Publications by authors named "Shunsuke Sugawara"
Objective: Whether metal stents (MS) or plastic stents (PS) yield better outcomes for malignant biliary obstruction in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is controversial. We aimed to compare outcomes of initial EUS-HGS performed with MS or PS.
Methods: In this single-center retrospective study, we included patients (MS/PS groups: n = 151/72) with unresectable malignant biliary obstruction and performed multivariable analysis.
Purpose: To evaluate the risk factors of non-diagnostic results based on cause of error in liver tumor biopsy.
Materials And Methods: This single-institution, retrospective study included 843 patients [445 men, 398 women; median age, 67 years] who underwent a total of 938 liver tumor biopsies between April 2018 and September 2022. An 18-G cutting biopsy needle with a 17-G introducer needle was used.
Article Synopsis
- Health economic evaluation is crucial for efficiently allocating healthcare resources, particularly in Japan, where a cost-effectiveness evaluation system for drugs was introduced in 2019 but not yet fully applied to medical procedures.
- Cancer care presents unique challenges for health economic evaluation due to the invasive nature of surgical treatments, which can lead to variable complications and costs, highlighting the need for collaboration with medical affairs.
- Quality of life (QOL) surveys are essential for assessing the impacts of surgical treatments on patients, yet there is a lack of large-scale studies in Japan, especially for cancer patients, signaling a need for future research in this area.
Purpose: This study aimed to evaluate the feasibility, safety, diagnostic yield, and technical aspects of percutaneous abdominal lavage cytology screening (PACS) in patients with resectable pancreatic cancer.
Methods: This single-center, retrospective study included patients with resectable pancreatic cancer who underwent PACS before pancreatectomy between May 2022 and October 2023. The technical success rate, position of the drainage tube, volume of fluid administered, volume of fluid retrieved, fluid retrieval rate, and adverse events were evaluated.
Article Synopsis
- * A total of 154 children were evaluated from January 2010 to December 2021, with a technical success rate of 99.4% and minimal intraoperative complications.
- * The findings suggest that younger children face higher risks of CVP inversions compared to older children, highlighting the need for tailored approaches in this age group.
Purpose: To evaluate the safety of propofol sedation administered by interventional radiologists during radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).
Materials And Methods: Propofol sedation was administered by interventional radiologists in 72 patients (85 procedures, 93 tumors) during RFA for HCC between August 2018 and December 2020. Interventional radiologists equipped with adequate knowledge and skills in sedation and respiratory management were responsible for sedation.
Article Synopsis
- Endoscopic ultrasound-guided gastroenterostomy is a procedure to connect the stomach with an afferent loop affected by dilation, aimed at treating afferent loop syndrome; the study assesses its effectiveness and safety.
- The research found a 100% technical success rate and a 96% clinical success rate among 25 patients, with some serious early adverse events related to fluid leakage but no late complications.
- The procedure demonstrated a 32% rate of recurrent intestinal obstruction after a median of 6.5 months, but was highly successful in re-interventions, confirming its overall effectiveness and safety for this condition.
The treatment strategy for refractory postoperative lymphatic leakage is controversial. While the utility of direct percutaneous embolization of lymphopseudoaneurysm has been investigated, only a few reports on this topic exist. The aim of this study was to evaluate the technical and clinical feasibility and safety of direct percutaneous embolization of lymphopseudoaneurysm for refractory postoperative lymphatic leakage.
View Article and Find Full Text PDFPurpose: The central venous port (CVP) is widely used for intravenous chemotherapy (IVC) in adult patients because of its lower infection rates and easier management than that of a central venous catheter. However, the feasibility and safety of the CVP for IVC in infants remain unknown. This study evaluated the usefulness of CVP for IVC in infants with retinoblastoma.
View Article and Find Full Text PDFPurpose This study aimed to evaluate the technical feasibility and safety of artificial pneumothorax induction for percutaneous procedures using the liver-directed approach and Seldinger's technique. Materials and methods The data of 25 consecutive patients who underwent percutaneous procedures after inducing artificial pneumothorax were reviewed retrospectively. The liver surface was punctured with an 18-gauge indwelling needle via the intercostal space in the inferior thoracic cavity under ultrasound guidance, avoiding the lung parenchyma and leaving the catheter in place.
View Article and Find Full Text PDFNecessity of Prophylactic Anticoagulation Therapy Following Inferior Vena Cava Stent Placement in Patients with Cancer.
Interv Radiol (Higashimatsuyama)
July 2023
Purpose: Although percutaneous stent placement for malignant inferior vena cava syndrome is a highly feasible and effective treatment option, there is no clear evidence for the necessity of prophylactic anticoagulation therapy after inferior vena cava stent placement. This study retrospectively evaluated the necessity of prophylactic anticoagulation following inferior vena cava stent placement in patients with malignant inferior vena cava syndrome.
