Miyazaki, Kurato

写真a

Affiliation

School of Medicine, Center for Diagnostic and Therapeutic Endoscopy (Shinanomachi)

Position

Instructor
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Books 【 Display / hide 】

  • Red Dichromatic Imaging (RDI)

    Miyazaki K., Kato M., Atlas of Advanced Endoscopy, 2024.01

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    RDI (red dichromatic imaging) is a kind of novel image enhancement endoscopy technology included in EVIS X1 system recently launched by Olympus. It is an image enhancement technique that forms contrast of deep tissue and blood vessels and is expected to be used more widely in the future. In this chapter, we will describe the principle of RDI and its clinical applications.

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Papers 【 Display / hide 】

  • Feasibility of endoscopic submucosal dissection including papilla (with video)

    Yahagi N., Takatori Y., Sasaki M., Imura Y., Murata S., Sato T., Minezaki D., Hayakawa T., Nakajima Y., Okada H., Sakurai H., Tojo A., Iwata K., Miyazaki K., Kayashima A., Masunaga T., Mizutani M., Akimoto T., Seino T., Kawasaki S., Horibe M., Fukuhara S., Matsuura N., Sujino T., Nakayama A., Takabayashi K., Iwasaki E., Kato M.

    Digestive Endoscopy 37 ( 4 ) 402 - 410 2025.04

    ISSN  09155635

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    Objectives: Endoscopic papillectomy (EP) is a low-invasive treatment for duodenal tumors including papilla. The limit of lesion size and local recurrence have been issues in EP. We developed endoscopic submucosal dissection (ESD) for the duodenal tumors including papilla (ESDIP: ESD including papilla) to overcome the problems. The aim of this study was to evaluate the feasibility of ESDIP. Methods: We included the patients who underwent ESDIP from August 2010 to January 2024 in this study. We evaluated the retrospective characteristics of patients and lesions, clinical results of ESDIP and of endoscopic retrograde cholangiopancreatography (ERCP) as prevention for delayed adverse events, and pathological findings. We also calculated the cumulative recurrence rate and overall survival rate at 12 months after ESDIP. Results: Fifty-four patients were included in this study. The mean lesion size was 39 mm. The third-quarter cases revealed a less than half-circumferential lesion, and the one case with a full-circumferential lesion. Resection was accomplished in 96% (n = 52), and also the en-bloc resection rate was 96%. Of the cases in accomplished resection, 98% of patients were intubated with a pancreaticobiliary drainage tube by ERCP. Intraprocedural perforation occurred in eight cases. Delayed bleeding occurred in 10 cases. Delayed perforation was seen only in one case. The incidence of post-ERCP pancreatitis was 25%. Cumulative local recurrence rate and the overall survival rate were 15% and 96%, respectively. Conclusion: ESDIP may be feasible for duodenal tumors including papilla, and is a potential alternative option to avoid pancreaticoduodenectomy.

  • Feasibility of modified double-layered suturing for a large mucosal defect after duodenal endoscopic submucosal dissection (origami method)

    Masunaga T., Sasaki M., Murata S., Imura Y., Minezaki D., Tojo A., Sakurai H., Iwata K., Miyazaki K., Mizutani M., Nishikawa M., Akimoto T., Takatori Y., Kawasaki S., Matsuura N., Tomida H., Nakayama A., Sujino T., Takabayashi K., Yahagi N., Kato M.

    Endoscopy 57 ( 5 ) 478 - 483 2025.01

    ISSN  0013726X

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    Background A modified double-layered suturing procedure (origami method; OGM) can achieve robust closure, even for large mucosal defects, by folding the muscle layer using through-the-scope clips. This study aimed to evaluate the feasibility of OGM in duodenal endoscopic submucosal dissection (ESD). Methods This retrospective, observational study was conducted at a tertiary care hospital. We reviewed cases of OGM attempted after duodenal ESD between June 2022 and April 2023.We excluded lesions located in the duodenal bulb or involving the major papilla. We measured the clinical characteristics and outcomes. Results OGM was attempted in 28 cases after duodenal ESD. The median mucosal defect size was 38mm (range 26 ?110). Complete closure was achieved in 27 cases (96%), including the largest lesion. The median closure time was 16 minutes. There were no perforations caused by clips. Delayed perforation and bleeding were not observed. Among 28 cases, 21 underwent follow-up endoscopy 3 5 days after ESD, and the muscle layer remained folded in all cases. Conclusion OGM achieved a high rate of complete closure even after duodenal ESD. Closure with OGM was robust enough to maintain the folded muscle layer for at least 3 days postoperatively.

