Masaru Konishi

National Cancer Center, Japan, Edo, Tōkyō, Japan

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Publications (187)562.45 Total impact

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    ABSTRACT: The treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. In the present study, the recurrence pattern of AEGs according to Siewert's classification after radical resection was reviewed, and predictive factors of recurrence were examined.
    Anticancer research 08/2014; 34(8):4391-7. · 1.71 Impact Factor
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    ABSTRACT: The prognostic significance of bile duct tumor thrombus (BDTT) in hepatocellular carcinoma (HCC) is unclear and the usefulness of resection for HCC with BDTT is still controversial. The aim of the present study was to evaluate the impact of BDTT on prognosis in HCC and to determine whether resection of HCC with BDTT was useful.
    Anticancer research 08/2014; 34(8):4367-72. · 1.71 Impact Factor
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    ABSTRACT: Neural invasion is a characteristic pattern of invasion and an important prognostic factor for invasive ductal carcinoma (IDC) of the pancreas. M2 macrophages have reportedly been associated with poor prognosis in various cancers. The aim of the present study was to investigate the prognostic impact of M2 macrophages at extrapancreatic nerve plexus invasion (plx-inv) of pancreatic IDC.
    European journal of cancer (Oxford, England: 1990) 05/2014; · 4.12 Impact Factor
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    ABSTRACT: Duodenal cancer excluding Vater's papilla cancer is a relatively rare disease entity; therefore, the most appropriate operative methods depending on the tumor condition, such as the tumor site and/or depth of invasion, still remain unclear. The aim of this study is to determine an appropriate operative method and an appropriate extent of lymph node dissection depending on tumor site or tumor invasion depth. Data of a total of 35 patients with duodenal cancer who underwent resectional surgery with curative intent were reviewed retrospectively, and the clinicopathological factors and survival outcomes were investigated. Overall 5-year survival rates of all resected cases were 63.0% (median survival: 9.1 years). Multivariate analysis identified histological G3/4 (P = 0.002) and presence of lymph node metastasis (P = 0.004) as independent adverse prognostic factors. Of the 35 patients, 11 (31.4%) had lymph node metastasis. In all patients with the tumor invasion depth within limited to the mucosa or submucosa (T1a or T1b), lymph node metastasis was absent (0/15 patients). T2/3/4 tumor (P < 0.001) and G3/4 (P = 0.021) were identified as predictors of the presence of lymph node metastasis. Four (11.4%) of the 35 patients had metastasis in the infrapyloric node. Limited resection is sufficient for patients with T1a tumor. In the case of T1b tumor, limited resection or pancreatoduodenectomy may be selected after performing pancreaticoduodenal node biopsy as sentinel lymph node biopsy. For patients with T2-4 tumor, pancreatoduodenectomy or substomach preserving pancreatoduodenectomy (excepting Pylorus-preserving pancreatoduodenectomy) with regional lymph node dissection should be performed.
    Japanese Journal of Clinical Oncology 01/2014; · 1.90 Impact Factor
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    ABSTRACT: Background Neural invasion is a characteristic pattern of invasion and an important prognostic factor for invasive ductal carcinoma (IDC) of the pancreas. M2 macrophages have reportedly been associated with poor prognosis in various cancers. The aim of the present study was to investigate the prognostic impact of M2 macrophages at extrapancreatic nerve plexus invasion (plx-inv) of pancreatic IDC. Methods Participants comprised 170 patients who underwent curative pancreaticoduodenectomy for pancreatic IDC. Immunohistochemical examination of surgical specimens was performed by using CD204 as an M2 macrophage marker, and the area of immunopositive cells was calculated automatically. Prognostic analyses of clinicopathological factors including CD204-positive cells at plx-inv were performed. Results Plx-inv was observed in 91 patients (53.5%). Forty-eight patients showed a high percentage of CD204-positive cell area at plx-inv (plx-inv CD204%high). Plx-inv CD204%high was an independent predictor of poor outcomes for overall survival (OS) (P < 0.001) and disease-free survival (DFS) (P < 0.001). Patients with plx-inv CD204%high showed a shorter time to peritoneal dissemination (P < 0.001) and locoregonal recurrence (P < 0.001). In patients who underwent adjuvant chemotherapy, plx-inv CD204%high was correlated with shorter OS (P = 0.011) and DFS (P = 0.038) in multivariate analysis. Conclusions Plx-inv CD204%high was associated with shortened OS and DFS and early recurrence in the peritoneal cavity and locoregional space. The prognostic value of plx-inv CD204%high was also applicable to patients who received adjuvant chemotherapy. High accumulation of M2 macrophages at plx-inv represents an important predictor of poor prognosis.
