Updated on 2025/01/10

写真a

 
Okada Ichiro
 
Affiliation
Nippon Medical School Hospital, Department of Emergency and Critical Care Medicine, Senior Assistant Professor
Title
Senior Assistant Professor
External link

Papers

  • Recanalization of port-superior mesenteric vein thrombosis with long-term anticoagulant therapy after failed early anticoagulant therapy. International journal

    Ichiro Okada, Masahiro Hagiwara, Hisashi Yoneyama, Saeko Kohara, Yokobori Shoji

    Surgical case reports   10 ( 1 )   154 - 154   2024.6

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    BACKGROUND: Anticoagulant therapy with heparin is the first-line treatment for acute mesenteric vein thrombosis and is effective in improving outcomes. Conversely, patients with failed early anticoagulant therapy occasionally develop bowel infarction requiring surgery. The efficacy of long-term anticoagulant therapy on recanalizing mesenteric vein thrombosis in patients with failed early anticoagulant therapy remains unclear. Herein, we report a patient who achieved recanalization of port-superior mesenteric vein thrombosis treated with anticoagulant therapy for 10 years after failed early anticoagulant therapy, followed by bowel resection. CASE PRESENTATION: A 38-year-old male patient visited an outpatient clinic due to acute exacerbation of abdominal pain that had persisted for a month. He was diagnosed with port-superior mesenteric vein thrombosis on contrast-enhanced computed tomography (CT) scan and was transferred to our institution. Although he presented with abdominal pain, his respiration and circulation were stable upon hospital arrival. Anticoagulant therapy with heparin was started, and the patient was admitted to the intensive care unit. However, the patient's abdominal pain worsened, and he began to develop signs of peritonitis. Repeat CT scan revealed bowel infarction. Thus, the patient underwent bowel resection 6 h after admission. The initial surgery was completed with open abdomen management. Bowel anastomosis was performed on the second-look surgery on the first postoperative day. Finally, the abdomen was closed on the third postoperative day after confirming the absence of bowel ischemia progression. The patient had prolonged impaired bowel function with paralytic ileus, but was discharged on the 60th postoperative day. He was then diagnosed with protein C and S deficiency based on the tests performed. Anticoagulant therapy with warfarin was initiated. He also received anticoagulant therapy in the outpatient setting. The patient's port-superior mesenteric vein thrombosis had improved gradually with warfarin during the follow-up period. At 10 years after surgery, total occlusion of the port-superior mesenteric vein was recanalized with improvement of the portal collateral vessels. In addition, no gastric or esophageal varices were observed. CONCLUSIONS: Long-term anticoagulation therapy could affect the recanalization of extensive thrombus in multiple segments in patients with mesenteric venous thrombosis.

    DOI: 10.1186/s40792-024-01948-0

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  • Survival benefits of interventional radiology and surgical teams collaboration during primary trauma surveys: a single-centre retrospective cohort study. International journal

    Ichiro Okada, Toru Hifumi, Hisashi Yoneyama, Kazushige Inoue, Satoshi Seki, Ippei Jimbo, Hiroaki Takada, Koichi Nagasawa, Saiko Kohara, Tsuyoshi Hishikawa, Hiroki Shiojima, Eiju Hasegawa, Kohei Morimoto, Yoshiaki Ichinose, Fumie Sato, Nobuaki Kiriu, Junichi Matsumoto, Shoji Yokobori

    BMC emergency medicine   24 ( 1 )   65 - 65   2024.4

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    BACKGROUND: A team approach is essential for effective trauma management. Close collaboration between interventional radiologists and surgeons during the initial management of trauma patients is important for prompt and accurate trauma care. This study aimed to determine whether trauma patients benefit from close collaboration between interventional radiology (IR) and surgical teams during the primary trauma survey. METHODS: A retrospective observational study was conducted between 2014 and 2021 at a single institution. Patients were assigned to an embolization group (EG), a surgery group (SG), or a combination group (CG) according to their treatment. The primary and secondary outcomes were survival at hospital discharge compared with the probability of survival (Ps) and the time course of treatment. RESULTS: The analysis included 197 patients, consisting of 135 men and 62 women, with a median age of 56 [IQR, 38-72] years and an injury severity score of 20 [10-29]. The EG, SG, and CG included 114, 48, and 35 patients, respectively. Differences in organ injury patterns were observed between the three groups. In-hospital survival rates in all three groups were higher than the Ps. In particular, the survival rate in the CG was 15.5% higher than the Ps (95% CI: 7.5-23.6%; p < 0.001). In the CG, the median time for starting the initial procedure was 53 [37-79] min and the procedure times for IR and surgery were 48 [29-72] min and 63 [35-94] min, respectively. Those times were significantly shorter among three groups. CONCLUSION: Close collaboration between IR and surgical teams, including the primary survey, improves the survival of severe trauma patients who require both IR procedures and surgeries by improving appropriate treatment selection and reducing the time process.

