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| 1 | Diagnosis and management of insulinoma显示文摘Insulinomas,the most common cause of hypoglycemia related to endogenous hyperinsulinism,occur in 1-4 people per million of the general population.Common autonomic symptoms of insulinoma include diaphroresis,tremor,and palpitations,whereas neuroglycopenenic symptoms include confusion,behavioural changes,personality changes,visual disturbances,seizure,and coma.Diagnosis of suspected cases is based on standard endocrine tests,especially the prolonged fasting test.Non-invasive imaging procedures,such as computed tomography and magnetic resonance imaging,are used when a diagnosis of insulinoma has been made to localize the source of pathological insulin secretion.Invasive modalities,such as endoscopic ultrasonography and arterial stimulation venous sampling,are highly accurate in the preoperative localization of insulinomas and have frequently been shown to be superior to noninvasive localization techniques.The range of techniques available for the localization of insulinomas means thatblind resection can be avoided.Intraoperative manual palpation of the pancreas by an experienced surgeon and intraoperative ultrasonography are both sensitive methods with which to finalize the location of insulinomas.A high proportion of patients with insulinomas can be cured with surgery.In patients with malignant insulinomas,an aggressive medical approach,including extended pancreatic resection,liver resection,liver transplantation,chemoembolization,or radiofrequency ablation,is recommended to improve both survival and quality of life.In patients with unresectable or uncontrollable insulinomas,such as malignant insulinoma of the pancreas,several techniques should be considered,including administration of ocreotide and/or continuous glucose monitoring,to prevent hypoglycemic episodes and to improve quality of life. | Takehiro Okabayashi Yasuo Shima Tatsuaki Sumiyoshi Akihito Kozuki Satoshi Ito Yasuhiro Ogawa Michiya Kobayashi Kazuhiro Hanazaki | 2013 | World Journal of Gastroenterology2013，19，6： | 78 |
| 2 | Relationship between perioperative glycemic control and postoperative infections显示文摘Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis, and depressed bactericidal capacity. These leukocyte deficiencies are the cause ofinfection and improve with tight glycemic control, which leads to fewer POIs in critically ill surgical patients. Tight glycemic control, such as intensive insulin therapy, has a risk of hypoglycemia. In addition, the optimal targeted blood glucose range to reduce POI remains unknown. Since 2006, we have investigated tight perioperative blood glucose control using a closed-loop artificial endocrine pancreas system, to reduce POI and to avoid hypoglycemia. In this Topic Highlight, we review the relationship between perioperative glycemic control and POI, including the use of the artificial pancreas. | Kazuhiro Hanazaki Hiromichi Maeda Takehiro Okabayashi | 2009 | World Journal of Gastroenterology2009，15，33： | 13 |
| 3 | Surgical outcome of adenosquamous carcinoma of the pancreas显示文摘Adenosquamous carcinoma is rare,accounting for 3%-4% of all pancreatic carcinoma cases. These tumors are characterized by the presence of variable proportions of mucin-producing glandular elements and squamous components,the latter of which should account for at least 30% of the tumor tissue. Recently,several reports have described cases of adenosquamous carcinoma of the pancreas. However,as the number of patients who undergo resection at a single institute is limited,large studies describing the clinicopathological features,therapeutic management,and surgical outcome for adenosquamous carcinoma of the pancreas are lacking. We performed a literature review of English articles retrieved from Medline using the keywords 'pancreas' and 'adenosquamous carcinoma'. Additional articles were obtained from references within the papers identif ied by the Medline search. Our subsequent review of the literature revealed that optimal adjuvant chemotherapy and/or radiotherapy regimens for adenosquamous carcinoma of the pancreas have not been established,and that curative surgical resection offers the only chance for long-term survival. Unfortunately,the prognosis of the 39 patients who underwent pancreatic resection for adenosquamous carcinoma was very poor,with a 3-year overall survival rate of 14.0% and a median survival time of 6.8 mo. Since the postoperative prognosis of adenosquamous carcinoma of the pancreas is currently worse than that of pancreatic adenocarcinoma,new adjuvant chemotherapies and/or radiation techniques should be investigated as they may prove indispensible to the improvement of surgical outcomes. | Takehiro Okabayashi Kazuhiro Hanazaki | 2008 | World Journal of Gastroenterology2008，14，44： | 9 |
