下部消化管チームで扱う疾患は大腸癌（結腸癌、直腸癌、肛門管癌、虫垂癌）を中心とした悪性疾患だけでなく、良性疾患では潰瘍性大腸炎やクローン病などの炎症性腸疾患（IBD）や大腸憩室症（憩室出血、憩室炎）、遺伝性腫瘍（家族性大腸ポリポーシス）、小腸・大腸良性腫瘍と多岐にわたります。

特に大腸癌手術の領域では2000年以降、高度な技術を要する腹腔鏡下手術の比率が増加しています。当科では現在、4名の日本内視鏡外科学会技術認定医を中心に、安全かつ質の高い医療を提供しています。

また、2018年より直腸癌に対してロボット支援下手術が保険適応となり、当科でも日常的におこなっています。

腹腔鏡下手術

腹腔鏡下手術は数ヶ所の小さな穴（5～12mm）と病変部を体外に取り出す小切開創（3～7cm）でおこなう手術術式です。これらの小さな穴からお腹の中にカメラや専用の手術器械を挿入し、病変部を切除します。従来の開腹手術では20cm以上の傷が必要となることが珍しくありませんでした。腹腔鏡下手術の長所として、以下が挙げられます。

・  傷が小さいので痛みが少なく早期離床が可能

・  腸蠕動の回復が良好で早期の食事摂取が可能

・  術後在院日数が短縮

・  傷が小さく目立ちにくい、美容的

・  拡大視効果により微細な出血も止血可能で術中出血量が少ない

・  骨盤内など狭い場所でも手術スタッフ全員が同じ視野・情報を共有できる

しかしながら全ての患者様に腹腔鏡下手術が可能ではなく、癌の進展が高度な時や、お腹の中の癒着が高度な場合は従来通りの開腹手術となることがあります。当科での大腸癌症例数および腹腔鏡・ロボット下手術比率の年次推移はグラフのとおりです。直近5年間の実績では大腸癌手術症例数は年間約150例であり、うち9割以上が腹腔鏡・ロボット手術でした。

ロボット支援下手術

当院では、インテュイティブサージカル社のda Vinci Xi＠ならびにX＠を、メディカロイド社のhinotori＠をそれぞれ1台ずつ保有しています。

ロボット支援下手術には上記に挙げた腹腔鏡下手術の長所に加え、以下のような長所があります。

・　カメラの画像がぶれない、奥行きのある3D画像であり立体視に優れている

・　手術操作を行う鉗子に関節機能があり、狭い骨盤内の操作に優れている

治療成績について、従来の開腹手術や腹腔鏡下手術と比較しての優劣は現在のところ証明されておらず、どちらを選択しても問題はありません。

当科の実績は2018年が5例、2019年が25例、2020年が1～6月で17例（年間約40例ペース）、と順調に増加しています。

肛門温存

従来、下部直腸癌には肛門ごと病巣を切除し、永久人工肛門を作製する手術が一般的でした。現在は病巣の局在や進行度によりますが、肛門に近い癌であっても肛門括約筋の一部を温存しながら病巣を切除し、自然肛門を温存する手術（括約筋間直腸切除術: intersphincteric resection (ISR)）が普及してきました。この術式は肛門機能低下に伴う排便障害（便回数の増加、便漏れ）や局所再発のリスクが問題となることがあり、十分なインフォームドコンセントをおこなった上で患者様がこの手術を希望される場合は積極的におこなっています。

また、下部直腸の進行癌の場合、肛門を残せるかという問題以外に手術をしても局所再発する頻度が他の部位の大腸癌に比べて高いという問題があります。そこで当科では術前に抗癌剤と放射線治療を併用することで（術前化学放射線療法）、原発巣の縮小を図り術後局所再発の制御をおこなっています。

炎症性腸疾患

潰瘍性大腸炎やクローン病は基本的には薬物療法などの内科的治療をおこないます。しかし病気が進行して、どうしても外科的切除が必要となることがあります。

潰瘍性大腸炎の標準手術は大腸全摘術です。従来通りの開腹手術でおこなうとみぞおちから恥骨まで大きな傷がつくことになります。当科では、大腸全摘術も原則として腹腔鏡下手術でおこない、可能な限り永久人工肛門を避ける術式を選択しています。

