研究者詳細 - 大脇　哲洋

講演・口頭発表等 - 大脇　哲洋

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奥村浩, 瀬戸山徹郎, 内門泰斗, 喜多芳昭, 有上貴明, 松本正隆, 上之園芳一, 帆北修一, 中馬豊, 石神純也, 大脇哲洋, 森正樹, 夏越祥次 . SF-015-4 DNA傷害シグナル蛋白の上部消化管発癌マーカーとしての可能性(腫瘍基礎-2,サージカルフォーラム,第110回日本外科学会定期学術集会) . 日本外科学会雑誌 2010年3月一般社団法人日本外科学会

奥村浩, 内門泰斗, 大脇哲洋, 喜多芳昭, 松本正隆, 尾本至, 櫻井俊秀, 瀬戸山徹郎, 佐々木健, 辺木文平, 松下大輔, 石神純也, 上野真一 . SF-013-5 食道癌術前化学放射線療法症例の組織学的予後因子に基づいた予後予測法(SF-013 サージカルフォーラム(13)食道悪性-2,第112回日本外科学会定期学術集会) . 日本外科学会雑誌 2012年3月一般社団法人日本外科学会

大脇哲洋, 奥村浩, 内門泰斗, 佐々木建, 松本正隆, 尾本至, 川崎洋太, 瀬戸山徹郎, 辺木文平, 新地洋之, 上野真一, 石神純也, 前村公成, 喜多芳昭, 根路銘安仁, 嶽崎俊郎, 夏越祥次 . SF-012-1 食道癌切除術後の下痢対策(SF-012 サージカルフォーラム(12)食道悪性-2,第112回日本外科学会定期学術集会) . 日本外科学会雑誌 2012年3月一般社団法人日本外科学会

Owaki T., Okumura H., Uchikado Y., Sasaki K., Matsumoto M., Omoto I., Setoyama T., Kita Y., Sakurai T., Matsushita D., Ishigami S., Ueno S., Natsugoe S. . Serum concentrations of antibiotics during severe invasive surgery such as esophagectomy for esophageal cancer . International Surgery 2013年 International Surgery

記述言語：日本語

This study was performed to confirm the antibiotic regimen during a severe invasive surgery, such as esophagectomy, with a long procedure and a large amount of normal volumes of infusion. Ten patients with esophageal cancer were enrolled in this study, and cefmetazole sodium concentrations in serum were measured during esophagectomy. The ranges of minimum inhibitory concentrations for 90% of isolates of cefmetazole sodium for microorganisms in our institutions for 8 years were investigated. The maximum concentration was 83.9 μg/mL just after the completion of infusion, and its half-life was 1.5 hours. Serum concentration of cefmetazole sodium was kept above 16 μg/mL for 4 hours during esophagectomy. It was kept above 32 μg/mL for 2.5 hours after injection. There are almost no differences in the pharmacokinetics of cefmetazole sodium between common use and during esophagectomy. In addition, additive infusion of antibiotics 4 hours after the first infusion was recommended during esophagectomy.

DOI： 10.9738/CC164.1

Scopus

中野静雄, 東泰志, 喜島佑子, 大脇哲洋, 愛甲孝 . 特集甲状腺外科-最新の臨床甲状腺癌におけるsentinel nodeの検索 . 臨床外科 2001年10月株式会社医学書院

Nakano S., Kijima Y., Owaki T., Shirao K., Baba M., Aikou T. . Section 2. Thyroid - Anterior chest wall approach for video-assisted thyroidectomy using a modified neck skin lifting method . Biomedicine and Pharmacotherapy 2002年11月 Biomedicine and Pharmacotherapy

記述言語：日本語

Neck endoscopic surgery is likely to prove less invasive and more cosmetically advantageous than conventional methods. The surgical procedure used for 42 consecutive patients undergoing video-assisted thyroidectomy by the anterior chest wall approach is described herein. A 3-4 cm incision was made at the anterior chest wall 2 cm below the clavicle on the tumor side. Two Kirshner wires connected to a winching device were horizontally inserted beneath the skin in order to lift the neck skin. Specially made retractors were passed through the chest wall wound to the lateral neck bilaterally. Strap muscle on the tumor side was retracted laterally and the thyroid tumor was retracted medially. A suitable working space was thus created using this modified neck lifting method without gas insufflation. All patients underwent video-assisted thyroidectomy utilizing an anterior chest wall approach without conversion to open thyroidectomy. Mean operative time from incision to removal of the tumor was 145 min. Mean tumor size was 4.1 cm (range: 2.0-7.5 cm). The advantage of our approach is that the scar below the clavicle is invisible under normal clothing. In addition, conventional instruments for open thyroidectomy can be used. In our method, the thyroid tumor and trachea are palpable and some parts of the operation can be conducted under direct visualization if the assistant retracts the anterior chest wall wound upward. Video-assisted thyroidectomy utilizing an anterior chest wall approach is cosmetically less invasive, particularly for women who are frequently nervous about operative scars on the neck. © 2002 Éditions scientifiques et médicales Elsevier SAS. All rights reserved.