    DOI: 10.1186/s12873-024-00977-0

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  • The effect of participation of interventional radiology team in a primary trauma survey on patient outcome. International journal

    Ichiro Okada, Toru Hifumi, Hisashi Yoneyama, Kazushige Inoue, Satoshi Seki, Ippei Jimbo, Hiroaki Takada, Koichi Nagasawa, Saiko Kohara, Tsuyoshi Hishikawa, Eiju Hasegawa, Kohei Morimoto, Yoshiaki Ichinose, Fumie Sato, Nobuaki Kiriu, Junichi Matsumoto, Shoji Yokobori

    Diagnostic and interventional imaging   103 ( 4 )   209 - 215   2022.4

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    PURPOSE: The purpose of this study was to examine the survival benefits of a workflow in which an interventional radiology (IR) team participates in a primary trauma survey on patients with hemodynamically unstable trauma. MATERIALS AND METHODS: A retrospective observational study was conducted between 2012 and 2019 at a single institution. Patients who underwent an IR procedure as the initial hemostasis were assigned to the hemodynamically stable group (HSG) or hemodynamically unstable group (HUG). The primary and secondary outcomes were survival at hospital discharge compared with the probability of survival (Ps) and the time course. RESULTS: A total of 160 patients (100 men, 60 women; median age, 57.5 years [interquartile range (IQR): 31.5-72 years]) with an injury severity score of 24 (IQR: 13.75-34) were included. A total of 125 patients were included in the HSG group and 35 patients in the HUG group. The observational survival rate was significantly greater than the Ps rate by 4.9% (95% confidence interval [CI]: 1.6-8.4%; P = 0.005) in HSG and by 24.6% in HUG (95% CI: 16.9-32.3%; P < 0.001). The observational survival rate was significantly greater than Ps in HUG than in HSG (P < 0.001). The median time to initiate IR procedures and the median procedure time in HUG were 54 min [IQR: 45-66 min] and 48 min [IQR: 30-85 min], respectively; both were significantly shorter than those in the HSG. CONCLUSION: A trauma workflow utilizing an IR team in a primary survey is associated with improved survival of patients with hemodynamically unstable trauma when compared with Ps with a shorter time course.

    DOI: 10.1016/j.diii.2021.11.002

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  • Preoperative physical functional status affects the long-term outcomes of elderly patients with open abdomen. International journal

    Ichiro Okada, Toru Hifumi, Nobuaki Kiriu, Hisashi Yoneyama, Kazushige Inoue, Satoshi Seki, Eiju Hasegawa, Hiroshi Kato, Tomohiko Masuno, Shoji Yokobori

    Acute medicine & surgery   7 ( 1 )   e602   2020

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    AIM: The mortality rates among elderly patients with open abdomen (OA) are high, and pre-existing comorbidities could affect the outcomes. However, long-term prognosis remains uncertain. We examined long-term outcomes in elderly patients with OA, focusing on physical functional status. METHODS: We undertook a retrospective cohort study between 2007 and 2017 at a single institution. Patients with OA who were aged ≥65 years were categorized into two groups: "good preoperative functional status" group (GFG) and "poor preoperative functional status" group (PFG). The GFG was defined as Eastern Cooperative Oncology Group/World Health Organization performance status (PS) 0-1, whereas PFG was defined as PS 2-4. The primary outcomes were survival and PS 2 years following the initial surgery. RESULTS: Of the 53 participants, 38 and 15 were assigned to the GFG and PFG, respectively. The PFG (median age, 81 years) was older than the GFG (median age, 75.5 years; P = 0.040). The 2-year survival rate was 39.5% in GFG and 6.7% in PFG, and Kaplan-Meier analysis showed significant difference (P = 0.022). Among all patients, the PS at 2 years was worse than that at discharge (P = 0.007). Preoperative PS was correlated with 2-year survival (P = 0.003), whereas age and pre-existing comorbidities were not. CONCLUSION: The long-term outcomes of elderly patients with OA are affected by the preoperative physical functional status. Functional status deteriorates in a time-dependent manner. Therefore, surgery requiring OA must be carefully considered for elderly patients with PS 2 or higher.

