Yuji Kaneoka

Ogaki Municipal Hospital, Gihu, Gifu, Japan

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Publications (108)231.03 Total impact

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    ABSTRACT: The correct timing of hepatectomy in patients with synchronous colorectal liver metastases is unclear. The aim of this study was to assess the clinical value of simultaneous resection (SR) for patients with colorectal cancer and synchronous liver metastases. Between January 2006 and December 2013, 158 patients underwent resection of primary colorectal cancer and liver metastases. Sixty-three patients possessed synchronous colorectal liver metastases. Of those with synchronous colorectal liver metastases, 41 patients (65 %) underwent SR, and 22 (35 %) underwent delayed resection (DR). The clinicopathologic and operative data and the surgical outcomes of the patients in the SR and DR groups were retrospectively analyzed. The type of primary/liver resection, liver resection time, total blood loss volume, R0 resection rate, and morbidity rate were similar between the two groups. The SR group was associated with a shorter total postoperative hospital stay (21 vs 32 days, p < 0.001). However, the overall survival rate was similar between the two groups (3-year survival, 65.6 % in the SR group versus 66.8 % in the DR group, p = 0.054). Simultaneous resection of colorectal cancer and synchronous liver metastases is associated with a comparable morbidity rate and shorter hospital stay, even when following rectal resection and major hepatectomy.
    Surgery Today 05/2015; DOI:10.1007/s00595-015-1188-1 · 1.21 Impact Factor
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    ABSTRACT: One-stage colectomy with intraoperative colonic irrigation (OCICI) may be useful in early resolution of acute left-sided malignant colonic obstruction (ALMCO). However, the clinical benefit of this technique has not been fully investigated. Between January 2007 and July 2014, 451 patients underwent left hemicolectomy or sigmoidectomy for colon cancer, of whom 25 underwent OCICI for ALMCO. The medical records of the patients who underwent OCICI for ALMCO were compared to 174 medical records of a control population (without ALMCO) who were matched for tumor characteristics. There were no statistically significant differences between the two groups in regard to age, sex, American Society of Anesthesiologists Physical Status, location of tumor, preoperative CEA levels, and previous abdominal surgeries. The OCICI for ALMCO group was associated with a longer operation time (153 ± 33 vs. 111 ± 47 min, p < 0.001). However, no significant differences were found in patient morbidity, the duration of the postoperative hospital stay, or the tumor pathology between the two groups. Univariate and multivariate analyses indicated that OCICI for ALMCO did not increase the risk of postoperative morbidity in patients with left-sided colon cancer. OCICI for ALMCO did not increase the rate of morbidity or prolong the hospital stay duration compared to treatment of a control population.
    World Journal of Surgery 04/2015; 148(4). DOI:10.1007/s00268-015-3078-5 · 2.35 Impact Factor
  • Gastroenterology 04/2015; 148(4):S-1141. DOI:10.1016/S0016-5085(15)33891-9 · 13.93 Impact Factor
  • Gastroenterology 04/2015; 148(4):S-1132. DOI:10.1016/S0016-5085(15)33856-7 · 13.93 Impact Factor
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    ABSTRACT: Liver fibrosis is associated with the prognosis of patients with hepatocellular carcinoma (HCC) after treatment. The laboratory marker for liver fibrosis, the FIB-4 index, is reportedly correlated with the degree of liver fibrosis. We evaluated the predictive value of FIB-4 index on the recurrence and survival of HCC patients who underwent curative hepatectomy. A total of 431 consecutive patients who underwent hepatectomy for primary, nonrecurrent HCC were analyzed. The FIB-4 index was calculated from the patient's age, serum alanine aminotransferase and aspartate aminotransferase levels, and platelet count at the time of HCC diagnosis. Postoperative recurrence and survival rates were compared according to tumor characteristics, tumor markers, Child-Pugh class, and the FIB-4 index. The pretreatment FIB-4 index was associated with recurrence and survival rates, independent of HCC progression or tumor marker levels in a multivariate analysis. Recurrence rates after hepatectomy were higher in patients with a FIB-4 index >3.25 versus ≤3.25 (5-year recurrence rates 69.6% vs 54.8%; P = .0049). Survival was also worse in patients with a FIB-4 index >3.25 than those with a FIB-4 index ≤3.25 (5-year survival rates 67.1% vs 72.2%; P = .0030). The FIB-4 index is a predictive marker for long-term outcomes in patients with HCC treated with curative hepatic resection. Copyright © 2015 Elsevier Inc. All rights reserved.
