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| 1 | Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma显示文摘AIM:To determine the efficacy of external beam radiotherapy(EBRT),with or without intraluminal brachytherapy(ILBT),in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS:We analyzed 64 patients with locally advanced hilar cholangiocarcinoma,including 25 who underwent resection(17 curative and 8 non-curative),28 treated with radiotherapy,and 11 who received best supportive care(BSC).The radiotherapy group received EBRT(50 Gy,30 fractions),with 11 receiving an additional 24 Gy(4 fractions) ILBT by iridium-192 with remote after loading.ILBT was performed using percutaneous transhepatic biliary drainage(PTBD) route.Uncovered metallic stents(UMS) were inserted into nonresected patients with obstructive jaundice,with the exception of four patients who received percutaneous transhepatic biliary drainage only.UMS were placed endoscopically or percutaneously,depending on the initial drainage procedure.The primary endpoints were patient death or stent occlusion.Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups.Stent patency was compared in the radiotherapy and BSC groups.RESULTS:No statistically significant differences in patient characteristics were found among the resection,radiotherapy,and BSC groups.Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone;cholangitis occurred after endoscopic stenting,and patients were treated with PTBD.A total of 16 patients were administered additional systemic chemotherapy(5-fluorouracil-based regimen in 9,S-1 in 6,and gemcitabine in 1).Overall survival varied significantly among groups,with median survival times of 48.7 mo in the surgery group,22.1 mo in the radiotherapy group,and 5.7 mo in the BSC group.Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery(P = 0.0076).Cumulative survival in the radiotherapy group was significantly longer than in the BSC group(P = 0.0031),but did not differ significantly from those in the non-resection group.Furthermore,the median survival time of patients in the radiotherapy group who were considered for possible resection(excluding the seven patients who were not candidates for surgery due to comorbid disease or age) was 25.9 mo.Stent patency was evaluated only in the 24 patients who received a metallic stent.Stent patency was significantly longer in the radiotherapy than in the BSC group(P = 0.0165).Biliary drainage was not eliminated in any patient.To determine the efficacy of ILBT,we compared survival time and stent patency in the EBRT alone and EBRT plus ILBT groups.However,we found no significant difference in survival time between groups or for stent patencies.Hemorrhagic gastroduodenal ulcers were observed in 5 patients(17.9%),three in the EBRT plus ILBT group and two in the EBRT alone group.Ulcers occurred 5 mo,7 mo,8 mo,16 mo,and 29 mo following radiotherapy.All patients required hospitalization,but blood transfusions were unnecessary.All 5 patients recovered following the administration of anti-ulcer medication.CONCLUSION:Radiotherapy improved patient prognosis and the patency of uncovered metallic stents in patients with locally advanced hilar cholangiocarcinoma,but ILBT provided no additional benefits. | Hiroyuki Isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki Keiichi Nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike | 2012 | World Journal of Gastroenterology2012，18，19： | 24 |
| 2 | Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection显示文摘AIM: To determine the effective hospitalization period as the clinical pathway to prepare patients for endoscopic submucosal dissection (ESD). METHODS: This is a retrospective observational study which included 189 patients consecutively treated by ESD at the National Cancer Center Hospital from May 2007 to March 2009. Patients were divided into 2 groups; patients in group A were discharged in 5 d and patients in group B included those who stayed longer than 5 d. The following data were collected for both groups: mean hospitalization period, tumor site, median tumor size, post-ESD rectal bleeding requiring urgent endoscopy, perforation during or after ESD, abdominal pain, fever above 38 ℃, and blood test results positive for inflammatory markers before and after ESD. Each parameter was compared after data collection. RESULTS: A total of 83% (156/189) of all patients could be discharged from the hospital on day 3 postESD. Complications were observed in 12.1% (23/189) of patients. Perforation occurred in 3.7% (7/189) of