臨牀消化器内科 Vol.32 No.6(2-3-3)


特集名 高齢者・超高齢者消化管癌の内視鏡治療
題名 各論(3)大腸癌 c.内視鏡治療後の経過観察はいつまで施行するか?
発刊年月 2017年 06月
著者 岡 志郎 広島大学病院消化器・代謝内科
著者 田中 信治 広島大学病院内視鏡診療科
著者 鴫田 賢次郎 広島大学病院消化器・代謝内科
著者 二宮 悠樹 広島大学病院消化器・代謝内科
著者 茶山 一彰 広島大学病院消化器・代謝内科
【 要旨 】 本邦では大腸癌の罹患率や死亡率は高齢者を中心に増加しており,高齢者における大腸内視鏡治療症例も増加している.現在,大腸腫瘍性病変に対する内視鏡治療後いつまで経過観察するかに関する明確なエビデンスはないが,高齢者は全身の機能低下や基礎疾患を有する割合が高いため,経口的前処置を含めた大腸内視鏡検査に際して慎重に対応する必要がある.前処置の下剤が問題なく内服可能なことが大腸内視鏡検査および治療可能な全身状態の指標であり,高齢者であっても年齢そのものは大腸内視鏡検査の支障にはならない.
Theme Endoscopic Treatment for Elderly Patients with Gastro‒intestinal Cancer
Title Surveillance after Endoscopic Treatment for Colorectal Tumors in Elderly Patients
Author Shiro Oka Department of Gastroenterology and Metabolism, Hiroshima University Hospital
Author Shinji Tanaka Department of Endoscopy, Hiroshima University Hospital
Author Kenjiro Shigita Department of Gastroenterology and Metabolism, Hiroshima University Hospital
Author Yuki Ninomiya Department of Gastroenterology and Metabolism, Hiroshima University Hospital
Author Kazuaki Chayama Department of Gastroenterology and Metabolism, Hiroshima University Hospital
[ Summary ] Colorectal cancer is one of the commonest cancers and causes of cancer‒related deaths in Japan. A key principle of the US or EU guidelines regarding surveillance programs after endoscopic treatment for colorectal tumors was risk stratification of patients based on the findings at the baseline colonoscopy. However, there is no evidence of surveillance periods and limitation after endoscopic treatment for colorectal tumors. Currently, the world is progressively aging, and the life span is approximately 80 years in Japan. As the aging society advances, the annual incidence of elderly patients with colorectal cancer has also increased. Our data showed that colonoscopy in elderly patients without severe comorbidities such as cardiopulmonary disease and renal disease was a safe and reliable procedure. Thus, the indications for surveillance colonoscopy after endoscopic treatment should be carefully considered and be based on the safe administration of oral polyethylene glycol in elderly patients.
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