    DOI: 10.1002/ams2.602

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  • Long-Term Outcomes of Endovascular Stenting for Blunt Renal Artery Injuries with Stenosis: A Report of Five Consecutive Cases.

    Ichiro Okada, Junichi Inoue, Hiroshi Kato, Yuichi Koido, Nobuaki Kiriu, Takayuki Hattori, Kohei Morimoto, Yoshiaki Ichinose, Hiroyuki Yokota

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   86 ( 3 )   172 - 178   2019

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    BACKGROUND: Renal artery stenting is performed for renal artery injuries to preserve renal function and prevent renovascular hypertension. However, its indications are controversial and its long-term prognosis remains unknown. Here, we evaluate the characteristics and long-term outcomes of renal artery stenting for blunt renal artery injuries at our institution. METHODS: We retrospectively reviewed patients with blunt renal artery injuries who had been treated with stenting over a 12-year period at our institution. Five patients (three men and two women) were included. RESULTS: Trauma resulted from falls in three patients and motor vehicle accidents in two. All patients had experienced multiple injuries (median injury severity score, 24 [range, 16-48]; median revised trauma score, 5.9672 [4.0936-7.8408]; and median probability of survival, 0.689 [0.533-0.980]). All renal artery injuries involved stenosis because of traumatic arterial dissection or intimal tear; no cases of total occlusion were observed. No complications due to the intervention itself were observed. Although two patients developed reversible acute renal failure, none required long-term hemodialysis. One patient with renovascular hypertension was treated with antihypertensive agents for a month and subsequently became normotensive without further medication. All patients underwent postoperative computed tomography, which revealed no stent occlusion or renal atrophy. Renal scintigraphy for three patients demonstrated preserved differential renal function. All five patients survived. CONCLUSIONS: Renal artery stenting for hemodynamically stable blunt renal artery injuries with stenosis is suggested to be safe and helps in avoiding long-term hemodialysis and renovascular hypertension.

    DOI: 10.1272/jnms.JNMS.2019_86-306

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Misc.

  • 【国内・国際災害医療と日本医大:令和6年能登半島地震とガザ紛争対応報告】日本医科大学付属病院5次隊(岡田隊)総括

    岡田 一郎, 中田 淳

    日本医科大学医学会雑誌   20 ( 3 )   160 - 162   2024.8

  • 能登半島地震(1-(1)) 発災前~初動体制 能登半島地震AMAT活動からみたフェーズ1~2における災害医療体制の新視点

    布施 明, 岡田 一郎, 横堀 将司, 大桃 丈知, 猪口 正孝, 加納 繁照

    日本臨床救急医学会雑誌   27 ( 3 )   255 - 255   2024.7

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  • 軽度脳低温療法は効果がある 冷却速度が機能良好なLFT延長に及ぼす影響

    鹿野 恒, 長間 将樹, 遠藤 晃生, 井上 一成, 金谷 貴大, 脇坂 璃子, 出口 琢人, 濱口 拓郎, 三宅 のどか, 富永 直樹, 溝渕 大騎, 重田 健太, 佐藤 陽介, 坂本 和嘉子, 五十嵐 豊, 恩田 秀賢, 岡田 一郎, 金 史英, 中江 竜太, 布施 明, 横堀 將司

    日本脳低温療法・体温管理学会誌   27 ( 1 )   52 - 52   2024.7

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  • 深部体温14℃の低温曝露性偶発性超低体温症に対して、ECPRを導入し神経学的後遺症なく復帰した1例

    鹿野 恒, 長間 将樹, 遠藤 晃生, 井上 一成, 金谷 貴大, 脇坂 璃子, 出口 琢人, 濱口 拓郎, 三宅 のどか, 富永 直樹, 溝渕 大騎, 重田 健太, 佐藤 陽介, 坂本 和嘉子, 五十嵐 豊, 恩田 秀賢, 岡田 一郎, 金 史英, 中江 竜太, 布施 明, 横堀 將司

    日本脳低温療法・体温管理学会誌   27 ( 1 )   54 - 54   2024.7

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  • 能登半島地震(1-(1)) 発災前~初動体制 同一教室8隊のリレーで展開した避難所医療支援

