucinous neoplasm of the pancreatic body who underwent laparoscopic distal pancreatectomy. During surgery, an approximately 5-cm defect in the transverse mesocolon was inadvertently made. The defect was not closed as it was thought to be large enough to preclude incarceration. However, the patient developed a bowel obstruction 2 months postoperatively. Laparotomy revealed that a loop of the proximal jejunum herniated through the defect and was adherent to the stapled pancreatic stump. An additional loop of the jejunum was herniated through the narrowed mesenteric defect. To our knowledge, this is the first case of an internal hernia through a transverse mesocolon defect after laparoscopic distal pancreatectomy.

  May 2017, Asian journal of endoscopic surgery, 10(2) (2), 187 - 190, English, Domestic magazine

  Scientific journal


• Pancreatic Duct Involvement in Well-Differentiated Neuroendocrine Tumors is an Independent Poor Prognostic Factor.

  Yoshihide Nanno, Ippei Matsumoto, Yoh Zen, Kyoko Otani, Jun Uemura, Hirochika Toyama, Sadaki Asari, Tadahiro Goto, Tetsuo Ajiki, Keiichi Okano, Yasuyuki Suzuki, Yoshifumi Takeyama, Takumi Fukumoto, Yonson Ku

  BACKGROUND: The biological behavior of well-differentiated neuroendocrine tumors of the pancreas (PNETs) is difficult to predict. This study was designed to determine whether involvement of the main pancreatic duct (MPD) serves as a poor prognostic factor for PNETs. METHODS: The involvement of the MPD in PNETs was defined as ductal stenosis inside the tumor mass associated with distal MPDs more than twofold larger in diameter than the proximal ducts. We examined the correlation between MPD involvement and other clinicopathological parameters, including nodal metastasis and recurrence-free survival, in 101 patients treated consecutively at three referral centers in Japan. All patients underwent surgical resection. RESULTS: MPD involvement was observed in 13 of the 101 cases (13%) and was associated with multiple unfavorable clinicopathological features (e.g., larger tumor size, higher histological grade, more frequent nodal metastasis, and higher recurrence rates). Patients with MPD involvement also showed significantly worse recurrence-free survival than did those without ductal involvement (P < 0.001), with a 5 years recurrence-free rate of 41%. On multivariate analysis, MPD involvement was significantly associated with nodal metastasis [odds ratio (OR) 16; 95% confidence interval (CI) 3.8-89; P < 0.001] and recurrence (OR 8.0; 95% CI 1.7-46; P = 0.009). The radiology-pathology correlation revealed that stenosis of the MPD was due to periductal and/or intraductal tumor invasion. Cases with MPD involvement had microscopic venous invasion (P = 0.010) and perineural infiltration (P = 0.002) more frequently than did those with no ductal infiltration. CONCLUSIONS: MPD involvement in PNETs may serve as an imaging sign indicating an aggressive clinical course.

  Apr. 2017, Annals of surgical oncology, 24(4) (4), 1127 - 1133, English, International magazine

  Scientific journal


• Baseline plasma chromogranin A levels in patients with well-differentiated neuroendocrine tumors of the pancreas: A potential predictor of postoperative recurrence

  Yoshihide Nanno, Hirochika Toyama, Ippei Matsumoto, Kyoko Otani, Sadaki Asari, Tadahiro Goto, Tetsuo Ajiki, Yoh Zen, Takumi Fukumoto, Yonson Ku

  Background: The present study aimed to elucidate prognostic values of baseline plasma chromogranin A (CgA) concentrations in patients with resectable, well-differentiated pancreatic neuroendocrine tumors (PNETs). Methods: Preoperative CgA levels in 21 patients with PNET were correlated with clinicopathological factors and patients' survival. Results: Plasma CgA levels ranged 2.9-30.8 pmol/mL (median 6.0), and were significantly elevated in patients with post-operative recurrence (P - 0.004). Using the receiver operating characteristic curve, the optimal cutoff value to predict tumor recurrence was determined as 17.0 pmol/mL. This threshold identified patients with recurrence with 60% sensitivity, 100% specificity, and 90% overall accuracy. Patients with higher CgA levels showed worse recurrence-free survival than those with low CgA levels, both in total (P < 0.001) and in G2 patients (P = 0.020). Conclusions: Combined plasma CgA concentrations and WHO grading may assist in better stratification of PNET patients in terms of the risk of recurrence. (C) 2016 Published by Elsevier B.V. on behalf of IAP and EPC.

  ELSEVIER SCIENCE BV, Mar. 2017, PANCREATOLOGY, 17(2) (2), 291 - 294, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• CD133 expression in well-differentiated pancreatic neuroendocrine tumors: a potential predictor of progressive clinical courses.