クローン病では腸管狭窄（腸閉塞）や瘻孔形成（腸管とその近接臓器に連続性ができてしまうこと）となり、腸切除が必要となることがあります。当科では可能な限り腹腔鏡下で腸切除をおこなっています。クローン病では何度も狭窄がおこり、その都度、腸切除が必要になることが珍しくありません。一度でも腹部手術をうけるとお腹の中が癒着します。腹腔鏡下手術は開腹手術に比べ癒着が少ないと言われており、その面からみてもクローン病に適した手術方法であると考えています。

集学的治療

全ての大腸癌が手術だけで根治できるわけではありません。リンパ節転移を伴う大腸癌（Stage III）は再発のリスクが高いため、内服または点滴の抗癌剤を投与して補助化学療法を主に外来でおこなっています。さらに、Stage IIでも再発リスクが高い場合はお勧めすることがあります。また、再発症例や他臓器転移を伴う進行大腸癌には従来の抗癌剤に新規抗癌剤である分子標的治療薬や免疫チェックポイント阻害薬（ただし、使用できる対象は限られています）を併用し、さらに外科的切除や放射線療法などを加えた集学的治療を駆使し、大腸癌の治療成績の向上に努めています。

週に1回、当科だけでなく消化器内科や放射線科と合同カンファレンスを行い、個々の病状に沿って最善の治療を検討しています。 

論文業績

1. Sakakura C, Nishio M, Miyashita A, Nagata H, Hamada T, Nakanishi M, Ikoma H, Kubota K, Ichikawa D, Kikuchi S, Fujiwara H, Okamoto K, Ochiai T, Kokuba Y, Taniguchi H, Sonoyama T, Otsuji E. [A case of huge advanced rectal cancer invaded into the surrounding organs resected successfully after preoperative chemotherapy with mFOLFOX6]. Gan To Kagaku Ryoho. 2008 Nov;35(12):2132-4. Japanese. PMID: 19106547.

2. Sakakura C, Nishio M, Miyagawa K, Miyashita A, Nagata H, Kin S, Fukuda K, Nakase Y, Hagiwara A, Nakanishi M, Yamazaki J, Yoshikawa S, Okamoto K, Kokuba Y, Otsuji E. Laparoscope-assisted superlow anterior resection combined with inter sphincteric rectal dissection for very low advanced rectal cancers combined with preoperative chemotherapy. Hepatogastroenterology. 2009 May-Jun;56(91-92):692-5. PMID: 19621682.

3. Arita T, Shiozaki A, Fujiwara H, Kokuba Y, Kuriu Y, Kubota T, Ichikawa D, Okamoto K, Ishii H, Ikoma H, Nakanishi M, Ochiai T, Sakakura C, Sonoyama T, Otsuji E. [A case of esophageal cancer with sigmoid colon tumor treated by laparoscopic surgery]. Gan To Kagaku Ryoho. 2010 Nov;37(12):2388-90. Japanese. PMID: 21224582.

4. Nakanishi M, Kokuba Y, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Otsuji E. A new approach to laparoscopic lymph node excision in cases of transverse colon cancer. Digestion. 2012;85(2):121-5. doi: 10.1159/000334683. Epub 2012 Jan 19. PMID: 22269292.

5. Kuriu Y, Kokuba Y, Murayama Y, Komatsu S, Shiozaki A, Ikoma H, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Otsuji E. [Neoadjuvant chemoradiotherapy for locally advanced rectal cancer]. Gan To Kagaku Ryoho. 2012 Nov;39(12):1951-3. Japanese. PMID: 23267940.

6. Koizumi N, Murayama Y, Kuriu Y, Nakanishi M, Okamoto K, Kokuba Y, Otsuji E. Incidentally Discovered Adenocarcinoma in situ of the Appendix in a Young Woman. Case Rep Gastroenterol. 2012 Sep;6(3):726-33. doi: 10.1159/000345805. Epub 2012 Sep 22. PMID: 23275764; PMCID: PMC3531942.

7. Kamada Y, Nakanishi M, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Kimura A, Ichikawa D, Okamoto K, Fujiwara H, Ochiai T, Kokuba Y, Ishikawa T, Kokura S, Otsuji E. [A case of advanced colon cancer resected successfully after neoadjuvant chemotherapy]. Gan To Kagaku Ryoho. 2012 Nov;39(12):2213-5. Japanese. PMID: 23268027.