    European Journal of Cancer. 01/2014;
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    ABSTRACT: Postoperative pancreatic fistula (POPF) remains a serious complication after pancreaticoduodenectomy (PD). Preoperative risk assessment of POPF is desirable in careful preparation for operation. The aim of this study was to assess simple and accurate risk factors for clinically relevant POPF based on a schematic understanding of the pancreatic configuration using preoperative multidetector computed tomography. Three hundred and eighteen consecutive patients who underwent PD in the National Cancer Center Hospital East between November 2006 and March 2013 were investigated. Pre-, intra-, and postoperative clinicopathological findings as well as pancreatic configuration data were analyzed for the risk of clinically relevant POPF. POPF was defined according to the International Study Group of Pancreatic Fistula classification. POPF grade A occurred in 52 patients (16.4 %), grade B in 84 (26.4 %), and grade C in 6 (1.9 %). Independent risk factors for POPF grade B/C included main pancreatic duct diameter (MPDd) < 2 mm (P = 0.001), parenchymal thickness ≥ 8 mm (P = 0.018), not performing portal vein/superior mesenteric vein resection (P = 0.004), and amylase level of drainage fluid on postoperative day 3 ≥ 375 IU/L (P < 0.001). Pancreatic configuration data including MPDd and parenchymal thickness were good indicators of clinically relevant POPF.
    Journal of Gastrointestinal Surgery 08/2013; · 2.36 Impact Factor
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    ABSTRACT: Detection of early remnant gastric cancer (ERGC) is increasing as a result of the development of endoscopic technology and a surveillance program. The aim of this study was to evaluate the results of limited subtotal gastrectomy (SG) surgery for ERGC compared to total gastrectomy (TG). We retrospectively reviewed a database of 72 consecutive patients with remnant gastric cancer who underwent laparotomy at the National Cancer Center Hospital East between January 1993 and December 2008. Thirty-five patients with a preoperative diagnosis of ERGC underwent curative resection: 13 SG and 22 conventional TG. Patients and tumor characteristics, operative results, and postoperative assessments 1 year after surgery were compared between the two groups. Operating time, blood transfusion, and hospital stay were similar in the two groups. In the SG group, blood loss and postoperative recovery of body weight tended to be better than in the TG group. There was no dumping syndrome in the SG group, while this occurred in three patients in the TG group. The levels of hemoglobin and total protein were higher 1 year after remnant gastrectomy in the SG group than in the TG group. No recurrence of gastric cancer was detected in the SG group during median follow-up of 99.2 months. In comparison to TG, limited SG surgery for ERGC improved the postoperative course, with no recurrence of cancer. Therefore, SG is a safe and effective treatment for ERGC.
