臨床外科74巻8号

2019年08月発行

特集 これだけは押さえたい！—大腸癌取扱い規約・治療ガイドライン—改訂のポイント

大腸癌治療ガイドライン2019

腹腔鏡手術—横行結腸癌，下行結腸癌，直腸癌などの適応

著者： 齋藤稔史¹ 茂原富美¹ 青柳康子¹ 山本雄大¹ 高岡亜弓¹ 馬場裕信¹ 菊池章史¹ 山内慎一¹ 松山貴俊¹ 絹笠祐介¹

所属機関： ¹東京医科歯科大学消化管外科学分野

ページ範囲：P.952 - P.956

文献概要

【ポイント】
◆腹腔鏡手術の短期成績：海外および本邦におけるランダム化比較試験において，腹腔鏡手術の安全性が確認されている．ただし，横行結腸癌に関しては多くの試験で除外されている．
◆結腸癌に対する長期成績：海外の試験において，腹腔鏡手術の開腹手術に対する非劣性が確認されている．わが国におけるJCOG0404では，開腹手術群・腹腔鏡手術群ともに良好な成績だが，腹腔鏡手術の非劣性は確認されなかった．
◆直腸癌に対する成績：短期成績に関しては結腸癌と同様，術後3年までの無再発生存率に関しても非劣性が確認されている．ただし，試験によっては腫瘍学的成功率に関して開腹手術に対する腹腔鏡手術の非劣性を確認できなかった．

参考文献

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