    Surgery 02/2015; 157(4). DOI:10.1016/j.surg.2014.10.022 · 3.11 Impact Factor
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    ABSTRACT: The aim of the study was to investigate the prognostic impact of lymph node metastasis in cholangiocarcinoma using three different classifications. Patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma in 24 hospitals in Japan between 2001 and 2010 were included. Survival was calculated by means of the Kaplan-Meier method and differences between subgroups were assessed with the log rank test. The Cox proportional hazards model was used to identify independent predictors of survival. χ(2) scores were calculated to determine the cut-off value of the number of involved nodes, lymph node ratio (LNR) and total lymph node count (TLNC) for discriminating survival. Some 370 patients were included. The median (range) TLNC was 19 (3-59). Nodal metastasis occurred in 157 patients (42·4 per cent); the median (range) number of involved nodes and LNR were 2 (1-19) and 0·11 (0·02-0·80) respectively. Four or more involved nodes was associated with a significantly shorter median survival (1·3 versus 2·2 years; P = 0·001), as was a LNR of at least 0·17 (1·4 versus 2·3 years; P = 0·002). Involvement of nodes along the common hepatic artery, present in 21 patients (13·4 per cent), was also associated with a shorter survival (median 1·3 versus 2·1 years; P = 0·046). Multivariable analysis among 157 node-positive patients identified the number of involved nodes as an independent prognostic factor (risk ratio 1·87; P = 0·002). The number of involved nodes was a strong predictor of survival in patients with distal cholangiocarcinoma. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.
    British Journal of Surgery 01/2015; 102(4). DOI:10.1002/bjs.9752 · 5.21 Impact Factor
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    ABSTRACT: En bloc resection of the hepatoduodenal ligament (HDL) for advanced biliary malignancy by hepato-ligamento-pancreatoduodenectomy (HLPD) or hepatoligamentectomy (HL) remains challenging, and only short-term outcomes have been reported. We showed our surgical technique of HLPD and HL, and retrospectively investigated surgical outcomes of the patients. Between 2003 and 2014, we performed four HLPD and three HL including major hepatectomy with concomitant caudate lobectomy. Portal vein reconstruction (PVR) was performed with a right external iliac vein graft, and hepatic artery reconstruction (HAR) was accomplished with the heterogeneous artery using the continuous suturing method. Mean operation time and blood loss were 575 ± 111 min and 1539 ± 950 mL, respectively, and patency of the reconstructed vessels was confirmed postoperatively in all cases. Histologically, negative surgical margins (R0) were achieved in 57 % of patients, while the resected vascular invasion was confirmed in all patients. Overall morbidity was high at 57 %, but we have achieved no postoperative mortality. Overall median survival time of the patients was 36 months, and a patient of HL survived over 5 years. En bloc resection of the HDL based on steady vascular reconstruction can improve the surgical outcome of biliary cancer in selected patients.
    Journal of Gastrointestinal Surgery 01/2015; 19(4). DOI:10.1007/s11605-014-2731-x · 2.39 Impact Factor
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    ABSTRACT: We previously demonstrated that the expression of HSP20, a small heat shock protein, is inversely correlated with the progression of HCC. Inflammation is associated with HCC, and numerous cytokines, including TNF-α, act as key mediators in the progression of HCC. In the present study, we investigated whether HSP20 is implicated in the TNF-α-stimulated intracellular signaling in HCC using human HCC-derived HuH7 cells in the presence of TNF-α. In HSP20-overexpressing HCC cells, the cell growth was retarded compared with that in the control cells under long-term exposure of TNF-α. Because NF-κB pathway is the main intracellular signaling system activated by TNF-α, we investigated the effects of HSP20-overexpression of this pathway. The protein levels of IKK-α, but not IKK-β, in the HSP20-overexpressing cells were decreased. Short-term exposure to TNF-α-induced phosphorylation and degradation of IκB, and the phosphorylation and transactivational activity of NF-κB were suppressed in the HSP20-overexpressing HCC cells. Furthermore, the increase in IKK-α levels was accompanied by a decrease in the HSP20 levels in human HCC tissues. These findings strongly suggest that HSP20 might decrease the IKK-α protein level and that it down-regulates the TNF-α-stimulated intracellular signaling in HCC, thus resulting in the suppression of HCC progression. Copyright © 2014. Published by Elsevier Inc.
