JaLCDOI 10.18926/AMO/57953
FullText URL 74_1_53.pdf
Author Kubota, Risa| Araki, Motoo| Wada, Koichiro| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Ariyoshi, Yuichi| Iwata, Takehiro| Nishimura, Shingo| Takamoto, Atsushi| Sako, Tomoko| Edamura, Kohei| Kobayashi, Yasuyuki| Kano, Yuzuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci® robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort® and irrigated on ice with Ringer’s solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery.
Keywords renal autotransplantation robotic porcine model transplantation
Amo Type Original Article
Published Date 2020-02
Publication Title Acta Medica Okayama
Volume volume74
Issue issue1
Publisher Okayama University Medical School
Start Page 53
End Page 58
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
JaLCDOI 10.18926/AMO/56871
FullText URL 73_3_269.pdf
Author Tsuboi, Ichiro| Araki, Motoo| Fujiwara, Hiroyasu| Iguchi, Toshihiro| Hiraki, Takao| Arichi, Naoko| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Sako, Tomoko| Takamoto, Atsushi| Wada, Koichiro| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Yanai, Hiroyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Shiina, Hiroaki| Kanazawa, Susumu| Nasu, Yasutomo|
Abstract Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.
Keywords cryoablation partial nephrectomy renal cell carcinoma renal allograft renal transplantation
Amo Type Case Report
Published Date 2019-06
Publication Title Acta Medica Okayama
Volume volume73
Issue issue3
Publisher Okayama University Medical School
Start Page 269
End Page 272
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31235976
JaLCDOI 10.18926/AMO/55445
FullText URL 71_5_449.pdf
Author Mitsui, Yosuke| Wada, Koichiro| Araki, Motoo| Yoshioka, Takashi| Ariyoshi, Yuichi| Nishimura, Shingo| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract We describe a 40-year-old living-donor renal-transplant recipient who underwent successful ureterolithotripsy. He had been on hemodialysis for >15 years pre-transplant and underwent ureteroureterostomy along with the surgery. One year post-transplant, ultrasound examination demonstrated hydronephrosis, and CT showed a 6-mm ureteral calculus at the ureteroureterostomy site. No pain and no elevated serum creatinine were present. As the ureter was easily accessed, we performed a ureterolithotripsy, which would confirm whether a suture caused the calculus. Despite ureteral tortuosity, laser stone fragmentation succeeded. The calculus was completely removed with an antegrade guidewire. Mild postoperative ureteral stenosis resolved with a temporary ureteral stent without balloon dilation. Ureterolithotripsy is effective even in renal transplant recipients with ureteroureterostomy.
Keywords lithotripsy recipient renal transplant ureteroscopy ureteral stone
Amo Type Case Report
Published Date 2017-10
Publication Title Acta Medica Okayama
Volume volume71
Issue issue5
Publisher Okayama University Medical School
Start Page 449
End Page 452
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29042705
JaLCDOI 10.18926/AMO/55313
FullText URL 71_4_351.pdf
Author Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Yoshioka, Takashi| Ariyoshi, Yuichi| Fujio, Kei| Takamoto, Atsushi| Sugimoto, Morito| Sasaki, Katsumi| Kobayashi, Yasuyuki| Ebara, Shin| Taninishi, Hideki| Amano, Hiroyuki| Inui, Masashi| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract A 38-year-old woman with a 2.7-cm left ureteral stenosis requiring chronic ureteral stent exchange elected to undergo robotic renal autotransplantation. Left ureteropelvic junction obstruction (UPJO) was also suspected. Robotic donor nephrectomy contributed to the fine dissection for desmoplastic changes. The kidney was removed through a Gelport and examined on ice. UPJO was not seen. An end-to-side robotic anastomosis was created between the renal and external iliac vessels. The console time was 507 min, and the warm ischemia time was 4 min 5 sec. She became stent-free. Robotic renal autotransplantation is a new, minimally invasive approach to renal preservation.