8. Hatakeyama T, Nakanishi M, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Kokuba Y, Otsuji E. Laparoscopic resection for colorectal cancer improves short-term outcomes in very elderly colorectal cancer patients. Surg Laparosc Endosc Percutan Tech. 2013 Dec;23(6):532-5. doi: 10.1097/SLE.0b013e31828e3da5. PMID: 24300931.

9. Ishimoto T, Nakanishi M, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Kubota T, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. [Laparoscopic lateral lymph node dissection technique and short-term results in our hospital]. Gan To Kagaku Ryoho. 2013 Nov;40(12):1924-6. Japanese. PMID: 24393967.

10. Kinoshita O, Nakanishi M, Ishimoto T, Murayama Y, Yasukawa S, Kuriu Y, Masuzawa N, Kishimoto M, Konishi E, Yanagisawa A, Otsuji E. [An appropriate distal resection margin for lower rectal cancer after preoperative chemoradiotherapy]. Gan To Kagaku Ryoho. 2013 Nov;40(12):1623-5. Japanese. PMID: 24393869.

11. Nakanishi M, Kuriu Y, Murayama Y, Konishi H, Komatsu S, Shiozaki A, Ikoma H, Kubota T, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Otsuji E. Efficacy of perioperative chemotherapy in patients with colorectal cancer undergoing hepatectomy for resectable synchronous liver metastasis. Hepatogastroenterology. 2014 Sep;61(134):1582-7. PMID: 25436346.

12. Kinoshita O, Murayama Y, Kuriu Y, Nakanishi M, Sakakura C, Otsuji E. Invasive mucinous adenocarcinoma associated with adjacent sessile serrated lesion of the appendix vermiform: a case report. Case Rep Pathol. 2014;2014:979674. doi: 10.1155/2014/979674. Epub 2014 Jul 9. PMID: 25114824; PMCID: PMC4119926.

13. Kinoshita O, Nakanishi M, Murayama Y, Kuriu Y, Kokuba Y, Otsuji E. Flattened tumor requires a more careful attention for residual distal cancer spread in locally advanced lower rectal carcinoma after chemoradiotherapy. Dig Surg. 2015;32(3):159-65. doi: 10.1159/000371586. Epub 2015 Mar 28. PMID: 25833218.

14. Kinoshita O, Kishimoto M, Murayama Y, Kuriu Y, Nakanishi M, Sakakura C, Otsuji E, Yanagisawa A. The number of metastatic lymph nodes exhibiting poorly differentiated clusters predicts survival in patients with pStage III colorectal cancer. Int J Colorectal Dis. 2016 Feb;31(2):283-90. doi: 10.1007/s00384-015-2393-5. Epub 2015 Sep 28. PMID: 26412250; PMCID: PMC4744259.

15. Kudou M, Murayama Y, Konishi H, Morimura R, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Kojima O, Otsuji E. Peritoneal colon cancer metastasis to bilateral inguinal hernia repair sites: report of a case. Surg Today. 2015 Aug;45(8):1053-7. doi: 10.1007/s00595-014-1037-7. Epub 2014 Oct 16. PMID: 25319214.

16. Matsuo H, Nakanishi M, Arita T, Murayama Y, Kuriu Y, Kosuga T, Konishi H, Morimura R, Komatsu S, Shiozaki A, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Otsuji E. [Tolerability of Oxaliplatin-Based Adjuvant Chemotherapy for Patients with Colorectal Cancer]. Gan To Kagaku Ryoho. 2015 Nov;42(12):2112-4. Japanese. PMID: 26805281.

17. Kamada Y, Murayama Y, Ota U, Takahashi K, Arita T, Kosuga T, Konishi H, Morimura R, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Tanaka T, Otsuji E. Urinary 5-Aminolevulinic Acid Concentrations as a Potential Tumor Marker for Colorectal Cancer Screening and Recurrence. Anticancer Res. 2016 May;36(5):2445-50. PMID: 27127156.