    Archives of Biochemistry and Biophysics 10/2014; 565C:1-8. DOI:10.1016/j.abb.2014.10.010 · 3.04 Impact Factor
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    ABSTRACT: To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs). A total of 99 surgically resected nodular HCCs with a maximum diameter of 3 cm or less were analysed. HCCs were macroscopically categorized as simple nodular (SN) and non-SN. CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape). Sixty-eight HCCs were categorized as SN and the remaining 31 were categorized as non-SN. For diagnosis of non-SN HCC, the areas under the receiver operating characteristic curve (A (z)) value for the shape of enhancement in the late arterial phase and the shape of the post-vascular image were 0.824 (95 % confidence interval [CI] 0.721-0.895) and 0.878 (95 % CI 0.788-0.933), respectively. The A (z) value for the combination of the shape of enhancement in the late arterial phase and the shape of the post-vascular image for the diagnosis of non-SN HCC was 0.907 (95 % CI 0.815-0.956), corresponding to a high diagnostic value. CEUS can provide high-quality imaging assessment for determining the macroscopic classification of small nodular HCCs. aEuro cent Non-SN is one of the poor prognostic factors in patients with HCC aEuro cent Assessment of macroscopic type provides valuable information for the management of HCC aEuro cent CEUS can provide high-quality imaging assessment for macroscopic classification of HCC aEuro cent For non-SN HCC diagnosed using CEUS, hepatectomy is preferred as curative treatment.
    European Radiology 06/2014; 24(9). DOI:10.1007/s00330-014-3254-2 · 4.34 Impact Factor
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    ABSTRACT: We investigated changes in highly sensitive lens culinaris agglutinin A-reactive fraction of alpha-fetoprotein (hsAFP-L3) measured using a novel method and its predictive ability for prognosis in patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy, comparing to other HCC tumor markers, that is, AFP, des-gamma-carboxy prothrombin (DCP), and AFP-L3 measured with conventional method (cAFP-L3). AFP, DCP, and AFP-L3 including both cAFP-L3 and hsAFP-L3 were measured before and after curative hepatectomy in 187 patients. The percentage of patients with elevated tumor marker levels pre- and postoperatively was compared, and recurrence-free and overall survival rates were analyzed based on changes in tumor markers. The percentages of patients with elevated AFP, DCP, and cAFP-L3 decreased postoperatively. In contrast, the percentage of patients with elevated hsAFP-L3 did not decrease postoperatively. Both recurrence-free and overall survival rates were significantly lower in patients whose tumor marker levels remained elevated postoperatively than patients without tumor marker elevation postoperatively. Recurrence-free and overall survival rates of patients in whom hsAFP-L3 became elevated postoperatively despite normal preoperative hsAFP-L3 levels were significantly lower than those of patients with normal hsAFP-L3 postoperatively, and were similar to those of patients with persistent elevation. Preoperative elevations of AFP, DCP, and cAFP normalized in many patients postoperatively, but not for hsAFP-L3. The elevation of hsAFP-L3 identifies patients with poor prognosis despite the normalization of AFP and DCP.
