contents
sp
title_geka01

HOME Activities Gastrointestinal Surgery

1.Research Summary

At Niigata University Graduate School of Medicine and Dental Sciences, we are divided into the following two departments, both of which conduct highly technical research. With the two departments working together cooperatively, we also implement research in which surgical oncology and regenerative medicine are combined.

  • 1jCourse for Molecular and Cellular Medicine/Gene Control/Surgical Oncology Department
  • 2jCourse for Biological Functions and Medical Control/Regenerative Medicine/Gastrointestinal and General Surgery Department

2.Research Groups by Organ

  • Hepato-Biliary-Pancreatic Group
  • Esophagus and Gastric Surgery Group
  • Colorectal Surgery Group
  • Breast and Endocrine Surgery, and Surgical Metabolism and Nutrition Group

3-1.Research subjects of Hepato-Biliary-Pancreatic Group

  • DNA damage response in malignant hepato-biliary-pancreatic tumor (see research results)
  • Intrahepatic micrometastases from liver metastases of colon cancer (see research results)
  • Mechanisms of resistance to anticancer agents and sensitization action against anticancer agents in malignant hepato-biliary-pancreatic tumor
  • Practice and immunological study of liver and pancreas transplantation

3-2.Research subjects of Esophagus and Gastric Surgery Group

  • Intervention study on esophageal cancer with risk factors for postoperative early recurrence (see research results)
  • Clinical study on multidisciplinary treatment performed with chemoradiotherapy in esophageal cancer (2 studies)
  • Effect of gastrectomy for gastric cancer with positive cytologic washings on prognosis
  • Transhiatal distal esophagectomy and mediastinal lymph node dissection for gastric cancer with esophageal invasion
  • Clinical studies (5 studies) and clinical trials (4 trials) on genetic polymorphisms of gastrointestinal stromal tumor (GIST) and molecular targeted drugs

3-3.Research subjects of Colorectal Surgery Group

  • Curability of colon cancer by endoscopic treatment and laparoscopic resection, and QOL
  • Anal function-preserving operation for ulcerative colitis, postoperative defecation function, and QOL
  • Efficacy of proctectomy using da Vinci surgical system Si and QOL
  • Water channels (AQ8 and AQ9) in human gastrointestinal tract

3-4.Research subjects of Breast and Endocrine Surgery, and Surgical Metabolism and Nutrition Group

  • Safety and efficacy of subtotal thyroidectomy for thyroid cancer
  • Usefulness of Minimally Invasive Radio-guided Parathyroidectomy (MIRP)
  • Usefulness of administration of immune modulating nutrients during cancer chemotherapy

4.Research Results

[Area] Malignant hepato-biliary-pancreatic tumor (surgical oncology)

[Research subject] DNA damage response in bile duct cancer

[Description]
We posited that gif a bile duct stump tests positive for cancer by intraoperative rapid tissue diagnosis, it is important to differentiate whether it is positive for invasive cancer or in situ cancer.h This idea was acknowledged by the American Cancer Society as the worldfs first such report and was published in CANCER 2005;103:1210-6.
In addition, we showed failure of the early DNA damage response mediated by 53BP1 and reduction in apoptosis in in situ cancer persisting in bile duct stumps to be associated with local recurrence. This finding was published in Int J Oncol 2011;38:1227-36 and Bile Duct 2010;24:667-74, and we received the 2010 Japan Biliary Association Award.

[Photographs]
Photographs

sp sp

[Area] Malignant hepato-biliary-pancreatic tumor (surgical oncology)

[Research subject] Intrahepatic micrometastases from liver metastases of colon cancer

[Description]
We revealed that lymphatic re-metastases from liver metastases of colon cancer exist and elucidated that the deep lymphatic network of the liver is a major route for hepatic lymph node metastasis. This study was given the Society Award at the 42nd World Congress of the International Society of Surgery and was published in Ann Surg Oncol 2007;14:3472-80.
We elucidated the significance of a 1-cm margin for intrahepatic micrometastases in liver metastases of colon cancer and received the Society Award at the 8th World Congress of the IHPBA. This finding was published in Ann Surg Oncol 2008;15:2472-81.

[Photographs]
Photographs

We elucidated that risk is markedly reduced with a hepatectomy margin of 2 mm and that the risk of death gradually decreases thereafter as the margin increases.

sp sp

[Area] Esophageal cancer (surgical oncology)

[Research subject] Intervention study on esophageal cancer with risk factors for postoperative early recurrence

[Description]
We have reported that the prognosis of esophageal cancer with intramural metastases is poor (Figure). We reported in Ann Surg Oncol 2011;18:2961-7 that the only risk factor for early recurrence and mortality within 1 year post-procedure is intramural metastasis. This is true even after esophagectomy with 3-region dissection, which is the ultimate treatment. This may thus be the limitation of surgical therapy. Esophageal cancer with positive intramural metastasis is a refractory condition in the current treatment system. We are thus implementing an intervention study with the aim of establishing a new treatment strategy.

[Photographs]
Photographs

Group 1 represents esophageal cancer with intramural metastasis.
Group 2 represents esophageal cancer without intramural metastasis.

sp sp

sp
sp