| Project/Area Number |
18K16300
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 55020:Digestive surgery-related
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| Research Institution | Dokkyo Medical University |
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Principal Investigator |
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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 |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
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| Keywords | 胃癌 / 低侵襲手術 / 幽門保存胃切除 / 粘膜漿膜マーキング / non-opened / 非開放式 / NoCEAM / 胃局所切除 / 蛍光マーキング / 漿膜マーキング / 近赤外線 / ナビゲーション |
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| Outline of Final Research Achievements |
We are still developing novel drugs to fix the layers of the gastric wall and to transmit positional information from the gastric mucosal side to the serosal side.
During the development process, a new surgical technique was also devised to penetrate the stomach wall and temporarily suture it. We applied this technique to the reconstruction of pylorus-preserving gastrectomy for gastric cancer. We named it the non-opened clean end-to-end anastomosis method; NoCEAM, and introduced it clinically. The feasibility and short-term results of NoCEAM were favorable, suggesting its potential to reduce postoperative complications. The paper was accepted for publication in English. We also applied this technique to early-stage gastric cancer in the upper gastric region and presented a new concept of the procedure at a conference. We have also further developed this technique into other procedures. Clinical studies are underway.
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| Academic Significance and Societal Importance of the Research Achievements |
幽門保存胃切除術は幽門側胃切除術に比べ、術後の下痢やダンピング症状が軽度で、術後栄養状態が良好で体重減少が抑えられ、胆石発生が少ないことが既に示されているが、唯一のデメリットは食物排出遅延の率が高いことであった。本研究で開発されたNoCEAMは、胃を開放しない端々吻合の再建法であるため、感染性合併症と共に食物排出遅延をも低減させることが期待された。実際に臨床試験では、感染性合併症と食物排泄遅延は極めて低率であった。NoCEAMによって幽門保存胃切除術の唯一のデメリットが低減すれば、幽門側胃切除に代わり幽門保存胃切除術が普及することで、胃切除後の合併症や機能障害に苦しむ率が低減すると期待される。
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