徳島大学 / 教育研究者総覧 --- 津田恵

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学術論文(審査論文):

1.	K. Ozaki, Takashi Kawanaka, Tomoya Fukawa, Kei Daizumoto, Yutaro Sasaki, Megumi Tsuda, Yoshito Kusuhara, Yasuyo Yamamoto, Kunihisa Yamaguchi, Masayuki Takahashi and Hiro-omi Kanayama : Appropriate management reduces radiation exposure in daily urological practice, International Journal of Urology, 2022. (要約) To identify and raise awareness of the radiation exposure of urologists due to X-ray fluoroscopic procedures in daily practice. This was a single-center, cohort study of 30 consecutive patients who underwent periodic percutaneous or transurethral replacements of urinary tract catheters. A total of 55 replacements every 3 months with cases aligned were performed by a single urologist. The urologist's radiation exposure and the incident dose to patients per case were measured with thermoluminescent dosimeters. In the latter 3-month period, the pulse fluoroscopy condition was changed from 15 to 7.5 pulses per second, and collimation was added to the field of view. In the analysis of all patients, the use of a modified pulse rate and collimation did not affect the fluoroscopy time, but it did significantly reduce the air kerma and dose area product; in addition, with respect to the medical exposure dose during percutaneous catheter replacement, fluoroscopy time was longer, but air kerma and dose area product showed significant decreases. As with decreases in medical exposure of patients, the equivalent dose for eye lenses of the urologist decreased from 1.2 mSv in the first 3-month period to 0.2 mSv in the second 3-month period. Similarly, the exposure dose for the extremities also decreased significantly, from 33.9 mSv to 8.1 mSv. Urologists are exposed to non-negligible amounts of radiation due to fluoroscopy. Appropriate management such as modified pulse fluoroscopy condition and precautions are required. (出版サイトへのリンク) ● Publication site (DOI): 10.1111/iju.14971 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35851694 ● Search Scopus @ Elsevier (PMID): 35851694 ● Search Scopus @ Elsevier (DOI): 10.1111/iju.14971 (DOI: 10.1111/iju.14971, PubMed: 35851694)
2.	Yutaro Sasaki, Kei Daizumoto, Megumi Tsuda, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Yasuyo Yamamoto and Hiro-omi Kanayama : Efficacy of the Mercedes-Benz closure technique for vaginal reconstruction in female robot-assisted radical cystectomy, Asian Journal of Endoscopic Surgery, 2022. (要約) Vaginal reconstruction using the posterior vaginal wall is required following radical cystectomy in women with resection of the uterus, adnexa, and anterior vaginal wall. Roll closure and clamshell closure are two widely known techniques. Of these, clamshell closure is recommended because roll closure has a high likelihood of breakdown or a resultant canal that is too narrow for sexual intercourse. In clamshell closure, however, folding the posterior vaginal wall anteriorly can be difficult. Therefore, we devised Mercedes-Benz closure, in which the vaginal wall is sutured from three directions to form a Mercedes-Benz shape, for anastomosis without tension on the vaginal wall. The present study was performed to investigate the efficacy of this alternative surgical technique for vaginal reconstruction. Twenty-six patients who underwent vaginal reconstruction following robot-assisted radical cystectomy were divided into two groups: 15 underwent clamshell closure and 11 underwent Mercedes-Benz closure. The patients' characteristics and surgical outcomes were compared between the two groups. There were no significant differences in clinical characteristics, including age, body mass index, and prior abdominal surgery between the two groups. The median vaginal reconstruction time tended to be longer in the Mercedes-Benz closure group than in the clamshell closure group (35.0 vs. 27.0 min, p = 0.102). No complications associated with vaginal reconstruction were identified. The surgical outcomes were comparable between Mercedes-Benz closure and clamshell closure. If vaginal reconstruction with clamshell closure is difficult, Mercedes-Benz closure is a valuable alternative technique. (出版サイトへのリンク) ● Publication site (DOI): 10.1111/ases.13109 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35842843 ● Search Scopus @ Elsevier (PMID): 35842843 ● Search Scopus @ Elsevier (DOI): 10.1111/ases.13109 (DOI: 10.1111/ases.13109, PubMed: 35842843)
