| Project/Area Number |
18K16368
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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 | Nagasaki University |
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Principal Investigator |
Maruya Yasuhiro 長崎大学, 医歯薬学総合研究科(医学系), 助教 (20817085)
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| Project Period (FY) |
2018-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 筋芽細胞シート / 十二指腸ESD / 内視鏡手術 / 十二指腸非乳頭部腫瘍 / 細胞シート / 骨格筋芽細胞シート / 再生医療等製品 / デリバリーデバイス / 早期十二指腸癌 / 十二指腸 / 内視鏡下粘膜剥離術 / 術後穿孔 / 脂肪由来幹細胞シート |
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| Outline of Final Research Achievements |
Endoscopic submucosal dissection (ESD) is recently adapted to Superficial Non-Ampullary Duodenal Epithelial Tumor (SNADET). However, duodenal ESD is difficult, and the high intraoperative/late perforation rate becomes a problem. Thus, minimally invasive treatment to SNADET is achieved when postoperative perforation after duodenal ESD is prevented.
We have already reported on the preventive effect of the use of myoblast sheet on gastric perforation and pancreatic fluid leakage. From these results, it was thought that myoblast sheet could be useful for the prevention of intraoperative/late duodenal perforation caused by ESD. We have already confirmed the preventive effect of autologous myoblasts sheet on perforation caused by duodenal ESD in open transplantation experiments using a large animal model. As we are looking forward to the development of laparoscopic transplantation in the future, we have already successfully developed a laparoscopic delivery device.
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| Academic Significance and Societal Importance of the Research Achievements |
表在性非乳頭部十二指腸腫瘍に対して十二指腸部分切除や膵頭十二指腸切除などの高侵襲な開腹手術が行われていたが、現在では低侵襲な内視鏡的粘膜下層剥離術（以下ESD）が適応されつつある。十二指腸は腸管が狭く屈曲しているうえに、消化管壁が非常に薄く、更に胆汁や膵液に暴露される。これらの解剖学的特性から約30％と他の消化管に比べて高確率で術後穿孔を来すことが問題点として挙げられる。十二指腸穿孔が起こると腹膜炎を発症し緊急手術が必要となるため、結果的に高侵襲な治療を要するジレンマを抱えている。
本研究によって十二指腸ESDに再生医療を組み合わせた新たな治療法のコンセプトを世界に先駆けて報告することが出来た。
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