DOI： 10.1016/s0753-3322(02)00233-0

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PubMed

中野静雄, 馬場政道, 上之園芳一, 馬場道宏, 大脇哲洋, 草野力, 夏越祥次, 愛甲孝 . S01-03 食道表在癌に対するsentinel nodeと分水嶺を用いた治療戦略 . 日本消化器外科学会雑誌 2001年7月一般社団法人日本消化器外科学会

大脇哲洋, 夏越祥次, 松本正隆, 奥村浩, 瀬戸山徹郎, 内門泰斗, 石神純也, 愛甲孝 . RS-85 消化器外科病棟での検出細菌,薬剤耐性,抗菌薬の使用について : 12年間の調査結果(要望演題4-6 消化器外科とSSI対策6,第63回日本消化器外科学会総会) . 日本消化器外科学会雑誌 2008年7月一般社団法人日本消化器外科学会

尾本至, 奥村浩, 松本正隆, 内門泰斗, 瀬戸山徹郎, 佐々木健, 桜井俊秀, 大脇哲洋, 石神純也, 夏越祥次 . RS-5-1 高齢者進行食道癌に対する治療方針(要望演題5-1 高齢者手術の諸問題1,第64回日本消化器外科学会総会) . 日本消化器外科学会雑誌 2009年7月一般社団法人日本消化器外科学会

奥村浩, 夏越祥次, 松本正隆, 瀬戸山徹郎, 内門泰斗, 佐々木健, 櫻井俊秀, 石神純也, 大脇哲洋, 愛甲孝 . RS-398 食道癌術前化学放射線療法症例における臨床病理学的予後因子の検討(要望演題28-1 食道癌の放射線療法,化学療法と外科療法の関係1,第63回日本消化器外科学会総会) . 日本消化器外科学会雑誌 2008年7月一般社団法人日本消化器外科学会

櫻井俊秀, 夏越祥次, 大脇哲洋, 松本正隆, 瀬戸山徹郎, 内門泰斗, 佐々木健, 奥村浩, 石神純也, 愛甲孝 . RS-282 食道癌術後周術期管理における好中球エラスターゼ阻害薬の効果(要望演題16-2 消化器外科領域における侵襲と生体防御機構2,第63回日本消化器外科学会総会) . 日本消化器外科学会雑誌 2008年7月一般社団法人日本消化器外科学会

Sasaki K., Uchikado Y., Okumura H., Omoto I., Kita Y., Arigami T., Uenosono Y., Owaki T., Maemura K., Natsugoe S. . Role of <sup>18</sup>F-FDG-PET/CT in esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy . Anticancer Research 2017年 Anticancer Research

記述言語：日本語

Aim: The aim of this study was to assess the role of 18F-fluorodeoxyglucose positron-emission tomography/ computed tomography (FDG-PET/CT) in predicting pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). Patients and Methods: Thirty patients with advanced ESCC received nCRT followed by surgery, and underwent FDG-PET/CT twice before and after nCRT. We compared the results of FDG-PET/CT with the pathological results and prognosis. Results: Pathological response was found to correlate with the maximum standardised uptake value (SUVmax) after nCRT and the rate of decrease of SUVmax. Using univariate analysis, pN, SUVmax after nCRT and the rate of decrease of SUVmax were found to be prognostic factors. Multivariate analysis revealed that only pN was an independent prognostic factor. Conclusion: The prediction of pathological response and prognosis using FDG-PET/CT is not as reliable as pathological detection of lymph node metastasis, but could be a useful method contributing to treatment decisions.