  Yasuhiro Sakai, Seung-Mo Hong, Soyeon An, Joo Young Kim, Denis Corbeil, Jana Karbanová, Kyoko Otani, Kohei Fujikura, Ki-Byung Song, Song Cheol Kim, Masayuki Akita, Yoshihide Nanno, Hirochika Toyama, Takumi Fukumoto, Yonson Ku, Takanori Hirose, Tomoo Itoh, Yoh Zen

  The present study aimed to elucidate whether the stemness molecule, CD133, is expressed in well-differentiated pancreatic neuroendocrine tumors (PanNETs; World Health Organization grades 1 and 2) and establish its clinical relevance using 2 separate cohorts. In the first series (n = 178) in which tissue microarrays were available, immunohistochemistry revealed that CD133 was expressed in 14 cases (8%). CD133+ PanNETs had higher TNM stages (P < .01), more frequent lymphovascular invasion (P = .01), and higher recurrence rates (P = .01). In the second cohort (n = 56), the expression of CD133 and CK19 was examined in whole tissue sections. CD133 and CK19 were positive in 10 (18%) and 36 (64%) cases, respectively. CD133 expression correlated with higher pT scores (P < .01), the presence of microscopic venous infiltration (P = .03), and shorter disease-free periods (P < .01). When cases were divided into grade 1 and 2 neoplasms, patients with CD133+ PanNET continued to have shorter disease-free periods than did those with CD133- tumors in both groups (P < .01 and P = .02, respectively). Although CK19+ cases had shorter disease-free periods than did CK19- cases in the whole cohort (P = .02), this difference was less apparent in subanalyses of grade 1 and 2 cases. CD133 expression also appeared to be an independent predictive factor for tumor recurrence in a multivariate analysis (P = .018). The CD133 phenotype was identical between primary and metastatic foci in 17 of 18 cases from which tissues of metastatic deposits were available. In conclusion, the combination of CD133 phenotyping and World Health Organization grading may assist in stratifying patients in terms of the risk of progressive clinical courses.

  Mar. 2017, Human pathology, 61, 148 - 157, English, International magazine

  Scientific journal


• PET-CTおよびEUS-FNAで診断し腹腔鏡下脾温存膵尾部切除(LAP-SPDP)にて切除した骨肉腫膵転移の1例

  外山 博近, 浅利 貞毅, 後藤 直大, 寺井 祥雄, 白川 幸代, 南野 佳英, 水本 拓哉, 福本 巧, 味木 徹夫, 木戸 正浩, 田中 基文, 松本 拓, 木下 秘我, 蔵満 薫, 具 英成

  患者は44歳、女性。2012年、右腓骨頭通常型骨肉腫に対し、術前化学療法、原発巣切除および術後化学療法を施行した。2015年、フォローのPET-CTにて膵尾部に集積を指摘された。造影CTでは、13mm大の境界明瞭な乏血性腫瘍を認めた。EUSでは内部不均一な充実性腫瘍であり、EUS-FNAにて骨肉腫膵転移と確定診断した。2015年5月、腹腔鏡下脾温存膵尾部切除(LAP-SPDP)にて切除した。病理診断で通常型骨肉腫の膵転移と診断された。腫瘍内に一部ラ氏島の細胞がみられ、膵実質への浸潤性発育が示唆された。術後化学療法施行したが、2016年6月肺転移が出現した。胸腔鏡下肺部分切除施行し、現在生存中である。骨肉腫の膵転移はまれである。文献的考察を加えて報告する。(著者抄録)

  (株)癌と化学療法社, Nov. 2016, 癌と化学療法, 43(12) (12), 1988 - 1990, Japanese


• 亜全胃温存膵頭十二指腸切除により切除し得た卵巣原発線維肉腫再発の1例

  水本 拓也, 外山 博近, 浅利 貞毅, 後藤 直大, 寺井 祥雄, 白川 幸代, 南野 佳英, 味木 徹夫, 木戸 正浩, 松本 拓, 田中 基文, 中村 哲, 福本 巧, 掛地 吉弘, 具 英成

  症例は66歳、女性。1999年8月他院にて左卵巣線維肉腫に対し広汎子宮全摘術+両側付属器切除術、術後補助化学療法を施行されたが、その後腹膜再発を繰り返し、三度の腫瘍切除ならびに抗癌剤治療を施行された。2015年9月にも膵頭部に再発を認めたため、10月亜全胃温存膵頭十二指腸切除術、上腸間膜静脈合併切除術を施行した。腫瘍は膵実質、上腸間膜静脈壁に浸潤していた。術後はおおむね良好に経過し、現在8ヵ月の経過観察にて再発を認めていない。卵巣原発線維肉腫は非常にまれな疾患であり、周囲臓器への強い浸潤傾向を認めることが多い。今回、膵実質、上腸間膜静脈に浸潤を認め、亜全胃温存膵頭十二指腸切除、上腸間膜静脈合併切除にて切除し得た卵巣原発線維肉腫再発の1例を経験した。本症例につき文献的考察を加えて報告する。(著者抄録)

