Development of a novel device for transmitting and fixing positional information from the mucosa side to the serosa side

2023 Fiscal Year Final Research Report

• Project/Area Number: 18K16300
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Dokkyo Medical University
• Principal Investigator: MITSUI Takashi 獨協医科大学, 医学部, 講師 (30816591)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Keywords: 胃癌 / 低侵襲手術 / 幽門保存胃切除

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.

Free Research Field

上部消化管外科

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。