    上村 浩貴, 溝渕 大騎, 重田 健太, 恩田 秀賢, 岡田 一郎, 中江 竜太, 増野 智彦, 布施 明, 横田 裕行, 横堀 將司

    日本臨床救急医学会雑誌   27 ( 3 )   255 - 255   2024.7

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  • MRIを用いた脳低温療法における冷却期間の検討

    鹿野 恒, 長間 将樹, 遠藤 晃生, 井上 一成, 金谷 貴大, 脇坂 璃子, 出口 琢人, 濱口 拓郎, 三宅 のどか, 富永 直樹, 溝渕 大騎, 重田 健太, 佐藤 陽介, 坂本 和嘉子, 五十嵐 豊, 恩田 秀賢, 岡田 一郎, 金 史英, 中江 竜太, 布施 明, 横堀 將司

    日本脳低温療法・体温管理学会誌   27 ( 1 )   51 - 51   2024.7

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  • 防ぎえた外傷死を減らすためには:現状と課題 災害における防ぎえた外傷死を減らすためには 外科系医師の協働がカギとなる

    岡田 一郎, 重田 健太, 溝渕 大騎, 寺岡 晋太郎, 金 史英, 横堀 將司

    日本外科系連合学会誌   49 ( 3 )   244 - 244   2024.5

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  • 今後の外傷(外科)医の育成と学会の役割 外傷医の認知度向上と地位向上

    岡田 一郎, 金 史英, 重田 健太, 溝渕 大騎, 寺岡 晋太郎, 横堀 將司

    日本外傷学会雑誌   38 ( 2 )   178 - 178   2024.4

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  • 東京都での包括的外傷診療体制の構築へ向けて

    岡田 一郎, 大塚 洋幸, 金 史英, 重田 健太, 溝渕 大騎, 寺岡 晋太郎, 横堀 將司

    日本外傷学会雑誌   38 ( 2 )   207 - 207   2024.4

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  • 下横隔動脈損傷の検討

    金 史英, 重田 健太, 溝渕 大騎, 岡田 一郎, 増野 智彦, 新井 正徳, 横堀 將司

    日本外傷学会雑誌   38 ( 2 )   243 - 243   2024.4

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  • flail chestを伴う外傷性肺ヘルニアに対して胸壁形成術を施行した1例

    長谷川 和洋, 寺岡 晋太郎, 溝渕 大騎, 重田 健太, 岡田 一郎, 中江 竜太, 金 史英, 横堀 將司

    日本外傷学会雑誌   38 ( 2 )   266 - 266   2024.4

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  • 骨性胸壁外傷に対する各施設の治療指針 骨性胸壁外傷の外科的安定化を個別症例から考える

    金 史英, 岡田 一郎, 重田 健太, 溝渕 大騎, 寺岡 晋太郎, 増野 智彦, 新井 正徳, 横堀 將司

    日本外傷学会雑誌   38 ( 2 )   188 - 188   2024.4

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  • ベットサイド吊り上げ式腹腔鏡手術を利用した新たな非閉塞性腸間膜虚血の診断・治療プロトコールの確立を目指して

    瀧口 徹, 岡田 一郎, 金 史英, 寺岡 晋太郎, 溝渕 大騎, 重田 健太, 萩原 純, 横堀 將司

    日本腹部救急医学会雑誌   44 ( 2 )   328 - 328   2024.2

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  • 多診療科合同の腹部救急領域疾患に対する教育体制 当施設における緊急大動脈疾患に対する診療・教育体制

    重田 健太, 金 史英, 寺岡 晋太郎, 溝渕 大騎, 岡田 一郎, 増野 智彦, 横堀 將司

    日本腹部救急医学会雑誌   44 ( 2 )   314 - 314   2024.2

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  • 災害医療におけるacute care surgeonの役割とその育成 高度技能医および外傷リーダーとしての役割を中心に