Methods: The data of 54 patients (28 men and 26 women; median age 61.
Guidelines for Central Venous Port Placement and Management (Abridged Translation of the Japanese Version).
Interv Radiol (Higashimatsuyama)
July 2023
The central venous port has been widely used for patients who require long-term intravenous treatments, and the number of palcement has been increasing. The Japanese Society of Interventional Radiology developed a guideline for central venous port placement and management to provide evidence-based recommendations to support healthcare providers in the decision-making process regarding the central venous port. The guideline consisted of two parts: (i) a comprehensive review of topics including preoperative preparation, techniques for placement or removal, complications, and maintenance methods and (ii) recommendations for the six clinical questions regarding blood vessels for central venous port placement, port implantation site, prophylactic antibiotic therapy, imaging guidance for puncture, disinfectant prior to accessing the central venous port, and the optimal procedure at the end of drug administration via the central venous port, generated on the basis of the rating quality of evidence by systematic review.
View Article and Find Full Text PDFPurpose: To assess the safety and efficacy of long intestinal tube placement following percutaneous image-guided esophagostomy for palliative decompression of incurable malignant small bowel obstruction.
Materials And Methods: Between January 2013 and June 2022, a single-institution retrospective study was conducted to examine patients undergoing percutaneous transesophageal intestinal intubation for an occluded intestinal segment. Patients' baseline characteristics, procedural details, and clinical courses were reviewed.
Article Synopsis
- Transcatheter arterial embolization (TAE) is being studied to see how effective and safe it is for relieving pain from bone metastases, with early studies showing good pain reduction.
- This confirmatory, multicenter study involves enrolling patients with painful bone tumors and using TAE as the main treatment, checking for pain relief 72 hours post-procedure and monitoring for adverse effects.
- The research is ongoing, with patient enrollment starting in March 2021 and a total of 36 participants by August 2022, aiming to offer a new treatment option if the results are positive.
Article Synopsis
- A study was conducted to compare the effectiveness of two treatment methods for hepatocellular carcinoma (HCC): drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE), both using the drug epirubicin.
- The trial included 200 patients with unresectable HCC, finding that cTACE had significantly higher complete response (CR) rates at both 1 and 3 months compared to DEB-TACE.
- Despite cTACE showing higher efficacy, it also resulted in a greater incidence of adverse events than DEB-TACE, including symptoms like fatigue and increased liver enzyme levels.
Purpose: To evaluate the accuracy and time-efficiency of newly developed software in automatically creating curved planar reconstruction (CPR) images along the main pancreatic duct (MPD), which was developed based on a 3-dimensional convolutional neural network, and compare them with those of conventional manually generated CPR ones.
Materials And Methods: A total of 100 consecutive patients with MPD dilatation (≥ 3 mm) who underwent contrast-enhanced computed tomography between February 2021 and July 2021 were included in the study. Two radiologists independently performed blinded qualitative analysis of automated and manually created CPR images.
Aim: Catheter removal, survival, and recurrence rates after percutaneous pericardial effusion drainage in cancer patients are not fully understood. We evaluated the clinical outcomes of image-guided percutaneous pericardial effusion drainage in cancer patients.
Methods: From January 2014 to September 2017, 113 percutaneous drainages for symptomatic pericardial effusion were performed in 100 cancer patients (median 60 years; range, 7-84 years) using ultrasound or angio-computed tomography.
Background: In recent years, the number of patients with hepaticojejunostomy anastomotic strictures has increased. Balloon dilation and placement of multiple plastic stents have proven effective for hepaticojejunostomy anastomotic strictures. However, for refractory strictures, there is often a need for repeated endoscopic procedures within a short period.
View Article and Find Full Text PDFBackground: Splenic artery (SpA) involvement heralds poor prognosis in pancreatic ductal adenocarcinoma (PDAC) of the body and tail but is not included in the resectability criteria. This study evaluated the prognostic impact of radiological SpA involvement in PDAC of the body and tail.
Methods: Preoperative computed tomography images of patients who underwent distal pancreatectomy for resectable PDAC of the body and tail (n = 242) at our hospital between 2004 and 2018 were graded according to splenic vessel involvement status as clear, abutment, or encasement.
Article Synopsis
- The study assessed the feasibility of using percutaneous radiologic gastrostomy in patients who have had partial gastrectomy, focusing on various techniques and imaging methods used during the procedure.
- It involved analyzing 15 patients over a seven-year period, where some received conventional gastrostomy and others had modified techniques due to challenges in accessing the stomach.
- Results showed a 100% success rate for conventional gastrostomy and an 85.7% rate for modified methods, with no major complications reported during follow-up, indicating that multimodal imaging and technique adjustments can effectively facilitate the procedure.