{"created":"2023-05-25T05:25:56.211177+00:00","id":4480,"links":{},"metadata":{"_buckets":{"deposit":"f0b4671f-6460-4ba4-82a9-815646557fda"},"_deposit":{"created_by":17,"id":"4480","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4480"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004480","sets":["29:31:124:156"]},"author_link":["13841","13927","13920","13842","13835","13924","13926","13923","13928","13843","13840","13922","13838","13836","13921","13925","13837","13839"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Clinico-pathological study for duodenal gastrointestinal stromal tumor (GIST) : Special reference to surgical procedures"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ジュウニシチョウ Gastrointestinal stromal tumor（GIST） ノ リンショウ ビョウリガクテキ ケントウ : トクニ シュジュツ ジュツシキ ニ ツイテ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-08-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"113","bibliographicPageStart":"106","bibliographicVolumeNumber":"36","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【背景】Gastrointestinal stromal tumor（GIST）は消化管や腸間膜に発生する消化管間質腫瘍であるが、十二指腸に発生するものはGIST全体の４～５％と少ない。十二指腸は膵実質やVater乳頭が近く、術式選択が難しい。特に至適術式について報告する。\n【方法】当科で手術を行った十二指腸GIST10例を対象とした。診断契機、CT、MRI所見、術前に診断できたかどうか、十二指腸の局在と手術術式について考察した。腫瘍サイズ、核分裂像数、再発の有無、予後、分子標的薬の使用も検討した。\n【結果】平均年齢は56.1±4.1歳（33～74歳）であった。男性：女性＝６：４。診断契機は貧血が４例であった。術前検査の10例すべてでGIST疑いが第１鑑別診断であった。\n　発生部位は下降部（第２部）４例、水平部（第３部）５例、水平部（第３部）～上行部（第４部）が１例であった。下降部の４例中２例はVater乳頭部の場所にGISTがあり膵頭十二指腸切除術（PD）を行った。その他の２例は部分切除を行い、内１例はVater乳頭部が近く部分切除に乳頭形成術を加えた。水平部にGISTが存在した５例はすべて部分切除で切除しえた。水平部～上行部の１例には十二指腸の分節切除を行い、空腸と逆蠕動の側々吻合を行ったが、術後胃排出遅延が生じた。\n　腫瘍の最大径は40.4±7.8mm（15～100mm）であった。術式と大きさには関係はなかった。発育形式は管外型５例、管内外型５例であった。\n　Mitotic indexは10例とも５以下/50HPFsであった。PDの１例は術後４年で肝転移が出現し、イマチニブ投与中である。別のPD症例は術後１年４ヵ月で多発性肝転移認め、治療行うも術後６年８ヵ月で現病死となった。10例の５年全生存率は100％、無病生存率は85.7％と良好であった。\n【結論】\n１．管外発育型と管内外発育型でも小型の十二指腸GISTは部分切除が可能である。膵実質側に局在しても十二指腸を遊離することにより局所切除できる。\n２．分節切除後の再建には順蠕動の吻合が消化液や食事の通過の点で好ましい。\n３．Vater乳頭を圧排するような発育形式の十二指腸GISTではPDを行う。\n４．術後４年経過してからの肝転移例もあり、術後のフォローアップを長期間行う必要がある。","subitem_description_type":"Other"}]},"item_3_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"13920","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Hirai, Ichiro"}]},{"nameIdentifiers":[{"nameIdentifier":"13921","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kimura, Wataru"}]},{"nameIdentifiers":[{"nameIdentifier":"13922","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Watanabe, Toshihiro"}]},{"nameIdentifiers":[{"nameIdentifier":"13923","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tezuka, Koji"}]},{"nameIdentifiers":[{"nameIdentifier":"13924","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sugawara, Shuichiro"}]},{"nameIdentifiers":[{"nameIdentifier":"13925","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Okazaki, Shinji"}]},{"nameIdentifiers":[{"nameIdentifier":"13926","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Takahashi, Ryosuke"}]},{"nameIdentifiers":[{"nameIdentifier":"13927","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Ashitomi, Yuya"}]},{"nameIdentifiers":[{"nameIdentifier":"13928","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Nozu, Shintaro"}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/00004451","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_value":"ヤマガタ ダイガク"}]},"item_3_text_34":{"attribute_name":"別言語の出版者","attribute_value_mlt":[{"subitem_text_value":"Yamagata University"}]},"item_3_text_43":{"attribute_name":"資源タイプ・ローカル","attribute_value_mlt":[{"subitem_text_value":"紀要論文"}]},"item_3_text_44":{"attribute_name":"資源タイプ・NII","attribute_value_mlt":[{"subitem_text_value":"Departmental Bulletin Paper"}]},"item_3_text_45":{"attribute_name":"資源タイプ・DCMI","attribute_value_mlt":[{"subitem_text_value":"text"}]},"item_3_text_46":{"attribute_name":"資源タイプ・ローカル表示コード","attribute_value_mlt":[{"subitem_text_value":"2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"平井, 一郎"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"木村, 理"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"渡邊, 利広"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"手塚, 康二"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"菅原, 秀一郎"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岡﨑, 慎史"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高橋, 良輔"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"安次富, 裕哉"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"野津, 新太郎"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-08-30"}],"displaytype":"detail","filename":"kiyoum-36-2-106to113.pdf","filesize":[{"value":"1.7 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"kiyoum-36-2-106to113","url":"https://yamagata.repo.nii.ac.jp/record/4480/files/kiyoum-36-2-106to113.pdf"},"version_id":"892f84d9-a206-4350-88f8-351053064300"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"十二指腸Gastrointestinal stromal tumor（GIST）の臨床病理学的検討 : 特に手術術式について","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"十二指腸Gastrointestinal stromal tumor（GIST）の臨床病理学的検討 : 特に手術術式について"}]},"item_type_id":"3","owner":"17","path":["156"],"pubdate":{"attribute_name":"公開日","attribute_value":"2018-08-15"},"publish_date":"2018-08-15","publish_status":"0","recid":"4480","relation_version_is_last":true,"title":["十二指腸Gastrointestinal stromal tumor（GIST）の臨床病理学的検討 : 特に手術術式について"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2023-05-25T06:24:28.718445+00:00"}