3.	Yutaro Sasaki, Masayuki Takahashi, Kei Daizumoto, Megumi Tsuda, Yoshito Kusuhara, Tomoya Fukawa, Yasuyo Yamamoto, Kunihisa Yamaguchi and Hiro-omi Kanayama : The patient-side surgeon plays a key role in facilitating robot-assisted intracorporeal ileal conduit urinary diversion in men, Journal of Robotic Surgery, Vol.16, No.2, 437-444, 2022. (要約) The influence of the console surgeon on the feasibility and outcome of various robot-assisted surgeries has been evaluated. These variables may be partially affected by the skills of the patient-side surgeon (PSS), but this has not been evaluated using objective data. This study aimed to describe the surgical techniques of the PSS in robot-assisted radical cystectomy (RARC) and intracorporeal ileal conduit (ICIC) urinary diversion and objectively examine the changes in surgical outcomes with increasing PSS experience. During a 3-year period, 28 men underwent RARC and ICIC urinary diversion. Clinical characteristics and surgical outcomes were compared between patients who underwent surgery early (first half group) or late in the study period (second half group). The pre-docking incision enabled easy specimen removal. The glove port technique widened the working space of the PSS. The stay suture allowed the PSS to control the distal portion of the conduit, facilitating the passage of the ureteral stents. During stoma creation, pneumoperitoneum pressure was lost by opening the abdominal cavity. To overcome this problem, the robotic arm was used to lift the abdominal wall to maintain the surgical field and facilitate the PSS procedure. Compared with the first half group, the second half group had significantly shorter times for urinary diversion (202 min vs 148 min, p < 0.001), ileal isolation and anastomosis (73 min vs 45 min, p < 0.001), and stenting (23.0 min vs 6.5 min, p < 0.001). As the experience of the PSS increased, the time of the PSS procedures decreased. (キーワード) Cystectomy / Humans / Male / Robotic Surgical Procedures / Robotics / Surgeons / Treatment Outcome / Urinary Bladder Neoplasms / Urinary Diversion (徳島大学機関リポジトリ) ● Metadata: 116363 (出版サイトへのリンク) ● Publication site (DOI): 10.1007/s11701-021-01256-x (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 34081290 ● Search Scopus @ Elsevier (PMID): 34081290 ● Search Scopus @ Elsevier (DOI): 10.1007/s11701-021-01256-x (徳島大学機関リポジトリ: 116363, DOI: 10.1007/s11701-021-01256-x, PubMed: 34081290)
4.	佐々木雄太郎, 安宅真利花, 多田航生, 中西亮太, 橋本啓佑, 吉岡拓哉, 大豆本圭, 尾崎啓介, 上野恵輝, 津田恵, 楠原義人, 布川朋也, 山本恭代, 山口邦久, 高橋正幸, 金山博臣, 柏原秀也, 徳永卓哉 : 局所進行直腸癌に対してロボット支援骨盤内臓全摘除術および体腔内回腸導管造設術を施行した2例, 泌尿器科紀要, Vol.68, No.5, 155-159, 2021年. (キーワード) Robot-assisted total pelvic exenteration / Intracorporeal urinary diversion / Intracorporeal ileal conduit (出版サイトへのリンク) ● Publication site (DOI): 10.14989/actauroljap_68_5_155 (文献検索サイトへのリンク) ● CiNii @ 国立情報学研究所 (CRID): 1390855656035011840 ● Search Scopus @ Elsevier (DOI): 10.14989/actauroljap_68_5_155 (DOI: 10.14989/actauroljap_68_5_155, CiNii: 1390855656035011840)
5.	佐々木雄太郎, 角陸文哉, 深谷友祐, 山本拓, 大豆本圭, 尾崎啓介, 上野恵輝, 津田恵, 楠原義人, 布川朋也, 山本恭代, 山口邦久, 高橋正幸, 金山博臣 : 膀胱浸潤を来たした局所進行性前立腺癌に対してロボット支援腹腔鏡下膀胱前立腺全摘除術を施行した1例, 泌尿器科紀要, Vol.67, No.4, 163-166, 2021年. (要約) While robot-assisted radical cystoprostatectomy (RARC) for locally advanced prostate cancer (LAPC) may sometimes prove to be excessive treatment, it can significantly reduce the risk of positive surgical margins and lower urinary tract obstruction in some cases. Here, we report a case of LAPC treated with RARC in a patient with right hydronephrosis due to bladder infiltration and left hypoplastic kidney. A 71-year-old man presented with frequent urination in August 2019. Prostate-specific antigen (PSA) level was 8.633 ng/ml, and magnetic resonance imaging led to the suspicion that the prostate cancer extended beyond the prostate capsule without distant metastasis. Prostatic biopsy revealed Gleason score 10 (5+5) adenocarcinoma in 8 out of 8 specimens. We diagnosed left hypoplastic kidney and LAPC with right hydronephrosis due to bladder infiltration. We performed percutaneous right nephrostomy and started neoadjuvant hormone therapy. RARC and intracorporeal ileal conduit were performed in March 2020. The prostate was adherent to the anterior surface of the rectum and was difficult to remove. At present, five months after the surgery, the patient remains free of recurrence and metastasis with PSA level <0.003 ng/ml. RARC for LAPC with bladder infiltration can be an effective therapeutic strategy in some cases. (キーワード) Locally advanced prostate cancer / Bladder Invasion / Robot-assisted radical cystoprostatectomy (出版サイトへのリンク) ● Publication site (DOI): 10.14989/ActaUrolJap_67_4_163 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 34107613 ● Summary page in Scopus @ Elsevier: 2-s2.0-85108011497 (DOI: 10.14989/ActaUrolJap_67_4_163, PubMed: 34107613, Elsevier: Scopus)