| 4 | Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing pancreatectomy显示文摘Perioperative glycemic control is important for reducing postoperative infectious complications. However, clinical trials have shown that efforts to maintain normoglycemia in intensive care unit patients result in deviation of glucose levels from the optimal range, and frequent attacks of hypoglycemia. Tight glycemic control is even more challenging in those undergoing pancreatic resection. Removal of lesions and surrounding normal pancreatic tissue often cause hormone deficiencies that lead to the destruction of glucose homeostasis, which is termed pancreatogenic diabetes. Pancreatogenic diabetes is characterized by the occurrence of hyperglycemia and iatrogenic severe hypoglycemia, which adversely effects patient recovery. Postoperatively, a variety of factors including surgical stress, inflammatory cytokines, sympathomimetic drug therapy, and aggressive nutritional support can also affect glycemic control. This review discusses the endocrine aspects of pancreatic resection and highlights postoperative glycemic control using a closed-loop system or artificial pancreas. In previous experiments, we have demonstrated the reliability of the artificial pancreas in dogs with total pancreatectomy, and its postoperative clinical use has been shown to be effectiveand safe, without the occurrence of hypoglycemic episodes, even in patients after total pancreatectomy. Considering the increasing requirement for tight perioperative glycemic control and the recognized risk of hypoglycemia, we propose the use of an artificial endocrine pancreas that is able to monitor continuously blood glucose concentrations with proven accuracy, and administer automatically substances to return blood glucose concentration to the optimal narrow range. | Hiromichi Maeda Takehiro Okabayashi Tomoaki Yatabe Koichi Yamashita Kazuhiro Hanazaki | 2009 | World Journal of Gastroenterology2009，15，33： | 9 |
| 5 | Surgical outcome of carcinosarcoma of the gall bladder:A review显示文摘Carcinosarcoma,which comprises less than one percent of all gall bladder neoplasms,is characterized by the presence of variable proportions of carcinomatous and sarcomatous elements.Recently,several reports have described patients suffering from carcinosarcoma of the gall bladder.However,there are no large studies regarding the clinicopathologic features,therapeutic management,and surgical outcome of this disease because the number of patients who undergo resection of gall bladder carcinosarcoma at a single institution is limited.A Medline search was performed using the keywords 'gall bladder' and 'carcinosarcoma'.Additional articles were obtained from references within the papers identified by the Medline search.Optimal adjuvant chemotherapy and/or radiotherapy protocols for carcinosarcoma of the gall bladder have not been established.Curative surgical resection offers the only chance for long-term survival from this disease.The outcome of 36 patients who underwent surgical resection for carcinosarcoma of the gall bladder was poor;the 3-year overall survival rate was only 31.0% and the median survival time was 7.0 mo.Since the postoperative prognosis of carcinosarcoma of the gall bladder is worse than that of adenocarcinoma,new adjuvant chemotherapies and/or radiation techniques are essential for improvement of surgical outcome. | Takehiro Okabayashi Zhao-Li Sun Robert A Montgomery Kazuhiro Hanazaki | 2009 | World Journal of Gastroenterology2009，15，39： | 9 |