18. Nakanishi M, Kuriu Y, Murayama Y, Arita T, Ito H, Kosuga T, Morimura R, Konishi H, Komatsu S, Shiozaki A, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Otsuji E. Usefulness of Reduced Port Surgery for Left Colon Cancer. Anticancer Res. 2016 Sep;36(9):4749-52. doi: 10.21873/anticanres.11030. PMID: 27630322.

19. Nakanishi M, Kuriu Y, Murayama Y, Arita T, Kosuga T, Morimura R, Konishi H, Komatsu S, Shiozaki A, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Otsuji E. A Study on the Tolerability of Capecitabine plus Oxaliplatin as Adjuvant Chemotherapy. Anticancer Res. 2016 Apr;36(4):1851-4. PMID: 27069169.

20. Kubo H, Murayama Y, Arita T, Kuriu Y, Nakanishi M, Otsuji E. The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer. World J Surg. 2016 Nov;40(11):2796-2802. doi: 10.1007/s00268-016-3595-x. PMID: 27307087.

21. Matsumoto T, Nakanishi M, Miyamae M, Takao K, Fukunaga T, Otsuji E. [A Case of Locally Advanced Rectal Cancer with Abscess and Rectovesical Fistula Curatively Resected Following Preoperative Chemotherapy]. Gan To Kagaku Ryoho. 2017 Nov;44(12):1482-1484. Japanese. PMID: 29394675.

22. Okajima W, Kuriu Y, Arita T, Murayama Y, Nakanishi M, Okayama T, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. [A Case Report of Adenocarcinoma with Pagetoid Growth(Secondary Paget's Disease)of the Anal Canal]. Gan To Kagaku Ryoho. 2017 Nov;44(12):1332-1334. Japanese. PMID: 29394624.

23. Yamamoto S, Hinoi T, Niitsu H, Okajima M, Ide Y, Murata K, Akamoto S, Kanazawa A, Nakanishi M, Naitoh T, Kanehira E, Shimamura T, Suzuka I, Fukunaga Y, Yamaguchi T, Watanabe M; Japan Society of Laparoscopic Colorectal Surgery. Influence of previous abdominal surgery on surgical outcomes between laparoscopic and open surgery in elderly patients with colorectal cancer: subanalysis of a large multicenter study in Japan. J Gastroenterol. 2017 Jun;52(6):695-704. doi: 10.1007/s00535-016-1262-5. Epub 2016 Sep 20. PMID: 27650199.

24. Nishibeppu K, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Shoda K, Kosuga T, Konishi H, Morimura R, Komatsu S, Shiozaki A, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Otsuji E. A successful case of a para-aortic lymphocele treated with autologous peripheral blood injection. Radiol Case Rep. 2017 Sep 28;12(4):760-763. doi: 10.1016/j.radcr.2017.08.014. PMID: 29484065; PMCID: PMC5823392.

25. Okamura R, Hida K, Yamaguchi T, Akagi T, Konishi T, Yamamoto M, Ota M, Matoba S, Bando H, Goto S, Sakai Y, Watanabe M; Japan Society of Laparoscopic Colorectal Surgery; Watanabe K, Otsuka K, Takemasa I, Tanaka K, Ikeda M, Matsuda C, Fukuda M, Hasegawa J, Akamoto S, Shiozawa M, Tsuruta A, Akiyoshi T, Kato T, Tsukamoto S, Ito M, Naito M, Kanazawa A, Takahashi T, Ueki T, Hayashi Y, Morita S, Yamaguchi T, Nakanishi M, Hasegawa H, Okamoto K, Teraishi F, Sumi Y, Tashiro J, Yatsuoka T, Nishimura Y, Okita K, Kobatake T, Horie H, Miyakura Y, Ro H, Nagakari K, Hidaka E, Umemoto T, Nishigori H, Murata K, Wakayama F, Makizumi R, Fujii S, Sunami E, Kobayashi H, Nakagawa R, Enomoto T, Ohnuma S, Higashijima J, Ozawa H, Ashida K, Fujita F, Uehara K, Maruyama S, Ohyama M, Yamamoto S, Hinoi T, Yoshimitsu M, Okajima M, Tanimura S, Kawasaki M, Ide Y, Hazama S, Watanabe J, Inagaki D, Toyokawa A. Local control of sphincter-preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis. Ann Gastroenterol Surg. 2017 Aug 14;1(3):199-207. doi: 10.1002/ags3.12032. PMID: 29863157; PMCID: PMC5881346.

