消化管穿孔時の定圧自動送気内視鏡の安全性と有用性に関する前臨床研究

2015 Fiscal Year Annual Research Report

• Project/Area Number: 25350566
• Research Institution: Osaka University
• Principal Investigator: 中島 清一 大阪大学, 国際医工情報センター, 特任教授(常勤) (30432537)
• Co-Investigator(Kenkyū-buntansha): 山崎 誠 大阪大学, 医学(系)研究科(研究院), 講師 (50444518) ; 高橋 剛 大阪大学, 医学(系)研究科(研究院), 助教 (50452389)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 定圧自動送気内視鏡SPACE / 手動送気装置

Outline of Annual Research Achievements

(1) 胃穿孔時の消化管圧動態
胃穿孔モデルの作成：雌ブタの胃前壁に開腹下にφ20mm大の穿孔部を作成し、胃内、腹腔内に圧測定用のラインを留置し、それぞれデジタル内圧計に接続した。穿孔時の循環動態は手動送気下、SPACE下共に変化は認められず、SPACEでは胃内圧、腹腔内圧共に設定圧（8mmHg）以下で推移した。
送気方式の差異検証モデルの作成：オーバーチューブの口側に接続した逆流防止弁の側管から外科用送気装置を用いて設定圧8mmHgで10分間SPACEを施行し、その間の胃内、腹腔内圧を連続測定し循環動態の変化とともに評価した。穿孔部の閉鎖は行わず、内視鏡による正面視を意識し観察するに留めた。手動送気では送気開始後2分間は胃内圧、腹腔内圧共に設定圧以下に留まっていたが、3分後より腹腔内圧が上昇しはじめ、7分後には49.87mmHgに達した。胃内圧も5分後より上昇を始め、9分後には38.21mmHgに達し、腹部は膨満し過送気状態となった。
(2) 穿孔部閉鎖モデルにおける圧動態：(1)と同様のモデルを使用し、手動、SPACE両群において穿孔部のクリップ閉鎖を試みた。完全閉鎖には手動送気群で33分及び50分、SPACE群で44分及び55分を要し、この間胃内から腹腔内へと漏出する送気ガスに伴う腹部膨満が経時的に進行したが、SPACE群では設定した胃内圧（8mmHg）を大きく逸脱する圧上昇はこさなかった。一方、手動送気群では腹腔内圧が20mmHgを超えた。
(3) より実臨床に近いモデルを用いた検証：胃壁の穿孔部を開腹下ではなく内視鏡的に作成したモデルにおいて(2)と同等の実験を行い、より実臨床に近い環境下で手動送気とSPACEによる消化管圧動態の違いを検証した。
内視鏡的に作成した全層性の胃穿孔＋送気モデルにおいては(1)(2)と同様手動送気群でSPACE群よりも有意に腹腔内圧が上昇した。

Research Products

• [Journal Article] Novel management of postoperative pain using only oral analgesics after LADG (2016)
  • Author(s): Mikami J, Takiguchi S, Miyazaki Y, Takahashi T, Kurokawa Y, Yamasaki M, Miyata H, Nakajima K, Mori M, Doki Y
  • Journal Title: Surgical Today Volume: 46 Pages: 117-122
  • Peer Reviewed
• [Journal Article] A novel device for cleaning the camera port during laparoscopic surgery (2016)
  • Author(s): Eiji Kobayashi, Mamoru Kakuda, Yusuke Tanaka, Akiko Morimoto, Tomomi Egawa-Takata, Shinya Matsuzaki, Toshihiro Kimura, Yutaka Ueda, Kiyoshi Yoshino, Kiyokazu Nakajima, Tadashi Kimura
  • Journal Title: Surg Endosc Volume: 30 Pages: 330-334
  • Peer Reviewed
• [Journal Article] Laparoscopic surgery for esophageal achalasia Multiport vs single-incision approach (2016)
  • Author(s): Shuichi Fukuda, Kiyokazu Nakajima, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
  • Journal Title: Asian Journal of Endoscopic Surgery Volume: 9 Pages: 14-20
  • Peer Reviewed
• [Journal Article] Percutaneous endoscopic gastrostomy under steady pressure automatically controlled endoscopy: First clinical series (2016)
  • Author(s): Hiroyuki Imaeda, Kiyokazu Nakajima, Naoki Hosoe, Masanori Nakahara, Shinichiro Zushi, Motohiko Kato, Kazuhiro Kashiwagi, Yasushi Matsumoto, Kayoko Kimura, Rieko Nakamura, Norihito Wada, Masahiko Tsujii, Naohisa Yahagi, Toshifumi Hibi, Takanori Kanai, Tetsuo Takehara, Haruhiko Ogata
  • Journal Title: Wolrd Jounal of Gastrointestinal Endoscopy Volume: 8 Pages: 186-191
  • Peer Reviewed
• [Journal Article] Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach (2016)
  • Author(s): Shuichi Fukuda, Kiyokazu Nakajima, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
  • Journal Title: Asian Journal of Endoscopic Surgery Volume: 9 Pages: 14-20
  • Peer Reviewed
• [Journal Article] Single-incision laparoscopic surgery for stricturing and penetrating Crohn's disease. (2016)
  • Author(s): Tsunekazu Mizushima, Kiyokazu Nakajima, Hiroshi Takeyama, Atsushi Naito, Hideki Osawa, Mamoru Uemura, Junichi Nishimura, Taishi Hata, Ichiro Takemasa, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
  • Journal Title: Surg Today Volume: 46 Pages: 203-208
  • Peer Reviewed
• [Journal Article] Perioperative therapy for esophageal cancer. (2015)
  • Author(s): Makoto Yamasaki, Hiroshi Miyata, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
  • Journal Title: Gen Thorac Cardiovasc Surg Volume: 62 Pages: 531-540
