Nobuyuki Takemura
University of Tokyo
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Featured researches published by Nobuyuki Takemura.
Journal of Hepatology | 2014
Takashi Kokudo; Kiyoshi Hasegawa; Satoshi Yamamoto; Junichi Shindoh; Nobuyuki Takemura; Taku Aoki; Yoshihiro Sakamoto; Masatoshi Makuuchi; Yasuhiko Sugawara; Norihiro Kokudo
BACKGROUND & AIMS Presence of hepatic vein tumor thrombosis (HVTT) in patients with hepatocellular carcinoma (HCC) is regarded as signaling an extremely poor prognosis. However, little is known about the prognostic impact of surgical treatment for HVTT. METHODS Our database of surgical resection for HCC between October 1994 and December 2011 in a tertiary care Japanese hospital was retrospectively analysed. We statistically compared the patient characteristics and surgical outcomes in HCC patients with tumor thrombosis in a peripheral hepatic vein, including microscopic invasion (pHVTT), tumor thrombosis in a major hepatic vein (mHVTT), and tumor thrombosis of the inferior vena cava (IVCTT). Among 1525 hepatic resections, 153 cases of pHVTT, 21 cases of mHVTT, and 13 cases of IVCTT were identified. RESULTS The median survival time (MST) in the pHVTT and mHVTT groups was 5.27 and 3.95 years, respectively (p=0.77), and the median time to recurrence (TTR) was 1.06 and 0.41 years, respectively (p=0.74). On the other hand, the MST and TTR in the patient group with IVCTT were 1.39 years and 0.25 year respectively; furthermore, the MST of Child-Pugh class B patients was significantly worse (2.39 vs. 0.44 years, p=0.0001). Multivariate analyses revealed IVCTT (risk ratio [RR] 2.54, p=0.024) and R 1/2 resection (RR 2.08, p=0.017) as risk factors for the overall survival. CONCLUSIONS Hepatic resection provided acceptable outcomes in HCC patients with mHVTT or pHVTT when R0 resection was feasible. Resection of HCC may be attempted even in patients with IVCTT, in the presence of good liver function.
Digestive Diseases and Sciences | 2007
Nobuyuki Takemura; Yasuhiko Sugawara; Sumihito Tamura; Masatoshi Makuuchi
Hepatitis B surface antigen−negative and hepatitis B core antibody−positive grafts were considered unsuitable for transplantation. The number of potential recipients for liver transplantation now exceeds that of potential donor organs, which has led us to reevaluate the feasibility of these grafts. Several strategies involving prophylactic administration of hepatitis B immunoglobulin and/or lamivudine to transplant recipients have been proposed. At the University of Tokyo, we have continued to use hepatitis B immunoglobulin monoprophylaxis with zero recurrence.In this article we report our experience with the use of hepatitis B surface antigen−negative/hepatitis B core antibody−positive grafts with hepatitis B immunoglobulin monotherapy. We conducted a review of the literature regarding the feasibility of these grafts to reconfirm optimal prophylactic strategies for preventing de novo hepatitis B virus infection in transplant recipients.
Liver Transplantation | 2005
Nobuyuki Takemura; Yasuhiko Sugawara; Takuya Hashimoto; Nobuhisa Akamatsu; Yoji Kishi; Sumihito Tamura; Masatoshi Makuuchi
The incidence of hepatic venous stenosis is higher in partial liver transplantation. New methods for hepatic venous reconstruction in left liver transplantation, which secure wide anastomosis, were devised and are reported here. In the graft, the right side of the middle hepatic vein or the left side of the left hepatic vein was cut longitudinally and a rectangular‐shaped vein patch was attached for venoplasty. In the recipient, after the left and middle hepatic veins were joined, the right side of the middle hepatic vein was cut toward the closed right hepatic vein, making a horizontal cavotomy for anastomosis. Of 92 patients who underwent conventional hepatic vein reconstruction, 3 were complicated by hepatic venous stenosis (median follow‐up 43 months). By contrast, there were no hepatic vein complications in the 20 patients who underwent the new technique (7 months). The current method appears to be technically feasible for outflow reconstruction in left liver graft transplantation. (Liver Transpl 2005;11:356–360.)
