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Article ; Online: Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis.

Kimura, Hideaki / Toritani, Kenichiro / Kunisaki, Reiko / Tatsumi, Kenji / Koganei, Kazutaka / Sugita, Akira / Endo, Itaru

BMC gastroenterology

2023 Volume 23, Issue 1, Page(s) 32

Abstract: Background: Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation ... ...

Abstract	Background: Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation and neoplasia. This study aimed to identify factors associated with the retention of a large amount of anorectal mucosa after DS-IPAA. Methods: The medical records of 163 patients who had undergone one-stage total proctocolectomy and DS-IPAA for UC between 2007 and 2020 were retrospectively reviewed. The patients were divided into two groups according to the length of the retained mucosa. The high anastomosis group was defined as having a retained mucosal length of ≥ 30 mm in the anterior or posterior wall. Clinical factors were compared between the high and low anastomosis groups. Results: The high anastomosis group showed a significantly higher body mass index (BMI) (high vs. low: 23.2 vs. 19.0), longer operation time (304 vs. 263) and greater blood loss (357 vs. 240). In the multivariate analysis, high BMI was the only factor significantly associated with high anastomosis (odds ratio 1.32). There was a positive correlation between BMI and the length of the retained mucosa. Conclusions: In DS-IPAA, BMI showed the strongest association with the retention of a large amount of the anorectal mucosa. In high BMI patients, although the risk of inability of anastomosis is little than that of IPAA with mucosectomy, the possible retention of a large amount of mucosa should be considered.
MeSH term(s)	Humans ; Proctocolectomy, Restorative/adverse effects ; Colitis, Ulcerative/surgery ; Body Mass Index ; Retrospective Studies ; Surgical Stapling/adverse effects ; Anastomosis, Surgical/adverse effects ; Intestinal Mucosa/surgery ; Treatment Outcome ; Colonic Pouches/adverse effects ; Postoperative Complications/etiology ; Postoperative Complications/surgery
Language	English
Publishing date	2023-02-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2041351-8
ISSN	1471-230X ; 1471-230X
ISSN (online)	1471-230X
ISSN	1471-230X
DOI	10.1186/s12876-023-02667-w
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Article ; Online: Curable leakage in stapled IPAA has little effect on the long-term pouch function.

Toritani, Kenichiro / Kimura, Hideaki / Goto, Koki / Kunisaki, Reiko / Watanabe, Jun / Ishibe, Atsushi / Endo, Itaru

International journal of colorectal disease

2023 Volume 38, Issue 1, Page(s) 43

Abstract: Purpose: This study aimed to evaluate the frequency and grade of anastomotic leakage (AL) in stapled ileal pouch-anal anastomosis (IPAA) and its long-term impact on the pouch functions.: Methods: A longitudinal cohort study was conducted on UC ... ...

Abstract	Purpose: This study aimed to evaluate the frequency and grade of anastomotic leakage (AL) in stapled ileal pouch-anal anastomosis (IPAA) and its long-term impact on the pouch functions. Methods: A longitudinal cohort study was conducted on UC patients who underwent stapled IPAA at Yokohama City University Medical Center between 2007 and 2018. The diagnosis and grading of AL were performed in accordance with the recommendations of the International Study Group of Rectal Cancer. We assessed the functional pouch rate, late complication, pouch survival rate, bowel function (bowel movements per day, soiling, spotting, difficulty in distinguishing feces from flatus) and pouch inflammation (pouchitis disease activity index; PDAI) in the long-term period. Results: Two hundred seventy-six patients were analyzed. Twenty-three (8.3%; grade B/C; 13/10) patients were diagnosed with AL, but a functional pouch was achieved in all the twenty-three patients. Anastomotic stricture was significantly more common in patients with AL (AL group) than in patients without AL (non-AL group; AL/non-AL: 13.0/3.2%, p = 0.020). There were no differences in other late complications. Furthermore, the pouch survival rate did not differ between the AL and non-AL groups (100.0/97.9%/10 years, p = 0.494). There were no differences between the groups in bowel movements per day, spotting, soling, difficulty in distinguishing feces from flatus, or PDAI postoperatively. Conclusions: Curable AL may not affect late complications (except anastomotic stricture), pouch survival, the bowel function, or pouch inflammation over the long term. Perioperative management to prevent the severity of AL is as important as preventing its occurrence.
MeSH term(s)	Humans ; Anastomosis, Surgical/adverse effects ; Colonic Pouches/adverse effects ; Longitudinal Studies ; Constriction, Pathologic/complications ; Constriction, Pathologic/surgery ; Flatulence/complications ; Flatulence/surgery ; Colitis, Ulcerative/surgery ; Proctocolectomy, Restorative/adverse effects ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Inflammation/complications ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2023-02-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-023-04339-3
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Article: [Diagnosis and treatment for anal canal cancer and fistula-associated anal cancer in Crohn's disease].