26. Ogawa S, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Kudo M, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. [Two Cases of Anal Canal Adenocarcinoma with Pagetoid Spread Treated with Laparoscopic Abdominoperineal Resection]. Gan To Kagaku Ryoho. 2018 Dec;45(13):2186-2188. Japanese. PMID: 30692326.

27. Matsumoto Y, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Kudou M, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. [Inflammatory Pseudotumor in the Cecum-A Case Report and Review of Literature]. Gan To Kagaku Ryoho. 2018 Dec;45(13):2072-2074. Japanese. PMID: 30692288.

28. Matsubara D, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Kudou M, Shoda K, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Preoperative inflammatory response as prognostic factor of patients with colon cancer. Langenbecks Arch Surg. 2019 Sep;404(6):731-741. doi: 10.1007/s00423-019-01811-z. Epub 2019 Aug 29. PMID: 31468113.

29. Kudou M, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Shoda K, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Essentiality of Imaging Diagnostic Criteria Specific to Rectal Neuroendocrine Tumors for Detecting Metastatic Lymph Nodes. Anticancer Res. 2019 Jan;39(1):505-510. doi: 10.21873/anticanres.13141. PMID: 30591502.

30. Matsubara D, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Kudou M, Konishi H, Komatsu S, Shiozaki A, Otsuji E. The impact of postoperative inflammation on recurrence in patients with colorectal cancer. Int J Clin Oncol. 2020 Apr;25(4):602-613. doi: 10.1007/s10147-019-01580-1. Epub 2019 Nov 22. PMID: 31758273.

31. Kudou M, Nakanishi M, Kuriu Y, Murayama Y, Arita T, Kishimoto M, Konishi E, Goto M, Yamada K, Otsuji E. Value of intra-tumor heterogeneity evaluated by diffusion-weighted MRI for predicting pathological stages and therapeutic responses to chemoradiotherapy in lower rectal cancer. J Cancer. 2020 Jan 1;11(1):168-176. doi: 10.7150/jca.38354. PMID: 31892983; PMCID: PMC6930416.

32. Takabatake K, Arita T, Nakanishi M, Kuriu Y, Murayama Y, Shimizu H, Kudou M, Kiuchi J, Kosuga T, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Impact of Inferior Mesenteric Artery Lymph Node Metastasis on the Prognosis of Left-sided Colorectal Cancer. Anticancer Res. 2021 May;41(5):2533-2542. doi: 10.21873/anticanres.15031. PMID: 33952481.

33. Matsumoto T, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. [A Case of Laparoscopic Resection for Rectal Cancer with Persistent Descending Mesocolon]. Gan To Kagaku Ryoho. 2021 Dec;48(13):2079-2081. Japanese. PMID: 35045499.

34. Kudou M, Nakanishi M, Kuriu Y, Arita T, Shimizu H, Kiuchi J, Katsurahara K, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. The Effect of Preoperative Oral Antibiotics in the Prevention of Surgical Site Infection after Laparoscopic Colorectal Cancer Surgery: A Propensity Score Matching Study. J Anus Rectum Colon. 2021 Jul 29;5(3):319-326. doi: 10.23922/jarc.2021-005. PMID: 34395946; PMCID: PMC8321581.

35. Mitsuda M, Shimizu H, Kuriu Y, Kubota T, Arita T, Ohashi T, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Fujiwara H, Okamoto K, Otsuji E. Is Preoperative Spirometry Necessary for Gastrointestinal Cancer Surgery? Anticancer Res. 2022 Mar;42(3):1623-1628. doi: 10.21873/anticanres.15637. PMID: 35220260.

36. Takabatake K, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Takaki W, Konishi H, Yamamoto Y, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Sonobe Y, Tanaka N, Konishi E, Otsuji E. Calcifying fibrous tumor of the ileum resected by single-port laparoscopic surgery: a case report. Surg Case Rep. 2022 Apr 13;8(1):64. doi: 10.1186/s40792-022-01423-8. PMID: 35416631; PMCID: PMC9008114.

37. Inoue H, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Colonic Metastasis from Breast Cancer: A Case Report and Review of the Literature. In Vivo. 2022 Jan-Feb;36(1):522-527. doi: 10.21873/invivo.12733. PMID: 34972757; PMCID: PMC8765167.

