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Papers by SHIN NAMIKI

Superiority of urgent vs early endoscopic hemostasis in patients with upper gastrointestinal bleeding with high-risk stigmata

Gastroenterology Report, Nov 2, 2021

Background Guidelines recommend that all patients with upper gastrointestinal bleeding (UGIB) und... more Background Guidelines recommend that all patients with upper gastrointestinal bleeding (UGIB) undergo endoscopy within 24 h. It is unclear whether a subgroup may benefit from an urgent intervention. We aimed to evaluate the influence of endoscopic hemostasis and urgent endoscopy on mortality in UGIB patients with high-risk stigmata (HRS). Methods Consecutive patients with suspected UGIB were enrolled in three Japanese hospitals with a policy to perform endoscopy within 24 h. The primary outcome was 30-day mortality. Endoscopic hemostasis and endoscopy timing (urgent, ≤6 h; early, &amp;gt;6 h) were evaluated in a regression model adjusting for age, systolic pressure, heart rate, hemoglobin, creatinine, and variceal bleeding in multivariate analysis. A propensity score of 1:1 matched sensitivity analysis was also performed. Results HRS were present in 886 of 1966 patients, and 35 of 886 (3.95%) patients perished. Median urgent-endoscopy time (n = 769) was 3.0 h (interquartile range [IQR], 2.0–4.0 h) and early endoscopy (n = 117) was 12.0 h (IQR, 8.5–19.0 h). Successful endoscopic hemostasis and urgent endoscopy were significantly associated with reduced mortality in multivariable analysis (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.09–0.52; P = 0.0006, and OR, 0.37; 95% CI, 0.16–0.87; P = 0.023, respectively). In a propensity-score-matched analysis of 115 pairs, adjusted comparisons showed significantly lower mortality of urgent vs early endoscopy (2.61% vs 7.83%, P &amp;lt; 0.001). Conclusions A subgroup of UGIB patients, namely those harboring HRS, may benefit from endoscopic hemostasis and urgent endoscopy rather than early endoscopy in reducing mortality. Implementing triage scores that predict the presence of such lesions is important.

総胆管結石に対する治療ERCP関連手技の検討―ERCP後膵炎予防におけるWire-guided cannulationの有用性について―

Iconographies supplémentaires de l'article : 117 THE MULTICENTER VALIDATION STUDY OF THE SIMPLE SCORE, WHICH PREDICTS NEED FOR AN URGENT ENDOSCOPIC INTERVENTION FOR SUSPECTED UPPER GASTROINTESTINAL BLEEDING

Progress of Digestive Endoscopy, 2019

Progress of Digestive Endoscopy, 2017

266P Elevation of neutrophil-to-lymphocyte ratio before first-line chemotherapy predicts a poor prognosis of second line chemotherapy in gastric cancer

Annals of Oncology, 2016

Progress of Digestive Endoscopy, 2010

Supplemental Material for Absence of high-risk stigmata predicts good prognosis even in severely ... more Supplemental Material for Absence of high-risk stigmata predicts good prognosis even in severely anemic patients with suspected acute upper gastrointestinal bleeding by Masayasu Horibe, Yuki Ogura, Juntaro Matsuzaki, Tetsuji Kaneko, Takuya Yokota, Osamu Okawa, Yukihiro Nakatani, Eisuke Iwasaki, Toshihiro Nishizawa, Naoki Hosoe, Tatsuhiro Masaoka, Naohisa Yahagi, Shin Namiki and Takanori Kanai in United European Gastroenterology Journal

Gastrointestinal Endoscopy, 2018

months), respectively. Before matching, the 5-year cumulative incidence rate of MGC was not signi... more months), respectively. Before matching, the 5-year cumulative incidence rate of MGC was not significantly different between the persistent and eradicated groups (11.3% vs 3.8%, p Z 0.06). After matching, the rate was significantly higher in the persistent group than the eradicated group (14.2% vs 3.8%, p Z 0.01). In the Cox proportional hazard analysis, the eradicated group was not significantly associated with preventing MGC before matching (HR Z 0.40, p Z 0.07). However, the eradicated group was significantly associated with preventing MGC after matching (HR Z 0.30, p Z 0.02). Conclusion: Although this is a retrospective cohort study conducted at a single institution by using PS matching to adjust the background factors in the real world, it demonstrated that successful H. pylori eradication may reduce the development of MGC after ESD of EGC.

Molecular and Clinical Oncology, 2021

Indocyanine green (ICG) fluorescence imaging is useful for the intraoperative detection of the pe... more Indocyanine green (ICG) fluorescence imaging is useful for the intraoperative detection of the peritoneal dissemination of hepatocellular carcinoma (HCC). However, in laparoscopic surgery, disseminations cannot be accurately identified unless the camera lens is positioned close to the lesion. The present study describes a case of HCC dissemination in which the lesions were accurately identified by combining intraoperative fluoroscopy with ICG fluorescence imaging. A 76-year-old male was diagnosed with HCC dissemination. Computed tomography revealed a 9-mm disseminated nodule near the gallbladder. Although transarterial chemoembolization had also been used to treat this lesion, chemoembolization was technically difficult to perform. Therefore, a coil was placed around the lesion to serve as an intraoperative landmark for later laparoscopic resection. Given the potential difficulty of detecting the lesion during laparoscopic surgery, ICG fluorescence imaging was used to determine the approximate location of the dissemination. The lesion exhibited strong fluorescence, which facilitated its complete resection.