DOI： 10.21873/anticanres.11390

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PubMed

Matsumoto M., Takeuchi K., Owaki T., Iguchi S., Inoue K., Kashima S., Tazuma S., Maeda T. . Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: A nationwide cross-sectional survey . BMJ Open 2017年12月 BMJ Open

記述言語：日本語

Objectives: Responding to the serious shortage of physicians in rural areas, the Japanese government has aggressively increased the number of entrants to medical schools since 2008, mostly as a chiikiwaku, entrants filling a regional quota. The quota has spread to most medical schools, and these entrants occupied 16% of all medical school seats in 2016. Most of these entrants were admitted to medical school with a scholarship with the understanding that after graduation they will practise in designated areas of their home prefectures for several years. The quota and scholarship programmes will be revised by the government starting in 2018. This study evaluates the intermediate outcomes of these programmes. Design: Cross-sectional survey to all prefectural governments and medical schools every year from 2014 to 2017 to obtain data on medical graduates. Settings Nationwide. Participants: All quota and non-quota graduates with prefecture scholarship in each prefecture, and all the quota graduates without scholarship in each medical school. Primary outcome measures: Passing rate of the National License Examination for Physicians and the percentage of graduates who have not bought out the scholarship contract after graduation. Results: Most prefectures and medical schools in Japan participated in this study (97.8%-100%). Quota graduates with scholarship were significantly more likely to pass the National License Examination for Physicians than the other medical graduates in Japan at all the years (97.9%, 96.7%, 97.4% and 94.7% vs 93.9%, 94.5%, 94.3% and 91.8%, respectively). The percentage of quota graduates with scholarship who remained in the scholarship contract 3 years after graduation was 92.2% and 89.9% for non-quota graduates with scholarship. Conclusions: Quota entrants showed better academic performance than their peers. Most of the quota graduates remained in the contractual workforce. The imminent revision of the national policy regarding quota and scholarship programmes needs to be based on this evidence.

DOI： 10.1136/bmjopen-2017-019418

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PubMed

馬場政道, 中野静雄, 大脇哲洋, 柳正和, 池田直徳, 夏越祥次, 愛甲孝 . 食道癌術後の反回神経麻痺 . 日本気管食道科学会会報 2002年特定非営利活動法人日本気管食道科学会

記述言語：英語

食道癌手術後の一過性あるいは永続的反回神経麻痺によるquality of life悪化を予防するためにリンパ節郭清手技を修正した。神経周囲でのクリップの多用，右側の前頸筋群や右下甲状腺動脈の気管への分枝の温存などである。食道癌根治切除例で退院時に反回神経麻痺を認め，術後1年間disease freeであった128例を対象とした。郭清手技の変更前（1993年以前）の63例（グループA）と1994年以降の65例（グループB）に分け，術後のquality of lifeを比較した。全切除例に対する退院時の耳鼻科医による反回神経麻痺の頻度は両群とも40%台であった。術後1年目のpersistent vocal cord paralysisの頻度はグループA：57.1%に対し，グループB：24.6%に減少した。さらに，severe hoarsenessを訴えた症例はグループA；28.6%からグループB：3.1%に減少した。術後の反回神経麻痺に伴う嗄声は，愛護的郭清手技や栄養状態の改善により軽減できる。しかし，永続的麻痺の症例ではその麻痺が適切に治療されるまではquality of lifeが阻害される。

DOI： 10.2468/jbes.53.97

Natsugoe S., Okumura H., Matsumoto M., Ishigami S., Owaki T., Nakano S., Aikou T. . Reconstruction of recurrent laryngeal nerve with involvement by metastatic node in esophageal cancer . Annals of Thoracic Surgery 2005年6月 Annals of Thoracic Surgery

記述言語：日本語

Background. Recurrent laryngeal nerve paralysis represents one of the major complications in esophageal cancer surgery, and patients with esophageal cancer sometimes develop recurrent laryngeal nerve paralysis before treatment. We evaluated recurrent laryngeal nerve reconstruction in patients with lymph node metastasis infiltrating the recurrent laryngeal nerve. Methods. Five patients with preoperative recurrent laryngeal nerve paralysis as a result of involvement of metastasis were enrolled in the present study. Ansa cervicalis-recurrent laryngeal nerve anastomosis in the neck was performed in 4 patients and direct anastomosis of recurrent laryngeal nerve in the mediastinum in 1 patient. Results. Six months after surgery, 3 patients who had undergone ansa cervicalis-recurrent laryngeal nerve anastomosis in the neck displayed good quality of life without hoarseness or aspiration. The patient who underwent direct anastomosis of the recurrent laryngeal nerve in the mediastinum experienced occasional aspiration and hoarseness. The remaining patient displayed poor condition because of recurrent lung tumor, and quality of life was decreased. Conclusions. If patients with recurrent laryngeal nerve paralysis before treatment can undergo potentially curative resection with lymph node dissection, including the metastatic lymph node infiltrating the recurrent laryngeal nerve, recurrent laryngeal nerve reconstruction should be performed to improve quality of life. © 2005 by The Society of Thoracic Surgeons.

