研究室紹介Laboratories

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運動・形態外科学形成外科学

研究室概要

診療内容は特に再建外科を主としています。また、小耳症、漏斗胸、口唇口蓋裂、多合指(趾)などの小児先天奇形や、手術創・外傷後の治癒遅延・糖尿病などの難治性潰瘍も扱っております。
チーム医療により、頭頸部腫瘍(耳鼻科、口腔外科、脳外科)、四肢悪性腫瘍(整形外科)、肝移植(移植外科)、口唇口蓋裂(口腔外科、小児科、リハビリ)、頭蓋底腫瘍(脳外科、耳鼻科)、食道腫瘍(外科)などの再建および形成手術を行っており、マイクロサージャリーによる再建手術は年間約150例行い98%の成功率をあげております。
研究分野では、脂肪由来幹細胞などを用いた再生医療、大網移植、マイクロサージャリー、難治性潰瘍、ケロイド、リンパ浮腫などのテーマについて取り組んでおります。

研究プロジェクト

1. マイクロサージャリーマイクロサージャリー(微小血管吻合)による組織移植

微小血管吻合を行うことにより皮膚、皮下組織、筋肉、骨、腸管、大網などの組織移植が可能となる。臨床では悪性腫瘍切除後の再建(頭頸部、骨軟部など)、乳房再建、四肢の外傷の再建、顔面神経麻痺の再建などを行っているが、この際に皮弁やrecipient vesselsの選択、移植組織の血行動態などが研究課題となる。また、近年では同種移植も話題となっている。
 特に継続的に研究を行っていることは以下のとおりである。

(i)臨床で遊離組織移植を行った症例の集積研究
 悪性腫瘍切除後の再建、四肢の再建、膿胸、頭蓋骨骨髄炎など

(ii)皮弁血流に関する研究
 遊離皮弁における皮弁血流量や血管抵抗の測定を行い、どのような皮弁の血流が多く、どのような皮弁の血流が少ないかを調査し、皮弁移植への応用を試みている。

2.再生医療

 形成外科では様々な組織移植を行っている。再生医療によって組織や臓器が再生することができれば自家組織移植によるドナー(採取部)の犠牲が最小限となる。

(i)培養皮膚の開発
 広範囲熱傷、先天性巨大母斑、慢性潰瘍、褥瘡などでは皮膚の欠損が生じる。培養皮膚により少ないドナーの犠牲で多くの皮膚欠損を覆うことができる。

(ii)脂肪由来幹細胞を用いた治療の開発
 脂肪由来幹細胞は多能性だけではなく、増殖因子やサイトカインなどの分泌によるパラクライン効果により血管増生効果や免疫制御効果など様々な作用をもち治療への応用が期待できる。

(iii)リンパ管の再生
 悪性腫瘍切除時のリンパ節郭清により、リンパ浮腫が生じる。現在の治療はリンパ管静脈吻合術や理学療法が主体であるが、リンパ管の再生が実現すれば新しい方向からの治療が期待できる。
3.創傷治癒
 形成外科では様々な創傷を扱うため、いかに創傷を早く治すか、または治ることのできる状態にするかが重要となる。また、ケロイドや肥厚性瘢痕など、治癒過程の異常に対する研究も行っている。

教員

構成員名役職所属
亀井 譲 教授 形成外科
高成啓介 講師 形成外科
宮永 亨 病院助教 形成外科
蛯沢克己 病院助教 形成外科
神戸未来 病院助教 形成外科
内堀貴文 助教 形成外科