38. Furuke H, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Nakanishi M, Fujiwara H, Okamoto K, Otsuji E. The survival after recurrence of colorectal cancer: a retrospective study focused on time to recurrence after curative resection. Surg Today. 2022 Feb;52(2):239-250. doi: 10.1007/s00595-021-02336-z. Epub 2021 Jul 16. PMID: 34269851.

39. Shimizu H, Kuriu Y, Arita T, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Simple and reliable method for the application of Seprafilm® during laparoscopic surgery. Asian J Endosc Surg. 2022 Apr;15(2):449-452. doi: 10.1111/ases.12995. Epub 2021 Sep 30. PMID: 34595840.

40. Tamai M, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Ohashi T, Konishi H, Yamamoto Y, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Clinical impact of postoperative prognostic nutritional index in colorectal cancer patients undergoing adjuvant chemotherapy. Am J Cancer Res. 2021 Oct 15;11(10):4947-4955. PMID: 34765302; PMCID: PMC8569341.

41. Shimizu H, Kuriu Y, Arita T, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Staging Paradox and Discrepancy in Adjuvant Chemotherapy in Patients with T4N0, T1-2N1, and T3N1 Colon Cancer. World J Surg. 2021 May;45(5):1561-1568. doi: 10.1007/s00268-021-05973-0. Epub 2021 Feb 4. PMID: 33538878.

42. Arita T, Kuriu Y, Shimizu H, Kiuchi J, Otsuji E. Laparoscopic anterior resection for patients with rectosigmoid cancer in situs inversus totalis - a video vignette. Colorectal Dis. 2022 Jun;24(6):797. doi: 10.1111/codi.16063. Epub 2022 Feb 3. PMID: 35068038.

43. Nakabayashi Y, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Takaki W, Ohashi T, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. [Reasonable Surgery for Sigmoid Colon Cancer with Asymptomatic Celiac Artery Stenosis and Superior Mesenteric Artery Stenosis-A Case Report]. Gan To Kagaku Ryoho. 2022 Dec;49(13):2013-2015. Japanese. PMID: 36733075.

44. Takaki W, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Ohashi T, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Impact of the preoperative clinical N stage on the prognosis of patients with colon cancer. Colorectal Dis. 2023 Feb;25(2):243-252. doi: 10.1111/codi.16366. Epub 2022 Oct 28. PMID: 36222385.

45. Sumiyoshi S, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Takaki W, Ohashi T, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Okamoto K, Otsuji E. Postoperative liver dysfunction is associated with poor long-term outcomes in patients with colorectal cancer: a retrospective cohort study. BMC Gastroenterol. 2023 Apr 18;23(1):128. doi: 10.1186/s12876-023-02762-y. PMID: 37072727; PMCID: PMC10114433.

46. Kiuchi J, Kuriu Y, Arita T, Shimizu H, Nanishi K, Takaki W, Ohashi T, Konishi H, Yamamoto Y, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Preoperative oral antibiotic administration in patients undergoing curative resection with stoma creation for colorectal cancer: effectiveness in preventing surgical site infection and the possibility of peristomal candidiasis induced by enterobacterial alteration. Colorectal Dis. 2023 Nov;25(11):2217-2224. doi: 10.1111/codi.16754. Epub 2023 Sep 30. PMID: 37776219.

47. Inoue H, Kudou M, Shiozaki A, Kosuga T, Shimizu H, Kiuchi J, Arita T, Konishi H, Komatsu S, Kuriu Y, Morinaga Y, Konishi E, Otsuji E. Value of the Tumor-Stroma Ratio and Structural Heterogeneity Measured by a Novel Semiautomatic Image Analysis Technique for Predicting Survival in Patients With Colon Cancer. Dis Colon Rectum. 2023 Nov 1;66(11):1449-1461. doi: 10.1097/DCR.0000000000002570. Epub 2022 Dec 15. PMID: 36649165.

48. Takabatake K, Shimizu H, Kuriu Y, Arita T, Kiuchi J, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Does Neoadjuvant Chemoradiotherapy Have an Additional Effect to Lateral Pelvic Lymph Node Dissection for Rectal Cancer? J Anus Rectum Colon. 2024 Apr 25;8(2):102-110. doi: 10.23922/jarc.2023-038. PMID: 38689781; PMCID: PMC11056532.

