Is laparoscopic hepatectomy really less invasive approach? Evaluation of surgical stress from the aspect of oxidative stress.

腹腔镜肝切除术真的是微创手术吗？

• 批准号: 21K16453
• 负责人: 川崎 洋太
• 金额: $ 2.91万
• 依托单位: Kagoshima University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Early-Career Scientists
• 财政年份: 2021
• 资助国家: 日本
• 起止时间: 2021-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-21K16453/
• 关键词: 手術侵襲; 蛋白異化; 腹腔鏡手術; 手術侵襲度; 肝切除; 腹腔鏡下肝切除術; 酸化ストレス

2022年度は手術侵襲ストレスに伴う蛋白異化程度を評価することで、腹腔鏡下肝切除術の開腹に対する低侵襲性を証明する研究を行った。開腹と腹腔鏡の手術侵襲度評価には術式の統一が必須であり、肝外側区域切除術を行った手術症例を対象とした後方視的検証を行った。2010年から2020年に行った肝外側区域切除症例を研究対象とし、研究期間に計31例施行していた。術式の内訳は開腹群13例、腹腔鏡下郡18例であった。蛋白異化程度の評価は、サルコペニア評価で用いられるpsoas muscle index(PMI)の術前・術後の変化量と規定し、その測定は術前・後に撮像するCTで行った。結果は、開腹群は腹腔鏡下郡と比較して有意にPMI変化量が大きく（p<0.01)、腹腔鏡下郡の低侵襲性を蛋白異化の観点から示唆することができた。また、術前後のPMI変化量が手術侵襲度評価に有用かの検証では、手術侵襲度評価に有用と報告されているestimation of physiologic ability and surgical stress (E-PASS)との相関を評価した。結果は術前後のPMI変化量とE-PASSスコア(surgical stress score: SSS)は強い相関を示し(r=0.561, p<0.01)、術前後のPMI変化量は手術侵襲度評価に有用であることが示唆された。この結果は、” Surgical stress evaluation of left lateral sectionectomy based on skeletal muscle catabolism”という表題で論文発表を行った(Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 32(4):p 435-440, August 2022.)。

In 2022, the study was conducted to evaluate the degree of surgical invasion and protein alienation, and to demonstrate the low invasiveness of laparoscopic hepatectomy. Laparoscopic surgery must be performed according to the patient's vision. From 2010 to 2020, 31 cases of lateral hepatectomy were performed during the study period. 13 cases were operated by laparoscopy and 18 cases by laparoscopy. The evaluation of the degree of protein dissimilation is carried out by using the psoas muscle index(PMI) and the preoperative and postoperative changes. Results: Compared with laparoscopy, there was a significant increase in intentional PMI (p<0.01), and a significant decrease in invasive protein differentiation (p<0.01). PMI changes before and after surgery are useful for evaluation of surgical invasiveness. Results PMI changes before and after surgery and E-PASS (surgical stress score: SSS) were strongly correlated (r=0.561, p<0.01), PMI changes before and after surgery were useful in evaluating surgical invasiveness. The results of this paper are as follows: "Surgical stress evaluation of left lateral sectomy based on skeletal muscle catabolism"(Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 32(4):p 435-440, August 2022.).

项目成果

Surgical stress evaluation by the skeletal muscle catabolism in left lateral sectionectomy

左侧外侧切片切除术中骨骼肌分解代谢的手术应激评估

• 发表时间: 2021
• 作者: Yota Kawasaki;Satoshi Iino;Yoichi Yamasaki;Yuto Hozaka;Tetsuya Idichi;Hideyuki Oi;Hiroshi Kurahara;Yuko Mataki;Shinichi Ueno;Takao Ohtsuka
• 通讯作者: Takao Ohtsuka

Effectiveness of Adjuvant Therapy in Patients with Pancreatic Cancer Who Underwent Neoadjuvant Therapy

• DOI: 10.1245/s10434-021-09712-6
• 发表时间: 2021-02-19
• 期刊: ANNALS OF SURGICAL ONCOLOGY
• 影响因子: 3.7
• 作者: Kurahara, Hiroshi;Mataki, Yuko;Ohtsuka, Takao
• 通讯作者: Ohtsuka, Takao

Usefulness of cranio-dorsal approach for laparoscopic left lateral sectionectomy

• DOI: 10.1007/s13304-023-01502-x
• 发表时间: 2023-04-15
• 期刊: UPDATES IN SURGERY
• 影响因子: 2.6
• 作者: Kawasaki，Yota;Yamasaki，Yoichi;Ohtsuka，Takao
• 通讯作者: Ohtsuka，Takao

Multidisciplinary treatment of advanced or recurrent solid pseudopapillary neoplasm of the pancreas: three case reports.

• DOI: 10.1186/s40792-022-01358-0
• 发表时间: 2022-01-10
• 期刊: Surgical case reports
• 影响因子: 0.8
• 作者: Tanoue K;Mataki Y;Kurahara H;Idichi T;Kawasaki Y;Yamasaki Y;Kita Y;Hozaka Y;Oi H;Nakajo A;Arigami T;Maemura K;Ohtsuka T
• 通讯作者: Ohtsuka T

Spread of lymph node metastasis and adjuvant therapy for distal cholangiocarcinoma

远端胆管癌的淋巴结转移及辅助治疗

• DOI: 10.1007/s10147-022-02175-z
• 发表时间: 2022
• 期刊: International Journal of Clinical Oncology
• 影响因子: 3.3
• 作者: Kurahara Hiroshi;Mataki Yuko;Idichi Tetsuya;Kawasaki Yota;Mori Shinichiro;Sasaki Ken;Arigami Takaaki;Nakajo Akihiro;Fukukura Yoshihiko;Higashi Michiyo;Ohtsuka Takao
• 通讯作者: Ohtsuka Takao