INTESTINE Vol.11 No.4(2-2-1)

特集名 早期直腸癌の治療 -- 局所切除 vs. 内視鏡的治療
題名 [各論](2) 早期直腸癌の外科治療 a. 早期直腸癌に対する経肛門的局所切除術
発刊年月 2007年 07月
著者 寺本 龍生 東邦大学医学部外科(大森)一般・消化器外科
著者 船橋 公彦 東邦大学医学部外科(大森)一般・消化器外科
著者 後藤 友彦 東邦大学医学部外科(大森)一般・消化器外科
著者 小池 淳一 東邦大学医学部外科(大森)一般・消化器外科
【 要旨 】 要旨はありません。
Theme Treatment of early rectal cancer -- Local excision vs. endoscopic resection
Title Peranal local excision for early rectal cancer
Author Tatsuo Teramoto Department Surgery (Omori) Toho University
Author Kimihiko Funabashi Department Surgery (Omori) Toho University
Author Tomohiko Goto Department Surgery (Omori) Toho University
Author Junichi Koike Department Surgery (Omori) Toho University
[ Summary ] The details of operative technique and indications of peranal local resection (PAR) for early rectal cancer are described. Using a self retaining Lone Star Retractor, lesions are removed easily with an adequate margin of normal tissue as observed under the direct views. A major advantage of PAR is that the entire lesion is available for pathological examination. This approach is most appropriate for laterally spreading or villous tumors, over 3 cm in size, located within 6 to 8 cm of the anal verge. However, more proximal lesions can be removed with PAR if the tumor can be effectively prolapsed into the operative field. Multifire Endo GIA staplers, designed for laparoscopic surgery, are utilized in PAR. This is attractive because of resultant simplicity and speed.