| 6 | Laparoscopic endoscopic cooperative surgery as a minimally invasive treatment for gastric submucosal tumor显示文摘Laparoscopic wedge resection is a useful procedure fortreating patients with submucosal tumor(SMT) including gastrointestinal stromal tumor(GIST) of the stomach. However, resection of intragastric-type SMTs can be problematic due to the difficulty in accurately judging the location of endoluminal tumor growth, and often excessive amounts of healthy mucosa are removed; thus, full-thickness local excision using laparoscopic and endoscopic cooperative surgery(LECS) is a promising procedure for these cases. Our experience with LECS has confirmed this procedure to be a safe, feasible, and minimally invasive treatment method for gastric GISTs less than 5 cm in diameter, with outcomes similar to conventional laparoscopic wedge resection. The important advantage of LECS is the reduction in the resected area of the gastric wall compared to that in conventional laparoscopic wedge resection using a linear stapler. Early gastric cancer fits the criteria for endoscopic resection; however, if performing endoscopic submucosal dissection is difficult, the LECS procedure might be a good alternative. In the future, LECS is also likely to be indicated for duodenal tumors, as well as gastric tumors. Furthermore, developments in endoscopic and laparoscopic technology have generated various modified LECS techniques, leading to even less invasive surgery. | Tsutomu Namikawa Kazuhiro Hanazaki | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，14： | 7 |
| 7 | Clinical applications of 5-aminolevulinic acid-mediated fluorescence for gastric cancer显示文摘5-aminolevulinic acid(ALA) is a naturally occurring amino acid that is a protoporphyrin IX(Pp IX) precursor and a next-generation photosensitive substance. After exogenous administration of ALA, Pp IX specifically accumulates in cancer cells owing to the impaired metabolism of ALA to Pp IX in mitochondria, which results in a red fluorescence following irradiation with blue light and the formation of singlet oxygen. Fluorescence navigation by photodynamic diagnosis(PDD) using ALA provides good visualization and detection of gastric cancer lesions and is a potentially valuable diagnostic tool for gastric cancer for evaluating both the surgical resection margins and extension of the lesion. Furthermore, PDD using ALA might be used to detect peritoneal metastases during preoperative staging laparoscopy, where it could provide useful information for the selection of a therapeutic approach. Another promising application for this modality is in the evaluation of lymph node metastases. Photodynamic therapy(PDT) using ALA to cause selective damage based on the accumulation of a photosensitizer in malignant tissue is expected to be a non-invasive endoscopic treatment for superficial early gastric cancer. ALA has the potential to be used not only as a diagnostic agent but also as a therapeutic drug, resulting in a new strategy for cancer diagnosis and therapy. Here, we review the current use of PDD and PDT in gastric cancer and evaluate its future potential beyond conventional modalities combined with a light energy upconverter, a light-emitting diode and nearinfrared rays as light sources. | Tsutomu Namikawa Tomoaki Yatabe Keiji Inoue Taro Shuin Kazuhiro Hanazaki | 2015 | World Journal of Gastroenterology2015，21，29： | 6 |
| 8 | Clinicopathological features of early gastric cancer with duodenal invasion显示文摘The incidence of early gastric cancer(EGC) with duodenal invasion is extremely low,although advanced gastric cancer that arises in the antrum occasionally invades the duodenum.We investigated the clinicopathological features of EGC with duodenal invasion and provided strategies for clinical management.A Medline search was performed using the keyword 'early gastric cancer' and 'duodenal invasion'.Additional articles were obtained from references within the papers identif ied by the Medline search.We revealed that EGC with duodenal invasion was of the superf icial spreading type of tumor.Tumors > 60 mm in size invaded the duodenum more extensively,and the distance of duodenal invasion from the pyloric ring was further in the elevated type than in the depressed type of tumor.There was no signif icant difference between the length of duodenal invasion and the