Shuichiro Uchiyama

Miyazaki University, Миядзаки, Miyazaki, Japan

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Publications (40)119.39 Total impact

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    ABSTRACT: To investigate the clinicopathological features and postoperative survival of patients with mucinous colorectal carcinoma (MC) and to identify the factors related to long-term survival.
    Surgery Today 06/2014; · 0.96 Impact Factor
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    ABSTRACT: Although fecal diversion is reported to improve the quality of life (QOL) of the patients with active perianal disease, the effect of the concomitant abdominal surgery was not well studied. The aim of this study was to investigate factors that impair postoperative QOL of patients with Crohn's disease. A SF-36v2 questionnaire was mailed to patients who underwent abdominal operation between January 2001 and February 2007. Patients were also asked about the medical therapy they were receiving. Data from 50 patients were analyzed. Univariate analyses revealed that patients with active perianal disease had lower scores for role physical, bodily pain and social functioning than did patients without it. Social functioning and role emotional scores were lower in patients older than 40 years than in those younger. The physical component summary score was significantly affected in patients with active perianal disease. Fecal diversion had no effect on QOL after abdominal surgery for Crohn's disease. Multivariate analysis showed that the physical component summary score was significantly lower in patients with active perianal disease than in patients without it. Active perianal disease is an important factor that impairs QOL in patients who have undergone surgery for intestinal Crohn's disease.
    Hepato-gastroenterology 09/2012; 59(118):1814-8. · 0.77 Impact Factor
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    ABSTRACT: To assess the role of positron emission tomography-computed tomography (PET-CT) and multidetector-row CT (MD-CT) in detecting the primary lesion and lymph node metastasis in patients with colorectal cancers. A collective total of 80 lesions resected from 77 patients were examined pathologically. We analyzed the significance of the standardized uptake value (SUV) and its relationship with the clinicopathologic findings of primary lesions and lymph node metastasis. The detectability of primary lesions and lymph node metastases on PET-CT images was compared with that on MD-CT images. The detectability of primary lesions was better on PET-CT images than on MD-CT images (p = 0.0023). We observed no significant differences in the SUV with respect to staging, tumor grade, lymphatic or vessel invasion, and macroscopic type; however, primary tumor size analysis revealed that tumors larger than 3 cm had a higher SUV than those smaller than 3 cm. The sensitivity of PET-CT for detecting lymph node metastasis was lower than that of MD-CT, but the specificity of PET-CT was higher than that of MD-CT. The SUV of primary cancers tends to increase in proportion to tumor size. Although the value of PET-CT in detecting lymph node metastasis is limited, PET -positive lymph nodes can be considered metastatic.
    Surgery Today 06/2012; 42(10):956-61. · 0.96 Impact Factor
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    ABSTRACT: Abstract This study aimed to investigate whether the initial indication for surgery or type of surgery (strictureplasty or resection) performed determines recurrence patterns in patients with Crohn disease. Recurrence patterns of 41 patients (31 patients: only resection and anastomosis of the intestine, and 10 patients: strictureplasty with/without resection and anastomosis) who underwent operation for recurrent Crohn disease (June 2002-December 2010) were evaluated. Strictureplasty for nonperforating disease was performed at 17 sites, and reoperation was required at 11 sites (10 sites for nonperforating disease and 1 site for perforating disease). There was a significant difference in the recurrence pattern in patients who underwent resection and anastomosis (P < 0.01) and in patients who underwent strictureplasty with resection and anastomosis (P < 0.05) between sites at which resection and anastomosis was performed for nonperforating and for perforating disease. Initial indication for surgery, but not the type of surgery, appeared to determine recurrence patterns.
    International surgery 04/2012; 97(2):120-128. · 0.31 Impact Factor
