和田 則仁 (ワダ ノリヒト)

Wada, Norihito

写真a

所属(所属キャンパス)

医学部 外科学教室(一般・消化器) (信濃町)

職名

専任講師

外部リンク

プロフィール 【 表示 / 非表示

  • 外科学(一般・消化器)専任講師 上部消化管班所属 ヘルニア外来開設

経歴 【 表示 / 非表示

  • 1992年04月
    -
    1993年03月

    東海大学医学部, 地域・環境保健系地域保健学部門, 奨励研究員

  • 1993年04月
    -
    1995年03月

    東海大学医学部, 地域・環境保健系地域保健学部門, 助手

  • 1995年05月
    -
    1996年04月

    慶應義塾大学病院, 外科, 研修医

  • 1996年05月
    -
    1997年04月

    練馬総合病院, 外科, 研修医

  • 1997年05月
    -
    1998年04月

    国立霞ケ浦病院, 外科, 専修医

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学歴 【 表示 / 非表示

  • 1992年03月

    慶應義塾, 医学部, 医学科

    東京都, 大学, 卒業

学位 【 表示 / 非表示

  • 博士(医学), 慶應義塾, 論文, 2004年07月

    Reduced angiogenesis in peritoneal dissemination of gastric cancer through gelatinase inhibition. (ゼラチナーゼ阻害による胃癌腹膜播種の血管新生抑制)

免許・資格 【 表示 / 非表示

  • 医師免許, 1992年06月

  • 外科専門医, Japan Surgical Society Board Certified Surgeon, 2002年12月

 

研究分野 【 表示 / 非表示

  • 外科学一般

  • 消化器外科学 (Digestive Organ Surgery)

研究キーワード 【 表示 / 非表示

  • 外科学

 

論文 【 表示 / 非表示

  • Effectiveness of active nasal surveillance culture for Methicillin-resistant Staphylococcus aureus in patients undergoing colorectal surgery

    Kondo T., Okabayashi K., Sugiura K., Obara H., Takeuchi H., Wada N., Takano Y., Iwata S., Hasegawa N., Kitagawa Y.

    Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy)  26 ( 12 ) 1244 - 1248 2020年12月

    ISSN  1341321X

     概要を見る

    © 2020 Objective: The aim of this study was to clarify the role of Methicillin-resistant Staphylococcus aureus (MRSA) carriers in the development of surgical site infection (SSI) after colorectal surgery. Summary background data: MRSA is commonly implicated in hospital-acquired infections. Active surveillance culture (ASC) using the nasal swab test is useful to detect MRSA in surgical patients. We hypothesized that MRSA carriers would be more susceptible to SSI after colorectal surgery Methods: Patients who underwent ASC between 2010 and 2013 were included in this study. The incidence of SSI was compared between MRSA carriers and non-carriers using the chi-square test. The odds ratio for SSI was computed using logistic regression analyses. Results: Among 355 patients, 12 (3.4%) were identified as MRSA carriers and 343 as non-carriers. Of all the patients, 65 patients (18.3%) developed an SSI. Of these, 6 cases were in MRSA carriers and 59 cases were in non-carriers (p < 0.01). This meant that half of the 12 MRSA carriers developed an SSI, compared with only 17.2% of non-carriers (59 cases out of 343 patients). Therefore, MRSA carriers had a significantly higher risk of SSI (adjusted odds ratio = 4.77 [1.37 to 16.6], p = 0.01). Conclusions: Detection of MRSA via ASC is significantly associated with the development of SSI after colorectal surgery. These findings indicate that ASC for MRSA is useful to predict an SSI.

  • Clinical outcomes of laparoscopic and endoscopic cooperative surgery for submucosal tumors on the esophagogastric junction: a retrospective single-center analysis

    Aoyama J., Kawakubo H., Matsuda S., Mayanagi S., Fukuda K., Irino T., Nakamura R., Wada N., Kitagawa Y.

    Gastric Cancer (Gastric Cancer)  23 ( 6 ) 1084 - 1090 2020年11月

    ISSN  14363291

     概要を見る

    © 2020, The International Gastric Cancer Association and The Japanese Gastric Cancer Association. Background: Laparoscopic and endoscopic cooperative surgery (LECS) technique for gastric submucosal tumor (SMT) has developed, but treatment of SMT on the esophagogastric junction (EGJ) remains technically difficult because excessive resection may result in postoperative transformation of the EGJ and cause stenosis, and intervention to lower esophageal sphincter may result in gastroesophageal reflux. The study aim was to evaluate the feasibility and safety of LECS for SMT on the EGJ. Methods: Between September 2012 and December 2018, LECS was performed for 21 patients with SMTs on the EGJ. Fundoplication was performed after LECS according to the intraoperative findings for each case. The patients’ backgrounds, operative outcomes, and follow-up data, including endoscopic findings of gastroesophageal reflux disease (GERD) and proton pomp inhibitor (PPI) use, were reviewed. Results: In all 21 cases, LECS was completed with a mean operation time of 225 min, and a mean blood loss of 8.8 mL. All patients were alive without recurrence within the mean follow-up period of 30.5 months. Both GERD and PPI use tended to be less frequent when fundoplication was performed, although these differences were not statistically significant. (7.7% vs. 37.5%; P = 0.091, 23.1% vs. 50.0%; P = 0.204, respectively). Conclusions: We demonstrated the feasibility and safety of LECS for SMTs even on the EGJ. Fundoplication after LECS may be an approach for the prevention of postoperative reflux esophagitis. Future research is warranted to validate the efficacy of the addition of fundoplication.

  • The perioperative presepsin as an accurate diagnostic marker of postoperative infectious complications after esophagectomy: a prospective cohort study

    Takeuchi M., Yokose T., Kawakubo H., Matsuda S., Mayanagi S., Irino T., Fukuda K., Nakamura R., Wada N., Obara H., Kitagawa Y.

