著者 Takagi, Kosei| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Watanabe, Nobuyuki| Kuise, Takashi| Fuji, Tomokazu| Araki, Hiroyuki| Fujiwara, Toshiyoshi|
発行日 2017-02
出版物タイトル Acta Medica Okayama
71巻
1号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/54594
フルテキストURL 70_5_363.pdf
著者 Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Fujiwara, Toshiyoshi|
抄録 Sarcopenia following liver surgery has been reported as a predictor of poor prognosis. Here we investigated predictors of outcomes in patients with hepatocellular carcinoma (HCC) and attempted to establish a new comprehensive preoperative assessment protocol. We retrospectively analyzed the cases of 254 patients who underwent curative hepatectomy for HCC with Child-Pugh classification A at our hospital between January 2007 and December 2013. Sarcopenia was evaluated by computed tomography measurement. The influence of sarcopenia on outcomes was evaluated. We used multivariate analyses to assess the impact of prognostic factors associated with outcomes, including sarcopenia. Of the 254 patients, 118 (46.5%) met the criteria for sarcopenia, and 32 had an American Society of Anesthesiologists (ASA) physical status ≥3. The sarcopenic group had a significantly lower 5-year overall survival rate than the non-sarcopenic group (58.2% vs. 82.4% , p=0.0002). In multivariate analyses of prognostic factors, sarcopenia was an independent predictor of poor survival (hazard ratio [HR]=2.28, p=0.002) and poor ASA status (HR=3.17, p=0.001). Sarcopenia and poor ASA status are independent preoperative predictors for poor outcomes after hepatectomy. The preoperative identification of sarcopenia and ASA status might enable the development of comprehensive approaches to assess surgical eligibility.
キーワード sarcopenia American Society of Anesthesiologists physical status hepatectomy hepatocellular carcinoma prognostic factor
Amo Type Original Articles
発行日 2016-10
出版物タイトル Acta Medica Okayama
70巻
5号
出版者 Okayama University Medical School
開始ページ 363
終了ページ 370
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol70/iss5/5
PubMed ID 27777428
Web of Sience KeyUT 000388098700005
JaLCDOI 10.18926/AMO/54419
フルテキストURL 70_3_197.pdf
著者 Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi|
抄録 The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p<0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p<0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes.
キーワード pancreaticoduodenectomy surgical outcome mortality major complication length of stay
Amo Type Original Article
発行日 2016-06
出版物タイトル Acta Medica Okayama
70巻
3号
出版者 Okayama University Medical School
開始ページ 197
終了ページ 203
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol70/iss3/7
PubMed ID 27339209
Web of Sience KeyUT 000379406100007
著者 Satoh, Daisuke| Yagi, Takahito| Nagasaka, Takeshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Utsumi, Masashi| Tanaka, Takehiro| Sadamori, Hiroshi| Fujiwara, Toshiyoshi|
発行日 2013-04-27
出版物タイトル World Journal of Hepatology
5巻
4号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/49671
フルテキストURL 67_2_117.pdf
著者 Sadamori, Hiroshi| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Sato, Daisuke| Nobuoka, Daisuke| Utsumi, Masashi| Fujiwara, Toshiyoshi|
抄録 We present a case of living donor liver transplantation to a 3-year disease-free survivor of liver resection for hepatocellular carcinoma (HCC) with major portal vein invasion. A 48-year-old man had HCC in the right lobe with a portal venous tumor thrombus extending into the left portal vein. An extended right lobectomy with thrombectomy was performed to remove the thrombus. Three years after liver resection, the patient experienced liver failure, with massive ascites and jaundice due to the formation of a thrombus in the main and left portal veins. During the 3 years after liver resection, no metastasis or recurrence of HCC had been detected, and tumor markers had been within normal ranges. The portal venous thrombus did not show any arterial enhancement under contrast-enhanced computed tomography, suggesting that the co-existence of any HCC component in the portal venous thrombus may have been negative. Based on these findings, living donor liver transplantation was performed using a right lobe graft from the patientʼs son. The patient is alive at 87 months after the transplantation, with no evidence of HCC recurrence.
キーワード living donor liver transplantation hepatocellular carcinoma portal vein invasion liver resection
Amo Type Case Report
発行日 2013-04
出版物タイトル Acta Medica Okayama
67巻
2号
出版者 Okayama University Medical School
開始ページ 117
終了ページ 121
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol67/iss2/7
PubMed ID 23603929
Web of Sience KeyUT 000317801700007
著者 稲田 涼| 永坂 岳司| 母里 淑子| 楳田 祐三| 久保田 暢人| 森川 達也| 近藤 喜太| 宇野 太| 貞森 裕| 八木 孝仁| 藤原 俊義|
発行日 2013-04-01
出版物タイトル 岡山医学会雑誌
125巻
1号
資料タイプ 学術雑誌論文
著者 稲田 涼| 永坂 岳司| 竹原 清人| 杉原 正大| 母里 淑子| 楳田 祐三| 久保田 暢人| 森川 達也| 近藤 喜太| 宇野 太| 貞森 裕| 八木 孝仁| 藤原 俊義|
発行日 2013-04-01
出版物タイトル 岡山医学会雑誌
125巻
1号
資料タイプ 学術雑誌論文