| Project/Area Number |
18K08796
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55040:Respiratory surgery-related
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| Research Institution | Jichi Medical University |
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Principal Investigator |
Endo Shunsuke 自治医科大学, 医学部, 教授 (10245037)
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| Co-Investigator(Kenkyū-buntansha) |
丹羽 康則 自治医科大学, 医学部, 講師 (20406060)
坪地 宏嘉 自治医科大学, 医学部, 教授 (50406055)
小形 幸代 自治医科大学, 医学部, 講師 (10448847)
大谷 智仁 大阪大学, 大学院基礎工学研究科, 准教授 (40778990)
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| Project Period (FY) |
2018-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2019: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 左房 / 肺葉切除術 / 数値流体力学 / スーパーコンピューター / 衝突流 / 散逸エネルギー / 左房血栓 / 心原性脳梗塞 / 肺癌 / 肺葉切除 / 左房内血栓 / 数理的流体解析 / ４DCT / 旋回流 / 流体解析 / 散逸係数 / 肺癌手術 / 左肺上葉切除術 / 左房血流 / 過流 / 4DCT / 血流解析 / 左上葉切除術 / 術後合併症 / 脳梗塞 |
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| Outline of Final Research Achievements |
Lung cancer patients who undergo lobectomy are prone to cardiogenic cerebral infarction. This may be due to changes in blood flow pattern in the left atrium after lobectomy. 4DCT images were taken before and after left upper lobectomy in 10 patients, and numerical fluid analysis in the left atrium was performed using a supercomputer.
This fluid pattern changed significantly after left upper lobectomy, and in some cases, the pulmonary vein blood flow into the left atrium collided with the pulmonary vein blood flow into the left atrium. We conducted a study to quantitatively evaluate the dissipated energy produced due to the collision of the incoming blood from the pulmonary veins after the procedure. As a result, we found some cases in which dissipated energy was significantly increased after left upper lobectomy. These results suggest that cerebral infarction after lung cancer surgery is caused by an increase in dissipated energy due to fluid impingement in the left atrium.
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| Academic Significance and Societal Importance of the Research Achievements |
左房内に発生する衝突流が心原性脳梗塞の原因と考えられた場合、術前のＣＴの情報から術後衝突流のリスクが高い症例では術式を肺葉切除術から区域切除に変更することによって、術後脳梗塞を予防できるものと考えられる。
また術後に発生する不整脈の原因とも考えられ、術後合併症対策の一環として術式変更や術後の抗血栓療法の開始の判断基準と考えられる。
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