| 特集名 | 消化器疾患に対するステント治療 | |
|---|---|---|
| 題名 | 大腸癌に対するステント治療 | |
| 発刊年月 | 2000年 06月 | |
| 著者 | 斉田 芳久 | 東邦大学医学部外科学第三講座 |
| 【 要旨 】 | 大腸疾患に対するステント治療は,その屈曲の強さや壁の薄さなどの解剖学的特徴からほかの消化管に遅れて1990年代後半からようやく臨床応用が報告されてきている.本稿ではその内容を紹介するとともに,われわれの開発したstent endoprosthesis for colorectal cancer(SECC)についての紹介と成績の報告をする.SECCは,われわれが1993年11月に開発した,通過障害を伴った全周性狭窄型左側大腸癌に対して透視下および大腸内視鏡下に金属ステントを挿入し拡張内痩化する手技で,現在までに34例にSECCを施行し,28例(82%)に挿入可能であった.イレウス発症時は待機手術が可能となり術後手術成績の向上が期待できた.本法は,ほかの減圧処置に比較して管理の容易さと患者の身体的,精神的負担が少なく,今後の専用キットの開発により大腸癌による狭窄・閉塞に対する第一選択的な手技となり,よりいっそう普及していくと思われる. | |
| Theme | Endoscopic Stenting for Digestive Diseases | |
|---|---|---|
| Title | Metallic Stent Endoprosthesis for Obstructive Colorectal Cancers | |
| Author | Yoshihisa Saida | The Third Department of Surgery, Toho University School of Medicine |
| [ Summary ] | The development of expandable metallic stent endoprosthesis for colorectal obstructions, was some what delayed, compared to other digestive tract procedures for treatment of anatomical peculiaries of the large bowel. However, in the late 1990's, several clinical cases concerning the application of metallic stents for rectal malignant stenosis were reported. Also, insertion of self-expanding stainless steel stents, under colonoscopic observation, for stenosis of large bowel cancer began in November 1993, as a preoperative preparation in our hospital. In this review, we described the history of the clinical literature on metallic stent endoprosthesis for colorectal obstruction. We also described the method of and results from stent endoprosthesis for colorectal cancer(SECC) that we developed. SECC was performed on 34 patients and the rate of insertion was 82% (28 cases) . SECC is a new method for operative preparation of patients with obstructing colorectal cancers, which may reduce morbidity and mortality associated with this difficult problem. This method is noteworthy. An exclusive stent and associated kit are being developed for sale. Development of an exclusive stent for use in the colon or rectum would promote popularization of metallic stent endoprosthesis for colorectal obstruction being popularized as a part of therapeutic endoscopic treatment. | |