| 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 | 高齢者の胃癌に対する腹腔鏡下胃切除術 | |
| 発刊年月 | 2007年 12月 | |
| 著者 | 安田 一弘 | 大分大学医学部第一外科 |
| 著者 | 衛藤 剛 | 大分大学医学部第一外科 |
| 著者 | 藤井 及三 | 大分大学医学部第一外科 |
| 著者 | 猪股 雅史 | 大分大学医学部第一外科 |
| 著者 | 白石 憲男 | 大分大学医学部第一外科 |
| 著者 | 北野 正剛 | 大分大学医学部第一外科 |
| 【 要旨 】 | 高齢者胃癌患者に対する腹腔鏡下胃切除術の治療成績を評価した．これまでに3編の症例対照研究があり，いずれも高齢者を70歳以上と定義して検討していた．高齢者は69歳以下の患者より基礎疾患は多いものの，腹腔鏡下胃切除術の治療成績は同等で，手術時間，出血量，合併症，在院日数に差はなかった．また，開腹術と比較すると，出血量が少なく，術後回復が早く，在院日数が短く，合併症は同等もしくは少なかった． 高齢胃癌患者に対する腹腔鏡下手術は69歳以下の患者に行う場合と同様に有用で，開腹術に比べて低侵襲であると評価されるが，まだ十分なevidenceがなく，今後は無作為化比較試験を含めて有用性の検証が望まれる． |
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| Theme | Gastrointestinal Disease in the Elderly Focusing on Minimally Invasive Therapy | |
|---|---|---|
| Title | Review of Laparoscopic Gastrectomy for Cancer in the Elderly | |
| Author | Kazuhiro Yasuda | Department of Surgery I, Oita University Faculty of Medicine |
| Author | Tsuyoshi Etoh | Department of Surgery I, Oita University Faculty of Medicine |
| Author | Kyuzo Fujii | Department of Surgery I, Oita University Faculty of Medicine |
| Author | Masafumi Inomata | Department of Surgery I, Oita University Faculty of Medicine |
| Author | Norio Shiraishi | Department of Surgery I, Oita University Faculty of Medicine |
| Author | Seigo Kitano | Department of Surgery I, Oita University Faculty of Medicine |
| [ Summary ] | This study provides an overview of the reported outcomes of laparoscopic gastrectomy for cancer in the elderly. Only three case-control studies regarding laparoscopic gastrectomy in elderly patients have been carried out. Although co-morbidity was more common in elderly patients than in younger patients who underwent laparoscopic gastrectomies, operation time, blood loss, postoperative complication rates, and postoperative hospital stays were similar in elderly and younger patients. Elderly patients who underwent laparoscopic gastrectomies had significantly reduced blood loss, shorter time to first flatus, and shorter postoperative hospital stays than elderly patients who had open gastrectomies. Currently available data shows that laparoscopic gastrectomies for elderly patients is safe and useful, and it improves the short-term outcome, in comparison with open gastrectomies. Further studies, including basic research on the hemodynamic effects of pneumoperitoneum, are needed to establish the role of laparoscopic gastrectomy for cancer in the elderly. |
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