Kimura, Hideaki

Nihon rinsho. Japanese journal of clinical medicine

2012 Volume 70 Suppl 1, Page(s) 541–545

MeSH term(s)	Anal Canal ; Crohn Disease/complications ; Female ; Humans ; Intestinal Neoplasms/diagnosis ; Intestinal Neoplasms/therapy ; Male ; Middle Aged ; Rectal Fistula/diagnosis
Language	Japanese
Publishing date	2012-02
Publishing country	Japan
Document type	Journal Article
ZDB-ID	390903-7
ISSN	0047-1852
ISSN	0047-1852
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Article ; Online: Successful Treatment With Ustekinumab for Enterocutaneous Fistulas in Crohn's Disease.

Madarame, Akira / Kimura, Hideaki / Kunisaki, Reiko

Journal of Crohn's & colitis

2019 Volume 14, Issue 4, Page(s) 569–570

MeSH term(s)	Adult ; Crohn Disease/complications ; Cutaneous Fistula/drug therapy ; Cutaneous Fistula/etiology ; Dermatologic Agents/therapeutic use ; Humans ; Intestinal Fistula/drug therapy ; Intestinal Fistula/etiology ; Male ; Ustekinumab/therapeutic use
Chemical Substances	Dermatologic Agents ; Ustekinumab (FU77B4U5Z0)
Language	English
Publishing date	2019-10-15
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjz161
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Article ; Online: Preoperative risk factors of incisional surgical site infection in severe or intractable ulcerative colitis.

Toritani, Kenichiro / Kimura, Hideaki / Fukuoka, Hironori / Watanabe, Jun / Ishibe, Atsushi / Kunisaki, Reiko / Endo, Itaru

Surgery today

2021 Volume 52, Issue 3, Page(s) 475–484

Abstract: Purpose: The present study explored preoperative risk factors (predictors) of incisional surgical site infection (I-SSI) in severe or intractable ulcerative colitis (UC).: Methods: This was a retrospective study of 230 consecutive patients who ... ...

Abstract	Purpose: The present study explored preoperative risk factors (predictors) of incisional surgical site infection (I-SSI) in severe or intractable ulcerative colitis (UC). Methods: This was a retrospective study of 230 consecutive patients who underwent primary surgery for UC. Patients whose surgical indications were UC with cancer or dysplasia were excluded. SSI was defined as an infection according to the Centers for Disease Control and Prevention Guidelines. Preoperative variables were examined by univariate, receiver operating characteristic curve, and multivariate analyses. Results: We analyzed 208 patients in this study. In a multivariate logistic analysis, C-reactive protein (CRP) ≥ 1.7 mg/dl [odds ratio (OR) 5.35; 95% confidence interval (CI) 1.50-19.06; p = 0.01), albumin ≤ 2.4 g/dl (OR 5.77; 95% CI 1.41-23.57; p = 0.02), and preoperative blood transfusion (OR 3.21; 95% CI 1.04-9.96; p = 0.04) were predictors of I-SSI. Patients with all predictors had a more than 50% incidence of I-SSI, a higher incidence of all severe complications (13.6% vs. 3.2%; p = 0.02), and a longer postoperative hospital stay (19.5 vs. 17.0 days, p = 0.04) than the other patients. Conclusions: CRP ≥ 1.7 mg/dl, albumin ≤ 2.4 g/dl, and transfusion are predictors of I-SSI in severe or intractable UC. Clinician should carefully evaluate the surgical options before these predictors appear.
MeSH term(s)	Colitis, Ulcerative/complications ; Colitis, Ulcerative/surgery ; Humans ; Incidence ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology
Language	English
Publishing date	2021-08-13
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-021-02354-x
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Article ; Online: Simultaneous Development of Ulcerative Colitis in the Sigmoidocolon Autotransplant Neovagina and the Residual Colorectum.

