Shinnichi Okazumi

Publications (3)3.68 Total impact

• Source

  Available from: Hideaki Shimada

  Article: Surgical outcome of elderly patients 75 years of age and older with thoracic esophageal carcinoma.

  Hideaki Shimada, Tooru Shiratori, Shinnichi Okazumi, Hisahiro Matsubara, Kiyohiko Shuto, Yasunori Akutsu, Kazuo Narushima, Yoshihiro Nabeya, Hideki Hayashi, Takenori Ochiai
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  ABSTRACT: This study aimed to evaluate the surgical outcome of esophagectomy in patients 75 years of age and older with thoracic esophageal carcinoma. Between 1980 and 2002, 55 (46%) of 120 patients 75 years of age and older with thoracic esophageal carcinoma underwent an esophagectomy. The risk factors that resulted in decreased survival were analyzed by both univariate and multivariate analyses. Differences in surgical outcome and long-term survival between the earlier time period (1980-1989) and later time period (1990-2002) were analyzed separately. Overall resection rate in elderly patients in both periods was similar (44%, earlier period; 46%, later period). Postoperative complications significantly reduced long-term survival [adjusted hazard ratio for death, 4.05; 95% confidence interval (CI), 1.70-9.62; P < 0.01). Surgical blood loss greater than 1,000 ml was less frequently observed in the later period than in the earlier period (19% vs. 54%, P = 0.01). The postoperative morbidity rate was lower in the later than in the earlier period (29% vs. 63%, P = 0.02). Overall 5-year survival rate was significantly higher in the later period than in the earlier period (57% vs. 18%, P < 0.01). Elderly patients who underwent an esophagectomy in the later period appeared to manifest less neoadjuvant treatment, less surgical stress, fewer postoperative complications, and a better long-term survival than those treated in the earlier period.
  World Journal of Surgery 04/2007; 31(4):773-9. · 2.36 Impact Factor
• Source

  Available from: Hideaki Shimada

  Article: Effect of steroid therapy on postoperative course and survival of patients with thoracic esophageal carcinoma

  Hideaki Shimada, Shinnichi Okazumi, Hisahiro Matsubara, Yoshihiro Nabeya, Hideki Hayashi, Tooru Shiratori, Taio Aoki, Kiyohiko Shuto, Yoshio Gunji, Takenori Ochiai
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  ABSTRACT: Perioperative steroid therapy has been shown to be safe and effective in inhibiting the production of inflammatory mediators and reducing postoperative hospital morbidity. However, there is limited information to show the effect of steroid therapy on long-term survival. In this study we evaluated the effect of perioperative steroid therapy on long-term survival of patients with thoracic esophageal cancer.MethodsBetween 1993 and 2000, 141 consecutive patients with primary thoracic esophageal cancer underwent radical esophagectomy. A total of 78 patients who underwent surgery between 1997 and 2000 received perioperative steroid therapy. Sixty-three patients who underwent surgery between 1993 and 1996 were analyzed as the control group. In the steroid group, 250mg methylprednisolone was administered intravenously just before surgery followed by 125mg on postoperative days 1 and 2. The postoperative course and overall cause-specific survival rates were compared between the groups.ResultsThe postoperative hospital morbidity rate was significantly lower in the steroid group than in the control group. Although overall survival of the steroid group was better than the control group, cause-specific survival of both groups was similar. Multivariate analysis suggested that the depth of tumor and postoperative hospital morbidity were significant independent prognostic factors; however, steroid therapy was not statistically significant after adjusting for pathological variables.ConclusionsPerioperative steroid therapy may improve the postoperative course but does not improve the long-term survival of patients with thoracic esophageal cancer.
  Esophagus 04/2004; 1(2):89-94. · 0.66 Impact Factor
• Article: Is the surgical stress associated with worse survival in patients with esophageal cancer?--Analysis of colon substitution for 37 patients with remnant stomach.

  Hideaki Shimada, Shinnichi Okazumi, Hisahiro Matsubara, Yoshihiro Nabeya, Tooru Shiratori, Hideki Hayashi, Kiyohiko Shuto, Yasunori Akutsu, Takenori Ochiai
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  ABSTRACT: Colon substitution is a standard method of reconstruction, although an aggressive surgery, for patients with esophageal carcinoma who have remnant stomach. Presence of postoperative complication was reported to be a risk factor for worse survival in the patients with esophageal cancer. We evaluated the affect of this surgical stress on the postoperative course and long-term survival of patients with esophageal carcinoma. Between 1980 and 2002, a total of 37 patients with primary thoracic esophageal squamous cell carcinoma, who had history of gastrectomy due to gastric ulcer, underwent R0 esophagectomy followed by colon substitution (colon group). The clinical affect of colon substitution was retrospectively evaluated in comparison with gastric substitution as the control group (stomach group). The postoperative hospital morbidity rate was significantly higher in the patients with remnant stomach than in the control group. Although the clinicopathological features in both groups were similar, except operative time and bleeding volume, the overall and cause-specific survival of the remnant stomach group were significantly worse than those of the control group. Multivariate analysis suggested that remnant stomach was an independent risk factor for a worse survival. Surgical stress and postoperative complications, resulted by colon substitution for the patients with remnant stomach, might be associated with worse survival of patients with esophageal cancer.
  Hepato-gastroenterology 54(75):791-5. · 0.66 Impact Factor