Kyushu University Academic Staff Educational and Research Activities Database
List of Reports
Kenoki Ohuchida Last modified dateļ¼š2024.06.03

Associate Professor / Department of Surgery and Oncology / Department of Clinical Medicine / Faculty of Medical Sciences

1. Tomohiko Shinkawa, Kenoki Ohuchida, Masafumi Nakamura, Heterogeneity of Cancer-Associated Fibroblasts and the Tumor Immune Microenvironment in Pancreatic Cancer, Cancers, 10.3390/cancers14163994, 14(16):3994, 2022.04.
2. Shindo K, Ohuchida K, Moriyama T, Kinoshita F, Koga Y, Oda Y, Eto M, Nakamura M, A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report, Surg Case Rep, 10.1186/s40792-020-01074-7, 6(1):303, 2020.04, Abstract
Background: Metastatic cancer to the stomach is relatively rare. Prostate-specific antigen (PSA) is a reliable biomarker used in the screening and management of patients with prostate cancer. However, it is difficult to definitively diagnose a PSA-negative metastatic gastric tumor of prostate cancer because the cancer sometimes resembles primary gastric cancer in clinical images. It is also difficult to distinguish metastatic cancer from primary cancer even in the pathological examination of biopsy samples when the lesion is poorly differentiated adenocarcinoma. There is a possibility that the characteristics of the cancer are changed during treatment such as chemotherapy or radiation therapy. Therefore, careful consideration is required for surgical indication.
Case presentation: A 60-year-old male underwent radical prostatectomy and subsequent radiation therapy for advanced prostate cancer (pT3N1M0) 10 years previously, and hormone therapy was started for metachronous multiple bone metastasis 10 months before. Upper gastrointestinal endoscopy revealed an irregular depressed lesion with a convergence of folds at the greater curvature of the upper gastric body. Biopsy showed poorly differentiated adenocarcinoma that was negative for PSA upon immunohistochemistry. He had high serum carcinoembryonic antigen (CEA) (946.1 ng/ml) and carbohydrate antigen 19-9 (CA19-9) (465.1 U/ml) levels with no elevation of PSA (0.152 ng/ml). The tumor was diagnosed as primary gastric cancer based on the clinical imaging and pathological examination of the biopsy sample including the PSA staining. Based on the diagnosis, laparoscopic proximal gastrectomy with lymphadenectomy was performed. However, pathological examination of the resected specimen revealed poorly differentiated adenocarcinoma that was positive for other prostate markers such as androgen receptor. Thus, the patient was diagnosed with metastasized prostate cancer to the stomach.
Conclusions: We report a case of metastatic gastric cancer of prostate cancer 10 years after radical prostatectomy. In the present case, it was difficult to diagnose a metastatic gastric tumor of prostate cancer preoperatively, because of its resemblance to primary gastric cancer without PSA expression and no serum PSA elevation. Although a rare case entity, it is important to consider the possibility of a metastatic gastric tumor when the surgical indication is determined in cases with another co-existing cancer.
3. Nagai S, Nagayoshi K, Mizuuchi Y, Fujita H, Ohuchida K, Ohtsuka T, Imai R, Nakamura M, Laparoscopic spacer placement for recurrent sacral chordoma before carbon ion radiotherapy: A case report, Asian J Endosc Surg, 10.1111/ases.12792, 13(4):582-585, 2020.04, Abstract
Recently, several scholars have demonstrated the efficacy of carbon ion radiotherapy (CIRT). To treat abdominal or pelvic tumors by CIRT, it is necessary to separate the tumor from the adjacent organs. Surgical placement of a GORE-TEX sheet as a spacer has been reported as a separation method. Usually, surgical spacer placement is done by open surgery. Here, we report a case of surgical spacer placement undertaken by a "pure" laparoscopic procedure. A 47-year-old man with recurrent sacral chordoma was referred for surgical spacer placement before CIRT. Laparoscopic dissection of the rectum and placement of a GORE-TEX sheet as a spacer were successfully performed. Surgical spacer placement by a pure laparoscopic procedure was safe and effective, and it seems to play an important part before CIRT..
4. Oyama K, Ohuchida K, Shindo K, Moriyama T, Hata Y, Wada M, Ihara E, Nagai S, Ohtsuka T & Nakamura M, Thoracoscopic Surgery Combined With Endoscopic Creation of a Submucosal Tunnel for a Large Complicated Esophageal Leiomyoma, Surgical case report, 10.1186/s40792-020-00854-5, 6(1):92, 2020.04.
5. Ohtsuka T, Tomosugi T, Kimura R, Nakamura S, Miyasaka Y, Nakata K, Mori Y, Morita M, Torata N, Shindo K, Ohuchida K, Nakamura M, Clinical assessment of the GNAS mutation status in patients with intraductal papillary mucinous neoplasm of the pancreas, Surg Today, 10.1007/s00595-019-01797-7 , 49(11):887-893, 2019.04, Abstract
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by cystic dilation of the pancreatic duct, caused by mucin hypersecretion, with slow progression via the adenoma-carcinoma sequence mechanism. Mutation of GNAS at codon 201 is found exclusively in IPMNs, occurring at a rate of 41-75%. Recent advances in molecular biological techniques have demonstrated that GNAS mutation might play a role in the transformation of IPMNs after the appearance of neoplastic cells, rather than in the tumorigenesis of IPMNs. GNAS mutation is observed frequently in the intestinal subtype of IPMNs with MUC2 expression, and less frequently in IPMNs with concomitant pancreatic ductal adenocarcinoma (PDAC). Research has focused on assessing GNAS mutation status in clinical practice using various samples. In this review, we discuss the clinical application of GNAS mutation assessment to differentiate invasive IPMNs from concomitant PDAC, examine the clonality of recurrent IPMNs in the remnant pancreas using resected specimens, and differentiate pancreatic cystic lesions using cystic fluid collected by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), duodenal fluid, and serum liquid biopsy samples
6. Ohuchida K, Ohtsuka T, Mizumoto K, Hashidume M, Tanaka M, Pancreatic Cancer: Clinical Significance of Biomarkers, Gastro Intestinal Tumors, 1(1):33-40, 2014.04.
7. Ohuchida K, Hashizume M, Preface to topic "Robotic surgery for hepato-biliary-pancreatic (HBP) surgery"., J Hepatobiliary Pancreat Sci. , 21(1):1-2, 2014.04.
8. Ohuchida K, Ohtsuka T, Mizumoto K, Hashidume M, Tanaka M, Pancreatic Cancer: Clinical Significance of Biomarkers, Gastro Intestinal Tumors, 1(1):33-40, 2014.04.
9. Ohuchida K, Hashizume M, Robotic surgery for cancer., Cancer J, 19(2):130-132, 2013.04, Currently, robot-assisted surgery is the most common type of robotic surgery used. In robot-assisted surgery, the operator is a surgeon, not a robotic system. Robotic systems assist the surgeons, but do not operate automatically. In this section, we focus on the master-slave type, which is the predominant type of robotic surgery used in cancer treatment, and discuss the role, present status, and the future of surgical robotic system in cancer treatment. In addition, the advantages and disadvantages of a robotic system are discussed, but further development of technologies and equipment is necessary to allow the safe, widespread introduction of a robotic system in more advanced surgery for malignant tumors. Such advances in the surgical robotic system will hopefully overcome the remaining problems and provide the ultimate minimally invasive surgery for cancer treatment..
10. Otsuka T, Nagai E, Toma H, Ohuchida K, Takanami H, Odate S, Eguchi D, Ueki T, Shimizu S, Tanaka M, Single-incision laparoscopy-assisted surgery for bowel obstruction: Report of three cases.
, Surg Today. , 41(11):1519-1523, 2011.04, Abstract
We applied single-incision laparoscopy-assisted surgery for several different types of bowel obstruction in selected patients. Before the operation, a long nasal tube was inserted for intestinal decompression and assessment of a stenotic lesion. A specially-designed instrument for single-incision laparoscopic surgery, the SILS Port, was introduced at the umbilicus or proposed ileostomy site. After intracorporeal procedures, extracorporeal resection and reconstruction of the intestine was performed as needed. Three patients with bowel obstruction due to jejunal carcinoma, colonic stenosis, and adhesion underwent single-incision laparoscopy-assisted surgery. The port site was used for subsequent extracorporeal resection and anastomosis of the jejunum in two patients, and for ileostomy in the remaining patient. All of the procedures were completed safely, and there were no postoperative complications. Single-incision laparoscopy can therefore be applied for selected patients with bowel obstruction. In such cases, the preoperative insertion of a long nasal tube for decompression of intestinal contents and assessment of the stenotic lesion is necessary.