    Gastric Cancer 07/2013; · 3.99 Impact Factor
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    ABSTRACT: Laparoscopic distal gastrectomy for gastric cancer has been firmly established in recent decades but still is a difficult procedure, especially for obese patients, as with open surgery. This study aimed to evaluate the perioperative outcome of total laparoscopic distal gastrectomy (TLDG) for early gastric cancer patients with a body mass index (BMI) exceeding 25 kg/m(2) and to consider countermeasures to this. Perioperative outcomes were compared between 42 patients with a BMI exceeding 25 kg/m(2) [overweight or obese group (OWG)] and 174 patients with a BMI lower than 25 kg/m(2) [normal or underweight group (NWG)] who underwent TLDG between September 2010 and December 2012. The BMI was 26.0 ± 1.4 kg/m(2) in the OWG group and 22.0 ± 2.1 kg/m(2) in the NWG group (P < 0.001). The groups did not differ in terms of age, sex, American Society of Anesthesiologists score, presence of diabetes, number of retrieved lymph nodes, number of metastatic lymph nodes, or metastatic lymph node ratio. The two groups did not differ significantly with respect to the extent of lymph node dissection [OWG: D1 (11.9 %), D1+ (66.7 %), D2 (21.4 %) vs NWG: D1 (5.2 %), D1+ (51.7 %), D2 (43.1 %); P = 0.020] or tumor size (OWG: 25.5 ± 20.2 mm vs NWG: 33.0 ± 17.2 mm; P = 0.037). Differences in operation time (OWG: 212 ± 31 min vs NWG: 200 ± 35 min; P = 0.005) and estimated blood loss (OWG: 15 ± 22 ml vs NWG: 10 ± 34 ml; P = 0.013) seemed to have a minimal impact clinically. Postoperative complications including infectious complications and recovery after surgery did not differ between the two groups. For overweight and obese patients, TLDG was managed safely. The procedure was considered to be difficult but sufficiently feasible.
    Surgical Endoscopy 06/2013; · 3.43 Impact Factor
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    ABSTRACT: Background/Aims: Effectiveness of infection control for prevention of pancreatic fistula (PF) after pancreaticoduodenectomy (PD) is not clear. We analyzed the impact of infection on the development of PF and examined the effect of enhanced infection control to prevent PF. Methodology: Amylase level (D-amylase) and bacterial culture (D-culture) of drainage fluid were evaluated on POD 1, 3, 5 and 7, in 90 consecutive patients with soft pancreas who underwent PD. The study period was divided into two periods. The relationship between D-amylase and D-culture was examined, and the clinicopathological factors predicting PF were analyzed in the first period. Then, anti-infection measures were introduced in the second period, and the effect of enhanced infection control was examined. Results: Twenty-nine out of 58 patients (50.0%) developed PF in the first period. D-amylase were higher in patients with D-culture infection than in those without it (p<0.05). D-amylase above 10,000IU/L on POD1 and D-culture infection on POD3 were independent predictive factors for PF by multivariate analysis (p<0.01). After introduction of enhanced infection control in the second period, four out of 32 patients (12.5%) developed PF. The rates of PF and D-culture infection were significantly reduced (p<0.05). Conclusions: Infection of drainage fluid is related to an increased level of amylase, resulting in PF. Enhanced infection control can effectively prevent PF after PD in soft pancreas.
    Hepato-gastroenterology 06/2013; 60(124):876-82. · 0.77 Impact Factor
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    ABSTRACT: BACKGROUND: Postoperative pancreatic fistula (POPF) is a major, intractable complication after distal pancreatectomy (DP). Risk factor evaluation and prevention of this complication are important tasks for pancreatic surgeons. METHODS: One hundred and six patients who underwent DP using a stapler for pancreatic division were retrospectively investigated. The relationship between clinicopathological factors and the incidence of POPF was statistically analyzed. RESULTS: Clinically relevant, Grade B or C POPF by International Study Group of Pancreatic Fistula criteria occurred in 52 patients (49.1 %). Age, American Society of Anesthesiologists score, body mass index, and concomitant gastrointestinal tract resection did not influence the incidence of POPF. Use of a double-row stapler and a thick pancreatic stump were significant risk factors for POPF in multivariate analysis. Compression index was also shown to be an important factor in cases in which the pancreas was divided by a stapler. CONCLUSIONS: The most important risk factor for POPF after DP was suggested to be the thickness of the pancreatic stump, reflecting the volume of remnant pancreas. A triple-row stapler seemed to be superior to a double-row stapler in preventing POPF. However, triple-row stapler use in a thick pancreas is considered to be a future problem to be solved.