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    ABSTRACT: To investigate the efficacy of infliximab for complicated perianal Crohn's disease with special reference to maintenance therapy. Between June 2002 and April 2009, 20 patients (15 men and 5 women, aged 31.4±2.9 years old (mean ± standard error)) with complicated fistulizing anal Crohn's disease underwent seton placement. For the induction therapy, intravenous infusion of infliximab was given 3 times after surgical treatment. Thereafter, infliximab was given every 8 weeks as maintenance therapy. Patients were followed-up for 31.8±4.2 months after the first infliximab infusion. The number of the infliximab treatments given was 13.6±2.5. After induction therapy, complete response (CR) was observed in 8 patients (40%), partial response (PR) in 9 and progress disease (PD) in 3. With (n=17) or without (n=3) maintenance therapy following the induction therapy, CR was observed in 15 of 20 patients (75%). Of the 17 patients who received maintenance therapy, CR was of observed in 13 patients, of whom 7 patients showed PR or PD before maintenance therapy. Seton drainage and infliximab therapy is effective in the patients with fistulizing perianal Crohn's disease. Maintenance infliximab therapy might be effective in patients with perianal Crohn's disease.
    Hepato-gastroenterology 08/2011; 58(109):1189-92. · 0.77 Impact Factor
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    ABSTRACT: Meckel diverticulum is one of the causes of gastrointestinal bleeding; however, preoperative conclusive diagnosis is very difficult even with the use of various radiologic modalities. The development of double-balloon enteroscopy enables us to diagnose various bleeding source, including Meckel diverticulum, in the small intestine. We herein report a case of bleeding Meckel diverticulum, diagnosed by double-balloon enteroscopy and treated successfully by laparoscopic surgery, and review of the literature.
    Surgical laparoscopy, endoscopy & percutaneous techniques 08/2010; 20(4):278-80. · 0.88 Impact Factor
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    ABSTRACT: A 57-year-old woman was diagnosed as having rectal cancer. A barium enema study showed the apple-core sign at the rectosigmoid colon, and colonoscopy revealed an encircled ulcerated tumor. A laparoscope-assisted resection of the rectum was planned; however, the rectal cancer directly invaded the uterus body. The operation was converted to open surgery. An elastic hard tumor suspected of being peritoneal dissemination at the peritoneal reflection was detected and excised together with the rectum below the peritoneal reflection. A histological examination of this tumor revealed that cystic glands lined by nonmucinous columnar epithelial cells were seen on the serosal side and were embedded in the proper muscle of the rectum. This tumorous lesion was diagnosed as endometriosis.
    Surgery Today 07/2010; 40(7):672-5. · 0.96 Impact Factor
  • Gastroenterology 05/2010; 138(5). · 12.82 Impact Factor
  • Gastroenterology 01/2010; 138(5). · 12.82 Impact Factor
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    ABSTRACT: Side-to-side strictureplasty is a useful procedure for preserving the bowel in patients with Crohn's disease. However, bowel resection is required in some patients, and diseased proximal bowel and disease-free distal bowel exist after resection. We performed a modified new technique called side-to-side-to-end strictureplasty. Four patients with Crohn's disease underwent this procedure. After resection of the diseased bowel that was not suitable for strictureplasty, side-to-side strictureplasty was performed with use of the proximal diseased loop. Thereafter, the distal end of the side-to-side stricture was anastomosed to the distal disease-free bowel in a side-to-side-to-end manner. The length of the small intestine requiring surgical intervention was 69.8 +/- 26.4 (mean +/- standard deviation) cm, and the length of the small intestine necessitating resection was 31.8 +/- 12.6 cm. Side-to-side stricture was performed by use of 48.8 +/- 20.2 cm of the diseased proximal bowel, which was anastomosed to the disease-free distal bowel. Intra-abdominal abscess, which was not associated with this procedure, was observed in one patient, but was treated by drainage. The recoveries of all four patients were uneventful, without recurrence, after a follow-up of 21.5 +/- 16.2 months. Side-to-side-to-end strictureplasty may be a useful procedure when diseased proximal bowel and disease-free distal bowel are present after bowel resection in patients with Crohn's disease.
    Diseases of the Colon & Rectum 11/2009; 52(11):1882-6. · 3.34 Impact Factor