Keywords robotic surgery renal autotransplantation ureteral stenosis laparoscopic surgery renal transplantation
Amo Type Case Report
Published Date 2017-08
Publication Title Acta Medica Okayama
Volume volume71
Issue issue4
Publisher Okayama University Medical School
Start Page 351
End Page 355
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28824192
JaLCDOI 10.18926/AMO/55205
FullText URL 71_3_227.pdf
Author Sasaki, Katsumi| Wada, Koichiro| Araki, Motoo| Kobayashi, Yasuyuki| Sugimoto, Morito| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract  We elucidate the fate of cases clinically suspected of carcinoma in situ (Cis) of the upper tract with serial ureteroscopy. Of 143 patients who underwent ureteroscopy for suspected upper tract urothelial carcinoma (UTUC) between January 2008 and February 2016, 12 cases with consistently positive urine cytology and poorly detectable upper-tract malignancies by imaging were reviewed. In these 12 patients, 19 ureteroscopy procedures (25 renal units) were performed. Vesical random biopsy was performed before the 1st ureteroscopy to exclude malignancy of the bladder in all 12 cases. Median follow-up was 42 (13-67) months. Positive biopsy results at the 1st ureteroscopy were obtained in 3 (25%) patients and all were diagnosed wth Cis of the upper tract. Two (17%) of 9 patients who were negative or inconclusive at the 1st ureteroscopy were finally diagnosed as UTUC, but plural ureteroscopy procedures were needed for the diagnoses in both. Carcinoma of the bladder appeared in 5 (42%) patients during follow-up, despite the earlier ruling out of vesical malignancy. Four (33%) of those 5 patients never developed upper-tract urothelial carcinoma during follow-up. Caution is required before undertaking radical surgery for cases clinically suspected of Cis of the upper tract. In our experience, only 42% of such patients developed UTUC; another 33% eventually developed carcinoma of the bladder without UTUC.
Keywords carcinoma in situ carcinoma of the bladder upper tract urothelial carcinoma ureteroscopy urine cytology
Amo Type Original Article
Published Date 2017-06
Publication Title Acta Medica Okayama
Volume volume71
Issue issue3
Publisher Okayama University Medical School
Start Page 227
End Page 232
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28655942
JaLCDOI 10.18926/AMO/54989
FullText URL 71_2_187.pdf
Author Takamoto, Atsushi| Araki, Motoo| Wada, Koichiro| Sugimoto, Morito| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract We report the case of a 58-year-old Japanese man with bilateral synchronous renal cell carcinoma (RCC). The diameters of the right and left tumors were 56 and 69 mm, respectively. Both tumors were endophytic. Cryoablation with prophylactic embolization was performed for the left tumor, and 1 month later, a right open partial nephrectomy was performed. No recurrence was observed during a 16-month follow-up, and the serum creatinine level has been stable. The prognosis of bilateral synchronous RCC is better than that of dialysis patients. The novel approach of combining cryoablation and partial nephrectomy can achieve good cancer control and renal function in bilateral RCC.
Keywords cryoablation multiple renal masses nephron-sparing surgery renal cell carcinoma synchronous multiple primary
Amo Type Case Report
Published Date 2017-04
Publication Title Acta Medica Okayama
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 187
End Page 190
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28420902
JaLCDOI 10.18926/AMO/54508
FullText URL 70_4_299.pdf
Author Wada, Koichiro| Uehara, Shinya| Ishii, Ayano| Sadahira, Takuya| Yamamoto, Masumi| Mitsuhata, Ritsuko| Takamoto , Atsushi| Araki, Motoo| Kobayashi, Yasuyuki| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
Abstract Urinary tract infections (UTIs) are the most common bacterial infections in women, and many patients experience frequent recurrence. The aim of this report is to introduce an on-going prospective phase II clinical trial performed to evaluate the preventive effectiveness of Lactobacillus vaginal suppositories for prevention of recurrent cystitis. Patients enrolled in this study are administered vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus every 2 days or 3 times a week for one year. The primary endpoint is recurrence of cystitis and the secondary endpoints are adverse events. Recruitment began in December 2013 and target sample size is 20 participants.
Keywords probiotics lactobacilli Lactobacillus crispatus urinary tract infection vaginal suppository
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 299
End Page 302
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549677
Web of Science KeyUT 000384748600012
JaLCDOI 10.18926/AMO/54507
FullText URL 70_4_295.pdf
Author Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Kubota, Risa| Yoshioka, Takashi| Ariyoshi, Yuichi| Kobayashi, Yasuyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hiroshi| Wada, Jun| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
Abstract Although graft survival following renal transplantation (RTx) has improved, outcomes following highrisk RTx are variable. Preexisting antibodies, including donor-specific antibodies (DSA), play an important role in graft dysfunction and survival. We have designed a study to investigate the safety and efficacy of anti-CD20 monoclonal antibodies (rituximab) in high-risk RTx recipients. Major eligibility criteria include: 1) major and minor ABO blood group mismatch, 2) positive DSA. Thirty-five patients will receive 200 mg/body of rituximab. The primary endpoint is the incidence of B cell depletion. This study will clarify whether rituximab is efficacious in improving graft survival in high-risk RTx recipients.