  (株)癌と化学療法社, Nov. 2016, 癌と化学療法, 43(12) (12), 2193 - 2195, Japanese


• Microscopic venous invasion in patients with pancreatic neuroendocrine tumor as a potential predictor of postoperative recurrence

  Yoshihide Nanno, Hirochika Toyama, Kyoko Otani, Sadaki Asari, Tadahiro Goto, Sachio Terai, Tetsuo Ajiki, Yoh Zen, Takumi Fukumoto, Yonson Ku

  Background: Microscopic venous and lymphatic invasion is a known prognostic factor for various cancers, but its prognostic relevance for pancreatic neuroendocrine tumors (PNETs) is unclear. Methods: Thirty-two consecutive patients with PNET who had complete resection were included in this study. Venous and lymphatic invasion was identified on elastic tissue or immunohistochemical staining, and correlated with other clinicopathological factors, including recurrence-free survival. Results: Venous and lymphatic invasion was identified in nine (28%) and three (9%) patients, respectively. Tumors with venous invasion were of significantly larger size, higher Ki-67 index, and higher mitotic counts. Patients with venous invasion showed significantly worse prognosis than those without venous invasion (P = 0.001). Five of nine patients (56%) with venous invasion had tumor recurrence, while a relapse was found in one case in patients without venous invasion (n = 23). Lymphatic invasion was not correlated with any other clinicopathological parameters including lymph node metastasis and recurrence-free survival. Predictive factors for recurrence in univariate analysis included microscopic venous invasion, tumor size >= 20 mm, non-functionality, and WHO grades. In multivariate analysis where WHO grades and microscopic venous invasion were applied, venous invasion remained a significant predictor of poor recurrence-free survival (P = 0.021). Conclusions: Microscopic venous invasion may serve as a predictive factor for tumor recurrence in patients with resectable PNET. The combination of WHO grades and microscopic venous invasion may assist in the stratification of the patients for risk of tumor recurrence. (C) 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  ELSEVIER SCIENCE BV, Sep. 2016, PANCREATOLOGY, 16(5) (5), 882 - 887, English, International magazine

  [Refereed]

  Scientific journal


• Second primary pancreatic ductal carcinoma in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma: High cumulative incidence rates at 5 years after pancreatectomy.

  Ishida J, Toyama H, Matsumoto I, Asari S, Goto T, Terai S, Nanno Y, Yamashita A, Mizumoto T, Ueda Y, Kido M, Ajiki T, Fukumoto T, Ku Y

  OBJECTIVES: The aim of this study was to determine the incidence rate and clinical features of second primary pancreatic ductal carcinoma (SPPDC) in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma (PDC). METHODS: Data of patients undergoing R0 resection for PDC at a single high-volume center were reviewed. SPPDC was defined as a tumor in the remnant pancreas after R0 resection for PDC, and SPPDC met at least one of the following conditions: 1) the time interval between initial pancreatectomy and development of a new tumor was 3 years or more; 2) the new tumor was not located in contact with the pancreatic stump. We investigated the clinical features and treatment outcomes of patients with SPPDC. RESULTS: This study included 130 patients who underwent surgical resection for PDC between 2005 and 2014. Six (4.6%) patients developed SPPDC. The cumulative 3- and 5-year incidence rates were 3.1% and 17.7%, respectively. Four patients underwent remnant pancreatectomy for SPPDC. They were diagnosed with the disease in stage IIA or higher and developed recurrence within 6 months after remnant pancreatectomy. One patient received carbon ion radiotherapy and survived 45 months. One patient refused treatment and died 19 months after the diagnosis of SPPDC. CONCLUSIONS: The incidence rate of SPPDC is not negligible, and the cumulative 5-year incidence rate of SPPDC is markedly high. Post-operative surveillance of the remnant pancreas is critical for the early detection of SPPDC, even in long-term survivors after PDC resection.