patients. All the perforations occurred during the ESD procedure and they were managed with endoscopic clipping. The incidence of post-operative bleeding was 2.6% (5/189); all the cases involved rectal bleeding. We divided the subjects into 2 groups: tumor diameter ≥ 4 cm and < 4 cm; there was no significant difference between the 2 groups (P = 0.93, χ 2 test with Yates correction). The incidence of abdominal pain was 3.7% (7/189). All the cases occurred on the day of the procedure or the next day. The median white blood cell count was 6800 ± 2280 (cells/μL; ± SD) for group A, and 7700 ± 2775 (cells/μL; ± SD) for group B, showing a statistically significant difference (P = 0.023, t-test). The mean C-reactive protein values the day after ESD were 0.4 ± 1.3 mg/dL and 0.5 ± 1.3 mg/dL for groups A and B, respectively, with no significant difference between the 2 groups (P = 0.54, t -test). CONCLUSION: One-day admission is sufficient in the absence of complications during ESD or early postoperative bleeding. | Takaya Aoki Takeshi Nakajima Yutaka Saito Takahisa Matsuda Taku Sakamoto Takao Itoi Yassir Khiyar Fuminori Moriyasu | 2012 | World Journal of Gastroenterology2012，18，28： | 22 |
| 3 | Preoperative portal vein embolization for hepatocellular carcinoma: consensus and controversy显示文摘Thirty years have passed since the first report of portal vein embolization(PVE),and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant(FLR).PVE has been shown to be useful in patients with hepatocellular carcinoma(HCC)and chronic liver disease.However,special caution is needed when PVE is applied prior to subsequent major hepatic resection in cases with cirrhotic livers,and volumetric analysis of the liver segments in addition to evaluation of the liver functional reserve before PVE is mandatory in such cases.Advances in the embolic material and selection of the treatment approach,and combined use of PVE and transcatheter arterial embolization/chemoembolization have yielded improved outcomes after PVE and major hepatic resections.A novel procedure termed the associating liver partition and portal vein ligation for staged hepatectomy has been gaining attention because of the rapid hypertrophy of the FLR observed in patients undergoing this procedure,however,application of this technique in HCC patients requires special caution,as it has been shown to be associated with a high morbidity and mortality even in cases with essentially healthy livers. | Taku Aoki Keiichi Kubota | 2016 | World Journal of Hepatology2016，8，9： | 19 |
| 4 | Advanced diffusion magnetic resonance imaging in patients with Alzheimer’s and Parkinson’s diseases显示文摘The prevalence of neurodegenerative diseases is increasing as human longevity increases. The objective biomarkers that enable the staging and early diagnosis of neurodegenerative diseases are eagerly anticipated. It has recently become possible to determine pathological changes in the brain without autopsy with the advancement of diffusion magnetic resonance imaging techniques. Diffusion magnetic resonance imaging is a robust tool used to evaluate brain microstructural complexity and integrity, axonal order, density, and myelination via the micron-scale displacement of water molecules diffusing in tissues. Diffusion tensor imaging, a type of diffusion magnetic resonance imaging technique is widely utilized in clinical and research settings;however, it has several limitations. To overcome these limitations, cutting-edge diffusion magnetic resonance imaging techniques, such as diffusional kurtosis imaging, neurite orientation dispersion and density imaging, and free water imaging, have been recently proposed and applied to evaluate the pathology of neurodegenerative diseases. This review focused on the main applications, findings, and future directions of advanced diffusion magnetic resonance imaging techniques in patients with Alzheimer's and Parkinson's diseases, the first and second most common neurodegenerative diseases, respectively. | Koji Kamagata Christina Andica Taku Hatano Takashi Ogawa Haruka Takeshige-Amano Kotaro Ogaki Toshiaki Akashi Akifumi Hagiwara Shohei Fujita Shigeki Aoki | 2020 | Neural Regeneration Research2020，15，9： | 11 |
| 5 | 胆道肿瘤临床实践指南(英文第三版)显示文摘日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。 | Masato Nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi Kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) | 2021 | 中华消化外科杂志2021，20，4： | 7 |