Keywords end-stage renal disease immunosuppression kidney transplantation
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 295
End Page 297
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549676
Web of Science KeyUT 000384748600011
JaLCDOI 10.18926/AMO/54423
FullText URL 70_3_223.pdf
Author Ebara, Shin| Kobayashi, Yasuyuki| Sasaki, Katsumi| Araki, Motoo| Sugimoto, Morito| Wada, Koichirou| Fujio, Kei| Takamoto, Atsushi| Watanabe, Toyohiko| Yanai, Hiroyuki| Nasu, Yasutomo|
Abstract The present case report describes a case of recurrent and advanced urachal carcinoma including neuroendocrine features with iliac bone metastasis after partial cystectomy and adjuvant chemotherapy consisting of irinotecan and cisplatin in a 32-year-old man. He received gemcitabine/cisplatin/ paclitaxel (GCP) combination chemotherapy, consisting of gemcitabin (1,000mg/m2) on day 1, 8, cisplatin (70mg/m2) on day 1, and paclitaxel (80mg/m2) on day 1 and 8. After three cycles of chemotherapy, PET-CT showed complete regression of the disease. So the patient underwent total cystourethrectomy, and histological examination showed an almost complete pathological response. External beam radiation therapy was also given to the ileac bone metastasis regions. However, PET-CT taken 17 months after the external beam radiation showed multiple lung metastases. He received GCP chemotherapy again, which resulted in a complete response again after three cycles of chemotherapy. This is the first report on GCP chemotherapy used not only as a salvage chemotherapy but also as a rechallenge regimen for metastatic urachal cancer including a neuroendocrine component.
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 223
End Page 227
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339213
Web of Science KeyUT 000379406100011
JaLCDOI 10.18926/AMO/54414
FullText URL 70_3_159.pdf
Author Yoshioka, Takashi| Otsuki, Hideo| Uehara, Shinya| Shimizu, Toshihiro| Murao, Wataru| Fujio, Koji| Fujio, Kei| Wada, Koichiro| Araki, Motoo| Nasu, Yasutomo|
Abstract Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the ʻ<65 groupʼ (<65 years old, n=108), the ʻ65-74 groupʼ (65-74 years old, n=42), and the ʻ 75 groupʼ ( 75 years old, n=39). The patientsʼ characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the<65 group. Compared to the<65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the<65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.
Keywords upper urinary tract calculi ureteroscopy (URS) holmium laser lithotripsy elderly patients stone-free rate (SFR)
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 159
End Page 166
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339204
Web of Science KeyUT 000379406100002
Author Kurahashi, Hiroaki| Watanabe, Masami| Sugimoto, Morito| Ariyoshi, Yuichi| Mahmood, Sabina| Araki, Motoo| Ishii, Kazushi| Nasu, Yasutomo| Nagai, Atsushi| Kumon, Hiromi|
Published Date 2013-12
Publication Title Endocrine Journal
Volume volume60
Issue issue12
Content Type Journal Article
JaLCDOI 10.18926/AMO/52144
FullText URL 68_1_47.pdf
Author Ishikawa, Tsutomu| Araki, Motoo| Hirata, Takeshi| Watanabe, Masami| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo| Kumon, Hiromi|
Abstract We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool.
Keywords complication indwelling urethral catheter imaging computed tomography ureter
Amo Type Case Report
Published Date 2014-02
Publication Title Acta Medica Okayama
Volume volume68
Issue issue1
Publisher Okayama University Medical School
Start Page 47
End Page 51
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24553489
Web of Science KeyUT 000331592800008
JaLCDOI 10.18926/AMO/51069
FullText URL 67_4_245.pdf
Author Araki, Tohru| Monden, Koichi| Araki, Motoo|
Abstract A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 α1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS.
Keywords alpha-1 blockers alpha1-adrenoceptor antagonists lower urinary tract symptoms benign prostatic hyperplasia crossover study
Amo Type Original Article
Published Date 2013-08
Publication Title Acta Medica Okayama
Volume volume67
Issue issue4
Publisher Okayama University Medical School
Start Page 245
End Page 251
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23970323
Web of Science KeyUT 000323470100006