  Jul. 2016, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 16(4) (4), 615 - 620, English, International magazine

  [Refereed]

  Scientific journal


• 【胆膵疾患における血管系IVR】術後動脈出血 TAEによる止血

  外山 博近, 浅利 貞毅, 後藤 直大, 寺井 祥雄, 石田 潤, 南野 佳英, 水本 拓哉, 味木 徹夫, 松本 拓, 木戸 正浩, 田中 基文, 木下 秘我, 蔵満 薫, 福本 巧, 具 英成

  胆膵手術後の動脈出血は、いまだ致命的な合併症であり、救命のためには、迅速な診断と止血が不可欠である。診断にはMDCTが有用であり、sentinel bleedingや患者の訴えなどの前駆症状を見逃さず主幹動脈を精査する。治療はIVRによる止血が第一選択であり、coil塞栓を中心としたTAEが広く行われている。術後出血の好発部位は肝動脈、胃十二指腸動脈断端であり、肝動脈塞栓による肝梗塞が懸念される。しかしわれわれの経験では、十分な門脈血流と下横隔動脈など1本の動脈側副路があれば、致死的肝梗塞に陥ることはなかった。術後動脈出血では、完全な止血なしに救命はなく、止血を最優先し、必要なら門脈ステントや血行再建などの処置を検討すべきである。また、TAEで止血困難な場合や、膵瘻や胆汁瘻、感染のコントロールを要する場合があり、常に再開腹による治療の可能性も忘れてはならない。(著者抄録)

  医学図書出版(株), May 2016, 胆と膵, 37(5) (5), 455 - 460, Japanese


• Case of intra-abdominal spindle cell tumor after laparoscopic resection of sigmoid colon cancer.

  Naoya Okada, Fumitaka Nakamura, Yoshihide Nanno, Minoru Takada, Yoshiyasu Ambo, Akihiro Kishida, Nobuichi Kashimura, Toshiya Shinohara

  We herein report a rare case of a patient who developed a spindle cell tumor at the inferior mesenteric artery clipping site. A 58-year-old man underwent laparoscopy-assisted sigmoid colectomy for sigmoid colon cancer. As follow-up, CT scans were performed every 6 months after the primary surgery. At the 1-year CT, an nodular soft tissue density mass measuring 54 mm in diameter was found in the mesentery. Although we initially suspected locoregional recurrence of the colon cancer resected 1 year earlier, PET-CT showed that the tumor was unrelated to the previous cancer. During the subsequent laparotomy, the mass appeared to originate from the inferior mesenteric artery clipping site, and it adhered to the jejunum and the left ureter. We completely resected the tumor and part of the jejunum, which we separated from the abdominal aorta and left ureter. The tumor was histologically diagnosed of a spindle cell tumor. The patient has been free from recurrence since the surgery more than 4.5 years ago. Preoperative PET-CT was helpful in ruling out local recurrence of colon cancer, which might have made palliative care a better option than surgical resection.

  Feb. 2016, Asian journal of endoscopic surgery, 9(1) (1), 68 - 71, English, Domestic magazine

  Scientific journal


• [A case of adjuvant surgery for a patient with initially unresectable locally advanced pancreatic cancer (LAPC) with a favorable response to S-1 chemotherapy].

  Ueta A, Toyama H, Goto T, Matsumoto I, Shinzeki M, Asari S, Ishida J, Nanno Y, Tsugawa D, Kuramitsu K, Tanaka M, Takebe A, Okazaki T, Kido M, Ajiki T, Fukumoto T, Okuno T, Kokubun M, Ito T, Ku Y

  Nov. 2014, Gan to kagaku ryoho. Cancer & chemotherapy, 41(12) (12), 2178 - 2180

  [Refereed]


• S-1が著効しR0切除し得た局所進行切除不能膵癌の1例

  植田 亜津紗, 外山 博近, 後藤 直大, 松本 逸平, 新関 亮, 浅利 貞毅, 石田 潤, 南野 佳英, 津川 大介, 蔵満 薫, 田中 基文, 武部 敦志, 岡崎 太郎, 木戸 正浩, 味木 徹夫, 福本 巧, 奥野 達哉, 国分 麻佑, 伊藤 智雄, 具 英成

  症例は67歳、男性。心窩部不快感を主訴に当院受診し、精査にて上腸間膜動脈(SMA)周囲神経叢に約3/4周の浸潤を伴う局所進行切除不能膵癌(LAPC)と診断された。S-1による化学療法(4コース)が著効し、R0切除可能と判断して亜全胃温存膵頭十二指腸切除(SSpPD-II)を施行した。病理所見では膵内に腫瘍細胞を認めず、膵外神経線維のなかに腺癌細胞を少量確認するのみで、Evans分類でGrade IIIに相当した。断端はすべて陰性であり、R0切除と判定された。しかし術後難治性下痢のためS-1は投与できず、術後4ヵ月で局所再発を来した。近年、切除不能膵癌に対する二次治療としての切除(いわゆるadjuvant surgery)の試みがなされ予後延長が期待されているが、現時点で明確なエビデンスはなく、切除のデメリットや非外科治療継続の効果も踏まえ、慎重に適応を判断する必要がある。(著者抄録)

  (株)癌と化学療法社, Nov. 2014, 癌と化学療法, 41(12) (12), 2178 - 2180, Japanese


• [Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy].