    岡田 一郎, 井上 和成, 関 聡志

    Japanese Journal of Acute Care Surgery   13 ( 1 )   157 - 161   2023.12

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    災害時には,しばしば大量の外傷患者が発生する。外傷の専門家であるACS医(acute care surgeon)は災害医療においても重要な役割を担う。災害時にacute care surgeonは外傷手術を行う高度技能医としての役割と,現場の外傷診療をマネジメントする外傷リーダーとしての役割の二つが大きく求められる。これまで実災害時には四肢外傷手術が多いことが報告されており,acute care surgeonは高度技能医として,体幹部外傷手術だけでなく,血管損傷を伴うような四肢外傷の初期治療にも慣れておく必要がある。また,外傷リーダーの適切なマネジメントが災害初期対応の成否に重要であるといわれており,初療室,手術室,集中治療室を仕事場とするacute care surgeonは外傷リーダーに適任と考えられる。災害時の対応能力の向上には,平時からの災害医療への参画が重要であり,一般外科医や各科専門外科も含めた外傷診療体制の構築にacute care surgeonの果たす役割は大きい。(著者抄録)

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  • 脳室-腹腔シャント(V-P shunt)を有し、外科的治療を要した腹腔内感染症5例

    寺岡 晋太郎, 金 史英, 溝渕 大騎, 萩原 純, 岡田 一郎, 中江 竜太, 横堀 將司

    日本救急医学会雑誌   34 ( 12 )   820 - 820   2023.12

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  • 当院における蘇生的緊急手術体制と教育、surgical rescueとしてのBleeding Rapid Response System

    金 史英, 寺岡 晋太郎, 溝渕 大騎, 萩原 純, 岡田 一郎

    日本救急医学会雑誌   34 ( 12 )   879 - 879   2023.12

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  • 大動脈十二指腸瘻に対する術中出血制御目的にREBOAを使用し救命し得た2例

    寺岡 晋太郎, 金 史英, 溝渕 大騎, 重田 健太, 萩原 純, 岡田 一郎, 増野 智彦, 新井 正徳

    Japanese Journal of Acute Care Surgery   13 ( Suppl. )   123 - 123   2023.10

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  • 開腹腸管切除に至るも長期抗凝固薬内服により再開通した上腸間膜静脈・門脈血栓症の一例

    岡田 一郎, 萩原 正弘, 霧生 信明, 米山 久詞, 小原 佐衣子, 横堀 將司

    Japanese Journal of Acute Care Surgery   13 ( Suppl. )   156 - 156   2023.10

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  • 「Acute care surgeonの育成と拡充/Training of acute care surgeon」 外科医としてのLearning curveを重視したACS教育体制

    益子 一樹, 安松 比呂志, 上田 太一朗, 山本 真梨子, 船木 裕, 川口 祐香理, 坂野 高大, 原 義明, 岡田 一郎, 金 史英, 井上 潤一, 横堀 将司

    Japanese Journal of Acute Care Surgery   13 ( Suppl. )   68 - 68   2023.10

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  • 当院における12年間の外傷診療の変遷 東京都での包括的外傷診療体制への提言を含めて

    岡田 一郎, 米山 久詞, 井上 和茂, 関 聡志, 菱川 剛, 塩島 裕樹, 高田 浩明, 永澤 宏一, 小原 佐衣子, 長谷川 栄寿, 大塚 洋幸

    日本外傷学会雑誌   37 ( 3 )   348 - 354   2023.7

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    目的 東京都多摩地区に位置する一救命救急センターの外傷診療状況の変遷を調査し,当該地域における外傷診療の課題を検討する.方法 単施設後方視的研究.2010年から2021年まで集中治療室へ入院した外傷患者を対象に,患者背景,外傷重症度および侵襲的治療(手術および動脈塞栓術)の推移ならびに診療成績を調査した.結果 集中治療室入院外傷は7,264例であった.期間中に高齢患者(65歳以上)割合は増加していた一方,重症外傷患者(Injury Severity Score 16以上)数とその割合は減少を認めた.侵襲的治療数は全2,257手技で期間中に減少を認めた.予測生存率(probability of survival:Ps)≧0.5の死亡は2.4%,Ps<0.5の生存は0.6%であり,期間中に変化は認めなかった.結論 重症患者数と侵襲的治療数は減少を認めていたが,診療成績の悪化は認めなかった.一方,重症外傷診療の縮小が続いており,外傷診療の質の維持には重症外傷集約化等を含めた地域包括的外傷診療体制確立が急務であると思われる.(著者抄録)

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    Other Link: https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02870&link_issn=&doc_id=20230802460012&doc_link_id=10.11382%2Fjjast.37.3_12&url=https%3A%2F%2Fdoi.org%2F10.11382%2Fjjast.37.3_12&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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