研究実績

  • 2017年
    1. Takanari K, Hashizume R, Hong Y, Amoroso NJ, Yoshizumi T, Gharaibeh B, et al. Skeletal muscle derived stem cells microintegrated into a biodegradable elastomer for reconstruction of the abdominal wall. Biomaterials. 2017;113:31-41.
    2. Takanari K.Toriyama K.; Kambe M, Nakamura R, Nakamura Y, Sato H, Ebisawa K.;Tsukushi S.Nishida Y. Kamei Y.Long-term functional outcome of tibial osteomyelitis reconstruction with free tissue transfer.J Plast Reconstr Aesthet Surg. 2017;S1748:30487-4
    3. Uchibori T, Takanari K, ;Hashizume R, Amoroso NJ, Kamei Y, Wagner WR.Use of a pedicled omental flap to reduce inflammation and vascularize an abdominal wall patch.J Surg Res. 2017;15:77-85
    4. Shimizu S, Yamamoto T, Nakayama S, Hirakawa A, Kuwatsuka Y, Funahashi Y, Matsukawa Y, Takanari K, Toriyama K, Kamei Y, Narimoto K, Yamanishi T, Ishizuka O, Mizuno M, Gotoh M.Design of a single-arm clinical trial of regenerative therapy by periurethral injection of adipose-derived regenerative cells for male stress urinary incontinence in Japan: the ADRESU study protocol.BMC Urol. 2017;17:89
    5. Sakatoku Y, Fukaya M, Fujieda H, Kamei Y, Hirata A, Itatsu K, Nagino M.Tracheoesophageal fistula after total resection of gastric conduit for gastro-aortic fistula due to gastric ulcer.2017;3:6P
    6. Nibu KI, Hayashi R, Asakage T, Ojiri H, Kimata Y, Kodaira T, Nagao T, Nakashima T, Kamei Y,et al.Japanese Clinical Practice Guideline for Head and Neck Cancer.Auris Nasus Larynx.2017;44:375-380
  • 2016年
    1. Takanari K, Hong Y, Hashizume R, Huber A, Amoroso NJ, D'Amore A, et al. Abdominal wall reconstruction by a regionally distinct biocomposite of extracellular matrix digest and a biodegradable elastomer. Journal of tissue engineering and regenerative medicine. 2016;10:748-61.
    2. Ono M, Takanari K, Toriyama K, Yagi S, Ebisawa K, Sawamura H, et al. Effects of Tissue Component Volumes on Vascular Resistance in Free Flaps. Journal of reconstructive microsurgery. 2016.
    3. Nishio N, Fujimoto Y, Suga K, Iwata Y, Toriyama K, Takanari K, et al. Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study. The Journal of laryngology and otology. 2016;130:914-22.
    4. Heo YH, Yagi S, Toriyama K, Takanari K, Fujimoto Y, Nishio N, et al. Relationship between BMI and Postoperative Complications with Free Flap in Anterolateral Craniofacial Reconstruction. Plastic and reconstructive surgery Global open. 2016;4:e636.
  • 2015年
    1. Tsukushi S, Nishida Y, Sugiura H, Yamada Y, Kamei Y, Toriyama K, et al. Non-rigid reconstruction of chest wall defects after resection of musculoskeletal tumors. Surgery today. 2015;45:150-5.
    2. Takanari K, Araki Y, Okamoto S, Sato H, Yagi S, Toriyama K, et al. Operative wound-related complications after cranial revascularization surgeries. Journal of neurosurgery. 2015;123:1145-50.
    3. Sato H, Ebisawa K, Takanari K, Yagi S, Toriyama K, Yamawaki-Ogata A, et al. Skin-derived precursor cells promote wound healing in diabetic mice. Annals of plastic surgery. 2015;74:114-20.
    4. Nishio N, Fujimoto Y, Fujii M, Saito K, Hiramatsu M, Maruo T, et al. Craniofacial Resection for T4 Maxillary Sinus Carcinoma: Managing Cases with Involvement of the Skull Base. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2015;153:231-8.
    5. Nishida Y, Tsukushi S, Urakawa H, Toriyama K, Kamei Y, Yokoi K, et al. Post-operative pulmonary and shoulder function after sternal reconstruction for patients with chest wall sarcomas. International journal of clinical oncology. 2015;20:1218-25.