histological type of the tumor.Gastric cancer located adjacent to the pyloric ring,even if cancer invasion was conf ined to the mucosa or submucosa,was more likely to invade the duodenum.The present study reveals that the elevated type of EGC is associated with more extensive duodenal invasion when the tumor size is > 60 mm,thus highlighting the importance of identif ication of duodenal invasion in these cases.We also reveal that suff icient duodenal resection with a cancer-free distal surgical margin should be performed in cases of duodenal invasion. | Tsutomu Namikawa Kazuhiro Hanazaki | 2009 | World Journal of Gastroenterology2009，15，19： | 4 |
| 9 | Laparoscopic splenectomy for splenic hamartoma:Case management and clinical consequences显示文摘Splenic hamartoma is a rare benign tumor,and although minimally invasive surgery may be suitable for this condition,there have only been 2 previous reports of laparoscopic surgery.Here we report the third case of splenic hamartoma managed by laparoscopic splenectomy.A 37-year-old male was incidentally diagnosed by abdominal ultrasonography with a hypoechoic mass measuring 2.5 cm × 2.4 cm in the spleen.Color Doppler sonography showed multiple flow signals within the mass and contrast-enhanced computed tomography revealed strong enhancement of the lesion.On T1-and T2-weighted magnetic resonance images,the splenic mass was demonstrated as isointense and hyperintense respectively.Although a malignant tumor could not be ruled out,a hand-assisted laparoscopic splenectomy was performed because the splenic mass was limited in size and had not invaded adjacent organs.The pathological diagnosis was splenic hamartoma.The postoperative course was uneventful and the patient was discharged by the seventh postoperative day.Although splenic hamartomas have some specific imaging features,more reports and analyses of these cases are required to increase the reliability of the diagnosis and management.Hand-assisted laparoscopic splenectomy may play a pivotal role in the postoperative diagnosis and management of this condition. | Tsutomu Namikawa Hiroyuki Kitagawa Jun Iwabu Michiya Kobayashi Manabu Matsumoto Kazuhiro Hanazaki | 2010 | World Journal of Gastrointestinal Surgery2010，2，4： | 4 |
| 10 | Cetuximab and panitumumab in a patient with colon cancer and concomitant chronic skin disease:A potential beneficial effect on psoriasis vulgaris显示文摘Monoclonal antibodies against epidermal growth factor receptor(EGFR) are used in the treatment of advanced colorectal cancer. However, these agents can induce severe dermatological side effects that discourage their administration in patients with chronic dermatological disease. EGFR plays a key role in normal skin development and immunological function, and is expressed in various tissues and organs, although contrarily, it is overexpressed in psoriasis-related skin lesions. Thus, discussion is ongoing regarding the putative pathological role and therapeutic potential of this protein. We herein report on a patient with advanced colon cancer and concomitant long-standing psoriasis vulgaris who received antiEGFR antibody monotherapy as a third-line treatment for metastatic disease. One week after the initiation of treatment, the patient's skin lesions dramatically subsided and the improvement was sustained during therapy. Based on this case, we propose that anti-EGFR antibody therapy is not necessarily contraindicated in patients with psoriasis vulgaris. Moreover, the findings reaffirmed that EGFR is an important molecule in the pathology of psoriasis. | Ken Okamoto Hiromichi Maeda Takeo Shiga Mai Shiga Ken Dabanaka Kazuhiro Hanazaki Michiya Kobayashi | 2015 | World Journal of Gastroenterology2015，21，12： | 4 |
| 11 | Clinical analysis of primary anaplastic carcinoma of the small intestine显示文摘Primary anaplastic carcinoma is a rare variant of small intestinal cancer. Most reports of primary anaplastic carcinoma of the small intestine are isolated case reports, therefore the clinicopathological features, therapeutic management, and surgical outcome of this tumor type remain unclear. This review analyzes the available clinical characteristics of primary anaplastic carcinoma of the small intestine and investigates key differences from differentiated adenocarcinoma of the small intestine. A Medline search was performed using | Tsutomu Namikawa Kazuhiro Hanazaki | 2009 | World Journal of Gastroenterology2009，15，5： | 3 |