    Journal of hepato-biliary-pancreatic sciences. 02/2013;
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    ABSTRACT: BACKGROUND: The optimal surgical strategy for resectable synchronous colorectal liver metastases (SCLM), whether simultaneous or staged resections, still remains obscure. The aim of this study was to assess the efficacy of the predicted operation time (POT) strategy, which recommends staged resections in case of POT ≥6 h, otherwise selecting simultaneous resection. METHODS: This was a prospective, nonrandomized, single-institution study. Fifty-nine patients with SCLM underwent tumor resection according to the POT strategy, with patients with a longer POT (≥6 h) undergoing staged resection. Morbidity, overall hospitalization, tumor resection rates, and survival were compared with that of 86 patients who underwent simultaneous resection for SCLM irrespective of POT from 1992 to 2004. RESULTS: The former simultaneous and the latter POT strategy groups were similar in terms of patient and tumor demographics as well as surgical procedures. Of the 59 POT group patients, 26 patients (44 %) experienced 40 postoperative complications. Comparing the surgical results of simultaneous resection from 1992 to 2004 and those of resection according to the POT strategy, morbidity (64 vs. 44 %, p = 0.02), frequency of anastomotic leakage (21 vs. 5 %, p < 0.01), and length of hospital stay (27 vs. 18 days, p < 0.01) were significantly lower in the latter group, while tumor resection rates (85 vs. 87 %, p = 0.77) were not different. CONCLUSIONS: The POT strategy is effective in reducing the morbidity in SCLM patients by selecting staged resections in the high-morbidity-risk group without adverse effects on oncologic outcome.
    Journal of Gastrointestinal Surgery 02/2013; · 2.36 Impact Factor
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    ABSTRACT: BACKGROUND: Early recurrence correlates with poor survival following various cancer surgeries and puts considerable stress on patients both physically and mentally. This retrospective study investigated the predictive factors for early recurrence after surgical resection for initially unresectable colorectal liver metastasis to elucidate indications for conversion strategies. METHODS: We retrospectively studied 46 patients who underwent hepatectomy after chemotherapy for initially unresectable colorectal liver metastasis from 1997 to 2010. RESULTS: Recurrences occurred within 6 months after hepatectomy in 13 patients (37 %). The median survival time of 21.2 months and the 5-year survival rate of 0 % after hepatectomy in patients with recurrence within 6 months were significantly worse than those in patients with recurrence more than 6 months after hepatectomy. Recurrence in less than 6 months was significantly correlated with impossibility of anticancer therapy for recurrence after hepatectomy (p = 0.01). Eight or more hepatic tumors after chemotherapy were the only predictor of recurrence within 6 months (p = 0.01; odds ratio 9.6; 95 % confidence interval 1.5-60.6). CONCLUSION: Recurrence within 6 months was significantly correlated with a poorer outcome following surgery for initially unresectable colorectal liver metastasis. Surgical indication for initially unresectable colorectal liver metastasis with eight or more hepatic tumors after chemotherapy should be considered carefully in the light of mental and physical status, co-morbidity, and alternative treatment plans.
    Journal of Gastrointestinal Surgery 02/2013; · 2.36 Impact Factor
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    ABSTRACT: Metastatic pancreatic malignant melanoma is considered to be a highly aggressive neoplasm, and only few metastasectomies for lesions originating from the skin or the ocular region have been reported. We report a case of resection of pancreatic metastasis of malignant melanoma originating from the nasal cavity. An isolated pancreatic tumor was detected in a 46-year-old man who had undergone proton-beam therapy for nasal melanoma 12 months earlier. He underwent distal pancreatectomy with splenectomy and the pathological diagnosis was metastatic malignant melanoma. We review cases of malignant melanoma metastatic to the pancreas and further discuss their incidence, therapeutic strategy, and outcome of mucosal melanoma of the head and neck.