Matsune, Yusuke / Yaguchi, Katsuki / Saito, Shin / Sakakibara, Hideya / Inayama, Yoshiaki / Kimura, Hideaki / Kunisaki, Reiko

Inflammatory bowel diseases

2021 Volume 28, Issue 2, Page(s) e18–e20

MeSH term(s)	Autografts ; Colitis, Ulcerative/surgery ; Humans ; Transplantation, Autologous
Language	English
Publishing date	2021-08-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izab222
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Article: Human activity patterns at the Horokazawa Toma Upper Paleolithic stone tool manufacturing site in the Shirataki obsidian source area: Combining excavation with experimentation

Kimura, Hideaki / Evgeny Girya

Quaternary international. 2016 Mar. 18, v. 397

2016

Abstract: The Horokazawa site locality Toma (HT) is an Upper Paleolithic archeological site situated on a hillside near the Shirataki Akaishiyama obsidian source area, the largest in Japan. Excavations at HT over a period of more than 20 years have produced more ... ...

Abstract	The Horokazawa site locality Toma (HT) is an Upper Paleolithic archeological site situated on a hillside near the Shirataki Akaishiyama obsidian source area, the largest in Japan. Excavations at HT over a period of more than 20 years have produced more than 570,000 artifacts from an area of less than 100 m2. The Horokazawa Toma lithic assemblage was characterized by the Yubetsu technique, which was used to manufacture microblades in Siberia, the Far East, and North America. The assemblage at HT has been dated to the period just after the last glacial maximum, around 15,000 years ago, and when the microblade industry was flourishing in Eastern Asia. As flakes and chips account for 98% of the lithic artifacts, the site was evidently a lithic workshop. In this study, along with examination of excavated materials we identified the source of excavated materials by macroscopic observation and nondestructive analyses, and we experimentally replicated the manufacturing technique to analyze the activities carried at this workshop and infer the distribution network of raw materials and worked stone, beginning with the acquisition of the obsidian.The obsidian came from the East Atelier and Ajisainotaki (especially) sources near the summit of Mt. Akaishiyama. Large angular and slab-like nodules from these sources were likely collected at Hidarinosawa being closer to HT, brought to HT, and processed into large bifaces and boat-shaped blanks for microblade manufacture. Many of these products were exported to other sites. We showed by experiment that the first and second spalls efficiently removed from a large biface by the block-on-block technique. A similar microblade industry based on Shirataki obsidian is found at sites in the Yubetsu River drainage, below HT, and other sites in Hokkaido. In fact, Shirataki obsidian is found at remote sites such as Akatsuki site (eastern part of Hokkaido) and Sokol site (on Sakhalin island), suggesting that raw materials were exchanged between groups of people over long distances. This large distribution network was supported by mass production of blanks for microblade manufacturing at the Toma locality of the Horokazawa site.
Keywords	anthropogenic activities ; drainage ; hills ; manufacturing ; nondestructive methods ; raw materials ; rivers ; Japan ; North America ; Siberia
Language	English
Dates of publication	2016-0318
Size	p. 448-473.
Publishing place	Elsevier Ltd
Document type	Article
ISSN	1040-6182
DOI	10.1016/j.quaint.2015.04.015
Database	NAL-Catalogue (AGRICOLA)

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Article: [Surgical ulcerative colitis complicated by multiple lung abscesses secondary to septic pulmonary embolism after multidrug immunosuppressive therapies].

Araki, Kentaro / Kimura, Hideaki / Nakamori, Yoshinori / Madarame, Akira / Ikeda, Aya / Hirayama, Atsuhiro / Kunisaki, Reiko / Endo, Itaru

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology

2022 Volume 119, Issue 11, Page(s) 1029–1035

Abstract: This is a case implying a serious infectious complication risk during intensive severe ulcerative colitis treatment. A 26-year-old man developed diarrhea and bloody stool who was diagnosed with ulcerative colitis in 2018. He was managed with 5- ... ...

Abstract	This is a case implying a serious infectious complication risk during intensive severe ulcerative colitis treatment. A 26-year-old man developed diarrhea and bloody stool who was diagnosed with ulcerative colitis in 2018. He was managed with 5-aminosalicylic acid, but intolerance reaction resulted in discontinuation of treatment. He relapsed with severe abdominal pain and bloody stools in February 2019. He was referred to our department for intensive therapy. He had been treated with steroids, tacrolimus, granulocyte and monocyte apheresis, infliximab or tofacitinib, which temporarily improved his clinical symptoms. However, his medical condition could not be controlled. Hand-assisted laparoscopic subtotal colectomy was then performed in October 2019. He developed intermittent fever on postoperative day 3. Enhanced computed tomography (CT) revealed multiple deep vein thromboses and pulmonary embolism. Antibiotics and anticoagulation therapy were initiated, but postoperative day 13 CT showed multiple pulmonary cavities containing fluids and air, which were diagnosed as pulmonary abscess. His intermittent fever was over 38.0°C. Severe cough and hemoptysis lasted 3 weeks, the clinical symptoms and laboratory data then gradually improved after the fourth week.
MeSH term(s)	Male ; Humans ; Adult ; Colitis, Ulcerative/drug therapy ; Lung Abscess/complications ; Lung Abscess/drug therapy ; Infliximab/therapeutic use ; Immunosuppression Therapy ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/drug therapy ; Pulmonary Embolism/etiology
Chemical Substances	Infliximab (B72HH48FLU)
Language	Japanese
Publishing date	2022-11-07
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	708695-7
ISSN	1349-7693 ; 0446-6586
ISSN (online)	1349-7693
ISSN	0446-6586
DOI	10.11405/nisshoshi.119.1029
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Article ; Online: Progression of ulcerative colitis following diversion colitis.

