| 特集名 | 大腸癌 -- 最新の進行大腸癌治療戦略 | |
|---|---|---|
| 題名 | 低侵襲性治療 -- 腹腔鏡下大腸切除術の適応と限界 | |
| 発刊年月 | 2000年 11月 | |
| 著者 | 長谷川 博俊 | 慶應義塾大学医学部外科 |
| 著者 | 渡邊 昌彦 | 慶應義塾大学医学部外科 |
| 著者 | 北島 政樹 | 慶應義塾大学医学部外科 |
| 【 要旨 】 | 1992年から現在までの8年間に大腸癌患者327例(Dukes A:245例，B:38例，C:39例，D:5例)に対し腹腔鏡下大腸切除術を施行した．術後観察期間中央値は37カ月(1～97カ月)であった．治癒切除322例中8例に再発を認めた．このうち腹膜再発を認めた4例の深達度はss:1例，se:2例，si:1例であった．Kaplan-Meier法による5年無再発生存率はDukes A:97.4％，B:95.2％(4年無再発生存率)，C:81.5％であり，5年全生存率はDukes A:99.3％，B:100％(4年全生存率)， C:96.0％であった．早期大腸癌に対する腹腔鏡下手術の長期予後は良好で，本法のよい適応であると思われた．mp癌の予後も比較的良好であったが，ss以深の進行癌に対しては慎重な経過観察が必要である． | |
| Theme | Up-to-date Therapuetic Strategy for Advanced Colorectal Cancer | |
|---|---|---|
| Title | Indications and the Limit of Laparoscopic Colectomy for Colorectal Cancer | |
| Author | Hirotoshi Hasegawa | Department of Surgery, Keio University School of Medicine |
| Author | Masahiko Watanabe | Department of Surgery, Keio University School of Medicine |
| Author | Masaki Kitajima | Department of Surgery, Keio University School of Medicine |
| [ Summary ] | During the past 8 years, 327 patients with colorectal cancer (Dukes A:245, B:38, C:39, D:5) underwent laparoscopic colectomy. The median follow-up period was 37 months (1-97months). In 322 curative cases 8 patients had recurrences. Of these, 3 patients with pT3 tumours, and 1 with a pT4, had peritoneal recurrences. The 5 year disease-free survival rates, using the Kaplan-Meier method, were 97.4% for Dukes A, 95.2% for Dukes B and 81.5% for Dukes C. The 5 year overall survival rates were 99.3% for Dukes A, 100% for Dukes B and 96.0% for Dukes C. The long-term results of laparoscopic surgery, in patients with early color ectal cancer, were favourable, whereas strict follow ups are necessary in patients with pT3 tumours. | |