    Anticancer research 02/2013; 33(2):567-73. · 1.71 Impact Factor
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    ABSTRACT: A global consensus on how to treat recurrent pancreatic cancer after adjuvant chemotherapy with gemcitabine (ADJ-GEM) does not exist. We retrospectively reviewed the clinical data of 41 patients with recurrences who were subsequently treated with chemotherapy. The patients were divided into two groups according to the time until recurrence after the completion of ADJ-GEM (ADJ-Rec): patients with an ADJ-Rec < 6 months (n = 25) and those with an ADJ-Rec ≥ 6 months (n = 16). The disease control rate, the progression-free survival after treatment for recurrence and the overall survival after recurrence for these two groups were 68 and 94% (P = 0.066), 5.5 and 8.2 months (P = 0.186), and 13.7 and 19.8 months (P = 0.009), respectively. Furthermore, we divided the patients with an ADJ-Rec < 6 months into two groups: patients treated with gemcitabine (n = 6) and those treated with alternative regimens including fluoropyrimidine-containing regimens (n = 19) for recurrent disease. Patients treated with the alternative regimens had a better outcome than those treated with gemcitabine. Fluoropyrimidine-containing regimens may be a reasonable strategy for recurrent disease after ADJ-GEM and an ADJ-Rec < 6 months.
    Pancreatology 09/2012; 12(5):428-33. · 2.04 Impact Factor
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    ABSTRACT: Tumor-associated macrophages (TAMs) are candidate histological factors in invasive ductal carcinoma (IDC) of the pancreas. Tumor-associated macrophages can be affected by cancer-related inflammation and pancreatitis and interact with important invasive behavior in a recurrent manner in pancreatic IDC. These features may help elucidate the aggressiveness of pancreatic IDC. The aim of this study was to characterize TAMs in pancreatic IDC in comparison with chronic pancreatitis (CP) and to reveal TAM-related factors and the clinical impact of TAMs. CD68 (a pan-macrophage marker) and CD204 (an M2 macrophage marker) immunohistochemistry was carried out in pancreas head specimens from 107 IDC cases and 11 CP cases. Immunopositive cell areas were calculated at the periphery and center of the tumor. The distributions of macrophages in IDC and CP and the relationship between TAMs and histological tumor factors, survival, and recurrence were evaluated. Macrophages were more frequently observed in the lesion periphery than the center in IDC and CP. The density of macrophages was elevated in IDC compared to CP. Dense M2 macrophages at the tumor periphery were frequently seen in large tumors and showed an independent impact on overall survival and disease-free time. Early recurrence in the liver or the local manipulated area was associated with high accumulation of peripheral M2 macrophages. More M2 macrophages were seen in IDC than in CP in both the periphery and the center. High numbers of peripheral M2 macrophages were associated with large tumor size, early recurrence in the liver, local recurrence, and shortened survival time in patients with pancreatic IDC. (Cancer Sci, doi: 10.1111/j.1349-7006.2012.02411.x, 2012).
    Cancer Science 08/2012; · 3.48 Impact Factor
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    ABSTRACT: Laparoscopic distal gastrectomy has gained wide acceptance, and laparoscopic total gastrectomy (LTG) and laparoscopic proximal gastrectomy (LPG) are now also performed for gastric cancer. We extended these techniques to treat Siewert type II adenocarcinoma of the esophagogastric junction (AEG). Ten patients with clinical T1 AEG type II underwent laparoscopic transhiatal (LTH) resection combined with LTG reconstructed by Roux-en-Y (LTH+LTG: n=2) or LPG reconstructed by jejunal interposition (LTH+LPG: n=8). Intracorporeal esophagojejunostomy was performed using a circular stapler, of which the anvil head was introduced transabdominally or transorally. The median operation time was 243 minutes, and blood loss was 25.5 g. There were no intraoperative complications or conversion to open surgery. No anastomotic leak was observed, but 1 diaphragmatic herniation to the left thoracic cavity occurred postoperatively. The median length of the proximal margin was 14.5 mm. This operation is technically feasible and can be safely performed after adequate experience of LTG or LPG, though esophagojejunostomy in the mediastinum is technically demanding.