  Tadahiro Goto, Ippei Matsumoto, Makoto Shinzeki, Hirochika Toyama, Sadaki Asari, Azusa Ueta, Jun Ishida, Yoshihide Nanno, Shinichi So, Hisoka Kinoshita, Taku Matsumoto, Kaori Kuramitsu, Motofumi Tanaka, Atsushi Takebe, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku

  Here, we report a case of Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy. A 69-year old man underwent pancreatoduodenectomy for pancreatic cancer in 2006 in which the splenic vein was ligated near the portal vein and then divided. The patient suffered repeated episodes of anemia between 2010 and 2013. However, we could not identify the bleeding site at that time. In 2011, local recurrence was detected. Disease progression occurred despite chemotherapy treatment, which was then discontinued. The left-sided portal hypertension gradually progressed, and the collateral vessels became dilated. In 2014, he was examined in our department for gastrointestinal bleeding. An upper gastrointestinal endoscopy revealed bleeding from gastric varices. Gastrointestinal bleeding ceased after endoscopic injection sclerotherapy ( EIS) was performed; however, the bleeding recurred. Balloon retrograde transvenous occlusion (BRTO) could not be performed because blood flow was not detected within the gastro-renal shunt. An emergency surgery was performed. Surgical splenectomy and devascularization (Hassab's operation) were performed. After surgery, the gastric body varices and gastrointestinal anastomosis disappeared and the bleeding did not occur. He is currently receiving outpatient treatment.

  (株)癌と化学療法社, Nov. 2014, Gan to kagaku ryoho. Cancer & chemotherapy, 41(12) (12), 2214 - 6, Japanese, Domestic magazine

  Scientific journal


• Trastuzumabを基軸とした併用療法により長期生存が得られた乳癌巨大肝転移再発の1例

  岡田 尚也, 成田 吉明, 南野 佳英, 嶋口 万友, 今村 清隆, 井上 玲, 中村 透, 高田 実, 加藤 弘明, 鈴木 温, 安保 義泰, 中村 文隆, 岸田 明博, 樫村 暢一, 松波 己

  trastuzumabを基軸とした内分泌化学療法により、長期生存が得られているHER2陽性乳癌肝転移再発症例を経験したので報告する。患者は1999年右乳癌に対しBt+Ax+Icを施行した60歳、女性。2007年乳癌肝転移再発に対する治療目的で当院を受診した。来院時CT上最大径15cm大の巨大肝転移巣が認められ、trastuzumabを基軸とした併用療法によりCT上PRを得られた。その後も治療の継続によって、肝転移後4年経過する現在もQOLを十分保ちながら長期生存している。乳癌肝転移は極めて予後不良であり、より早い段階で適切な治療がなされるべきである。HER2陽性乳癌肝転移再発の場合は、trastuzumabを基軸とした併用療法の有用性が示唆された。(著者抄録)

  (株)癌と化学療法社, Sep. 2012, 癌と化学療法, 39(9) (9), 1399 - 1402, Japanese


• 超高齢者乳癌切除例の臨床病理学的特徴と治療成績

  成田 吉明, 岡田 尚也, 嶋口 万友, 南野 佳英, 今村 清隆, 加藤 弘明, 松波 己, 篠原 敏也

  1987年11月から2008年12月までに施行した原発性乳癌切除719例のうち、80歳以上の超高齢者45名46側(6.4%)の臨床病理学的特徴と治療成績を検討した。全例しこりを主訴として来院したが、皮膚浸潤を伴うものが多く、病悩期間が長い傾向にあり、91%が何らかの合併症を有していた。病期はIIIb期の比率が高く、60%の症例に縮小手術が選択されており、全症例の5年生存率は56.6%と比較的良好であった。また、単変量解析で予後に影響を及ぼしたと思われる因子は、認知症の有無・PS・内分泌感受性・腫瘍径・内分泌療法施行の有無であり、年齢・手術の根治度・術前遠隔転移検索実施の有無・病悩期間・病期・HER2発現の有無・核グレードに有意差は認めなかった。以上より、従来の治療方針を今後も継続していく方向性を確認できた。

  (株)篠原出版新社, Aug. 2012, 乳癌の臨床, 27(4) (4), 433 - 438, Japanese

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• Proton radiotherapy as a treatment strategy to increase survival in locally advanced pancreatic cancer in the body and tail: a retrospective study

