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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 600-602页

作者： Tomohide Hori daiki yasukawa Department of Surgery Shiga General HospitalMoriyama 524-8524Japan Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan

The incidence of pancreatic cancer(PC)has increased,and in-vasive ductal adenocarcinoma is the most common among PC pa-tients[1].Even in patients who receive radical treatments,namely chemotherapy and surgery,the five-year survival is only 2%-9%[1].Currently,many physicians recognize that further developments in multidisciplinary therapy are crucial to overcome PC[1].

关键词： cancer chemotherapy surgery

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

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World Journal of Gastrointestinal Surgery 2020年第7期12卷 307-325页

作者： daiki yasukawa Yuki Aisu Tomohide Hori Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan Department of Surgery Kyoto University Graduate School of MedicineKyoto 606-8507Japan

Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of "tension-free repair" is generally accepted, and surgical repairs with mesh are categorized as "hernioplasties". Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal(TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal(posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.

关键词： Inguinal hernia Femoral hernia Obturator hernia Laparoscopic surgery Laparoscope Anatomy

Laparoscopic and endoscopic cooperative surgery for gastric tumors: Perspective for actual practice and oncological benefits

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World Journal of Gastrointestinal Oncology 2018年第11期10卷 381-397页

作者： Yuki Aisu daiki yasukawa Yusuke Kimura Tomohide Hori Department of Digestive Surgery Tenri Hospital Department of Surgery Shiga University of Medical Science Department of Hepato-Biliary-Pancreatic Surgery and Transplantation Graduate School of Medicine Kyoto University Department of Surgery Shiga General Hospital

Laparoscopic and endoscopic cooperative surgery(LECS) is a surgical technique that combines laparoscopic partial gastrectomy and endoscopic submucosal dissection. LECS requires close collaboration between skilled laparoscopic surgeons and experienced endoscopists. For successful LECS, experience alone is not sufficient. Instead, familiarity with the characteristics of both laparoscopic surgery and endoscopic intervention is necessary to overcome various technical problems. LECS was developed mainly as a treatment for gastric submucosal tumors without epithelial lesions, including gastrointestinal stromal tumors(GISTs). Local gastric wall dissection without lymphadenectomy is adequate for the treatment of gastric GISTs. Compared with conventional simple wedge resection with a linear stapler, LECS can provide both optimal surgical margins and oncological benefit that result in functional preservation of the residual stomach. As technical characteristics, however, classic LECS involves intentional opening of the gastric wall, resulting in a risk of tumor dissemination with contamination by gastric juice. Therefore, several modified LECS techniques have been developed to av-oid even subtle tumor exposure. Furthermore, LECS for early gastric cancer has been attempted according tothe concept of sentinel lymph node dissection. LECS is a prospective treatment for GISTs and might become a future therapeutic option even for early gastric cancer. Interventional endoscopists and laparoscopic surgeons collaboratively explore curative resection. Simultaneous intraluminal approach with endoscopy allows surgeons to optimizes the resection area. LECS, not simple wedge resection, achieves minimally invasive treatment and allows for oncologically precise resection. We herein present detailed tips and pitfalls of LECS and discuss various technical considerations.

关键词： Minimally invasive surgery Laparoscopic and endoscopic cooperative surgery Facility-based Gastrointestinal stromal tumor Early gastric cancer

Laparoscopic approach for choledochojejunostomy

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 285-288页

作者： Tomohide Hori Yuki Aisu Michihiro Yamamoto daiki yasukawa Taku Iida Shintaro Yagi Kentaro Taniguchi Shinji Uemoto Department of Surgery Shiga General Hospital Moriyama 524-8524 Japan Department of Digestive Surgery Tenriyorodusoudanjyo Hospital Tenri 632-8552 Japan Department of Hepato-Biliary-Pancreatic and Surgery and Transplantation Kyoto University Hospital Kyoto 606-8507 Japan First Department of Surgery Mie University Hospital Tsu 514-8507 Japan

Laparoscopic hepatobiliary and pancreatic (HBP) surgery has been developed slowly because of technical challenges and a protracted learning curve with the exception of laparoscopic cholecystectomy [1]. Surgical treatments for benign diseases of the extrahepatic bile duct (EHBD) are classified according to their therapeutic purpose as lithotomy (i.e., choledocholithotomy) or diversion (i.e., choledochojejunostomy)[2].