6.	Yutaro Sasaki, Masayuki Takahashi, Keisuke Ozaki, Kei Daizumoto, Yoshiteru Ueno, Megumi Tsuda, Yoshito Kusuhara, Tomoya Fukawa, Yasuyo Yamamoto, Kunihisa Yamaguchi and Hiro-omi Kanayama : Efficacy of the direct grasping technique using pean forceps under fluoroscopy to replace ureteral stents in women, The Journal of Medical Investigation : JMI, Vol.3.4, No.68, 326-329, 2021. (要約) Purpose : To evaluate the efficacy of the direct grasping technique using pean forceps under fluoroscopic guidance for ureteral stent replacement in women. Methods : Between April 2018 and September 2020, 28 female patients underwent ureteral stent replacements at our facility, and 184 stent replacement procedures were performed. A total of 127 stents were replaced using pean forceps under fluoroscopic guidance (pean forceps group), and 57 stents were replaced using the cystoscope (cystoscopy group). Clinical characteristics and surgical outcomes were compared between the groups. Results : All stents were successfully replaced. There was a statistically significant difference in the procedure time between the two groups (median [interquartile range], pean forceps group : 10.8 [8.2-13.9] minutes vs. cystoscopy group : 15.8 [11.1-20.9] minutes, P < 0.001). There were no intraoperative complications in either group and no difference in the incidence of postoperative complications (pean forceps group : 1.6% vs. cystoscopy group : 1.8%, P = 1.000). Fluoroscopy time was longer in the pean forceps group, although this difference was not statistically significant (pean forceps group : 38.9 [22.6-60.1] seconds vs. cystoscopy group : 33.0 [20.0-48.9] seconds, P = 0.0558). Conclusion : The direct grasping technique using pean forceps under fluoroscopy may be a beneficial alternative to cystoscopy for ureteral stent replacement in women. J. Med. Invest. 68 : 326-329, August, 2021. (キーワード) 女性 (female) / Fluoroscopy / Humans / Stents / Surgical Instruments / Ureter / Ureteral Obstruction (徳島大学機関リポジトリ) ● Metadata: 116511 (出版サイトへのリンク) ● Publication site (DOI): 10.2152/jmi.68.326 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 34759153 ● Search Scopus @ Elsevier (PMID): 34759153 ● Search Scopus @ Elsevier (DOI): 10.2152/jmi.68.326 (徳島大学機関リポジトリ: 116511, DOI: 10.2152/jmi.68.326, PubMed: 34759153)
7.	山本恭代, 布川朋也, 津田恵, 矢野哲弘, 大豆本圭, 佐々木雄太郎, 尾﨑啓介, 上野恵輝, 楠原義人, 山口邦久, 高橋正幸, 金山博臣 : 骨盤臓器脱と膀胱憩室を同時に治療した1例, 泌尿器科紀要, Vol.66, No.8, 269-272, 2020年. (要約) We report a case of bladder diverticulum presumably caused by lower urinary tract dysfunction due to pelvic organ prolapse (POP) simultaneously treated with transurethral coagulation (TUC) of the bladder diverticulum and laparoscopic sacrocolpopexy (LSC). A literature search showed this is the first report of bladder diverticulum and POP surgically treated at the same time. A 71-year-old woman was referred to our hospital for the treatment of cystocele. She had both storage and voiding symptoms. She had a POPQ stage III cystocele and stage I uterine prolapse. Ultrasonography and computed tomographic scan showed a large volume of residual urine along with a bladder diverticulum. Since urodynamic studies revealed a low compliance bladder and obstruction, we opined that the lower urinary tract symptoms were induced by the cystocele. TUC of the bladder diverticulum and LSC were performed at the same time. After the operation, clean intermittent catheterization (CIC) was needed once a day for one month. Gradually, residual urine decreased and CIC became unnecessary. The bladder diverticulum disappeared, and there has been no recurrence of POP. (キーワード) Aged / Diverticulum / 女性 (female) / Humans / Lower Urinary Tract Symptoms / Pelvic Organ Prolapse / Urinary Bladder / Urinary Bladder, Overactive (出版サイトへのリンク) ● Publication site (DOI): 10.14989/ActaUrolJap_66_8_269 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 32882124 ● Summary page in Scopus @ Elsevier: 2-s2.0-85090318500 (DOI: 10.14989/ActaUrolJap_66_8_269, PubMed: 32882124, Elsevier: Scopus)

国際会議:

1.	Yasuyo Yamamoto, Megumi Tsuda, Kei Daizumoto, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Masayuki Takahashi and Hiro-omi Kanayama : Examination of Mid-Urethral Sling (MUS) for elderly patients over 75 years old, Athens, Oct. 2019.