    Cancer Medicine 06/2014; 3(3). DOI:10.1002/cam4.218
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    ABSTRACT: [Background] In our hospital, computed tomography (CT) has been available for use in the emergency department since 1996 and has changed the diagnosis of obturator hernia. [Methods] A total of 61 consecutive patients who underwent surgery for obturator hernia from 1973 to 2011 in our hospital were divided into the before 1995 group (n=30) and the after 1996 group. The background factors, preoperative diagnosis, surgical outcomes, and postoperative courses were compared between the two groups. [Results] The average duration of symptoms of obturator hernia was 2.8 days in the after 1996 group versus 3.2 days in the before 1995 group, with no significant difference. There were significant differences between the after 1996 group and the before 1995 group in the rate of preoperative diagnosis (93.5% vs 53.3%) and the average length of hospital stay (20.0 days vs 26.1 days). However, there were no significant differences between the groups in the incidence of bowel resection (54.8% vs 56.7%) and of complications (38.7% vs 36.7%). [Conclusion] CT scan improved the preoperative diagnosis rate of obturator hernia. However, the bowel resection rate remained unchanged because the duration of disease symptoms was not significantly different.
    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2014; 75(8):2073-2078. DOI:10.3919/jjsa.75.2073
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    ABSTRACT: In patients with hepatocellular carcinoma (HCC), gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) often identifies non-hypervascular hypointense hepatic nodules during the hepatobiliary phase, but their prognostic significance is unclear. We conducted a prospective observational study to investigate the impact of non-hypervascular hypointense hepatic nodules detected by Gd-EOB-DTPA-enhanced MRI on the outcome of patients with early-stage HCC. Post-treatment recurrence and survival rates were analyzed in 138 patients with non-recurrent, early-stage HCC [Barcelona Clinic Liver Cancer (BCLC) stage 0 or A] and Child-Pugh A liver function according to the presence of non-hypervascular hypointense nodules on pretreatment Gd-EOB-DTPA-enhanced MRI. Non-hypervascular hypointense hepatic nodules were detected in 51 (37.0 %) patients with early-stage HCC on pretreatment Gd-EOB-DTPA-enhanced MRI. Recurrence rates were significantly higher in patients with non-hypervascular hypointense nodules (p < 0.0001). Based on a multivariate analysis, the presence of non-hypervascular hypointense hepatic nodules on Gd-EOB-DTPA-enhanced MRI was independently associated with an increased recurrence rate, independent of tumor progression or treatment (p = 0.0005). The survival rate was significantly lower in patients with non-hypervascular hypointense nodules on Gd-EOB-DTPA-enhanced MRI (p = 0.0108). In patients with early-stage typical HCC (BCLC 0 or A), the presence of concurrent non-hypervascular hypointense hepatic nodules in the hepatobiliary phase of pretreatment Gd-EOB-DTPA-enhanced MRI is an indicator of higher likelihood of recurrence after treatment and may be a marker for unfavorable outcome.
    Hepatology International 01/2014; 9(1). DOI:10.1007/s12072-014-9553-5 · 2.47 Impact Factor
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    ABSTRACT: HSP20 (HSPB6), one of small heat shock proteins (HSPs), is constitutively expressed in various tissues and has several functions. We previously reported that the expression levels of HSP20 in human hepatocellular carcinoma (HCC) cells inversely correlated with the progression of HCC, and that HSP20 suppresses the growth of HCC cells via the AKT and mitogen-activated protein kinase signaling pathways. However, the exact mechanism underlying the effect of HSP20 on the regulation of these signaling pathways remains to be elucidated. To clarify the details of this effect in HCC, we explored the direct targets of HSP20 in HCC using human HCC-derived HuH7 cells with HSP20 overexpression. HSP20 proteins in the HuH7 cells were coimmunoprecipitated with the p85 regulatory subunit and p110 catalytic subunit of phosphoinositide 3-kinase (PI3K), an upstream kinase of AKT. Although HSP20 overexpression in HCC cells failed to affect the expression levels of PI3K, the activity of PI3K in the unstimulated cells and even in the transforming growth factor-α stimulated cells were downregulated by HSP20 overexpression. The association of HSP20 with PI3K was also observed in human HCC tissues in vivo. These findings strongly suggest that HSP20 directly associates with PI3K and suppresses its activity in HCC, resulting in the inhibition of the AKT pathway, and subsequently decreasing the growth of HCC.