11. Toyonaga T, Nagaoka S, Ohuchida K, Nagata M, Shirota T, Ogawa T, Yoshida J, Sinohara M, Matsuo K, Sumitomo K, Akao M, Case of a bleeding pseudoaneurysm of the middle colic artery complicating acute pancreatitis, Hepatogastroenterology , 49(46):1141-1143, 2002.04, Massive bleeding from a pseudoaneurysm is rare, but it can be a life-threatening complication in patients with acute pancreatitis. We present a case in which massive bleeding from a pseudoneurysm in the middle colic artery complicating acute pancreatitis was successfully treated by transcatheter embolization and by continuous regional arterial infusion of a protease inhibitor and antibiotic. We also discuss the clinical features, diagnosis and treatment of such lesions in light of the literature. We emphasize the value of computed tomography in the early diagnosis of mesenteric hematoma in cases of acute pancreatitis and the value of angiography for control of bleeding from the complicating pseudoaneurysm.PMID: 12143222 [PubMed - indexed for MEDLINE] .
12. Toyonaga T, Shinohara M, Miyatake E, Ohuchida K, Shirota T, Ogawa T, Yoshida J, Sumitomo K, Matsuo K, Akao M, Penetration of the duodenum by an ingested needle with migration to the pancreas: report of a case., Surg Today, 31(1):68-71, 2001.04, A case of a penetration of the duodenum by a needle with migration to the pancreas in a 50-year-old man is reported herein. The patient was referred to us with a chief complaint of diarrhea. An abdominal plain roentgenogram showed a needle in the upper abdominal area. An abdominal computed tomography scan and contrast X-ray revealed the foreign body to be located outside of the duodenum and in the head of the pancreas. An emergency operation was therefore performed on the first day and the needle in the head of the pancreas was thus extirpated safely. A perforation of the gastrointestinal tract by an ingested foreign body is difficult to accurately and quickly diagnose when no peritonitis or abscess formation is observed. Therefore, the use of contrast X-ray is considered to be useful in the diagnosis of such a perforation..