DOI： 10.1016/j.athoracsur.2004.11.055

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PubMed

大脇哲洋, 夏越祥次, 松本正隆, 花園幸一, 瀬戸山徹郎, 奥村浩, 愛甲孝 . RD-3-6 NSTによる消化器癌患者術前スクリーニングにおけるrapid turnover proteinの有用性(ラウンドテーブルディスカッション3 消化器外科とnutrition support team,第62回日本消化器外科学会定期学術総会) . 日本消化器外科学会雑誌 2007年7月一般社団法人日本消化器外科学会

Natsugoe S., Okumura H., Matsumoto M., Uchikado Y., Setoyama T., Yokomakura N., Ishigami S., Owaki T., Aikou T. . Randomized controlled study on preoperative chemoradiotherapy followed by surgery versus surgery alone for esophageal squamous cell cancer in a single institution . Diseases of the Esophagus 2006年12月 Diseases of the Esophagus

記述言語：日本語

The purpose of the present study was to compare the clinical results between preoperative chemoradiotherapy followed by surgery (CRT group) and surgery alone (Surgery group) by a randomized controlled study. Twenty-two patients were assigned to the CRT group and 23 to the Surgery group. A total radiation dose of 40.Gy was applied and in the same period, intravenous chemotherapy was performed using cisplatin (7 mg over 2 h) and 5-fluorouracil (5-FU; 350 mg over 24 h). Surgical treatment was performed in 20 patients in the CRT group except for two patients with bone metastasis after CRT. According to histological effects of primary tumors, the number of patient with Grades 1, 2 and 3 was 11, 7 and 3, respectively. Frequency of lymphatic and venous invasion was significantly lower in the CRT group than in the Surgery group. The 5-year survival rate was 57% in the CRT group and 41% in the Surgery group (P = 0.58). According to the histological effect in the CRT group, 5-year survival was 30% for Grade 1, 83% for Grade 2 and 100% for Grade 3 (P = 0.0069). This randomized trial did not demonstrate a statistically significant survival difference between the CRT group and the Surgery group. © 2006 The Authors Journal compilation © 2006 The International Society for Diseases of the Esophagus.

DOI： 10.1111/j.1442-2050.2006.00615.x

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PubMed

大脇哲洋, 奥村浩, 内門泰斗, 佐々木健, 松本正隆, 尾本至, 石神純也, 上野真一, 松下大輔, 夏越祥次, 根路銘安仁, 新村英士, 桑原和代, 嶽崎俊郎 . PS-263-2 離島での地域医療・外科診療実習の影響 : 全国公募医学生への臨床実習(PS ポスターセッション,第113回日本外科学会定期学術集会) . 日本外科学会雑誌 2013年3月一般社団法人日本外科学会

奥村浩, 内門泰斗, 尾本至, 喜多芳昭, 佐々木健, 松本正隆, 大脇哲洋, 有上貴明, 上之園芳一, 石神純也, 夏越祥次 . PS-206-2 局所進行食道癌における術前化学放射線療法(PS-206 食道化学療法・放射線療法-2,ポスターセッション,第114回日本外科学会定期学術集会) . 日本外科学会雑誌 2014年3月一般社団法人日本外科学会

出先亮介, 奥村浩, 内門泰斗, 松本正隆, 大脇哲洋, 喜多芳昭, 瀬戸山哲郎, 尾本至, 佐々木健, 恵浩一, 南幸次, 石神純也, 夏越祥次 . PS-203-3 骨髄異型性症候群(MDS)合併食道癌切除症例の検討(PS-203 食道悪性-5,ポスターセッション,第114回日本外科学会定期学術集会) . 日本外科学会雑誌 2014年3月一般社団法人日本外科学会

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講演・口頭発表等 - 大脇 哲洋

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講演・口頭発表等 - 大脇　哲洋