    Esophagus (Esophagus)  17 ( 4 ) 399 - 407 2020年10月

    ISSN  16129059

     概要を見る

    © 2020, The Japan Esophageal Society. Background: Presepsin is suggested to be an accurate sepsis diagnostic biomarker, playing an important role in distinguishing infection from no-infection status. However, to date, there is no study determining presepsin’s role in diagnosing post-esophagectomy infectious complications. Methods: Thirty patients who underwent esophagectomy for esophageal carcinoma were included in this prospective observational study. We investigated preoperative presepsin levels’ changes and evaluated the relationship between infectious complications and presepsin levels. Moreover, we analyzed the classification and regression tree (CART) to determine presepsin’s optimal cutoff values for discriminating infectious complications. Results: For 10 patients with infectious complications, median presepsin levels were 168, 337, 303, 271, 314, 978, and 752 pg/ml, pre- and immediately post-surgery, and 1, 2, 3, 5, 7 days post-surgery, respectively. Presepsin levels were significantly higher in the infectious complication group exclusively from preoperation to POD 7 (p = 0.048). Furthermore, area under the curve’s value of presepsin on POD 5 and 7 was higher than the other three biomarkers included for discriminating infectious complications (i.e., procalcitonin, leukocyte, and C-reacted protein). We set an optimal cutoff value for presepsin calculated by CART. Specifically, on POD 5, the cutoff was 888 pg/ml with a sensitivity of 60% and a specificity of 90%, and on POD 7, the cutoff was 668 pg/ml with a sensitivity of 60% and a specificity of 85%. Conclusions: Presepsin levels on POD 5 and 7 after esophagectomy are a valuable indicator of infectious complication’s detection vs. leukocyte, C-reacted protein, and procalcitonin.

  • Clinical significance of preoperative serum concentrations of interleukin-6 as a prognostic marker in patients with esophageal cancer

    Maeda Y., Takeuchi H., Matsuda S., Okamura A., Fukuda K., Miyasho T., Nakamura R., Suda K., Wada N., Kawakubo H., Kitagawa Y.

    Esophagus (Esophagus)  17 ( 3 ) 279 - 288 2020年07月

    ISSN  16129059

     概要を見る

    © 2019, The Japan Esophageal Society. Background: Although the clinical outcome of esophageal cancer has recently improved, the relapse rate remains high for all disease stages. At present, there is no diagnostic method to predict the long-term outcome for esophageal cancer. In this study, we evaluated serum preoperative proinflammatory cytokine levels and investigated the correlation between preoperative interleukin-6 (IL-6) and IL-8 levels and survival of patients with esophageal cancer. Methods: Between 2008 and 2015, we evaluated preoperative serum cytokine levels in 122 patients who underwent esophagectomy for esophageal cancer. Serum IL-6 and IL-8 levels were measured by enzyme-linked immunosorbent assays. We investigated the relationship between serum cytokine levels and the response to chemotherapy and survival. Results: The preoperative IL-6 levels were significantly associated with shorter recurrence-free survival (RFS, p = 0.001) and overall survival (OS, p = 0.001) after esophagectomy. Higher IL-8 levels were significantly associated with RFS (p = 0.018). In the multivariate analysis, age, preoperative chemotherapy, lymph node metastasis, serum C-reactive protein (CRP) levels and serum IL-6 levels (hazard ratio (HR), 2.888; p = 0.049) were significantly independent prognostic factors of RFS. Additionally, age, pathological stage, and serum IL-6 levels (HR, 3.247; p = 0.027) were shown to be significantly independent prognostic factors of OS. Serum IL-6 levels were significantly higher in the non-responder group (pathological response pGrade0 and pGrade1) after neoadjuvant therapy. Conclusions: High preoperative serum IL-6 levels are associated with a poor response to chemotherapy or chemoradiotherapy and poor prognosis after esophagectomy. Preoperative serum IL-6 levels may be a useful independent prognostic marker for esophageal cancer patients.

  • Successful minimally invasive two-stage operation for rare synchronous cancers of the esophagus and the pancreatic head: A case report

    Ozawa H., Kawakubo H., Kitago M., Mayanagi S., Fukuda K., Nakamura R., Suda K., Wada N., Kitagawa Y.

    Asian journal of endoscopic surgery (Asian journal of endoscopic surgery)  13 ( 3 ) 410 - 414 2020年07月

     概要を見る

    © 2019 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd. We report the case of a 70-year-old woman with synchronous advanced esophageal cancer and pancreatic head cancer. To reduce the surgical invasiveness, we performed a two-stage operation that included percutaneous endoscopic gastrostomy and minimally invasive esophagectomy. In the first stage, we performed a percutaneous endoscopic gastrostomy, a thoracoscopic esophagectomy with cervical and mediastinal lymph node dissection, and an esophagostomy without a laparotomy. The second stage, which was performed 28 days after the first operation, consisted of a total gastrectomy, pancreaticoduodenectomy, colonic reconstruction, and jejunostomy. Fifty days after the second operation, the patient was discharged from the hospital. A two-stage operation that includes minimally invasive esophagectomy seems to be useful for avoiding serious postoperative complications, even in patients with rare, synchronous advanced cancers of the esophagus and the pancreatic head.

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  • マトリックス分解酵素阻害剤を用いた胃癌腹膜播種抑制に関する研究

    1999年04月
    -
    2000年03月

    日本学術振興会, 科学研究費補助金(文部科学省・日本学術振興会), 補助金,  代表

 

担当授業科目 【 表示 / 非表示

  • 先端医療技術

    2020年度

  • 先端医療技術

    2019年度