    PLoS ONE 11/2013; 8(11):e78440. DOI:10.1371/journal.pone.0078440 · 3.53 Impact Factor
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    ABSTRACT: An incisional surgical site infection (I-SSI) is a frequently observed complication following colorectal surgery. Intraoperative wound management is one of the most important factors that determine the incidence of postoperative I-SSI. The purpose of this study was to assess the impact of the methods used for intraoperative wound management on the incidence of I-SSI following elective surgery for colorectal cancer. Between November 2009 and February 2011, the data of 1,980 consecutive patients who underwent elective colorectal resection for colorectal cancer were prospectively collected from 19 affiliated hospitals. The incidence of and risk factors for I-SSI were investigated. Overall, 233 I-SSIs were identified (11.7 %). Forty-two possible risk factors were analyzed. Using a multivariate analysis, the independent risk factors for I-SSI were identified to be a high body mass index, previous laparotomy, chronic liver disease, wound length, contaminated wound class, creation or closure of an ostomy, right hemicolectomy procedure, the suture material used for fascial closure and the incidence of organ/space SSI. To prevent I-SSI following elective colorectal surgery, it is crucial to avoid making large incisions and reduce fecal contamination whenever possible. A high quality randomized control trial is necessary to confirm the definitive intraoperative procedure(s) that can minimize the incidence of I-SSI.
    Surgery Today 08/2013; 44(7). DOI:10.1007/s00595-013-0677-3 · 1.21 Impact Factor
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    ABSTRACT: A 78-year-old male presented with the chief complaints of abdominal pain and vomiting. Contrast-enhanced computed tomography and abdominal angiography showed occlusion of the superior mesenteric artery due to thrombosis, and emergency percutaneous transluminal angioplasty and stent placement were carried out. Two months later, stent thrombosis developed, and a second stent was placed. Eight months later, he complained of general fatigue and anorexia. Gastrointestinal endoscopy revealed a duodenal ulcer at the third portion close to the superior mesenteric artery. Thirteen days after conservative management, duodenal ulcer penetration into the superior mesenteric artery with subsequent air embolism developed, and the patient died of multiple organ failure.
    Surgery Today 05/2013; 44(8). DOI:10.1007/s00595-013-0557-x · 1.21 Impact Factor
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    ABSTRACT: Many studies support the hypothesis that specific microRNA (miRNA) expression in various human cancers including hepatocarcinogenesis is closely associated with diagnosis and prognosis. In hepatocellular carcinoma (HCC), malignancy level is related to the degree of histological differentiation. In order to establish a novel biomarker that can determine the degree of malignancy and forecast patient prognosis, we performed a microarray analysis to investigate the miRNA expression profiles in 110 HCC which were comprised of 60 moderately, 30 poorly, and 20 well differentiated HCC. We found that the expression of 12 miRNAs varied significantly according to the degree of histological differentiation. Particularly, miR-18b expression in poorly differentiated HCC was significantly higher than in well differentiated HCC. Based on miRanda and Targetscan target search algorithms and Argonaute 2 immunoprecipitation study, we noted that miR-18b can control the expression of trinucleotide repeat containing 6B (TNRC6B) as a target gene. Additionally, in two hepatoma cell lines, we found that over-expression of miR-18b or down-regulation of TNRC6B accelerated cell proliferation and loss of cell adhesion ability. Finally, we observed that after surgical resection, HCC patients with high miR-18b expression had a significantly shorter relapse-free period than those with low expression. miR-18b expression is an important marker of cell proliferation and cell adhesion, and is predictive of clinical outcome. From a clinical point of view, our study emphasizes miR-18b as a diagnostic and prognostic marker for HCC progression.