49. Matsui T, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Nanishi K, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Deep pelvis and low visceral fat mass as risk factors for neurogenic bladder after rectal cancer surgery. BMC Gastroenterol. 2024 Sep 27;24(1):323. doi: 10.1186/s12876-024-03433-2. PMID: 39333910; PMCID: PMC11437677.

50. Inoue H, Shimizu H, Kuriu Y, Arita T, Nanishi K, Kiuchi J, Ohashi T, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Patients with T4N0 and T1‑3N1 colon cancer and a high preoperative carcinoembryonic antigen level benefit from adjuvant chemotherapy with oxaliplatin for 6 months. Oncol Lett. 2024 Oct 18;29(1):13. doi: 10.3892/ol.2024.14759. PMID: 39526306; PMCID: PMC11544698.

51. Takashima Y, Shimizu H, Kuriu Y, Arita T, Kiuchi J, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Advantages of robotic surgery for rectal cancer compared to laparoscopic surgery: pelvic anatomy and its impact on urinary dysfunction. J Robot Surg. 2024 Sep 11;18(1):338. doi: 10.1007/s11701-024-02095-2. PMID: 39261385.

52. Kido M, Arita T, Shoda K, Shimizu H, Kiuchi J, Nanishi K, Yan L, Otsuji E. Inter-prefectural and urban-rural regional disparities in rectal cancer and rectal resections: A Japanese nationwide population-based cohort study from 2014 to 2019. Ann Gastroenterol Surg. 2024 Oct 1;9(2):281-287. doi: 10.1002/ags3.12865. PMID: 40046527; PMCID: PMC11877343.

53. Taniguchi H, Uehara K, Ishikawa T, Okochi O, Akazawa N, Okuda H, Hasegawa H, Shiozawa M, Kataoka M, Satake H, Shimura T, Kondoh C, Kuramochi H, Matsumoto T, Takegawa N, Yamaguchi T, Nagase M, Nakamura M, Takano N, Fujita H, Watanabe T, Nishina T, Sakamoto Y, Moriwaki T, Ohori H, Nakanishi M, Kito Y, Utsunomiya S, Ishikawa T, Manaka D, Matsuoka H, Suto T, Arai T, Shinzaki S, Funakoshi T, Nakayama G, Negoro Y, Tsuji Y, Makiyama A, Takuma K, Arimoto A, Shinozaki K, Mishima A, Masuishi T. BRAF V600E and Non-V600E Mutations in RAS Wild-Type Metastatic Colorectal Cancer: Prognostic and Therapeutic Insights from a Nationwide, Multicenter, Observational Study (J-BROS). Cancers (Basel). 2025 Jan 25;17(3):399. doi: 10.3390/cancers17030399. PMID: 39941768; PMCID: PMC11815755.

54. Kido M, Arita T, Shoda K, Inoue K, Okimura H, Shimizu H, Kiuchi J, Nanishi K, Shiozaki A. (2025). Indirect assessment of hemorrhoid incidence using invasive treatment data in Japan: A 5‐year study based on nationwide health insurance claims. Annals of Gastroenterological Surgery.

55. Marunaka Y, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Nanishi K, Imamura T, Ohashi T, Konishi H, Yamamoto Y, Morimura R, Shiozaki A, Ikoma H, Kubota T, Fujiwara H, Otsuji E. Re-examining the optimal extent of lymph node dissection for colon cancer using the lymphadenectomy index. Sci Rep. 2025 Feb 24;15(1):6575. doi: 10.1038/s41598-025-91250-2. PMID: 39994326; PMCID: PMC11850810.

56. Hida K, Okita Y, Fujii Y, Miyake T, Kuriu Y, Hidaka Y, Arita T, Kawaguchi K, Ochi S, Fujita Y, Obama K, Naitoh T; Japan Society of Laparoscopic Colorectal Surgery. Surgical trend including minimally invasive surgeries for ulcerative colitis in the COSUC study: the largest multicenter cohort study in Japan. Surg Endosc. 2025 Jun;39(6):3911-3920. doi: 10.1007/s00464-025-11758-6. Epub 2025 May 12. PMID: 40355738.