| 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 d. Minimally invasive transanal surgery (MITAS) | |
| 発刊年月 | 2007年 07月 | |
| 著者 | 前田 耕太郎 | 藤田保健衛生大学医学部外科 |
| 著者 | 花井 恒一 | 藤田保健衛生大学医学部外科 |
| 著者 | 佐藤 美信 | 藤田保健衛生大学医学部外科 |
| 著者 | 升森 宏次 | 藤田保健衛生大学医学部外科 |
| 著者 | 小出 欣和 | 藤田保健衛生大学医学部外科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Treatment of early rectal cancer -- Local excision vs. endoscopic resection | |
|---|---|---|
| Title | Minimally invasive transanal surgery | |
| Author | Kotaro Maeda | Department of Surgery, Fujita Health University School of Medicine |
| Author | Tsunekazu Hanai | Department of Surgery, Fujita Health University School of Medicine |
| Author | Harunobu Sato | Department of Surgery, Fujita Health University School of Medicine |
| Author | Koji Masumori | Department of Surgery, Fujita Health University School of Medicine |
| Author | Yoshikazu Koide | Department of Surgery, Fujita Health University School of Medicine |
| [ Summary ] | Historical concerns, techniques, indications and outcomes of minimally invasive transanal surgery (MITAS) are described. MITAS is one of the endoluminal techniques which facilitate en-block excision of rectal tumors, along with “total biopsy” for proper histological evaluation. MITAS includes the use of E anal retractor connected to an Octopus retractor holder, which produces a fine surgical field of 4 cm in diameter, along with several techniques to allow excision at a more distal location. An endo-stapler is used for simultaneous excision and anastomosis in MITAS. Cancer in situ (T0) and slight invasive T1 tumors are suitable for MITAS treatment. However, precise histopathological evaluation is needed for indications of additional surgery after MITAS. The surgical margin in this case was negative in 92 of 93 tumors after MITAS. No mortality was observed, with only one abscess and two cases of transient bleeding after surgery. Median operative time and blood loss were 20 minutes and 0 mg respectively. No recurrent diseases were observed in negative surgical margin cases with T0 and low risk T1 tumors. MITAS is a minimally invasive transluminal procedure, which facilitates total excisional biopsy. |
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