| 12 | Oral supplementation of branched-chain amino acids reduces early recurrence after hepatic resection in patients with hepatocellular carcinoma: a prospective study显示文摘 | Kengo Ichikawa Takehiro Okabayashi Hiromichi Maeda Tsutomu Namikawa Tatsuo Iiyama Takeki Sugimoto Michiya Kobayashi Toshiki Mimura Kazuhiro Hanazaki | 2013 | Surgery Today2013，，7： | 2 |
| 13 | Mucin phenotype of gastric cancer and clinicopathology of gastric-type differentiated adenocarcinoma显示文摘Differentiated adenocarcinoma of the stomach is classified into gastric or intestinal phenotypes based on mucus expression. Recent advances in mucin histochemistry and immunohistochemistry have highlighted the importance of such a distinction, and it is important clinically to distinguish between gastricand intestinal-type differentiated adenocarcinoma. However, a clinical and pathological diagnosis of this type is often difficult in early gastric cancer because of histological similarities between a hyperplastic epithelium and lowgrade atypia. Furthermore, determining tumor margins is often difficult, even with extensive preoperative examination. It is therefore critical to consider these diagnostic difficulties and different biological behaviors with high malignant potential when treating patients with gastric-type differentiated adenocarcinoma. | Tsutomu Namikawa Kazuhiro Hanazaki | 2010 | World Journal of Gastroenterology2010，16，37： | 2 |
| 14 | Tight glycemic control using an artificial endocrine pancreas may play an important role in preventing infection after pancreatic resection显示文摘It is well known that perioperative hyperglycemia is the main cause of infectious complications after surgery.To improve perioperative glycemic control,we wish to highlight and comment on an interesting paper published recently by the Annals of Surgery entitled:'Early postoperative hyperglycemia is associated with postoperative complications after pancreatoduodenectomy(PD)' by Eshuis et al.The authors concluded that early postoperative glucose levels more than 140 mg/dL was significantly associated with complications after PD.Since we recommend that perioperative tight glycemic control(TGC) is an effective method to prevent postoperative complications including surgical site infection after distal,proximal,and total pancreatic resection,we support strongly this conclusion drawn in this article.However,if early postoperative glucose control in patients undergoing PD was administrated by conventional method such as sliding scale approach as described in this article,it is difficult to maintain TGC.Therefore,we introduce a novel perioperative glycemic control using an artificial endocrine pancreas against pancreatogenic diabetes after pancreatic resection including PD. | Kazuhiro Hanazaki | 2012 | World Journal of Gastroenterology2012，18，29： | 2 |
| 15 | Impact of jejunal pouch interposition reconstruction after proximal gastrectomy for early gastric cancer on quality of life: short- and long-term consequences显示文摘 | Tsutomu Namikawa Toyokazu Oki Hiroyuki Kitagawa Takehiro Okabayashi Michiya Kobayashi Kazuhiro Hanazaki | 2012 | The American Journal of Surgery2012，，2： | 2 |
| 16 | Pancreatic transection using a sharp hook-shaped ultrasonically activated scalpel显示文摘 | Okabayashi T Hanazaki K Nishimori I | 2007 | Langenbecks Arch Surg2007，392，6： | 1 |
| 17 | Survival and recurrence after hepatic resection of 386 consecutive patients with hepatocellular carcinoma显示文摘 | Hanazaki K Kajikawa s Shimozawa N | 2000 | JAm Coil Surg2000，191，4： | 1 |
| 18 | Perioperative blood transfusion and survival following curative hepatic reseection for hepatoeellular carcinoma 显示文摘 | Hanazaki K Kajikawa S Shimozawa N | 2005 | Hepatogastroentero logy2005，52，62： | 1 |
| 19 | Palliative gastrectomy for advanced gastric cancer 显示文摘 | Sodeyama H Mochizuki Y | 2001 | Hepatogastroenterology2001，48，： | 1 |
| 20 | Retroperitoneal venous hemangioma显示文摘 | Igarashi J Hanazaki K | 1998 | Am J Gastroenterol1998，93，11： | 1 |
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