    6. Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, et al. Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy. Nagoya journal of medical science. 2015;77:667-73.
    7. Iwami K, Momota H, Fujii M, Natsume A, Yagi S, Toriyama K, et al. Anaplastic meningioma with rapid growth after omental flap transposition: a case report and experimental study. Brain tumor pathology. 2015;32:137-44.
    8. Hishida M, Toriyama K, Yagi S, Ebisawa K, Morishita T, Takanari K, et al. Does a muscle flap accelerate wound healing of gastric wall defects compared with an omental flap? International journal of surgery. 2015;18:41-7.
  • 2014年
    1. Sato H, Toriyama K, Yagi S, Takanari K, Takama H, Sawada M, et al. Surgical correction of microstomia in a patient with antilaminin 332 mucous membrane pemphigoid. Annals of plastic surgery. 2014;72:553-5.
    2. Gotoh M, Yamamoto T, Kato M, Majima T, Toriyama K, Kamei Y, et al. Regenerative treatment of male stress urinary incontinence by periurethral injection of autologous adipose-derived regenerative cells: 1-year outcomes in 11 patients. International journal of urology : official journal of the Japanese Urological Association. 2014;21:294-300.
  • 2013年
    1. Yu J, Takanari K, Hong Y, Lee KW, Amoroso NJ, Wang Y, et al. Non-invasive characterization of polyurethane-based tissue constructs in a rat abdominal repair model using high frequency ultrasound elasticity imaging. Biomaterials. 2013;34:2701-9.
    2. Toriyama K, Hatano H, Yagi S, Saito K, Kamei Y. Long follow-up of cranofacial cleft treated by the folded vascularized calvarial bone. The Journal of craniofacial surgery. 2013;24:e202-3.
    3. Kohyama K, Sugiura H, Yamada K, Hyodo I, Kato H, Kamei Y. Posterior interosseous nerve palsy secondary to pigmented villonodular synovitis of the elbow: case report and review of literature. Orthopaedics & traumatology, surgery & research : OTSR. 2013;99:247-51.
    4. Hashizume R, Hong Y, Takanari K, Fujimoto KL, Tobita K, Wagner WR. The effect of polymer degradation time on functional outcomes of temporary elastic patch support in ischemic cardiomyopathy. Biomaterials. 2013;34:7353-63.
  • 2012年
    1. Yamamoto T, Gotoh M, Kato M, Majima T, Toriyama K, Kamei Y, et al. Periurethral injection of autologous adipose-derived regenerative cells for the treatment of male stress urinary incontinence: Report of three initial cases. International journal of urology : official journal of the Japanese Urological Association. 2012;19:652-9.
    2. Yagi S, Kamei Y, Toriyama K, Nakazato K, Torii S. A new technique for abdominal closure in obese patients. Plastic and reconstructive surgery. 2012;129:213e-4e.
    3. Kozawa E, Nishida Y, Nakashima H, Tsukushi S, Toriyama K, Kamei Y, et al. Foot sarcomas: Factors affecting oncological and functional outcomes. Oncology letters. 2012;3:82-8.
    4. Kohyama K, Sugiura H, Kozawa E, Wasa J, Yamada K, Nishioka A, et al. Antitumor activity of an interleukin-2 monoclonal antibody in a murine osteosarcoma transplantation model. Anticancer research. 2012;32:779-82.
    5. Iwata N, Koike M, Kamei Y, Tanaka C, Ohashi N, Nakayama G, et al. Antethoracic pedicled jejunum reconstruction with the supercharge technique for esophageal cancer. World journal of surgery. 2012;36:2622-9.
