臨牀消化器内科 Vol.22 No.13(9)


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 高齢者の大腸癌に対する腹腔鏡下大腸切除術
発刊年月 2007年 12月
著者 井原 厚 北里大学医学部外科学
著者 渡邊 昌彦 北里大学医学部外科学
【 要旨 】 全大腸癌のうち70歳以上の高齢者が占める割合は33 %で，今後さらに増加が予想される．高齢者は，術前から諸臓器の機能が一般に低下しており，また各種の疾患を併存していることが多い．したがって，一種のcompromized hostと考えられる．腹腔鏡下手術では，早期に腸管蠕動が回復するため経口摂取を早期に開始でき，術後の疼痛が軽微で，在院期間の短縮が可能である．また，腹腔鏡下手術は，術中出血量も少なく，術後の呼吸機能の低下も軽く，感染のリスクも開腹手術より低い．このような腹腔鏡下大腸切除術の低侵襲性は，高齢者に適した手術と考えられる．
Theme Gastrointestinal Disease in the Elderly Focusing on Minimally Invasive Therapy
Title Laparoscopic Colectomy for Elderly Patients with Colorectal Cancer
Author Atsushi Ihara Department of Surgery, School of Medicine Kitasato University
Author Masahiko Watanabe Department of Surgery, School of Medicine Kitasato University
[ Summary ] Elderly patients over 70 with colorectal cancer (CRC) comprise 33 % of the total CRC cases. These cases are expected to increase in number in the near future. In general, such elderly patients have unsatisfactory of vital organ functions, accompanied by various preoperative complications. Such patients are therefore often compromised hosts and unable to ward off infections. Laparoscopic colectomy for CRC patients is characterized by early recovery of intestinal peristalsis, early initation of oral food intake, and lack of postoperative pain resulting in shortened hospital stays. It also facilitates procedures with relatively smaller volumes of blood loss, modest respiratory dysfunction, and low risk of infection as compared to conventional laparotomy for CRC. These less invasive traits of laparoscopic surgery are desirable for elderly patients with CRC.
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