  • Peer Reviewed
• [Journal Article] Monitoring gastric cancer progression with circulating tumour DNA. (2015)
  • Author(s): Hamakawa T, Kukita Y, Kurokawa Y, Miyazaki Y, Takahashi T, Yamasaki M, Miyata H, Nakajima K, Taniguchi K, Takiguchi S, Mori M, Doki Y, Kato K
  • Journal Title: Br J Cancer Volume: 112 Pages: 352-356
  • Peer Reviewed
• [Journal Article] Clinical outcomes of laparoscopic partial gastrectomy for gastric submucosal tumors (2015)
  • Author(s): Masashi Hirota, Kiyokazu Nakajima, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa,
  • Journal Title: Asian J Endosc Surg Volume: 8 Pages: 24-28
  • Peer Reviewed
• [Journal Article] Chylothorax After Esophagectomy Cured by Intranodal Lymphangiography: A Case Report (2015)
  • Author(s): Yamamoto M, Miyata H, Yamasaki M, Maeda N, Miyazaki Y, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, Mori M, Doki Y
  • Journal Title: Anticancer Research Volume: 35 Pages: 891-896
  • Peer Reviewed
• [Journal Article] Surgical strategy for the gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm: Laparoscopic surgery is feasible, safe, and oncologically acceptable (2015)
  • Author(s): Takahashi T, Nakajima K, Miyazaki Y, Miyazaki Y, Kurokawa Y, Yamasaki M, Miyata H, Takiguchi S, Nishida T, Mori M, Doki Y
  • Journal Title: Surg Laparosc Endosc Percutan Tech Volume: 25 Pages: 114-118
  • Peer Reviewed
• [Journal Article] Preoperative systemic and intraperitoneal chemotherapy consisting of S-1, cisplatin and docetaxel in patients with marginally resectable gastric cancer. (2015)
  • Author(s): Kurokawa Y, Hamakawa T, Miyazaki Y, Takahashi T, Yamasaki M, Miyata H, Nakajima K, Takiguchi S, Mori M, Doki Y
  • Journal Title: Anticancer Res Volume: 35 Pages: 2223-2228
  • Peer Reviewed
• [Journal Article] Laparoscopic intraoperative navigation surgery for gastric cancer using real-time rendered 3D CT images. (2015)
  • Author(s): Takiguchi S, Fujiwara Y, Yamasaki M, Miyata H, Nakajima K, Nishida T, Sekimoto M, Hori M, Nakamura H, Mori M, Doki Y
  • Journal Title: Surg Today Volume: 45 Pages: 618-624
  • Peer Reviewed
• [Journal Article] High infiltration of tumor-associated macrophages is associated with a poor response to chemotherapy and poor prognosis of patients undergoing neoadjuvant chemotherapy for esophageal cancer. (2015)
  • Author(s): Sugimura K, Miyata H, Tanaka K, Takahashi T, Kurokawa Y, Yamasaki M, Nakajima K, Takiguchi S, Mori M, Doki Y
  • Journal Title: J Surg Oncol Volume: 111 Pages: 752-759
  • Peer Reviewed
• [Journal Article] Use of double-lumen peripherally inserted central catheters for safer perioperative management of esophageal cancer patients (2015)
  • Author(s): Fukuda S, Nakajima K, Miyazaki Y, Takahashi T, Kurokawa Y, Yamasaki M, Miyata H, Takiguchi S, Mori M, Doki Y
  • Journal Title: JVA (The Journal of Vascular Access) Volume: 16 Pages: 338-343
  • Peer Reviewed
• [Journal Article] Gene therapy with SOCS1 for gastric cancer induces G2/M arrest and has an antitumour effect on peritoneal carcinomatosis. (2015)
  • Author(s): Natatsuka R, Takahashi T, Serada S, Fujimoto M, Ookawara T, Nishida T, Hara H, Nishigaki T, Harada E, Murakami T, Miyazaki Y, Makino T, Kurokawa Y, Yamasaki M, Miyata H, Nakajima K, Takiguchi S, Kishimoto T, Mori M, Doki Y, Naka T
  • Journal Title: British Journal of Cancer Volume: 113 Pages: 433-442
  • Peer Reviewed
• [Journal Article] Effects of ghrelin administration on the early postoperative inflammatory response after esophagectomy (2015)
  • Author(s): "Akihiro Takata, Shuji Takiguchi, Kohei Murakami, Yasuhiro Miyazaki, Hiroshi Miyata, Tsuyoshi Takahashi, Yukinori Kurokawa. Makoto Yamasaki,
  • Journal Title: Surg Today Volume: 45 Pages: 1025-1031
  • Peer Reviewed