  Ami K, Terashima K, Ishida J, Matsuo Y, Suga M, Fukuoka H, Okawa T, Takahashi D, Park S, Matsuo Y, Nanno Y, Komatsu S, Asari S, Yanagimoto H, Kido M, Tokumaru S, Okimoto T, Toyama H, Fukumoto T

  7th Kansai-Yeungnam HBP Surgeons Meeting, Oct. 2023, English, International conference

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• Risk Factors for Recurrence of Cholangitis After Pancreaticoduodenectomy and Comparison of Stents in Hepaticojejunostomy

  Fukuoka H, Toyama H, Ishida J, Asari S, Goto T, Nanno Y, Okawa T, Urade T, Fukushima K, Gon H, Tsugawa D, Komatsu S, Yanagimoto H, Kido M, Fukumoto T

  7th Kansai-Yeungnam HBP Surgeons Meeting, Oct. 2023, English, International conference

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• A comparative study of laparo-scopic liver resection for the segment 8 dorsal and ventral area

  Oji K, Urade T, Kido M, Komatsu S, Gon H, Fukushima K, So S, Yoshida T, Arai K, Akita M, Ishida J, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Fukumoto T

  4th World Congress of International Laparoscopic liver Society（ILLS）, Sep. 2023, English, International conference

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• Impact of malnutrition diagnosed by the GLIM criteria on postoperative complications after pancreaticoduodenectomy for biliary tract cancer

  Okazoe Y, Yanagimoto H, Tsugawa D, Akita M, Okawa T, Omiya S, Arai K, Yoshida T, So S, Ishida J, Urade T, Nanno Y, Fukushima K, Gon H, Komatsu S, Asari S, Toyama H, Kido M, Ajiki T, Fukumoto T

  45th ESPEN Congress, Sep. 2023, English, International conference

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• Impact of malnutrition diagnosed by the GLIM criteria on outcome of elderly patients with hepatocellular carcinoma after liver resection

  Omiya S, Urade T, Komatsu S, Kido M, So S, Gon H, Fukushima K, Yoshida T, Arai K, Okazoe Y, Akita M, Ishida J, Nanno Y, Tsugawa D, Asari S, Yanagimoto H, Toyama H, Fukumoto T

  45th ESPEN Congress, Sep. 2023, English, International conference

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• Hepatic Resection versus Particle Therapy for Single Hepatocellular Carcinoma as An Initial Treatment: A Multicenter Propensity Score Matched Analysis

  Omiya S, Komatsu S, Terashima K, Park SC, Matsuo Y, Sulaiman NS, So S, Nanno Y, Urade T, Fukushima K, Gon H, Tsugawa D, Kuramitsu K, Goto T, Yanagimoto H, Kido M, Toyama H, Tokumaru S, Okimoto T, Fukumoto T

  APASL Oncology 2022, Sep. 2023, English, International conference

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• Preoperative serum transthyretin level predicts survival in PDAC patients receiving pancreatectomy

  Nanno Y, Toyama H, Goto T, Gon H, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Fukumoto T

  -, Jul. 2023, English, Domestic conference

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• A study for infectious complication of hepatectomies in patients with preexisting bilioenteric anastomosis

  Oji K, Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Yoshida T, Arai K, Akita M, Ishida J, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Intracholecystic papillary neoplasm (ICPN) with pancreaticobiliary maljunction (PBM): Comparison with normal gallbladder cancer with PBM

  Akita M, Yanagimoto H, Tsugawa D, Nanno Y, Urade T, Fukushima K, Gon H, Komatsu S, Kuramitsu K, Goto T, Kido M, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Successful biliary drainage using hybrid EUS-BD for stricture of choledochojejunostomy

  Tsugawa D, Yanagimoto H, Akita M, Arai K, Yoshida T, Ishida J, Nanno Y, Urade T, Fukushima K, Gon H, Komatsu S, Kuramitsu K, Goto T, Asari S, Toyama H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Intended destination for a board certified surgeon under 45

  Arai K, Komatsu S, Kido M, Kuramitsu K, Gon H, Fukushima K, Urade T, So S, Yoshida T, Akita M, Ishida J, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Prognostic significance of malnutrition diagnosed by the GLIM criteria for resected extrahepatic cholangiocarcinoma: A single-center retrospective study

  Okazoe Y, Yanagimoto H, Tsugawa D, Akita M, Omiya S, Arai K, Yoshida T, So S, Ishida J, Urade T, Nanno Y, Fukushima K, Gon H, Komatsu S, Kuramitsu K, Goto T, Asari S, Toyama H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Improvement in stapler pancreatic transection to reduce pancreatic fistula after laparoscopic distal pancreatectomy: twelve-year experience at a single high-volume center