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    ABSTRACT: An 80-year-old woman who had undergone both a cholecystectomy and an appendectomy presented with intermittent abdominal pain. Computed tomography (CT) revealed an encapsulated circumscribed cluster of jejunal loops in the left upper quadrant. The hernia orifice was adjacent to the left side of the superior mesenteric artery and vein. An upper gastrointestinal series also revealed a cluster of jejunal loops, suggesting the possibility of an internal hernia. Laparoscopic surgery was performed. The hernia orifice was found to be caused by abnormal adhesion between the transverse mesocolon and the jejunum mesentery. An adhesiotomy reduced the jejunum entrapped in the hernia. The hernia space was a large mesocolic fossa composed of transverse mesocolon and mesentery, continuing to the splenic flexure. The hernia was classified as a variant of paraduodenal hernia.
    Surgery Today 02/2009; 39(6):533-5. · 0.96 Impact Factor
  • Source
    Shuichiro Uchiyama, Kazuo Chijiiwa
    Journal of Gastrointestinal Surgery 01/2009; · 2.36 Impact Factor
  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2009; 70(10):3146-3150.
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    ABSTRACT: To clarify the characteristics of hepatocellular carcinoma (HCC) with bile duct invasion, we retrospectively analyzed clinical features and surgical outcome of HCC with bile duct invasion (b(+) group, n = 15) compared to those without bile duct invasion (b(-) group, n = 256). In the b(+) group, four patients (27%) showed obstructive jaundice, and a diagnosis of bile duct invasion was obtained preoperatively in seven patients (47%). The levels of serum bilirubin and carbohydrate antigen 19-9 were significantly higher in the b(+) group. Macroscopically, confluent multinodular type and infiltrative type were predominant in the b(+) group (P = 0.002). Microscopically, capsule infiltration (P = 0.040) and intrahepatic metastasis (P = 0.013) were predominant in the b(+) group. Portal vein invasion was associated significantly with the b(+) group (P = 0.004); however, the frequency of hepatic vein invasion was similar (P = 0.096). The median survival after resection was significantly shorter in the b(+) group than in the b(-) group (11.4 vs. 56.1 months, P = 0.002), and eight of 11 intrahepatic recurrences in the b(+) group occurred within 3 months after surgery. HCC with bile duct invasion has an infiltrative nature and a high risk of intrahepatic recurrence, resulting in poor prognosis.
    Journal of Gastrointestinal Surgery 12/2008; 13(3):492-7. · 2.36 Impact Factor
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    ABSTRACT: Although benign and malignant tumors of the major duodenal papilla can be detected endoscopically, definitive diagnosis of such lesions by histologic examination of biopsy specimens is sometimes difficult, especially in cases with intraductal extension into the bile duct or pancreatic duct. We herein report a case of adenoma of the major duodenal papilla showing an intraductal extension into the lower common bile duct that necessitated pylorus-preserving pancreaticoduodenectomy.
    Journal of Gastrointestinal Surgery 07/2008; 12(6):1146-8. · 2.36 Impact Factor
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    ABSTRACT: According to the classification system of the Japanese Society for Cancer of the Colon and Rectum, Stage IV colorectal cancer is characterized by distant metastasis, which is defined by four factors: liver metastasis (H factor), metastasis to organs other than the liver (M factor), peritoneal dissemination (P factor), and distant lymph node metastasis (N factor). We conducted this study to investigate the postsurgical prognosis of patients with Stage IV colorectal cancer (CRC), in reference to each of these four factors. We analyzed the medical records of 73 patients who underwent surgery for Stage IV CRC at our hospital between 1991 and 2001. Univariate analysis revealed that P0 or P1 CRC (P < 0.001), absence of the M factor (P = 0.024), well or moderately differentiated adenocarcinoma (P < 0.001), resection of the primary tumor (P < 0.001), and curability B surgery (P < 0.0001) were associated with a better prognosis than other types of Stage IV CRC. Multivariate analysis revealed that tumor differentiation and surgical curability affected cancer-specific survival significantly. Surgery with curative intent should be considered for patients with Stage IV CRC defined by the P1 factor or H factor.
    Surgery Today 02/2008; 38(9):784-9. · 0.96 Impact Factor
