結腸癌に対する腹腔鏡補助下結腸切除術(2) : 当科における適応条件の妥当性について

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  • ケッチョウガン ニ タイスル フクコウキョウ ホジョ カ ケッチョウ セツジョジュツ 2 トウ カ トウキョウ ジョシイカ ダイガク フゾク ダイ2 ビョウイン ゲカ ニ オケル テキオウ ジョウケン ノ ダトウセイ ニ ツイテ
  • Laparoscopy-Assisted Colectomy (LAC) for Colon Cancer (2) : Validity of Our Indication Criteria for LAC

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Abstract

We established the following criteria for the absolute indications for laparoscopy-assisted colectomy (LAC) in advanced colon cancer patients based on histological findings: lymph node metastasis ^nl, the depth of invasion ≦ss or al, and the absence of metastases associated with peritoneal dissemination. In a retrospective study we performed, it was demonstrated that the preoperative macroscopic findings of tumor diameter < 4 cm and tumor circumference ≦1/2 colon circumference met the above histological criteria. Therefore, we regarded the above two preoperative macroscopic findings as indications for LAC in advanced colon cancer patients. With the above background, since 2001 we have performed LAC in 33 patients with colon cancer who met the two preoperative macroscopic criteria of tumor diameter < 4 cm and tumor circumference ≦1/2 of colon circumference. None of the patients met the absolute indication criteria of lymph node metastasis ≧ n2, the depth of invasion ≧ se or a2, and metastasis associated with peritoneal dissemination, and all patients had a cure rate of cur A. Only one of the patients developed liver metastasis 7 months postoperatively. Hepatectomy was performed in this case, and the patient is still living. It is considered that LAC is indicated for patients who have colon cancer and meet both of the preoperative macroscopic criteria.

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