  Ishida J, Toyama H, Asari S, Goto T, Nanno Y, Fukuoka H, Ami K, Akita M, Arai K, Yoshida T, So S, Urade T, Fukushima K, Gon H, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Reappraisal of malignant risk assessment for small (≦20 mm) non-functioning pancreatic neuroendocrine tumors

  Nanno Y, Toyama H, Matsumoto I, Uemura J, Asari S, Goto T, Lee D, Murakami T, Komatsu S, Yanagimoto H, Kido M, Ajiki T, Okano K, Takeyama Y, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Anterior approach for open rigththepatectomy for huge hepatocellular carcinoma

  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Yoshida T, Arai K, Omiya S, Fujinaka R, Akita M, Ishida J, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Our surgical technique of vascular dissection and resection for locally advanced pancreatic cancer

  Toyama H, Goto T, Nanno Y, Ishida J, Asari S, Yanagimoto H, Komatsu S, Tsugawa D, Gon H, Fukushima K, Urade T, Fukuoka H, Ami K, Kido M, Fukumoto T

  -, Jun. 2023, English, Domestic conference

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• Investigation of the relationship between complications after pancreaticoduodenectomy for distal cholangiocarcinoma and malnutrition diagnosed by the GLIM criteria

  Okazoe Y, Yanagimoto H, Tsugawa D, Akita M, Urade T, Nanno Y, Fukushima K, Gon H, Komatsu S, Goto T, Asari S, Toyama H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2023, English, International conference

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• Intraoperative Assessment of the Demarcation Line and Intersegmental/Sectional Planes in Liver Surgery

  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  15th World Congress of the International Hepato-Pancreato-Biliary Association (IHPBA), Mar. 2023, English, International conference

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  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Nanno Y, Tsugawa D, Goto T, Yanagimoto H, Toyama H, Fukumoto T

  Asian-Pacific Congress of Robotic Laparoscopic Surgery 2022 (ACRLS 2022), Dec. 2022, English, International conference

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  -, Dec. 2022, Japanese, Domestic conference

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  -, Nov. 2022, Japanese, Domestic conference

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• The usefulness of total tumor volume as a prognostic factor with colorectal cancer liver metastases

  Shimura Y, Komatsu S, Kido M, Kuramitsu K, Gon H, Fukushima K, Urade T, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Oct. 2022, English, Domestic conference

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• -

  -

  -, Sep. 2022, Japanese, Domestic conference

  Public symposium


• -

  -

  -, Jul. 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, Jul. 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, Jul. 2022, Japanese, Domestic conference

  Oral presentation


• Our surgical technique of vascular resection for locally advanced pancreatic cancer

  Goto T, Toyama H, Mizumoto T, Nanno Y, Asari S, Komatsu S, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jul. 2022, English, Domestic conference

  Public symposium


• Preoperative HbA1c and transthyretin concentrations predict survival after total pancreatectomy

  Nanno Y, Toyama H, Asari S, Goto T, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jul. 2022, English, Domestic conference

  Public symposium


• Survival outcome of chemotherapy-concurrent proton radiotherapy for non-metastatic locally advanced pancreatic cancer

  Ami K, Terashima K, Ogura Y, Takahata D, Park S, Matsuo Y, Mizumoto T, Shazrina SN, Nanno Y, Komatsu S, Kuramitsu K, Goto T, Asari S, Yanagimoto H, Kido M, Tokumaru S, Okimoto T, Ajiki T, Toyama H, Fukumoto T

  -, Jul. 2022, English, Domestic conference

  Oral presentation


• Diagnosis and treatment strategy of patients with early-stage(Stage 0/IA) pancreatic cancer

  Asari S, Toyama H, Goto T, Nanno Y, Mizumoto T, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jul. 2022, English, Domestic conference

  Oral presentation


• Prediction of diabetes outcome in recipients of total pancreatectomy and islet autotransplantation

  Nanno Y, Toyama H, Asari S, Goto T, Wastvedt S, Freeman ML, Trikudanathan G, Schwarzenberg SJ., Downs EM, Kirchner V, Pruett TL, Beilman GJ, Chinnakotla S, Hering BJ, Fukumoto T, Bellin MD

  -, Jul. 2022, English, Domestic conference

  Public symposium


• Our standardized technique of laparoscopic distal pancreatectomy for pancreatic cancer

  Goto T, Toyama H, Asari S, Nanno Y, Mizumoto T, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jul. 2022, English, Domestic conference

  Public symposium


• -

  -

  -, Jul. 2022, Japanese, Domestic conference

  Public symposium


• Standardization of laparoscopic anatomic liver resection of segment 2 by glissonean approach

  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  30th International Congress of the European Association for Endoscopic Surgery （EAES2022）, Jul. 2022, English, International conference