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    ABSTRACT: In some cases of bile duct stricture, malignancy cannot be diagnosed preoperatively even with the use of various diagnostic imaging modalities and histologic examination. As long as malignancy cannot be ruled out completely, surgery can be undertaken for the purposes of diagnosis and treatment. We report a case of unusual segmental stricture of the lower common bile duct mimicking bile duct cancer and discuss the differential diagnosis.
    Journal of Gastrointestinal Surgery 02/2008; 12(1):199-201. · 2.36 Impact Factor
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    ABSTRACT: A 77-year-old woman with a complaint of itching was shown to have an elevated serum bilirubin level. She had no history of liver disease. Computed tomography and magnetic resonance cholangiopancreatography revealed a 17-mm-diameter cystic lesion obstructing the main hepatic duct at the hepatic hilum. Drip infusion cholangiographic computed tomography and endoscopic retrograde cholangiography showed that the cyst did not communicate with the biliary tree; thus, a peribiliary cyst was diagnosed. Cystectomy was performed, and the jaundice resolved. Peribiliary cysts are generally asymptomatic and rarely cause obstructive jaundice. They are usually multiple and caused by an underlying liver disorder with a poor prognosis. Our case suggests that peribiliary cysts can arise in healthy liver and cause symptoms. Cystectomy is the treatment of choice if the cyst is solitary.
    Journal of Gastrointestinal Surgery 01/2008; 13(1):174-6. · 2.36 Impact Factor
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    ABSTRACT: Gastrointestinal stromal tumor (GIST) is recently defined as a tumor expressing c-kit and sometimes showing liver metastasis. We investigated the outcomes of gastric GIST with special attention to the effect of repeated treatment for the patients with liver metastases. Fourteen gastric GISTs were retrospectively reviewed and the significance of the NIH stratification system was examined. Liver metastasis was found in 4 of the 14 patients with gastric GISTs. Three of the 4 patients had metachronous liver metastases and underwent repeated hepatectomies after the initial operation for gastric GIST. The other patient had a synchronous liver metastasis and underwent total gastrectomy and partial resection of the liver as the initial treatment. Two of the 4 patients have received treatments 6 times, including hepatic resection, microwave coagulation therapy (MCT), radiofrequency ablation (RFA), or by imatinib. All 4 patients with hepatic metastases are alive after the first hepatectomy with a mean survival time of 64.8 months with or without imatinib treatment. None classified to very low risk and low risk groups by the NIH system showed liver metastasis, while 43% of the patients classified to the high risk showed liver metastasis. Repeated surgical and medical treatments for liver metastases from gastric GIST improve survival. Special attention should be paid to be the high risk group categorized by the NIH classification system.
    Hepato-gastroenterology 01/2008; 55(82-83):512-6. · 0.77 Impact Factor
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    ABSTRACT: Melanoma is a malignancy originating from melanocytes. The primary melanoma usually occurs on the skin, retina, anal canal or occasionally at other organs such as the esophagus, penis or vagina. Although melanoma represents about one-third of all metastatic lesions in the gastrointestinal tract, metastasis of melanoma to the GI tract, detected radiologically or endoscopically, is relatively rare. In most cases of malignant melanoma, recurrence and death occur within 10 years after treatment of the primary lesion. We herein report a case showing a recurrence 17 years after extirpation of primary malignant melanoma in the foot. A 65-year-old man, with a history of extirpation of a malignant melanoma in the sole of his foot 17 years before, presented with anorexia and severe anemia, and multiple duodenal tumors were pointed out with upper gastrointestinal endoscopy. Histologic examination of the endoscopic biopsy specimen revealed proliferation of large polygonal cells with distinct nucleoli, and malignant melanoma was diagnosed immunohistochemically. Further examination, including computed tomography and positron emission tomography with fluorodeoxyglucose, revealed systemic metastasis.
    Hepato-gastroenterology 01/2008; 55(86-87):1619-21. · 0.77 Impact Factor

Publication Stats

634 Citations
119.39 Total Impact Points

Institutions

  • 2004–2009
    • Miyazaki University
      • • School of Medicine
      • • Department of Pathology
      • • Faculty of Medicine
      Миядзаки, Miyazaki, Japan
  • 1984
    • Kansai Medical University
      • Third Department of Internal Medicine
      Moriguchi, Ōsaka, Japan