| 6 | Neither Multiple Tumors Nor Portal Hypertension Are Surgical Contraindications for Hepatocellular Carcinoma显示文摘 | Takeaki Ishizawa Kiyoshi Hasegawa Taku Aoki Michiro Takahashi Yosuke Inoue Keiji Sano Hiroshi Imamura Yasuhiko Sugawara Norihiro Kokudo Masatoshi Makuuchi | 2008 | Gastroenterology2008，，7： | 7 |
| 7 | Prognostic Impact of Anatomic Resection for Hepatocellular Carcinoma显示文摘 | Kiyoshi Hasegawa Norihiro Kokudo Hiroshi Imamura Yutaka Matsuyama Taku Aoki Masami Minagawa Keiji Sano Yasuhiko Sugawara Tadatoshi Takayama Masatoshi Makuuchi | 2005 | Annals of Surgery2005，，2： | 6 |
| 8 | AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC显示文摘 | Kentaroh Yamamoto Hiroshi Imamura Yutaka Matsuyama Yukio Kume Hitoshi Ikeda Gary L. Norman Zakera Shums Taku Aoki Kiyoshi Hasegawa Yoshifumi Beck Yasuhiko Sugawara Norihiro Kokudo | 2010 | Journal of Gastroenterology2010，，12： | 6 |
| 9 | Virtual liver resection: computer-assisted operation planning using a three-dimensional liver representation显示文摘 | Yoshihiro Mise Keigo Tani Taku Aoki Yoshihiro Sakamoto Kiyoshi Hasegawa Yasuhiko Sugawara Norihiro Kokudo | 2013 | Journal of Hepato-Biliary-Pancreatic Sciences2013，，2： | 4 |
| 10 | Risk factors of post‐operative recurrence and adequate surgical approach to improve long‐term outcomes of hepatocellular carcinoma显示文摘 | Junichi Shindoh Kiyoshi Hasegawa Yosuke Inoue Takeaki Ishizawa Rihito Nagata Taku Aoki Yoshihiro Sakamoto Yasuhiko Sugawara Masatoshi Makuuchi Norihiro Kokudo | 2012 | HPB2012，，1： | 2 |
| 11 | Perioperative chemotherapy and liver resection for hepatic metastases of colorectal cancer显示文摘 | Kiyoshi Hasegawa Michiro Takahashi Masaru Ohba Junichi Kaneko Taku Aoki Yoshihiro Sakamoto Yasuhiko Sugawara Norihiro Kokudo | 2012 | Journal of Hepato-Biliary-Pancreatic Sciences2012，，5： | 2 |
| 12 | Evaluation methods for pretransplant oncologic markers and their prognostic impacts in patient undergoing living donor liver transplantation for hepatocellular carcinoma显示文摘 | Junichi Shindoh Yasuhiko Sugawara Rihito Nagata Junichi Kaneko Sumihito Tamura Taku Aoki Yoshihiro Sakamoto Kiyoshi Hasegawa Tomohiro Tanaka Norihiro Kokudo | 2014 | Transpl Int2014，，4： | 1 |
| 13 | AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC显示文摘 | Kentaroh Yamamoto Hiroshi Imamura Yutaka Matsuyama Yukio Kume Hitoshi Ikeda Gary L. Norman Zakera Shums Taku Aoki Kiyoshi Hasegawa Yoshifumi Beck Yasuhiko Sugawara Norihiro Kokudo | 2010 | Journal of Gastroenterology2010，，12： | 1 |
| 14 | Surgical technique: new advances for expanding indications and increasing safety in liver resection for HCC显示文摘 | Takeaki Ishizawa Yoshihiro Mise Taku Aoki Kiyoshi Hasegawa Yoshifumi Beck Yasuhiko Sugawara Norihiro Kokudo | 2010 | Journal of Hepato - Biliary - Pancreatic Sciences2010，，4： | 1 |
| 15 | Is there any difference in survival according to the portal tumor thrombectomy method in patients with hepatocellular carcinoma?显示文摘 | Yosuke Inoue Kiyoshi Hasegawa Takeaki Ishizawa Taku Aoki Keiji Sano Yoshifumi Beck Hiroshi Imamura Yasuhiko Sugawara Norihiro Kokudo Masatoshi Makuuchi | 2009 | Surgery2009，，1： | 1 |
| 16 | AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC显示文摘 | Kentaroh Yamamoto Hiroshi Imamura Yutaka Matsuyama Yukio Kume Hitoshi Ikeda Gary L. Norman Zakera Shums Taku Aoki Kiyoshi Hasegawa Yoshifumi Beck Yasuhiko Sugawara Norihiro Kokudo | 2010 | Journal of Gastroenterology2010，，12： | 1 |
| 17 | Neither Multiple Tumors Nor Portal Hypertension Are Surgical Contraindications for Hepatocellular Carcinoma显示文摘 | Takeaki Ishizawa Kiyoshi Hasegawa Taku Aoki Michiro Takahashi Yosuke Inoue Keiji Sano Hiroshi Imamura Yasuhiko Sugawara Norihiro Kokudo Masatoshi Makuuchi | 2008 | Gastroenterology2008，，7： | 1 |
| 18 | Intra-operative freehand real-time elastography for small focal liver lesions: “Visual palpation” for non-palpable tumors显示文摘 | Yosuke Inoue Michiro Takahashi Junichi Arita Taku Aoki Kiyoshi Hasegawa Yoshifumi Beck Masatoshi Makuuchi Norihiro Kokudo | 2010 | Surgery2010，，5： | 1 |
| 19 | Double-balloon enteroscope-assisted enteral stent placement for malignant afferent-loop obstruction after Roux-en-Y reconstruction显示文摘 | Takashi Sasaki Hiroyuki Isayama Hirofumi Kogure Atsuo Yamada Taku Aoki Norihiro Kokudo Kazuhiko Koike | 2014 | Endoscopy2014，，： | 1 |
| 20 | New closure technique for large mucosal defects after endoscopic submucosal dissection of colorectal tumors (with video)显示文摘 | Yosuke Otake Yutaka Saito Taku Sakamoto Takaya Aoki Takeshi Nakajima Naoya Toyoshima Takahisa Matsuda Hiroyuki Ono | 2012 | Gastrointestinal Endoscopy2012，，3： | 1 |
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