国内講演発表:

1.	堀克仁, 佐々木雄太郎, 角陸文哉, 塩崎啓登, 大豆本圭, 冨田諒太郎, 上野恵輝, 津田恵, 楠原義人, 布川朋也, 山口邦久, 山本恭代, 高橋正幸, 金山博臣 : 当院での未固定遺体を用いた内シャント造設術トレーニングの試み ∼生体との違いについて∼, 日本泌尿器科学会四国地方会, 2022年7月.
2.	佐々木雄太郎, 堀克仁, 角陸文哉, 大豆本圭, 上野恵輝, 冨田諒太郎, 津田恵, 楠原義人, 布川朋也, 山口邦久, 山本恭代, 高橋正幸, 金山博臣 : 多診療科で行うロボット支援手術 ∼後方骨盤内臓全摘除術の1例∼, 日本泌尿器科学会四国地方会, 2022年7月.
3.	橋本啓佑, 佐々木雄太郎, 安宅真利花, 多田航生, 中西亮太, 吉岡拓哉, 大豆本圭, 尾崎啓介, 上野恵輝, 津田恵, 楠原義人, 布川朋也, 山本恭代, 山口邦久, 高橋正幸, 金山博臣 : ロボット支援体腔内回腸導管造設術においてストマ造設を円滑に行うための工夫, 日本ロボット外科学会学術集会, 2022年2月.
4.	山本恭代, 津田恵, 大豆本圭, 佐々木雄太郎, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 当院における外来排尿自立指導の臨床的検討, 日本泌尿器科學會雜誌, 2021年12月.
5.	山本恭代, 津田恵, 大豆本圭, 佐々木雄太郎, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 憩室口が遠位に存在する尿道憩室摘除術における工夫, 西日本泌尿器科, Vol.83, 2021年11月.
6.	山本恭代, 津田恵, 金山博臣 : 排尿ケアの要，リハビリテーションに望むこと∼泌尿器科医の立場から∼, 日本排尿機能学会誌, Vol.32, No.1, 2021年9月.
7.	山本恭代, 大豆本圭, 佐々木雄太郎, 津田恵, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 夜間頻尿に対するデスモプレシンの使用経験, 日本排尿機能学会誌, Vol.32, No.1, 2021年9月.
8.	山本恭代, 津田恵, 大豆本圭, 佐々木雄太郎, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 骨盤臓器脱に対し膣閉鎖術を行った症例の検討, 日本女性骨盤底医学会, 2021年7月.
9.	山本恭代, 津田恵, 大豆本圭, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 難治性過活動膀胱に対するボツリヌス毒素膀胱壁内注入療法の初期治療経験, 日本老年泌尿器科学会誌, Vol.34, No.1, 109, 2021年5月.
10.	高橋正幸, 楠原義人, 佐々木雄太郎, 大豆本圭, 尾﨑啓介, 上野恵輝, 津田恵, 布川朋也, 山本恭代, 山口邦久, 金山博臣 : ロボット支援下腎盂形成術-温故創新成人水腎症に対するロボット支援腎盂形成術の初期経験, 第33回日本内視鏡外科学会総会, 2021年3月.
11.	高橋正幸, 矢野哲弘, 大豆本圭, 佐々木雄太郎, 尾﨑啓介, 上野恵輝, 津田恵, 楠原義人, 森英恭, 布川朋也, 山本恭代, 山口邦久, 金山博臣 : 転移性腎細胞癌に対するニボルマブ・イピリムマブ併用療法の初期経験, 第108回日本泌尿器科学会総会, 2020年12月.