    BMC Cancer 03/2013; 13:99. DOI:10.1186/1471-2407-13-99 · 3.32 Impact Factor
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    ABSTRACT: BACKGROUND & AIMS: The gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) often depicts non-hypervascular hypointense hepatic nodules during the hepatobiliary phase in patients with hepatocellular carcinoma (HCC). It is not unclear whether the presence of these nodules is associated with HCC recurrence after hepatectomy. We conducted prospective observational study to investigate the impact of the presence of non-hypervascular hypointense hepatic nodules on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI on the recurrence of HCC after hepatectomy METHODS: A total of 77 patients who underwent hepatectomy for primary, non-recurrent, hypervascular HCC were prospectively followed up after hepatectomy. Post-operative recurrence rates were compared according to the presence of non-hypervascular hypointense nodules on preoperative Gd-EOB-DTPA-enhanced MRI. RESULTS: Recurrence rates after hepatectomy were higher in patients with non-hypervascular hypointense nodules (risk ratio 1.9396 [1.3615-2.7222]) and the presence of non-hypervascular hypointense nodules was an independent factor associated with postoperative recurrence (risk ratio 2.1767 [1.5089-3.1105]) along with HCC differentiation and portal vein invasion. Whereas no differences were found in the rate of intrahepatic metastasis recurrence based on the preoperative presence of non-hypervascular hypointense hepatic nodules, the rate of multicentric recurrence was significantly higher in patients with preoperative non-hypervascular hypointense hepatic nodules CONCLUSIONS: Patients with preoperative non-hypervascular hypointense hepatic nodules detected during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI are at higher risk of HCC recurrence after hepatectomy, mainly due to multicentric recurrence.
    Journal of Hepatology 01/2013; DOI:10.1016/j.jhep.2013.01.030 · 10.40 Impact Factor
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    ABSTRACT: We report 2 cases whereby patients underwent surgical resection of the isolated lung metastases from pancreatic cancer after radical pancreatectomy. Case 1: A 79-year-old woman underwent distal pancreatectomy with combined resection of the left adrenal gland for pancreatic cancer (pT4N0M0 Stage IVa). The lung metastases were identified 20 months after surgery, and she underwent thoracoscopic partial resection of the lung. Histological findings showed lung metastases from the pancreatic cancer. After the lung operation, she is living in tumor bearing with the lung and bone metastases for 18 months. Case 2: A 52-year-old man underwent subtotal preserving pancreatoduodenectomy for a pancreatic cancer (pT3N1M0 Stage III). The lung metastases were identified 54 months after surgery, and he underwent resection of the right upper lobe and partial resection of the lung. Immunohistochemical findings showed lung metastases from pancreatic cancer. After the lung operation, he died at 12 months because of having multiple brain metastases. If isolated lung metastasis of pancreatic cancer is found, there is a possibility that tumor resection is indicated for the better prognosis.
    Nippon Shokaki Geka Gakkai zasshi 01/2013; 46(9):678-685. DOI:10.5833/jjgs.2012.0266
  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2013; 74(5):1131-1137. DOI:10.3919/jjsa.74.1131
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    ABSTRACT: To evaluate safety and efficacy of the placement of sodium hyaluronate solution onto the liver surface as a supportive procedure for radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs) located on the liver surface as a possible alternative to RF ablation via laparoscopic approach or with the creation of artificial ascites. Changes in temperature of a sodium hyaluronate layer placed onto an egg white were measured during coagulation of the egg white by an RF ablation needle. A phase I study was performed to evaluate the safety of intraperitoneal injection of a maximum of 20 mL of sodium hyaluronate solution into humans by observing for the occurrence of intraperitoneal inflammation and adhesion. After these studies, RF ablation with ultrasound-guided injection of sodium hyaluronate onto the liver surface was performed, targeting 28 HCC nodules located on the liver surface. Treatment outcomes and complications of this procedure were investigated. In the in vitro experiment, the maximum temperature of sodium hyaluronate solution was 41°C during RF ablation. No intraperitoneal inflammation or adhesions were observed after intraperitoneal injection of sodium hyaluronate in the phase I study. HCC was completely ablated with sufficient margins after one session of RF ablation, without any burn injuries to the abdominal wall or adjacent organs. Local recurrence was observed in one of 28 patients (3.6%) during 30.1 months of follow-up. RF ablation can be safely and effectively performed on HCCs located close to the liver surface with placement of sodium hyaluronate onto the liver surface, thereby preventing burn injuries to abdominal wall or adjacent organs.
    Journal of vascular and interventional radiology: JVIR 12/2012; 23(12):1639-1645.e1. DOI:10.1016/j.jvir.2012.08.024 · 2.15 Impact Factor

Publication Stats

711 Citations
231.03 Total Impact Points

Institutions

  • 1998–2015
    • Ogaki Municipal Hospital
      Gihu, Gifu, Japan
  • 2004
    • University of Texas MD Anderson Cancer Center
      Houston, Texas, United States