关键词： HBP EHBD Laparoscopic

Fascinating history of groin hernias:Comprehensive recognition of anatomy,classic considerations for herniorrhaphy,and current controversies in hernioplasty

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World Journal of Methodology 2021年第4期11卷 160-186页

作者： Tomohide Hori daiki yasukawa Department of Surgery Shiga General HospitalMoriyama 524-8524ShigaJapan Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan

Groin hernias include indirect inguinal,direct inguinal,femoral,obturator,and supravesical hernias.Here,we summarize historical turning points,anatomical recognition and surgical repairs.Groin hernias have a fascinating history in the fields of anatomy and surgery.The concept of tension-free repair is generally accepted among clinicians.Surgical repair with mesh is categorized as hernioplasty,while classic repair without mesh is considered herniorrhaphy.Although various surgical approaches have been developed,the surgical technique should be carefully chosen for each patient.Regarding as interesting history,crucial anatomy and important surgeries in the field of groin hernia,we here summarized them in detail,respectively.Points of debate are also reviewed;important points are shown using illustrations and schemas.We hope this systematic review is surgical guide for general surgeons including residents.Both a skillful technique and anatomical knowledge are indispensable for successful hernia surgery in the groin.

关键词： Inguinal hernia Groin History Anatomy Hernioplasty Herniorrhaphy

Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy

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World Journal of Gastroenterology 2017年第32期23卷 5849-5859页

作者： tomohide hori takafumi machimoto yoshio kadokawa toshiyuki hata tatsuo ito shigeru kato daiki yasukawa yuki aisu yusuke kimura maho sasaki yuichi takamatsu taku kitano shigeo hisamori tsunehiro yoshimura department of gastrointestinal surgery tenriyorodusoudanjyo hospital

Acute appendicitis(AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy(LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Nonoperative management of AA may be tolerated only in children. Postoperative complications increase according to the patient's factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon's skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner(i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA.

关键词： Laparoscopic 阑尾切除术急性阑尾炎间隔阑尾切除术外科推迟的阑尾切除术

Impact of continuous local lavage on pancreatic juice-related postoperative complications: Three case reports

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World Journal of Clinical Cases 2019年第17期7卷 2526-2535页

作者： Tomohide Hori Kohei Ogawa Hidekazu Yamamoto Hideki Harada Kazuyoshi Matsumura Michihiro Yamamoto Masahiro Yamada Takefumi Yazawa Katsutoshi Kuriyama Masaki Tani daiki yasukawa Yasuyuki Kamada Yuki Aisu Ryotaro Tani Ryuhei Aoyama Shinnosuke Nakayama Yudai Sasaki Koki Nishimoto Masazumi Zaima Department of Surgery Shiga General HospitalMoriyama 524-8524Japan Department of Hepatobiliary Pancreatic and Breast Surgery Ehime UniversityToon 791-0295Japan Department of Gastroenterology and Hepatology Shiga General HospitalMoriyama 524- 8524Japan Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan Department of Surgery Kyoto University Graduate School of MedicineKyoto 606- 8507Japan

BACKGROUND Postoperative pancreatic leakage readily results in intractable pancreatic fistula and subsequent intraperitoneal abscess.This refractory complication can be fatal;therefore,intensive treatment is important.Continuous local lavage (CLL) has recently been reevaluated as effective treatment for severe infected pancreatitis,and we report three patients with postoperative intractable pancreatic fistula successfully treated by CLL.We also discuss our institutional protocol for CLL for postoperative pancreatic fistula.CASE SUMMARY The first patient underwent subtotal stomach-preserving pancreaticoduodenectomy,and pancreatic leakage was observed postoperatively.Intractable pancreatic fistula led to intraperitoneal abscess,and CLL near the pancreaticojejunostomy site was instituted from postoperative day (POD) 8.The abscess resolved after 7 d of CLL.The second patient underwent distal pancreatectomy.Pancreatic leakage was observed,and intractable pancreatic fistula led to intraperitoneal abscess near the pancreatic stump.CLL was instituted from POD 9,and the abscess resolved after 4 d of CLL.The third patient underwent aneurysmectomy and splenectomy with wide exposure of the pancreatic parenchyma.Endoscopic retrograde pancreatic drainage was performed on POD 15 to treat pancreatic fistula;however,intraperitoneal abscess was detected on POD 59.We performed CLL endoscopically via the transgastric route because the percutaneous approach was difficult.CLL was instituted from POD 63,and the abscess resolved after 1 wk of CLL.CONCLUSION CLL has therapeutic potential for postoperative pancreatic fistula.

关键词： Surgery Pancreas Pancreatic fistula Pancreatic juice Postoperative complications Case report

Protocol for laparoscopic cholecystectomy: Is it rocket science?

