| 特集名 | PEGの現状 | |
|---|---|---|
| 題名 | 各疾患に対するPEGの適応 (3) がん患者 | |
| 発刊年月 | 2013年 09月 | |
| 著者 | 都築 則正 | 藤田保健衛生大学外科・緩和医療学講座 |
| 著者 | 東口 髙志 | 藤田保健衛生大学外科・緩和医療学講座 |
| 著者 | 伊藤 彰博 | 藤田保健衛生大学外科・緩和医療学講座 |
| 【 要旨 】 | 近年，患者・家族のがん治療に対する社会的関心は著しく高くなり，進行・再発がん患者に対しても，質の高い医療，とくに適切な栄養管理が求められている． がん患者に対する経皮内視鏡的胃瘻造設術（PEG）は，おもに栄養管理目的（(1) 頭頸部がんや食道がんなど，(2) 長期のがん治療に伴う廃用症候群），および減圧目的（がん性腹膜炎を中心とする上部消化管閉塞・狭窄など）に施行される．さらに，少なくとも1カ月以上の生命予後が期待できる，造設に耐えうる全身状態であることなどを総合的に判断し，造設される．とくに，終末期がん患者に対するPEGは，侵襲ある手術と考え，合併症を発生させないことがきわめて重要である．また，PEGは患者・家族の死生観にも関わる大きな問題であることを医療者は強く認識すべきである． |
|
| Theme | The Present State of Percutaneous Endoscopic Gastrostomy (PEG) | |
|---|---|---|
| Title | PEG for Patients with Cancer | |
| Author | Norimasa Tsuzuki | Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine |
| Author | Takashi Higashiguchi | Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine |
| Author | Akihiro Ito | Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine |
| [ Summary ] | In recent years, there has been an increased focus on cancer treatment for both patients and their families. There is a demand for high quality medical treatment, particularly for appropriate nutrition management, which is necessary for patients with advanced or recurrent cancer. PEG for patients with cancer is performed for the purpose of nutrition management. It is employed for head and neck cancer, as well as esophageal cancer. It is also used to treat disuse syndrome accompanying long-term cancer treatment. It is utilized for purpose of drainage when there is upper gastric tract obstruction or stenosis, primarily that involving peritonitis carcinomatosa. PEG is performed by making comprehensive decisions on patientsʼ systemic conditions which determine that we may expect a life span of at least one additional month. The patient must be able to withstand the surgical stress of PEG. In particular, PEG for patients with terminal stage cancer is considered to be an invasive operation, and it is important that no complications arise. It is also important for healthcare providers to be aware that PEG has a significant impact on to the patients' and their familiesʼ lives. |
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