Yasuo Sakai

Publications (12)23.32 Total impact

• Article: Key factors influencing bowel function after ileal W-pouch anal anastomosis: A spectral analysis of W-pouch motor activity

  Tomoaki Maruta, Shinji Homma, Minoru Yagi, Jun Hasegawa, Kimitoshi Shimamura, Takeyasu Suda, Yasuo Sakai, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) has become the standard surgical procedure for ulcerative colitis (UC). The purpose of this study was to determine which factors are important to achieve good anal continence after IPAA in terms of the motor activity and pressure-volume relationship. A total of 17 patients with UC who underwent IPAA were evaluated. The internal ileal pouch pressure was transanally measured with and without volume-loading of the pouch which induces the urge to evacuate. The maximum tolerable volume (MTV), first urge volume (FUV), and ileal pouch compliance were calculated and the internal ileal pouch pressure records were subjected to spectral analysis for intensive evaluation of the intraluminal pressure waves. The FUV, correlation of the compliance of the FUV with MTV, and the remaining volume up to the MTV (RVMTV) were analyzed. Compliance of the FUV was significantly correlated with the RVMTV (r=0.736,P < 0.01). The frequency of the phasic waves in the pouch decreased with length of follow up, reflecting improved function (r=−0.588,P < 0.05). The findings of this intensive analysis of manometric measurement indicate that the key factors in postoperative pouch function are RVMTV and the frequency of phasic waves in the W-pouch. Key wordsUlcerative colitis–Ileal W-pouch–Spectral–analysis–Manovolumetry
  Surgery Today 04/2012; 30(10):886-891. · 1.22 Impact Factor
• Source

  Available from: Tatsuo Kanda

  Article: Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study.

  Tatsuo Kanda, Akihiro Tsukahara, Kyo Ueki, Yasuo Sakai, Tatsuo Tani, Atsushi Nishimura, Toshiyuki Yamazaki, Yoichi Tamiya, Tetsuya Tada, Masaki Hirota, Jun Hasegawa, Hiroyuki Funaoka, Hiroshi Fujii, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: Intestinal fatty acid-binding protein (I-FABP) is a low-molecular-mass (15 kDa) cytosolic protein found exclusively in the epithelial cells of the small bowel mucosa. We aimed to evaluate the clinical usefulness of serum I-FABP measurement for the diagnosis of ischemic small bowel disease. Patients with a clinical diagnosis of acute abdomen were recruited for this multicenter trial at one university hospital and nine city hospitals over a 13-month period. Serum I-FABP levels were measured in 361 eligible patients by an enzyme-linked immunosorbent assay using a specific monoclonal antibody. Of the 361 patients, 242 underwent surgery, and small bowel ischemia was diagnosed in 52 patients. The mean serum I-FABP level in the patients with small bowel ischemia was 40.7 ± 117.9 ng/ml, which was significantly higher than that in patients with non-ischemic small bowel disease (5.8 ± 15.6 ng/ml) and those with non-small bowel disease (1.8 ± 1.7 ng/ml). The serum I-FABP cutoff level for the diagnosis of small bowel ischemia was 3.1 ng/ml. Serum I-FABP was more efficient than conventional biochemical markers, in terms of sensitivity and positive and negative predictive values, in the diagnosis of small bowel ischemia. However, its specificity was slightly lower than that of creatinine phosphokinase or lactate dehydrogenase. The positive and negative likelihood ratios of serum I-FABP were 3.01 and 0.29, respectively. Serum I-FABP measurement is a non-invasive method that is potentially useful for the efficient identification of patients with acute abdomen who are at risk of small bowel ischemia.
  Journal of Gastroenterology 02/2011; 46(4):492-500. · 4.16 Impact Factor
• Article: Short-and long-term outcomes of surgery for diffuse peritonitis in patients 80 years of age and older.

  Ryoko Okubo, Kazuhito Yajima, Yasuo Sakai, Tomoki Kido, Ken-Ichiro Hirano, Nobuyuki Musha, Toshihiro Tsubono, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: We evaluated the impact of advanced age on the morbidity, mortality, and long-term outcome after emergency surgery for diffuse peritonitis. We retrospectively evaluated the mortality and morbidity rates in 36 patients who were 80 years of age or older and who had undergone emergency surgery for diffuse peritonitis, and calculated 5-year survival by the Kaplan-Meier method. Factors compromising prognosis were identified by univariate and multivariate analyses. The median patient age was 84 years (range, 80-97 years); 16 patients were men and 20 were women. Preoperative concomitant disease was present in 81% of patients; cardiac disease was most common. Sites of visceral perforation were in the upper gastrointestinal tract in five patients, colon or rectum in 30, and gallbladder in 1. The postoperative morbidity rate was 72%, the surgical mortality rate was 11%, and the in-hospital mortality rate was 28%. The median hospital stay was 56 days. The median survival was 41 months, with a 5-year survival rate of 23%. A multivariate analysis identified number of failing organs as the only independent adverse prognostic factor (P < 0.001; relative risk 5.51, 95% confidence interval 1.97-15.4). Elderly patients with diffuse peritonitis had an unsatisfactory rate of short-term morbidity and mortality compared with those undergoing elective surgery. Postoperative organ failure was most likely to compromise survival.
  Surgery Today 01/2008; 38(5):413-9. · 1.22 Impact Factor
• Article: [A resected case of fibrolamellar hepatocellular carcinoma with chronic hepatitis (type B)].