• [Journal Article] Randomized Phase II Study of the Anti-inflammatory Effect of Ghrelin During the Postoperative Period of Esophagectomy (2015)
  • Author(s): Takata A, Takiguchi S, Miyazaki Y, Miyata H, Takahashi T, Kurokawa Y, Yamasaki M, Nakajima K, Mori M, Kangawa K, Doki Y
  • Journal Title: Annals of Surgery Volume: 262 Pages: 230-236
  • Peer Reviewed
• [Journal Article] Clinical Importance of Supraclavicular Lymph Node Metastasis After Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma. (2015)
  • Author(s): Miyata H, Yamasaki M, Miyazaki Y, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, Mori M, Doki Y
  • Journal Title: Ann Surg Volume: 262 Pages: 280-285
  • Peer Reviewed
• [Journal Article] Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial. (2015)
  • Author(s): Yamada T, Hirota M, Tsutsui S, Kato M, Takahashi T, Yasuda K, Sumiyama K, Tsujii M, Takehara T, Mori M, Doki Y, Nakajima K.
  • Journal Title: Surg Endosc Volume: 29 Pages: 2748-2755
  • Peer Reviewed
• [Journal Article] Pyruvate Kinase M2 Modulates Esophageal Squamous Cell Carcinoma Chemotherapy Response by Regulating the Pentose Phosphate Pathway (2015)
  • Author(s): Fukuda S, Miyata H, Miyazaki Y, Makino T, Takahashi T, Kurokawa Y, Yamasaki M, Nakajima K, Takiguchi S, Mori M, Doki Y
  • Journal Title: Ann Surg Oncol Volume: 22 Pages: 1461-1468
  • Peer Reviewed
• [Journal Article] Feasibility and safety of optical biopsy using probe based confocal laser endomicroscopy for peritoneal dissemination (2015)
  • Author(s): Hara H, Takahashi T, Nakatsuka R, Higashi S, Miyazaki Y , Kurokawa Y, Takiguchi S, Mori M, Doki Y, Nakajima K
  • Journal Title: Jounal of Gstroenterology and Hepatology Volume: 30 Pages: 209
  • Peer Reviewed
• [Journal Article] Dynamics of intraluminal pressure of the sophagus ESD in preclinical experiments (2015)
  • Author(s): Y Miyazaki, M Yamasaki, Y Kurokawa, T Makino, S Takiguchi, M Mori, Y Doki, K Nakajima
  • Journal Title: Jounal of Gstroenterology and Hepatology Volume: 30 Pages: 316
  • Peer Reviewed
• [Journal Article] Feasibility study of real-time intestinal bloodstream evaluation using probe-based confocal laser endomicroscopy in porcine intestinal ischemia models. (2015)
  • Author(s): T Takahashi, R Nakatsuka, H Hara, S Higashi, Y Miyazaki, Y Kurokawa, S Takiguchi, M Mori, Y Doki, K Nakajima
  • Journal Title: Jounal of Gstroenterology and Hepatology Volume: 30 Pages: 71
  • Peer Reviewed
• [Presentation] #1358 Feasibility and safety of optical biopsy using probe based confocal laser endomicroscopy for peritoneal dissemination (2015)
  • Author(s): Hara H, Takahashi T, Nakatsuka R, Higashi S, Miyazaki Y, Kurokawa Y, Takiguchi S, Mori M, Doki Y, Nakajima K
  • Organizer: Asian Pacific Digestive Week (APDW)
  • Place of Presentation: Taipei Taiwan
  • Year and Date: 2015-12-05
  • Int'l Joint Research
• [Presentation] # 1497 Dynamics of intraluminal pressure of the esophagus ESD in preclinical experiments (2015)
  • Author(s): Higashi S, Takahashi T, Miyazaki Y, Yamasaki M, Kurokawa Y, Makino T, Takiguchi S, Mori M, Doki Y, Nakajima K
  • Organizer: APDW
  • Place of Presentation: Taipei Taiwan
  • Year and Date: 2015-12-05
  • Int'l Joint Research
• [Presentation] #1314 Feasibility study of real-time intestinal bloodstreamevaluation using probe-based confocal laser endomicroscopy in porcine intestinal ischemia models (2015)
  • Author(s): Takahashi T, Nakatsuka R, Hara H, Higashi S, Miyazaki Y, Kurokawa Y, Takiguchi S, Mori M, Doki Y, Nakajima K
  • Organizer: APDW
  • Place of Presentation: Taipei Taiwan
  • Year and Date: 2015-12-04
  • Int'l Joint Research
• [Presentation] Simposio-Cena de Bienvenida (2015)
  • Author(s): Nakajima K
  • Organizer: International NOTES W.I.D.E.R.