  Oral presentation


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Invited oral presentation


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Public symposium


• Impact of Delayed Gastric Emptying After Pancreatoduodenectomy on Postoperative Nutritional Status

  Mizumoto T, Toyama H, Asari S, Goto T, Nanno Y, So S, Urade T, Fukushima K, Gon H, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Spontaneous rupture of splenic hilar lymph node metastasis from hepatocellular carcinoma: a rare case report

  Fujinaka R, Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Laparoscopic anatomic liver resection of segment 2 based on the anatomical variation of the hepatic veins

  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Yanagimto H, Asari S, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Low levels of C-reactive protein on postoperative day 1 are an early predictor for posthepatectomy liver failure in hepatocellular carcinoma patients undergoing right hepatectomy

  Fukushima K, Kido M, Kuramitsu K, Komatsu S, Gon H, Urade T, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Current role of atezolizumab plus bevacizumab therapy in the sequential treatment of unresectable hepatocellular carcinoma

  Komatsu S, Kido M, Kuramitsu K, Gon H, Fukushima K, Urade T, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Utility of plasma serum D-dimer for diagnosis of venous thromboembolism after hepatectomy

  Yanagimoto H, Miyake T, Tsugawa D, Urade T, Nanno Y, Fukushima K, Gon H, Komatsu S, Kuramitsu K, Goto T, Asari S, Kido M, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Efficacy analyses of neoadjuvant treatment for patients with “resectable” pancreatic ductal adenocarcinoma

  Asari S, Toyama H, Goto T, Nanno Y, Mizumoto T, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• Laparoscopic Spleen Preserving Distal Pancreatectomy with Splenic Vessels Preservation

  Toyama H, Goto T, Nanno Y, Mizumoto T, Ogura Y, Fukuoka H, Ami K, Asari S, Kuramitsu K, Komatsu S, Tsugawa D, Yanagimoto H, Ajiki T, Kido M, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Poster presentation


• The usefulness of total tumor volume as a prognostic factor in patients with colorectal cancer liver metastases

  Shimura Y, Komatsu S, Kido M, Kuramitsu K, Gon H, Fukushima K, Urade T, So S, Mizumoto T, Nanno Y, Tsugawa D, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  -, Jun. 2022, English, Domestic conference

  Public symposium


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Poster presentation


• -

  -

  -, Jun. 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, May 2022, Japanese, Domestic conference

  Public symposium


• -

  -

  -, May 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, May 2022, Japanese, Domestic conference

  Oral presentation


• -

  -

  -, May 2022, Japanese, Domestic conference

  Public symposium


• -

  -

  -, May 2022, Japanese, Domestic conference

  Public symposium


• Laparoscopic anatomic liver resection of segment 2 by glissonean approach

  Urade T, Kido M, Kuramitsu K, Komatsu S, Gon H, Fukushima K, So S, Mizumoto T, Nanno Y, Goto T, Asari S, Yanagimoto H, Toyama H, Ajiki T, Fukumoto T

  SAGES 2022 Annual Meeting, Mar. 2022, English, International conference

  Poster presentation


• -

  -

  -, Mar. 2022, Japanese, Domestic conference

  Public symposium


• -

  -

  -, Feb. 2022, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Dec. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Dec. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Dec. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Nov. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Nov. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Nov. 2021, English, International conference

  Oral presentation


• ー

  ー

  ー, Oct. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Sep. 2021, Japanese, Domestic conference

  Public symposium


• ー

  ー

  ー, Sep. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Sep. 2021, Japanese, Domestic conference

  Others


• ー

  ー

  ー, Jul. 2021, Japanese, Domestic conference

  Oral presentation


• ー

  ー

  ー, Apr. 2021, Japanese, Domestic conference

  Poster presentation

• Japan Society of Clinical Oncology

  2021 - Present


• Japan Surgical Association

  2021 - Present


• Japan Biliary Association

  2021 - Present


• Japan Society of Hepatology

  2015 - Present


• Japan Pancreas Society

  2013 - Present


• The Japanese Society of Gastroenterology

  2013 - Present


• Japanese Society for Clinical Nutrition and Metabolism

  2012 - Present


• Japanese Society of Hepato-Biliary-Pancreatic Surgery

  2012 - Present


• Japan Society for Endoscopic Surgery

  2011 - Present


• The Japanese Society of Gastroenterological Surgery

  2010 - Present


• Japan Surgical Society

  2007 - Present

• Analysis of lipid absorption and metabolism in patients undergoing pancreaticoduodenectomy

  南野 佳英

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research Grant-in-Aid for Early-Career Scientists, Grant-in-Aid for Early-Career Scientists, Kobe University, 01 Apr. 2021 - 31 Mar. 2024