臨床外科68巻1号

2013年01月発行

臨床の疑問に答える「ドクターAのミニレクチャー」・8

食道がんの手術―鏡視下手術は利点があるか

著者： 安達洋祐¹

所属機関： ¹久留米大学医学部外科

ページ範囲：P.78 - P.81

素朴な疑問

　食道切除は大がかりな手術であり，肺炎のような術後合併症が多い．肺がんの胸腔鏡下手術や胃がんの腹腔鏡下手術のように，食道がんにも胸腔鏡や腹腔鏡を利用できるが，食道切除を鏡視下手術で行うと術後合併症や手術死亡は減るだろうか．患者の満足度は高いだろうか．食道がんの根治性や長期成績は問題ないだろうか．

参考文献

1）Nguyen NT （USA）：Minimally invasive esophagectomy：lessons learned from 104 operations. Ann Surg 248：1081-1091, 2008

2）Luketich JD （USA）：Outcomes after minimally invasive esophagectomy：review of over 1000 patients. Ann Surg 256：95-103, 2012

3）Smithers BM （USA）：Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 245：252-240, 2007

4）Thomson IG （USA）：Thoracoscopic-assisted esophagectomy for esophageal cancer：analysis of patterns and prognostic factors for recurrence. Ann Surg 252：281-291, 2010

5）Lazzarino AI （UK）：Open versus minimally invasive esophagectomy：trends of utilization and associated outcomes in England. Ann Surg 252：292-298, 2010

6）Mamidanna R （UK）：Short-term outcomes following open versus minimally invasive esophagectomy for cancer in England：a population-based national study. Ann Surg 255：197-203, 2012

7）Sgourakis G （Germany）：Minimally invasive versus open esophagectomy：meta-analysis of outcomes. Dig Dis Sci 55：3031-3040, 2101

8）Nagpal K （UK）：Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis. Surg Endosc 24：1621-1629, 2010

9）Verhage RJ （Netherlands）：Minimally invasive compared to open procedures in esophagectomy for cancer：a systematic review of the literature. Minerva Chir 64：135-146, 2009

10）Biere SS （Netherlands）：Minimally invasive versus open esophagectomy for cancer：a systematic review and meta-analysis. Minerva Chir 64：121-133, 2009

11）Briez N （France）：Open versus laparoscopically-assisted oesophagectomy for cancer：a multicentre randomised controlled phase III trial-the MIRO trial. BMC Cancer 11：310, 2011

12）Biere SS （Netherlands）：Traditional invasive vs. minimally invasive esophagectomy：a multi-center, randomized trial （TIME trial）. BMC Surgery 11：2, 2011

13）Biere SS （Netherlands）：Minimally invasive versus open oesophagectomy for patients with oesophageal cancer：a multicentre, open-label, randomised controlled trial. Lancet 379：1887-1892, 2012

14）Derogar M （Sweden）：Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery. J Clin Oncol 30：1615-1619, 2012

15）Kernstine KH （USA）：The first series of completely robotic esophagectomies with three-field lymphadenectomy：initial experience. Surg Endosc 21：2285-2292, 2007

16）Boone J （Netherlands）：Robot-assisted thoracoscopic oesophagectomy for cancer. Br J Surg 2009；96：878-885, 2009

17）Kim DJ （Korea）：Thoracoscopic esophagectomy for esophageal cancer：feasibility and safety of robotic assistance in the prone position. J Thorac Cardiovasc Surg 139：53-59, 2010