British Journal of Surgery | 2014
Nobuyuki Takemura; Kiyoshi Hasegawa; Tomonori Aoki; Y. Sakamoto; Yasuhiko Sugawara; Masatoshi Makuuchi; N. Kokudo
Peritoneal or thoracoabdominal wall implants from hepatocellular carcinoma (HCC) occur occasionally after biopsy, percutaneous therapy or resection, and spontaneously, with no effective treatment available. The objective of this study was to clarify the indications for, and benefits of, surgical resection of such HCC implants.
Asian Journal of Endoscopic Surgery | 2014
Kiyomi Morita; Takeaki Ishizawa; Keigo Tani; Nobuhiro Harada; Atsushi Shimizu; Satoshi Yamamoto; Nobuyuki Takemura; Junichi Kaneko; Taku Aoki; Yoshihiro Sakamoto; Yasuhiko Sugawara; Kiyoshi Hasegawa; Norihiro Kokudo
Fluorescence imaging using indocyanine green (ICG) has recently been applied to laparoscopic surgery to identify cancerous tissues, lymph nodes, and vascular anatomy. Here we report the application of ICG‐fluorescence imaging to visualize the boundary between the liver and subserosal tissues of the gallbladder during laparoscopic full‐thickness cholecystectomy. A patient with a potentially malignant gallbladder lesion was administered 2.5‐mg intravenous ICG just before laparoscopic full‐thickness cholecystectomy. Intraoperative fluorescence imaging enabled the real‐time delineation of both extrahepatic bile duct anatomy and hepatic parenchyma throughout the procedure, which resulted in complete removal of subserosal tissues between liver and gallbladder. Safe and feasible ICG‐fluorescence imaging can be widely applied to laparoscopic hepatobiliary surgery by utilizing a biliary excretion property of ICG.
World Journal of Hepatology | 2017
Nobuyuki Takemura; Akio Saiura
It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases (NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.
Hpb | 2010
Nobuyuki Takemura; Kiyoshi Hasegawa; Yasuhiko Sugawara; Keming Zhang; Taku Aoki; Yoshifumi Beck; Masatoshi Makuuchi; Norihiro Kokudo
BACKGROUND Accurate knowledge of the surgical anatomy of the caudate lobe is indispensable in the performance of liver surgery. Although previous cast studies have provided much useful overall information about the locations of the caudate veins, little is known about how to establish the exact locations of the caudate and short hepatic veins prior to surgery. OBJECTIVES This study was conducted as a practical morphometric analysis of the caudate veins using preoperative enhanced computed tomography (CT) and intraoperative ultrasound (IOUS). METHODS From July 2003 to October 2005, 116 donor hepatectomies were performed for adult living donor liver transplantation. The numbers and locations of visible caudate veins were examined pre- and intraoperatively using CT and IOUS. RESULTS In the 116 patients, a total of 152 caudate veins were detected, which were classified as being of either typical (n= 135) or non-typical (n= 17) type. One caudate vein was detectable in 83 patients (72%), two in 30 patients (26%) and three in three patients (3%). A total of 67% of caudate veins detected by IOUS and 70% detected by CT were located on the ventral 60 ° of the inferior vena cava (IVC). The remaining veins were scattered on both lateral sides. CONCLUSIONS Preoperative CT and IOUS were useful in providing morphometric information of sizable caudate veins. Precise information on these veins is essential for the safe dissection of the caudate lobe from the IVC in advanced liver surgery.
Surgical Endoscopy and Other Interventional Techniques | 2011
Takeaki Ishizawa; Junichi Kaneko; Yosuke Inoue; Nobuyuki Takemura; Yasuji Seyama; Taku Aoki; Yoshifumi Beck; Yasuhiko Sugawara; Kiyoshi Hasegawa; Nobuhiro Harada; Masayoshi Ijichi; K Kusaka; Masayuki Shibasaki; Yasutsugu Bandai; Norihiro Kokudo
Annals of Surgical Oncology | 2017
Suguru Yamashita; Yoshihiro Sakamoto; Satoshi Yamamoto; Nobuyuki Takemura; Kiyohiko Omichi; Hiroji Shinkawa; Kazuhiro Mori; Junichi Kaneko; Nobuhisa Akamatsu; Junichi Arita; Kiyoshi Hasegawa; Norihiro Kokudo
Nihon Naika Gakkai Zasshi | 2014
Kiyoshi Hasegawa; Taku Aoki; Satoshi Yamamoto; Nobuyuki Takemura; Yoshihiro Sakamoto; Yasuhiko Sugawara; Norihiro Kokudo