12.	山本恭代, 布川朋也, 津田恵, 大豆本圭, 楠原義人, 山口邦久, 高橋正幸, 金山博臣 : 腹腔鏡下仙骨腟固定術前後で比較した下部尿路機能症状とQOLの変化, 第108回日本泌尿器科学会総会, 2020年12月.
13.	山本恭代, 布川朋也, 津田恵, 大豆本圭, 楠原義人, 山口邦久, 高橋正幸, 金山博臣 : 骨盤臓器脱患者に対する腹腔鏡下仙骨腟固定術前後での下部尿路症状の変化, 第82回西日本泌尿器科学会総会, 2020年11月.
14.	山本恭代, 津田恵, 大豆本圭, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : TOT手術時のヘガールを用いたテープ調整の有用性, 第27回日本排尿機能学会, 2020年10月.
15.	西川木綿子, 山本恭代, 津田恵, 金山博臣, 金澤昭代, 高開登茂子, 近藤心 : 排尿ケアチームによる継続的排尿自立支援とアウトカム評価の検討, 第33回日本老年泌尿器科学会総会, 2020年9月.
16.	津田恵, 山本恭代, 大豆本圭, 楠原義人, 布川朋也, 山口邦久, 高橋正幸, 金山博臣 : 泌尿器科疾患以外の患者に対する排尿ケアチーム介入の臨床的検討, 第33回日本老年泌尿器科学会総会, 2020年9月.
17.	柿原紋太, 野崎夏江, 兼本ひろみ, 津田恵, 山本恭代, 山本雄貴, 山本伸昭, 石原学, 島田健司, 兼松康久, 西京子, 加藤真介, 髙木康志 : 徳島大学病院脳卒中センター(SCU)における排尿ケアチーム介入後の下部尿路機能障害の現状, 第45回日本脳卒中学会総会(web開催), 2020年8月.
18.	高橋正幸, 大豆本圭, 佐々木雄太郎, 尾﨑啓介, 上野恵輝, 津田恵, 楠原義人, 森英恭, 布川朋也, 山本恭代, 山口邦久, 金山博臣 : 転移性腎細胞癌に対しニボルマブ・イピリムマブ併用療法を施行した4例の症例報告, 2019年10月.
19.	山本恭代, 布川朋也, 大豆本圭, 津田恵, 楠原義人, 森英恭, 山口邦久, 高橋正幸, 金山博臣 : RARPにおける術前残尿量と術後尿禁制の関連, 第26回日本排尿機能学会, 2019年9月.
20.	山本恭代, 布川朋也, 津田恵, 大豆本圭, 楠原義人, 森英恭, 山口邦久, 福森知治, 高橋正幸, 金山博臣 : 骨盤臓器脱と膀胱憩室を同時に治療した1例, 第21回女性骨盤底医学会, 2019年7月.
21.	高橋正幸, 大豆本圭, 尾﨑啓介, 津田恵, 楠原義人, 森英恭, 布川朋也, 山本恭代, 山口邦久, 福森知治, 金山博臣 : 高齢腎癌患者に対する根治的腎摘除術/腎部分切除術の臨床的検討, 第50回腎癌研究会記念大会, 2019年7月.
22.	津田恵, 山本恭代 : 当院における排尿自立指導料算定を行った脳卒中症例に関する臨床的検討, 2019年6月.
23.	山本恭代, 大豆本圭, 楠原義人, 津田恵, 森英恭, 布川朋也, 山口邦久, 福森知治, 高橋正幸, 金山博臣 : 排尿ケアチームが複数回介入した症例の検討, 日本泌尿器科學會雜誌, 2019年4月.
24.	高橋正幸, 西山美月, 福田喬太郎, 大豆本圭, 尾﨑啓介, 津田恵, 楠原義人, 森英恭, 布川朋也, 山本恭代, 山口邦久, 福森知治, 金山博臣 : 小児膀胱尿管逆流症に対する気膀胱下Cohen法の初期治療経験, 第107回日本泌尿器科学会総会, 2019年4月.

科学研究費補助金 (KAKEN Grants Database @ NII.ac.jp)

筋組織内代謝変化を標的としたがん悪液質新規治療法の開発 (研究課題/領域番号: 19K07731 )
エキソソームを介した筋萎縮発症機序の解明と新たな治療へのアプローチ (研究課題/領域番号: 19H03516 )
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