    Surgical laparoscopy, endoscopy & percutaneous techniques 08/2012; 22(4):e199-203. · 0.88 Impact Factor
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    ABSTRACT: We report a rare case of an intraductal oncocytic papillary neoplasm (IOPN) of the extrahepatic bile duct. A 66-year-old man was admitted to our hospital for investigation of right-sided back pain. Ultrasonography, computed tomography and magnetic resonance imaging showed a papillary lesion, 3 cm in diameter, in the middle bile duct, invaginating into the cystic duct. We made a provisional diagnosis of middle bile duct cancer and performed substomach-preserving pancreatoduodenectomy. Macroscopically, the middle bile duct contained a two-humped papillary tumor, one tip of which invaginated into the cystic duct. Microscopically, the tumor consisted of cuboidal cells with abundant eosinophilic cytoplasm resembling that of oncocytes and a fine fibrovascular core. The tumor cells were stained strongly with antimitochondria antibody. Based on these findings, the tumor was diagnosed histologically as IOPN of the extrahepatic bile duct. The patient died of prostate cancer 51 months after surgery, but without evidence of recurrence of the IOPN.
    Surgery Today 06/2012; · 0.96 Impact Factor
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    ABSTRACT: BACKGROUND: The incidence of cancer in the proximal third of the stomach is increasing. Laparoscopic proximal gastrectomy (LPG) seems an attractive option for the treatment of early-stage proximal gastric cancer but has not gained wide acceptance because of technical difficulties, including the prevention of severe reflux. In this study, we describe our technique for LPG with jejunal interposition (LPG-IP) and evaluate its safety and feasibility. METHODS: In this retrospective analysis, we reviewed the data of patients with proximal gastric cancer who underwent LPG-IP (n = 22) or the same procedure with open surgery (OPG-IP; n = 68) between January 2008 and September 2011. Short-term surgical variables and outcomes were compared between the groups. The reconstruction method was the same in both groups, with creation of a 15 cm, single-loop, jejunal interposition for anastomosis. RESULTS: There were no differences in patient or tumor characteristics between the groups. Operation time was longer in the LGP-IP group (233 vs. 201 min, p = 0.0002) and estimated blood loss was significantly less (20 vs. 242 g, p < 0.0001). The average number of harvested lymph nodes did not differ between the two groups (17 vs. 20). There also were no differences in the incidence of leakage at the esophagojejunostomy anastomosis (9.1 vs. 7.4 %) or other postoperative complications (27 vs. 32 %). The number of times additional postoperative analgesia was required was significantly less in the LPG-IP group compared with the OPG-IP group (2 vs. 4, p < 0.0001). CONCLUSIONS: LPG-IP has equivalent safety and curability compared with OPG-IP. Our results imply that LPG-IP may lead to faster recovery, better cosmesis, and improved quality of life in the short-term compared with OPG-IP. Because of the limitations of retrospective analysis, a further study should be conducted to obtain definitive conclusions.