International Journal of Clinical Oncology, 2021

Background Although FOLFIRINOX is currently one of the standard therapies for chemotherapy-naïve ... more Background Although FOLFIRINOX is currently one of the standard therapies for chemotherapy-naïve patients with metastatic pancreatic cancer (MPC), the high rate of febrile neutropenia (FN) presents a clinical problem. This study aimed to evaluate the safety and efficacy of primary prophylactic pegfilgrastim with FOLFIRINOX in Japanese MPC patients. Methods FOLFIRINOX (intravenous oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, levofolinate 200 mg/m2, 5-fluorouracil (5-FU) bolus 400 mg/m2 and 5-FU 46 h infusion 2400 mg/m2) and pegfilgrastim 3.6 mg on day 4 or 5, every 2 weeks was administered to previously untreated MPC patients. The primary endpoint was the incidence of FN during the first 3 cycles. The planned sample size was 35 patients, but the trial was predefined to discontinue enrollment for safety if 4 patients developed FN. Results At the enrollment of 22 patients, 4 patients developed FN in the first cycle, resulting in an incidence of FN of 18% {95% confidence interval [CI], 0...

Scientific Reports, 2021

Immune-oncology (IO) drug therapy is effective against various types of cancer. Although several,... more Immune-oncology (IO) drug therapy is effective against various types of cancer. Although several, potential, clinical predictive markers have been identified, none so far have proven reliable. Herein we evaluated changes in serum alanine aminotransferase (ALT), which is upregulated by the accumulation of activated CD8+T cells in the liver, as a potentially reliable predictive marker. We retrospectively analyzed 265 patients with advanced malignancies at three institutions between 2016 and 2019. The patients received IO drug therapy. We defined the ALT ratio (ALR) as the serum ALT value at baseline / the highest serum ALT during IO drug therapy, then determined whether the ALR correlated with the objective response rate or progression-free survival. The median follow-up was 3.1 months. We observed objective responses in 65 patients. The ALR ranged from 0.19 to 32.2 (median 1.5), and a significant ALR increase was observed in responders (p

Efficacy of 6‐mm diameter fully covered self‐expandable metallic stents in preoperative biliary drainage for pancreatic ductal adenocarcinoma

DEN Open, 2021

Abstract Objectives Plastic stents (PS) used for preoperative biliary drainage (PBD) of pancreati... more Abstract Objectives Plastic stents (PS) used for preoperative biliary drainage (PBD) of pancreatic ductal adenocarcinomas (PDAC) tend to be associated with a high incidence of recurrent biliary obstruction (RBO). Although 10‐mm diameter fully covered self‐expanding metallic stents (FCSEMS) have come into use, vigilance is still required to prevent complications, such as cholecystitis and surgical site infection. The present study examined the efficacy and safety of the 6‐mm diameter FCSEMS for PBD. Methods The present retrospective study compared the incidence of complications associated with the use of 6‐mm FCSEMS and PS. The inclusion criteria were a diagnosis of PDAC and preoperative endoscopic biliary tract drainage performed at our institution between April 2012 and June 2019. Results Of the 51 patients enrolled, 25 and 26 patients received a PS and a 6‐mm FCSEMS, respectively. The RBO incidence was significantly lower in the 6‐mm FCSEMS group (7.7%) than in the PS group (40.0%) (p = 0.009), and time to RBO was significantly longer in the 6‐mm FCSEMS group (HR = 6.008, p = 0.021). The patency rate at three months after stent placement was significantly higher in the latter group (83.5% vs. 45.3%, p = 0.009, Log‐rank test). The groups did not differ significantly in terms of complications associated with PBD, such as cholecystitis and surgical site infection. Conclusion The present findings suggested that the 6‐mm FCSEMS may be an effective drainage device for use in PBD in PDAC treatment.

Su252 SUPERIORITY OF URGENT VS. EARLY ENDOSCOPIC HEMOSTASIS IN PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING

Gastroenterology, 2021

Journal of Gastroenterology and Hepatology Research, 2020

post-ERCP cholangitis. Clinical, microbiological, and procedural data were collected from the pat... more post-ERCP cholangitis. Clinical, microbiological, and procedural data were collected from the patients' electronic medical records. The relationship between each clinical feature and post-ERCP cholangitis was analyzed using univariate and multivariate logistic regression analysis. RESULTS: Of 376 patients with acute cholangitis due to choledocholithiasis, 200 consecutive patients meeting the inclusion criteria were identified. Among these, 23 (11.5%) received the diagnosis of post-ERCP cholangitis. In multivariate analysis, a duration of ≥ 11 days from biliary drainage to endoscopic stone extraction (adjusted odds ratio [aOR]: 8.57; 95% confidence interval [CI], 2.68-27.50) and the use of endoscopic papillary balloon dilation (aOR 6.04; 95% CI, 1.88-19.40) were identified as independent risk factors of post-ERCP cholangitis. CONCLUSIONS: The risk of post-ERCP cholangitis can be reduced by performing endoscopic stone extraction as soon as the patient achieves clinical stability after biliary stent insertion and by using endoscopic sphincterotomy instead of endoscopic papillary balloon dilation.

Needle tract seeding of the gastric wall after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic body cancer: a case report

Progress of Digestive Endoscopy, 2020

Multiple focal autoimmune pancreatitis diagnosed by the endoscopic ultrasound-guided fine needle aspiration: A case report

Pancreatology, 2016

Progress of Digestive Endoscopy, 2018

Gastrointestinal Endoscopy, 2020

AT, Kanai T, The Horibe GI bleeding prediction score: a simple score for triage decision-making i... more AT, Kanai T, The Horibe GI bleeding prediction score: a simple score for triage decision-making in patients with suspected upper GI bleeding,