  Toru Ishikawa, Hiroteru Kamimura, Atsunori Tsuchiya, Kouji Watanabe, Keiichi Seki, Hironobu Ohta, Toshiaki Yoshida, Nobuyuki Musya, Toshihiro Tsubono, Yasuo Sakai, Keiko Takeda, Noriko Ishihara, Tomoteru Kamimura
  [show abstract] [hide abstract]
  ABSTRACT: We report a case of a 34-year-old woman who tested positive for HBs Ag with fibrolamellar hepatocellular carcinoma of the liver. The sister of this patient, who was also positive for HBs Ag, died of hepatocellular carcinoma (HCC). The patient showed elevation of alpha-fetoprotein. Abdominal CT scan showed a tumor in the posterior segment of the liver and hepatic angiography revealed marked neovascularity in the tumor. Partial resection of the liver was performed, and the histological diagnosis was fibrolamellar hepatocellular carcinoma. The patient is now tumor free and doing well 20 months after the operation.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 08/2007; 104(7):1076-81.
• Source

  Available from: Tatsuo Kanda

  Article: Multiple carcinoids in the duodenum, pancreas and stomach accompanied with type A gastritis: a case report.

  Takeo Bamba, Shinichi Kosugi, Tatsuo Kanda, Toshihiro Tsubono, Yasuo Sakai, Nobuyuki Musha, Noriko Ishihara, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.
  World Journal of Gastroenterology 05/2007; 13(15):2247-9. · 2.47 Impact Factor
• Article: [A case of splenic inflammatory pseudotumor].

  Toru Ishikawa, Takashi Ushiki, Tadayuki Togashi, Kouji Watanabe, Keiichi Seki, Hironobu Oota, Toshiaki Yoshida, Tomoteru Kamimura, Nobuyuki Musha, Toshihiro Tsubono, Yasuo Sakai, Keiko Takeda, Noriko Ishihara
  [show abstract] [hide abstract]
  ABSTRACT: A 59-year-old man was admitted to our hospital because of continuous C-reactive protein elevation. Abdominal computed tomography scan revealed a low density mass on the surface of the spleen. Magnetic resonance imaging showed low intensity at peripheral area and slightly high intensity in the central area of the mass lesion on T1 and T2-weighted image. Splenectomy was performed since we could not rule out the possibility of malignant neoplasm only by diagnostic imaging. The pathological diagnosis of the tumor was inflammatory pseudotumor. Splenectomy is considered to be significant from the standpoints of both diagnosis and therapy in cases in which diagnostic imaging is difficult to interpret.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 04/2007; 104(3):407-12.
• Article: Colorectal carcinoma liver metastases: clinical significance of preoperative measurement of serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels

  Dai Ishizuka, Yoshio Shirai, Yasuo Sakai, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: The clinical significance of preoperative levels of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) was evaluated in patients with colorectal carcinoma liver metastases. Preoperative serum CEA and CA 19-9 levels, the number and size of liver metastases, and survival data were analyzed retrospectively in 73 patients. Using the cutoff level of 5 ng/ml for CEA and 37 U/ml for CA 19-9, the positivity of these for detecting metastatic deposits were 81% and 56%, respectively. CEA level was correlated with the number (P=0.0081) and size (P=0.013) of liver metastases among patients with positive CEA level, while CA 19-9 level was correlated only with the number of liver metastases (P=0.0072) among those with positive CA 19-9 level. In the overall series, preoperative CEA and CA 19-9 levels were correlated significantly with survival only at higher cutoff levels. In 46 patients undergoing curative hepatectomy, however, these levels were not correlated with survival, even at higher cutoff levels. In conclusion, the CEA level is closely associated with the extent of liver metastases, while the CA 19-9 level may reflect multiplicity of hepatic deposits. Preoperative measurement of serum CEA and CA 19-9 levels appears to be of some prognostic value.
  International Journal of Colorectal Disease 02/2001; 16(1):32-37. · 2.38 Impact Factor
• Article: LETTER: URACHAL HERNIA: AN UNUSUAL INTRA-ABDOMINAL HERNIA CAUSED BY INCARCERATION INTO A URACHAL CYST

  Toshiyuki Yamazaki, Yasuo Sakai, Katsuyoshi Hatakeyama, Yukiya Sekine, Yoshihiro Yuki
  Digestive Diseases and Sciences 11/2000; 45(12):2365-2366. · 2.12 Impact Factor
• Article: Sigmoid colon cancer presenting as complete rectal prolapse: Report of a case

