Kobe University · University Hospital

Research keywordspediatric surgery・esophageal atresia・laparoscopic training・neonatal bowel anomalies・hepaticojejunostomy・peritonitis models

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• 開腹歴,基礎疾患のない癒着性腸閉塞の原因は何か2025 · (一社)日本小児外科学会, 2025年10月, 日本小児外科学会雑誌, 61(6) (6), 992 - 993, 日本語
• Partial median sternotomy approach for the repair of esophageal atresia.2023 · 2023年, Pediatrics international : official journal of the Japan Pediatric Society, 65(1) (1), e15601, 英語, 国際誌
• Long-term course of gastrostomy nutritional management in patients with Duchenne muscular dystrophy: A retrospective cohort study.1991 · Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease that commonly requires gastrostomy due to dysphagia. This study aimed to investigate the proportion of patients with DMD requiring gastrostomy and to assess the timing and outcomes of gastrostomy in patients with DMD to optimize perioperative care and improve long-term management. We conducted a retrospective cohort study by reviewing the medical records of patients with DMD treated between March 1991 and November 2023 at Kobe University Hospital. To identify risk factors for gastrostomy, Fisher's two-tailed test and logistic analysis were used to compare the gastrostomy (group G) and comparison group without gastrostomy (group C) groups. We identified patients >18 years with DMD. We excluded those without medical records from the last decade and those on nasogastric tube feeding. Among the 135 eligible patients, five (median age, 23 years) underwent percutaneous endoscopic gastrostomy (PEG; uptake rate, 3.7 %), and their data were analyzed for perioperative outcomes. Complications included ventilatory disturbances, aspiration pneumonia, and hemorrhagic shock. Two patients experienced significant postoperative complications, underscoring the high-risk nature of PEG in this population. Participants' postoperative weight changes varied significantly. The presence or absence of ventilatory management, cardiomyopathy treatment, scoliosis, and steroid treatment were examined as risk factors between groups G and C, but no significant differences were observed. This study highlights low gastrostomy usage among patients with DMD, with varying outcomes. Meticulous planning and early consideration of gastrostomy are crucial to enhance the quality of life and nutritional outcomes in these patients.
• Endosurgery workshop to improve the confidence of novice pediatric surgeons in performing laparoscopic hepaticojejunostomy.PURPOSE: This study assessed the efficacy of a high-impact, short-term workshop in honing the laparoscopic hepaticojejunostomy technical skills and self-confidence of novice pediatric surgeons, focusing on vertical needle driving and knot tying. METHODS: Lectures, hands-on sessions, pre- and post-workshop evaluations, and training using porcine models were conducted to refine basic and advanced skills. The "hepaticojejunostomy simulator" was used for comparative analysis of precision in pre- and post-workshop vertical needle driving and knot tying. Participants self-evaluated their skills and confidence on a 5-point scale. RESULTS: After the workshop, eight inexperienced pediatric surgeons demonstrated a significant improvement in hepaticojejunostomy suturing task completion rates and needle-driving precision at the jejunum and hepatic duct. However, the A-Lap Mini Endoscopic Surgery Skill Assessment System indicated no significant improvements in most assessed parameters, except for the full-layer closure score (p = 0.03). However, a significant increase in participants' confidence levels in performing laparoscopic hepaticojejunostomy was observed. CONCLUSION: The workshop augmented technical proficiency and confidence in young pediatric surgeons. The combination of lectures, practical exposure, and model training is an effective educational strategy in pediatric surgical instruction.

• 小児声門下腔狭窄症の診断治療評価におけるOCT（光干渉断層撮影）技術の有用性の評価 尾藤 祐子, 大片 祐一, 冨岡 雄一郎, 光明 祐希 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2024年04月 - 2027年03月2024 · KUID parsed section
• 小児声門下腔狭窄症の診断治療評価におけるOCT（光干渉断層撮影）技術の有用性の評価

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