臨牀消化器内科 Vol.23 No.5(5)


特集名 炎症性腸疾患治療のup to date
題名 潰瘍性大腸炎における外科治療
発刊年月 2008年 05月
著者 福島 浩平 東北大学大学院分子病態外科分野／東北大学大学院生体調節外科分野
著者 小川 仁 東北大学大学院生体調節外科分野
著者 長尾 宗紀 東北大学大学院生体調節外科分野
著者 渡辺 和宏 東北大学大学院生体調節外科分野
著者 工藤 克昌 東北大学大学院生体調節外科分野
著者 佐々木 巌 東北大学大学院生体調節外科分野
著者 高橋 賢一 束北労災病院大腸肛門外科
著者 舟山 裕士 東北労災病院大腸肛門外科
【 要旨 】 潰瘍性大腸炎では，症例数の増加，難治例に対する手術適応の拡大，癌合併例の増加によって手術療法の比重が増大している．近年，わが国では疾患の根治と自然肛門の温存の両者を満足しうる大腸全摘，回腸肛門 (管) 吻合術が広く普及した．それによって，単なる救命にとどまらず内科治療と並ぶ優れた治療法として認知されつつある．しかし，手術適応および手術時期の選択，分割手術の適応，長期予後，回腸嚢炎の問題など課題も残されている．
Theme Up-to-date Treatment for Inflammatory Bowel Diseases
Title Surgical Treatment for Ulcerative Colitis
Author Kouhei Fukushima Division of Surgical and Molecular Pathrophysiology, Department of Biomedical Engineering, Tohoku University Gradeate School of Medicine / Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Hitoshi Ogawa Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Munenori Nagao Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Kazuhiro Watanabe Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Katsumasa Kudo Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Iwao Sasaki Division of Biological-Regulation and Oncology, Department of Surgery, Tohoku University Gradeate School of Medicine
Author Ken-ichi Takahashi Department of Colorectal Surgery, Tohoku Rosai Hospital
Author Yuji Funayama Department of Colorectal Surgery, Tohoku Rosai Hospital
[ Summary ] The role of surgery has become more important in the field of ulcerative colitis therapy because of the increasing number of cases, operative indications for intractable cases, and advances in cancer development. In the past two decades, total proctocolectomies and ileo-anal (canal) anastomosis have come to be accepted as standard operations, which will probably cure the disease and can preserve the anus. This procedure is recognized as an outstanding treatment not only in terms of mere lifesaving ability but is considered to be a standard internal medicine treatment. However, several problems remain to be solved, such as indications for surgery, timing of operations, multi-step surgery, results over long periods of time, and pouchitis.
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