  Toshiyuki Yamazaki, Yasuo Sakai, Yukiya Sekine, Kouei Nihei, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: We describe herein the unusual case of a 76-year-old woman who was diagnosed as having sigmoid colon cancer after presenting with complete rectal prolapse. The rectal prolapse was considered to have been caused by constipation accelerated by the colon cancer. The relationship between colorectal cancer and rectal prolapse has not yet been clarified; however, this case report suggests that rectal prolapse can present as a symptom of colorectal cancer. Thus, patients with a sudden onset of rectal prolapse should be screened for colorectal cancer. Key Wordscolorectal cancer-rectal prolapse-symptom-screening
  Surgery Today 04/1999; 29(3):266-267. · 1.22 Impact Factor
• Article: Ischemic stricture of the rectosigmoid colon caused by division of the superior rectal artery below sudeck's point during sigmoidectomy: Report of a case

  Toshiyuki Yamazaki, Yoshio Shirai, Yasuo Sakai, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: Despite Sudeck''s cautionary report regarding the risk of colon necrosis following a pull-through procedure, published in 1907, most colorectal surgeons do not pay close attention to Sudeck''s critical point when operating in the rectosigmoid region. We report herein the case of a patient who developed an ischemic stricture, 6 cm in length, in the rectosigmoid colon distal to the anastomosis following a radical sigmoidectomy with division of the superior rectal artery immediately distal to Sudeck''s point. This is the first documentation of a patient developing an ischemic stricture attributable to sigmoidectomy. Division of the artery distal to Sudeck''s point most probably impaired the blood supply to the rectosigmoid colon, which subsequently resulted in occlusive ischemic colitis. Thus, there is a risk that division of the superior rectal artery distal to Sudeck''s point may lead to colonic ischemia in the remaining rectosigmoid region following sigmoidectomy.
  Surgery Today 08/1997; 27(3):254-256. · 1.22 Impact Factor
• Article: What is the risk factor for metachronous colorectal carcinoma?

  Toshiyuki Yamazaki, Yasumasa Takii, Haruhiko Okamoto, Yasuo Sakai, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: PURPOSE: The purpose of this study was to determine the risk factors for developing metachronous colorectal carcinoma and to determine an adequate postoperative colonoscopic surveillance. METHODS: Two hundred eighty-four patients, examined by routine colonoscopy after resection for colorectal carcinoma, were reviewed. Clinical and pathologic factors were assessed by multiple logistic regression analysis. RESULTS: One hundred eighty-three patients with synchronous adenoma or carcinoma at the initial operation had a significantly higher incidence of both metachronous adenoma and carcinoma than the 101 patients without a synchronous lesion. Other clinical factors including age, gender, tumor stage, tumor site, and tumor grade were not significant for an increased incidence of metachronous carcinoma. The presence of synchronous lesions proved to be the only risk factor (relative risk, 3.293;P=0.0155) for developing metachronous carcinoma. Metachronous carcinoma was detected in 30 patients (10.6 percent) and completely removed from all patients. Mucosal carcinoma was found in 25 patients (8.8 percent) and invasive carcinoma in 5 patients (1.8 percent). All five invasive carcinomas were detected in asymptomatic patients having synchronous lesion. Four patients required a second operation for metachronous carcinoma more than 13 months following the first. CONCLUSION: The risk factor for developing metachronous carcinoma is the presence of synchronous adenoma or carcinoma at the initial operation. To detect metachronous carcinoma at a curable stage, annual colonoscopic surveillance should be performed for highrisk patients.
  Diseases of the Colon & Rectum 04/1997; 40(8):935-938. · 3.13 Impact Factor
• Article: Simultaneous development of Crohn's disease and myelodysplastic syndrome progressing to acute myelocytic leukemia in a patient with a normal karyotype

  Tatsuo Tani, Yasuo Sakai, Yoshio Shirai, Masahiro Ohtake, Katsuyoshi Hatakeyama
  [show abstract] [hide abstract]
  ABSTRACT: A 28-year-old man developed Crohn's disease and myelodysplastic syndrome concurrently. Chromosomal analysis of the bone marrow revealed a normal male karyotype. Subsequently, the myelodysplastic syndrome progressed to acute myelocytic leukemia. Several causes, including the medical treatment for Crohn's disease, chromosomal abnormalities, and a common underlying immune dysfunction, have been proposed as pathogenetic factors in the association with Crohn's disease of hematologic malignancies. This case suggests that neither medical treatment for Crohn's disease nor chromosomal abnormalities are inevitable causes of the development of hematologic malignancies associated with Crohn's disease. At present, the cause of the association remains unclear, although the idea of a common immune dysfunction is attractive.
  Journal of Gastroenterology 07/1996; 31(4):599-602. · 4.16 Impact Factor