    6. Hong Y, Takanari K, Amoroso NJ, Hashizume R, Brennan-Pierce EP, Freund JM, et al. An elastomeric patch electrospun from a blended solution of dermal extracellular matrix and biodegradable polyurethane for rat abdominal wall repair. Tissue engineering Part C, Methods. 2012;18:122-32.
    7. Fujimoto KL, Tobita K, Guan J, Hashizume R, Takanari K, Alfieri CM, et al. Placement of an elastic biodegradable cardiac patch on a subacute infarcted heart leads to cellularization with early developmental cardiomyocyte characteristics. Journal of cardiac failure. 2012;18:585-95.
  • 2011年
    1. Tsukushi S, Nishida Y, Yamada Y, Kamei Y, Toriyama K, Ishiguro N. Pedicle omental flap transfer combined with vascular reconstruction after wide resection of a myxoid liposarcoma in the inguinal region. Annals of vascular surgery. 2011;25:1139 e1-4.
    2. Nishida Y, Tsukushi S, Wasa J, Urakawa H, Toriyama K, Kamei Y, et al. Vascularized fibular flaps enhance histological repair in pasteurized autogenous bone graft. Annals of plastic surgery. 2011;67:416-20.
    3. Nakazato K, Toriyama K, Hishida M, Takanari K, Yagi S, Yamashita Y, et al. Free calvarial periosteum graft vascularized by an omental flap in a rat model. Annals of plastic surgery. 2011;67:649-54.
    4. Hong Y, Huber A, Takanari K, Amoroso NJ, Hashizume R, Badylak SF, et al. Mechanical properties and in vivo behavior of a biodegradable synthetic polymer microfiber-extracellular matrix hydrogel biohybrid scaffold. Biomaterials. 2011;32:3387-94.
    5. Hayakawa A, Suzuki H, Kamei Y, Tanuma S, Magae J. Cladribine enhances apoptotic cell death in lung carcinoma cells over-expressing DNase gamma. Biological & pharmaceutical bulletin. 2011;34:1001-4.
    6. Furuta T, Sone M, Fujimoto Y, Yagi S, Sugiura M, Kamei Y, et al. Free flap blood flow evaluated using two-dimensional laser speckle flowgraphy. International journal of otolaryngology. 2011;2011:297251.
  • 2010年
    1. Yamamoto T, Gotoh M, Hattori R, Toriyama K, Kamei Y, Iwaguro H, et al. Periurethral injection of autologous adipose-derived stem cells for the treatment of stress urinary incontinence in patients undergoing radical prostatectomy: report of two initial cases. International journal of urology : official journal of the Japanese Urological Association. 2010;17:75-82.
    2. Takanari K, Kamei Y, Toriyama K, Yagi S, Torii S. Management of postpneumonectomy empyema using free flap and pedicled flap. The Annals of thoracic surgery. 2010;89:321-3.
    3. Nagino M, Nimura Y, Nishio H, Ebata T, Igami T, Matsushita M, et al. Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Annals of surgery. 2010;252:115-23.
    4. Kamei Y, Toriyama K, Takada T, Yagi S. Tissue-engineering bone from omentum. Nagoya journal of medical science. 2010;72:111-7.
    5. Ishihara G, Eto Y, Tukamoto M, Sato T, Kaneko A, Kida D, et al. Omental free-tissue transfer following infected total knee arthroplasty with granuloma formation. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. 2010;15:140-3.
    6. Hishida M, Toriyama K, Yamashita Y, Akatsuka S, Hayakawa A, Torii S, et al. Omental flap closure of refractory wounds: rat model. Nagoya journal of medical science. 2010;72:91-9.
  • 2009年
    1. Toriyama K, Kamei Y, Yagi S, Uchibori M, Nishida Y, Torii S. Reconstruction of the first and second metatarsals with free vascularised double-barrelled fibular graft after resection of a chondrosarcoma. Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 2009;62:e580-3.
