臨牀消化器内科 Vol.22 No.13(4)


特集名 高齢者における消化器疾患 -- 低侵襲治療を中心に
題名 高齢者の食道癌に対する内視鏡治療
発刊年月 2007年 12月
著者 細川 正夫 恵佑会札幌病院外科
著者 高橋 宏明 恵佑会札幌病院消化器内科
【 要旨 】 食道癌は他の消化器癌に比べ高齢者に多い.進行食道癌に対する治療としての外科手術・化学放射線療法は侵襲が高く,このため高齢者では放射線単独治療の選択率が自然と高くなっている.しかし,主要臓器機能低下例を除き,高齢者でも標準的治療が安全になされていることも少なくなく,当院のデータでは外科手術でも非高齢者に匹敵する治療成績が得られ,治療関連死亡も低率であった.さらに低侵襲治療の代表である内視鏡治療は,年齢による制限なく,非高齢者と同様に行われており,早期食道癌の根治に大いに貢献している.ただし,高齢者では,他臓器や呼吸・循環器系の他病を併発していることも多く,他要素も加味した治療方針決定が必要である.
Theme Gastrointestinal Disease in the Elderly Focusing on Minimally Invasive Therapy
Title Endoscopic Treatment for Esophageal Carcinoma in Elderly Patients
Author Masao Hosokawa Department of Surgery, Keiyukai Sapporo Hospital
Author Hiroaki Takahashi Department of Gastroenterology, Keiyukai Sapporo Hospital
[ Summary ] In this study, patients over 75 years old were defined as elderly. Esophageal carcinoma more frequently occurs in elderly patients, compared to other types of organic carcinoma. Because surgical resection and chemoradiotherapy are invasive treatments, radiation therapy is often selected for esophageal carcinoma. However, for elderly patients without obvious problems in other organs, the standard therapy is, occasionally performed. In our hospital, the treatment results from surgical resection for elderly patients is equal to that for non elderly patients, and the mortality rate is very low. Endoscopic treatment, especially represents a major form of non-invasive therapy, which may be available for most elderly patients as well as for younger patients, this therapy contributes to the total cure of early esophageal carcinoma. However, due to the high incidence of carcinoma in other organs, or complications in respiratory and circulatory organs in elderly patients, it is necessary to decide on treatment plans which take into consideration other elements.
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