  • Automatic water irrigation synchronized with the electrosurgical unit: Bubble-free underwater endoscopic submucosal dissection

    Sasaki M., Masunaga T., Miyazaki K., Nakajima K., Yahagi N., Kato M.

    Endoscopy 56 ( S 01 ) E468 - E469 2024.12

  • Distinctive duodenal microbiomes and bile acid profiles in duodenal tumor patients revealed by prospective observational study

    Kubosawa Y., Sujino T., Miyamoto K., Kayashima A., Minezaki D., Morioka K., Iwata K., Miyazaki K., Masunaga T., Mizutani M., Akimoto T., Takatori Y., Matsuura N., Nakayama A., Takabayashi K., Nakamoto N., Honda A., Kato M., Yahagi N., Kanai T.

    Scientific Reports 14 ( 1 )  2024.12

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    The incidence of duodenal tumors (DTs) is increasing. However, the mechanisms underlying its development remain unclear. Environmental factors, including the microbiome and bile acids (BAs), are believed to influence tumor development. Therefore, we conducted a single-center, prospective, observational study to investigate the potential differences between patients with DTs and healthy controls (HCs) based on these factors. In addition, the BAs in the duodenal fluid were measured using liquid chromatography-tandem mass spectrometry. We recruited 41 patients and performed 16S rRNA-seq. There was no difference in the observed ASVs or PCoA plot of Bray–Curtis dissimilarity between the DTs and HCs. The lithocholic acid concentration was significantly lower in the DT group than in the control group. The ratio of CDCA to LCA was significantly higher in patients with DTs. No significant differences in microbiota were observed between DTs and HCs. In patients with DTs, the lithocholic acid concentration in duodenal was significantly lower than in HCs.

  • Novel perfusion system using continuous liquid-suction catheter attachment in colorectal endoscopic submucosal dissection with water pressure method (with video)

    Masunaga T., Takatori Y., Sasaki M., Sato M., Minezaki D., Morioka K., Tojo A., Sakurai H., Iwata K., Miyazaki K., Kubosawa Y., Mizutani M., Akimoto T., Kawasaki S., Matsuura N., Nakayama A., Sujino T., Takabayashi K., Nakajima K., Yahagi N., Kato M.

    Digestive Endoscopy 36 ( 9 ) 1043 - 1050 2024.09

    ISSN  09155635

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    Water pressure method (WPM) is useful for colorectal endoscopic submucosal dissection (ESD), characterized not only by underwater conditions but also by active water pressure via the waterjet function. However, the extension of the colorectum by injecting excess water and contaminating the operative field by stool and bleeding have been issues. This study aimed to evaluate the feasibility of a novel perfusion system using a continuous liquid-suction catheter attachment (CLCA) in colorectal ESD with WPM. We retrospectively reviewed cases in which the perfusion system was used in colorectal ESD with WPM between August 2022 and September 2023. We evaluated clinical characteristics, treatment outcomes, volume of injection by the waterjet function, volume of suction by the endoscope and CLCA, and concentration of floating matter in the operative field over time. Thirty-one cases were enrolled. The median lesion size was 30 (range, 15–100) mm. In all cases, en bloc resection was achieved without perforation. The median injection volume was 2312 (range, 1234–13,866) g. The median suction volumes by the endoscope and CLCA were 918 (range, 141–3162) and 1147 (range, 254–11,222) g, respectively. The median concentration of floating matter in the operative field (measured in 15 cases) was 15.3 (range, 7.3–112) mg/mL when the endoscope arrived at the lesion and 8.0 (range, 3.2–16) mg/mL after endoscopically washing at the beginning of the ESD. It ranged from 7.6 to 13.4 mg/dL every 20 min during ESD. This perfusion system could prevent the extension of the lumen and maintain a good field of view in colorectal ESD with WPM.

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