    2. Takanari K, Kamei Y, Toriyama K, Yagi S, Torii S. Differences in blood flow volume and vascular resistance between free flaps: assessment in 58 cases. Journal of reconstructive microsurgery. 2009;25:39-45.
  • 2008年
    1. Yagi S, Kamei Y, Nakayama B, Toriyama K, Torii S. A new design for free flap reconstruction of the tongue and oropharynx. Journal of reconstructive microsurgery. 2008;24:211-9.
    2. Toriyama K, Kamei Y, Morishita T, Torii S. Congenital dermoid cyst of the upper lip: a case report. Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 2008;61:970-1.
    3. Okada T, Saito K, Takahashi M, Hasegawa Y, Fujimoto Y, Terada A, et al. En bloc petrosectomy for malignant tumors involving the external auditory canal and middle ear: surgical methods and long-term outcome. Journal of neurosurgery. 2008;108:97-104.
    4. Nishida Y, Tsukushi S, Yamada Y, Kamei Y, Toriyama K, Ishiguro N. Reconstruction of the proximal humerus after extensive extraarticular resection for osteosarcoma: a report of two cases with clavicula pro humero reconstruction. Oncology reports. 2008;20:1105-9.
    5. Kamei Y, Toriyama K, Yagi S, Takanari K, Torii S. Analysis of 13 cases with gastroepiploic vessels used as grafts. Journal of reconstructive microsurgery. 2008;24:515-8.
    6. Ito E, Saito K, Nagatani T, Teranishi M, Kamei Y, Yagi S, et al. Lymphangioma of the skull base bones leading to cerebrospinal fluid rhinorrhea. Journal of neurosurgery Pediatrics. 2008;2:273-6.
    7. Ebisawa K, Kato R, Okada M, Kamei Y, Mazlyzam AL, Narita Y, et al. Cell therapy for facial anti-aging. The Medical journal of Malaysia. 2008;63 Suppl A:41.
  • 2007年
    1. Yagi S, Nakayama B, Kamei Y, Takahashi M, Torii S. Posterolateral cervical vein as a recipient vein in reconstructive microvascular surgery of the head and neck. Journal of reconstructive microsurgery. 2007;23:19-23.
    2. Yagi S, Kamei Y, Torii S. Prepositioning a closed negative-pressure drainage device in head and neck reconstruction. Plastic and reconstructive surgery. 2007;119:2336-7.
    3. Yagi S, Kamei Y, Fujimoto Y, Torii S. Use of the internal mammary vessels as recipient vessels for an omental flap in head and neck reconstruction. Annals of plastic surgery. 2007;58:531-5.
    4. Sugiura H, Takahashi M, Nakanishi K, Nishida Y, Kamei Y. Pasteurized intercalary autogenous bone graft combined with vascularized fibula. Clinical orthopaedics and related research. 2007;456:196-202.
    5. Kamei Y, Nakayama B, Toriyama K, Hyodo I, Yagi S, Sugiura H, et al. Combined fibular osteocutaneous and omental flaps. Plastic and reconstructive surgery. 2007;119:1499-504.
  • 2006年
    1. Yagi S, Kamei Y, Torii S. Donor side selection in mandibular reconstruction using a free fibular osteocutaneous flap. Annals of plastic surgery. 2006;56:622-7.
    2. Toriyama K, Morishita T, Kamei Y, Torii S. Accentuated varicella eruption: a complication of Q-switched alexandrite laser treatment. Plastic and reconstructive surgery. 2006;117:2108-9.
    3. Toriyama K, Kamei Y, Morishita T, Matsuoka K, Torii S. Z-plasty of dorsal and plantar flaps for hallux varus with preaxial polydactyly of the foot. Plastic and reconstructive surgery. 2006;117:112e-5e.
    4. Nakayama B, Kamei Y, Ikuo H, Hasegawa Y, Kitano H, Torii S. Free fibula bone wedge technique for mandible reconstruction using fibula osteocutaneous flaps. Plastic and reconstructive surgery. 2006;117:1980-5.
