INTESTINE Vol.21 No.2(11)


「個人年間予約購読者用全文閲覧サービス」でこの号を見る
特集名 小児・妊婦・高齢者に対するIBD診療
題名 高齢者炎症性腸疾患に対する外科治療
発刊年月 2017年 03月
著者 池内 浩基 兵庫医科大学炎症性腸疾患外科
著者 内野 基 兵庫医科大学炎症性腸疾患外科
著者 坂東 俊宏 兵庫医科大学炎症性腸疾患外科
著者 平田 晃宏 兵庫医科大学炎症性腸疾患外科
著者 蝶野 晃宏 兵庫医科大学炎症性腸疾患外科
著者 佐々木 寛文 兵庫医科大学炎症性腸疾患外科
著者 堀尾 勇規 兵庫医科大学炎症性腸疾患外科
著者 後藤 佳子 兵庫医科大学炎症性腸疾患外科
【 要旨 】 潰瘍性大腸炎（UC）では高齢者の増加が著しい．また，その緊急手術症例の予後は不良であるとの報告が多い．内科的治療法の選択肢が増加しているが，予後を考えると，重症例に対する治療法の追加・変更は慎重に行うべきである．また，術式は括約筋温存手術と，大腸全摘・永久回腸人工肛門造設術の選択となるが，QOLを考慮しつつ，患者の希望を優先させて選択しているのが現状である．一方，クローン病（CD）ではUCに比べて，高齢者手術症例の報告は少なく，多くが症例報告レベルである．ただ，バイオ製剤が導入された後の症例のほうが，手術時年齢が高齢化しているという現状もある．本稿では当科で経験した初回手術時年齢が60歳以上であった，23例の臨床経過を中心に述べる．
Theme Treatment for children, pregnant women and elderly patients with IBD
Title Surgical treatment for elderly patients with inflammatory bowel disease
Author Hiroki Ikeuchi Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Motoi Uchino Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Toshihiro Bando Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Akihiro Hirata Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Teruhiro Chohno Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Hirofumi Sasaki Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Yuki Horio Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
Author Yoshiko Goto Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine
[ Summary ] The number of elderly patients developing ulcerative colitis (UC) has rapidly escalated. The prognoses for those who undergo emergency surgery has frequently been reported to be poor. Although medical treatment options have increased, therapy for severely affected patients should be carefully considered before adding to or changing treatment regimens. Presently, the surgical options include sphincter-preserving operations or total colectomy/permanent ileostomy, with the choice being made in consideration of quality of life, with priority given to the wishes of the patient.
In relation to Crohn's disease (CD), the number of elderly patients treated surgically has been reported to be less than that of those treated for UC, with most results presented in case reports. However, age at the time of surgery has increased since the introduction of biological products. In the present study, we report on the clinical courses of 23 patients whose age at which initial surgery was performed in our department was 60 or older.
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