  • Place of Presentation: Barcelona Spain
  • Year and Date: 2015-11-23
  • Int'l Joint Research / Invited
• [Presentation] A novel portable endoscopy system for universal access. (2015)
  • Author(s): Nakajima K
  • Organizer: International NOTES W.I.D.E.R.
  • Place of Presentation: Barcelona Spain
  • Year and Date: 2015-11-23
  • Int'l Joint Research / Invited
• [Presentation] Project ENGINE: Our R&D and Achievements (2015)
  • Author(s): Nakajima K
  • Organizer: AIMS Academy
  • Place of Presentation: Milan Italy
  • Year and Date: 2015-11-19
  • Int'l Joint Research / Invited
• [Presentation] ENGINE & HEART: R&D of UHC Devices based on Unmet Needs in LMICs (2015)
  • Author(s): Nakajima K
  • Organizer: AIMS Academy
  • Place of Presentation: Milan Italy
  • Year and Date: 2015-11-19
  • Int'l Joint Research / Invited
• [Presentation] CO2 stabilizer for endoscopic diagnosis and interventions. (2015)
  • Author(s): Nakajima K
  • Organizer: Endocourse milan 2015 endoscopic management of gastrointestinal and pancreatico-biliary neoplasia 6th advanced course
  • Place of Presentation: Milan Italy
  • Year and Date: 2015-11-18
  • Int'l Joint Research / Invited
• [Presentation] Next Generation Endoscopy through Surgeon's Eyes (2015)
  • Author(s): Nakajima K
  • Organizer: DDW
  • Place of Presentation: Washington D.C. U.S.A
  • Year and Date: 2015-05-17
  • Int'l Joint Research
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM AND INSUFFLATION APPARATUS (2015)
  • Inventor(s): 鳥澤信幸、宮本学、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 15162631.4
  • Filing Date: 2015-04-07
  • Overseas
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM AND INSUFFLATION APPARATUS (2015)
  • Inventor(s): 鳥澤信幸、宮本学、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 201510163103.4
  • Filing Date: 2015-04-08
  • Overseas
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM AND INSUFFLATION APPARATUS (2015)
  • Inventor(s): 鳥澤信幸、宮本学、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 14/682,117
  • Filing Date: 2015-04-09
  • Overseas
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM AND INSUFFLATION APPARATUS (2015)
  • Inventor(s): 鳥澤信幸、宮本学、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 14/682,116
  • Filing Date: 2015-04-09
  • Overseas
• [Patent(Industrial Property Rights)] 送気システム (2015)
  • Inventor(s): 林健太郎、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 2014-550189
  • Filing Date: 2015-05-22
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM (2015)
  • Inventor(s): 林健太郎、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 14/720,993
  • Filing Date: 2015-05-26
  • Overseas
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM (2015)
  • Inventor(s): 林健太郎、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 201380061526.4
  • Filing Date: 2015-05-26
  • Overseas
• [Patent(Industrial Property Rights)] INSUFFLATION SYSTEM (2015)
  • Inventor(s): 林健太郎、中島清一
  • Industrial Property Rights Holder: 富士フイルム株式会社、国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 13858973.4
  • Filing Date: 2015-05-27
  • Overseas
• [Patent(Industrial Property Rights)] 内視鏡用オーバーチューブ (2014)
  • Inventor(s): 中島清一
  • Industrial Property Rights Holder: 国立大学法人大阪大学
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 5835760
  • Filing Date: 2014-09-24
  • Acquisition Date: 2015-11-13