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World Journal of Gastroenterology 2016年第47期22卷 10287-10303页

作者： Tomohide Hori Fumitaka Oike Hiroaki Furuyama Takafumi Machimoto Yoshio Kadokawa Toshiyuki Hata Shigeru Kato daiki yasukawa Yuki Aisu Maho Sasaki Yusuke Kimura Yuichiro Takamatsu Masato Naito Masaya Nakauchi Takahiro Tanaka Daigo Gunji Kiyokuni Nakamura Kiyoko Sato Masahiro Mizuno Taku Iida Shintaro Yagi Shinji Uemoto Tsunehiro Yoshimura Department of Gastrointestinal and General Surgery Tenriyorodusoudanjyo Hospital Department of Gastrointestinal Surgery Mitsubishi Kyoto Hospital Department of Anesthesiology Mitsubishi Kyoto Hospital Department of Gastroenterology and Hepatology Mitsubishi Kyoto Hospital Department of Hepatobiliary Pancreatic Surgery Kyoto University Hospital

Laparoscopic cholecystectomy(LC) does not require advanced techniques, and its performance has therefore rapidly spread worldwide. However, the rate of biliary injuries has not decreased. The concept of the critical view of safety(CVS) was first documented two decades ago. Unexpected injuries are principally due to misidentification of human factors. The surgeon's assumption is a major cause of misidentification, and a high level of experience alone is not sufficient for successful LC. We herein describe tips and pitfalls of LC in detail and discuss various technical considerations.Finally, based on a review of important papers and our own experience, we summarize the following mandatory protocol for safe LC:(1) consideration that a high level of experience alone is not enough;(2) recognition of the plateau involving the common hepatic duct and hepatic hilum;(3) blunt dissection until CVS exposure;(4) Calot's triangle clearance in the overhead view;(5) Calot's triangle clearance in the view from underneath;(6) dissection of the posterior right side of Calot's triangle;(7) removal of the gallbladder body; and(8) positive CVS exposure. We believe that adherence to this protocol will ensure successful and beneficial LC worldwide, even in patients with inflammatory changes and rare anatomies.

关键词： Laparoscopic 胆囊炎胆囊安全的批评看法胆汁的损害协议

Diffusion and collective motion of rotlets in 2D space

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Chinese Physics B 2020年第6期29卷 37-43页

作者： daiki Matsunaga Takumi Chodo Takuma Kawai Graduate School of Engineering Science Osaka University5608531 OsakaJapan

We investigate the collective motion of rotlets that are placed in a single plane. Due to the hydrodynamic interactions,the particles move through the two-dimensional(2D) plane and we analyze these diffusive motions. By analyzing the scaling of the values, we predict that the diffusion coefficient scales with φ0.5, the average velocity with φ, and relaxation time of the velocity autocorrelation function with φ-1.5, where φ is the area fraction of the particles. In this paper, we find that the predicted scaling could be seen only when the initial particle position is homogeneous. The particle collective motions are different by starting the simulation from random initial positions, and the diffusion coefficient is the largest at a minimum volume fraction of our parameter range, φ = 0.05. The deviations based on two initial positions can be explained by the frequency of the collision events. The particles collide during their movements and the inter-particle distances gradually increase. When the area fraction is large, the particles will result in relatively homogeneous configurations regardless of the initial positions because of many collision events. When the area fraction is small(φ < 0.25), on the other hand, two initial positions would fall into different local solutions because the rare collision events would not modify the inter-particle distances drastically. By starting from the homogeneous initial positions, the particles show the maximum diffusion coefficient at φ≈ 0.20. The diffusion coefficient starts to decrease from this area fraction because the particles start to collide and hinder each other from a critical fraction ~23%. We believe our current work contributes to a basic understanding of the collective motion of rotating units.

关键词： rotlet diffusion Stokes flow

Hochschild cohomology ring modulo nilpotence of a one point extension of a quiver algebra defined by two cycles and a quantum-like relation

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Frontiers of Mathematics in China 2016年第4期11卷 1003-1015页

作者： daiki OBARA Department of Mathematics Tokyo University of Science Shinjuku-ku Tokyo Japan

我们认为一点延期代数学是在地 k 上的 q 由二个周期和在 k 取决于非零元素 q 的一种像量的关系定义的 quiver 代数学的 B。我们决定 B 模 nilpotence 的 Hochschild cohomology 戒指并且证明如果 q 是统一的一条根，那么， B 是到 Sn... 详细信息

我们认为一点延期代数学是在地 k 上的 q 由二个周期和在 k 取决于非零元素 q 的一种像量的关系定义的 quiver 代数学的 B。我们决定 B 模 nilpotence 的 Hochschild cohomology 戒指并且证明如果 q 是统一的一条根，那么， B 是到 Snashall-Solbergs 的一个反例推测。

关键词： Hochschild 代数关系上同调幂零性定义域量子周期环模