附属病院 緩和ケア部

清水 敦

シミズ アツシ  (Atsushi Shimizu)

基本情報

所属
自治医科大学 消化器一般移植外科・緩和ケア 教授

研究者番号
40364517
researchmap会員ID
B000238625

論文

 93
  • Atsushi Miki, Yasunaru Sakuma, Jun Watanabe, Kazuhiro Endo, Hideki Sasanuma, Takumi Teratani, Alan Kawarai Lefor, Atsushi Shimizu, Joji Kitayama, Yoshikazu Yasuda, Naohiro Sata
    Scientific Reports 13(1) 2023年9月20日  
    Abstract It is important to assess the prognosis and intervene before and after surgery in patients with hepatocellular carcinoma. This study aims to elucidate the association of outcomes and residual liver function after hepatectomy. A total of 176 patients who underwent the initial resection for hepatocellular carcinoma between January 2011 and March 2021 at Jichi Medical University were included. Hepatic clearance of the remnant liver was measured using 99mTc-galactosyl serum albumin scintigraphy. The log-rank test was used to analyze survival using the Kaplan–Meier method. Hazard ratios (HR) and 95% confidence intervals (CI) for overall survival were calculated using Cox’s proportional hazard model. In multivariate analysis, microvascular invasion, intraoperative blood loss, and hepatic clearance of the remnant liver were independently associated with overall survival. Hepatic clearance of the remnant liver was independently associated with recurrence free survival. This is the first report to show that lower residual liver function is associated with shorter survival in patients with hepatocellular carcinoma undergoing hepatectomy. Preoperative determination of remnant liver function may allow assessment of prognosis in patients planned to undergo resection of hepatocellular carcinoma. Preservation of liver functional reserve may be crucial for improved long-term outcomes after hepatectomy.
  • 清水 敦, 野田 泰子, 佐久間 康成, 大西 康晴, 笹沼 英紀, 堀江 久永, 細谷 好則, 北山 丈二, 佐田 尚宏
    日本外科学会定期学術集会抄録集 123回 SF-4 2023年4月  
  • Atsushi Miki, Yasunaru Sakuma, Hideyuki Ohzawa, Akira Saito, Yoshiyuki Meguro, Jun Watanabe, Kazue Morishima, Kazuhiro Endo, Hideki Sasanuma, Atsushi Shimizu, Alan Kawarai Lefor, Yoshikazu Yasuda, Naohiro Sata
    World journal of gastroenterology 28(38) 5614-5625 2022年10月14日  
    BACKGROUND: Estimation of the functional reserve of the remnant liver is important to reduce morbidity and mortality. AIM: To estimate the functional reserve of the remnant liver in patients with hepatocellular carcinoma (HCC). METHODS: We reviewed the medical records of 199 patients who underwent resection of HCC. Hepatic clearance of the remnant liver was calculated using fusion images of 99mTc-labelled galactosyl-human serum albumin liver scintigraphy and computed tomography. Posthepatectomy liver failure (PHLF) was classified according to the International Study Group of Liver Surgery. Complications was classified according to Clavien-Dindo classification. We analyzed by the risk factors for PHLF, morbidity and mortality with multivariate analysis. RESULTS: Twenty-seven (30%) patients had major complications and 23 (12%) developed PHLF. The incidence of major complications increased with increasing albumin-bilirubin (ALBI) grade. The area under the curve values for hepatic clearance of the remnant liver, liver to heart-plus-liver radioactivity at 15 min (LHL15), and ALBI score predicting PHLF were 0.868, 0.629, and 0.655, respectively. The area under the curve for hepatic clearance of the remnant liver, LHL15, and ALBI score predicting major complications were 0.758, 0.594, and 0.647, respectively. The risk factors for PHLF and major complications were hepatic clearance of the remnant liver and intraoperative bleeding. CONCLUSION: The measurement of hepatic clearance may predict PHLF and major complications for patients undergoing resection of HCC.
  • 清水 敦, 倉科 憲太郎, 笹沼 英紀, 遠藤 俊輔, 大槻 マミ太郎, 村上 礼子, 春山 早苗, 渡井 恵, 大柴 幸子, 佐田 尚宏
    日本外科学会雑誌 123(1) 112-114 2022年1月  
  • 清水 敦, 倉科 憲太郎, 笹沼 英紀, 遠藤 俊輔, 大槻 マミ太郎, 村上 礼子, 春山 早苗, 渡井 恵, 大柴 幸子, 佐田 尚宏
    日本外科学会雑誌 123(1) 112-114 2022年1月  

MISC

 51