    Surgical Endoscopy 06/2012; · 3.43 Impact Factor
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    ABSTRACT: The carcinoembryonic antigen glypican-3 (GPC3) is an ideal target of anticancer immunotherapy against hepatocellular carcinoma (HCC). In this nonrandomized, open-label, phase I clinical trial, we analyzed the safety and efficacy of GPC3 peptide vaccination in patients with advanced HCC. Thirty-three patients with advanced HCC underwent GPC3 peptide vaccination (intradermal injections on days 1, 15, and 29 with dose escalation). The primary endpoint was the safety of GPC3 peptide vaccination. The secondary endpoints were immune response, as measured by IFN-γ ELISPOT assay, and the clinical outcomes tumor response, time to tumor progression, and overall survival (OS). GPC3 vaccination was well-tolerated. One patient showed a partial response, and 19 patients showed stable disease 2 months after initiation of treatment. Four of the 19 patients with stable disease had tumor necrosis or regression that did not meet the criteria for a partial response. Levels of the tumor markers α-fetoprotein and/or des-γ-carboxy prothrombin temporarily decreased in nine patients. The GPC3 peptide vaccine induced a GPC3-specific CTL response in 30 patients. Furthermore, GPC3-specific CTL frequency after vaccination correlated with OS. OS was significantly longer in patients with high GPC3-specific CTL frequencies (N = 15) than in those with low frequencies (N = 18; P = 0.033). GPC3-derived peptide vaccination was well-tolerated, and measurable immune responses and antitumor efficacy were noted. This is the first study to show that peptide-specific CTL frequency can be a predictive marker of OS in patients with HCC receiving peptide vaccination.
    Clinical Cancer Research 05/2012; 18(13):3686-96. · 7.84 Impact Factor
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    ABSTRACT: New energy devices are constantly being introduced for all types of surgery, including liver surgery. These devices help surgeons perform operations. Meanwhile, intraoperative blood loss is a concern of liver surgeons. Various methods to reduce intraoperative bleeding during liver resection have been reported. There are some reports that the use of energy devices was effective for liver transection. Recently, the Harmonic FOCUS™ (HF), an ultrasonically activated device, was developed. The shape of the HF is similar to that of Kelly forceps. Hepatectomy can be performed by the clamp-crushing method using the HF instead of Kelly forceps. We obtained good results of liver resection with the HF, and report these outcomes in this study. From November 2009 to March 2011, a total of 51 patients underwent hepatectomy with the use of the HF. The control group consisted of 59 patients who underwent hepatectomy without the HF from February 2009 to September 2009. The surgical outcomes were evaluated and compared retrospectively. Mean blood loss was 640 mL in the HF group compared to 1,176 mL in the control group. The number of patients needing a blood transfusion was smaller in the HF group (p = 0.02). Mean operative time was shorter in the HF group (171 vs. 235 min, p < 0.001). All these surgical outcomes were significantly better in the HF group. Postoperative morbidity was not increased in the HF group, and we could perform liver transection safely. The crush-clamping method combined with the HF is effective for liver transection. Liver resection can be performed quickly using this method.
    World Journal of Surgery 05/2012; 36(9):2156-60. · 2.23 Impact Factor

Publication Stats

3k Citations
562.45 Total Impact Points


  • 1999–2014
    • National Cancer Center, Japan
      • Center for Cancer Control and Information Services
      Edo, Tōkyō, Japan
  • 1996–2014
    • Chiba-East National Hospital
      Tiba, Chiba, Japan
  • 2011
    • Niigata Cancer Center Hospital
      Niahi-niigata, Niigata, Japan
  • 2002–2005
    • National Cancer Research Institute
      Londinium, England, United Kingdom
  • 2004
    • Osaka University
      • Department of Integrated Medicine
      Ōsaka-shi, Osaka-fu, Japan
  • 2000
    • Nakano Children's Hospital
      Ōsaka, Ōsaka, Japan
    • Tokyo Medical and Dental University
      Edo, Tōkyō, Japan
  • 1994–1999
    • Tokyo Metropolitan Komagome Hospital
      Edo, Tōkyō, Japan
  • 1992–1999
    • Tokyo Metropolitan Institute of Medical Science
      Edo, Tōkyō, Japan
  • 1997
    • Jichi Medical University
      • Department of Pathology
      Totigi, Tochigi, Japan