    5. Kamei H, Fujimoto Y, Yamamoto H, Nagai S, Kamei Y, Kiuchi T. The use of radial artery interpositional graft between recipient splenic artery and graft artery in living donor liver transplantation. Transplant international : official journal of the European Society for Organ Transplantation. 2006;19:945-6.
    6. Asai S, Kamei Y, Nishibori K, Katoh T, Torii S. Reconstruction of Romberg disease defects by omental flap. Annals of plastic surgery. 2006;57:154-8.
  • 2005年
    1. Nakayama B, Ikuo H, Kamei Y, Hachiya H, Torii S. Successful upper alveolar reconstruction for gingival cancer using a fibular osteoadipofascial flap without osseointegrated implants. Annals of plastic surgery. 2005;54:323-7.
  • 2004年
    1. Toriyama K, Kamei Y, Kazeto T, Yasue T, Suga Y, Inoie M, et al. Combination of short-pulsed CO2 laser resurfacing and cultured epidermal sheet autografting in the treatment of vitiligo: a preliminary report. Annals of plastic surgery. 2004;53:178-80.
    2. Hyodo I, Nakayama B, Takahashi M, Toriyama K, Kamei Y, Torii S. The gastrocnemius with soleus bi-muscle flap. British journal of plastic surgery. 2004;57:77-82.
    3. Asai S, Kamei Y, Torii S. One-stage reconstruction of infected cranial defects using a titanium mesh plate enclosed in an omental flap. Annals of plastic surgery. 2004;52:144-7.
  • 2002年
    1. Nakayama B, Kamei Y, Toriyama K, Hyodo I, Hasegawa Y, Torii S. Usefulness of a first transferred free flap vascular pedicle for secondary microvascular reconstruction in the head and neck. Plastic and reconstructive surgery. 2002;109:1246-53.
  • 2001年
    1. Kamei Y, Torii S, Hotta Y, Nishizeki O. Endoscopically assisted minimal laparotomy for jejunal harvest. Plastic and reconstructive surgery. 2001;108:995-9.
    2. Kamei Y, Torii S, Hasegawa T, Aoyama H, Yokoo K. Endoscopic correction of pectus excavatum. Plastic and reconstructive surgery. 2001;107:333-7.
    3. Kamei Y, Aoyama H, Yokoo K, Hayashi Y, Fujii K, Kondo C, et al. Possibility of venous return through bone marrow in the free fibular osteocutaneous flap. Annals of plastic surgery. 2001;47:450-2.
  • 2000年
    1. Kamei Y, Torii S. Natural skin reduction and breast recovery using a tissue expander after enucleation of a giant breast tumour. Scandinavian journal of plastic and reconstructive surgery and hand surgery. 2000;34:383-5.
  • 1998年
    1. Takada T, Kamei Y, Iwata T, Yokoi T, Torii S. Effect of omental lipid fraction on enhancement of skin flap survival. Annals of plastic surgery. 1998;41:70-4.
    2. Kamei Y, Torii S, Hasegawa T, Nishizeki O. Endoscopic omental harvest. Plastic and reconstructive surgery. 1998;102:2450-3.
  • 1994年
    1. Kamei Y, Torii S. A new composite gastric seromuscular and omental pedicle flap. Annals of surgery. 1994;220:97-101.
    2. Kamei Y, Aoyama H, Yokoo K, Fujii K, Kondo C, Sato T, et al. Composite gastric seromuscular and omental pedicle flap for urethral and scrotal reconstruction after Fournier's gangrene. Annals of plastic surgery. 1994;33:565-8.
  • 1993年
    1. Kamei Y, Torii S, Hasegawa M, Toriyama K, Kodera Y. Simultaneous allografting and autografting of skin for ulcers in a bone marrow transplant patient. Transplantation. 1993;56:1530-1.
    2. Kamei Y, Moriura S, Ikeda S, Hosokawa H, Hirai M, Naiki K, et al. Combination gastric seromuscular patch and omental pedicle flap for bronchial fistula. The Annals of thoracic surgery. 1993;56:366-8.

研究キーワード

遊離組織移植、再生医療、大網、脂肪由来幹細胞、培養表皮、リンパ浮腫、ケロイド、白斑