Yaguchi, Katsuki / Matsune, Yusuke / Kunisaki, Reiko / Araki, Kentaro / Kimura, Hideaki / Inayama, Yoshiaki / Kumagai, Jiro / Maeda, Shin

Clinical journal of gastroenterology

2022 Volume 15, Issue 6, Page(s) 1088–1093

Abstract: Diversion colitis and ulcerative colitis (UC) can be caused by different mechanisms; however, several case reports have described the development of typical UC following diversion colitis. A 63-year-old man underwent Hartmann's operation following a ... ...

Abstract	Diversion colitis and ulcerative colitis (UC) can be caused by different mechanisms; however, several case reports have described the development of typical UC following diversion colitis. A 63-year-old man underwent Hartmann's operation following a diagnosis of perforation of a sigmoid colon diverticulum and peritonitis. Stoma closure was performed 4 months later, and the portion of the sigmoid colon with the diverticulum was unintentionally left as a blind end. Following stoma closure, hematochezia worsened, and he was diagnosed as having developed diversion colitis only in the blind sigmoid colon. Intermittent use of topical mesalazine enemas controlled the bowel symptoms; however, 4 years after the stoma closure, bloody stools were observed again. Colonoscopy revealed coarse and friable granular mucosa with adherent mucopurulent exudate in the rectum, and mucosal erythematous edema with adherent mucopurulent exudate in the blind sigmoid colon. The histological findings indicated basal plasmacytosis, and goblet cell depletion and cryptitis in the lamina propria, which is characteristic of UC. To the best of our knowledge, this is the fourth description of a patient who developed UC following diversion colitis. Local inflammation may have triggered the development of UC through hematogenous or lymphogenous circulation of lymphocytes or autoantibodies.
MeSH term(s)	Male ; Humans ; Middle Aged ; Colitis, Ulcerative/pathology ; Colitis/pathology ; Diverticulum, Colon/complications ; Colonoscopy/adverse effects ; Mesalamine/therapeutic use
Chemical Substances	Mesalamine (4Q81I59GXC)
Language	English
Publishing date	2022-09-06
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2429411-1
ISSN	1865-7265 ; 1865-7257
ISSN (online)	1865-7265
ISSN	1865-7257
DOI	10.1007/s12328-022-01696-4
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Article ; Online: Inflammatory bowel disease-specific findings are common morphological changes in the ileal pouch with ulcerative colitis.

Toritani, Kenichiro / Kimura, Hideaki / Otani, Masako / Fukuoka, Hironori / Kunisaki, Reiko / Watanabe, Jun / Ishibe, Atsushi / Misumi, Toshihiro / Inayama, Yoshiaki / Endo, Itaru

Scientific reports

2022 Volume 12, Issue 1, Page(s) 20361

Abstract: Why inflammation is common in ileal pouches with ulcerative colitis (UC) is unclear. We therefore clarified the morphological changes in pouches and afferent limbs (AL) of patients with UC and explored the relationship between these findings. We ... ...

Abstract	Why inflammation is common in ileal pouches with ulcerative colitis (UC) is unclear. We therefore clarified the morphological changes in pouches and afferent limbs (AL) of patients with UC and explored the relationship between these findings. We evaluated the morphological findings (histological and endoscopic inflammation as the Pouchitis Disease Activity Index [PDAI] histology subscore [hPDAI] and endoscopy subscore [ePDAI], inflammatory bowel disease [IBD]-specific findings using the IBD score [S
MeSH term(s)	Humans ; Colonic Pouches ; Colitis, Ulcerative ; Inflammatory Bowel Diseases ; Inflammation ; Chronic Disease ; Metaplasia
Language	English
Publishing date	2022-11-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-24708-2
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