臨床外科76巻6号

2021年06月発行

特集 神経・神経叢を極める—さらに精緻な消化器外科手術を求めて 胆・膵

上腸間膜動脈神経叢の取り扱い方：半周切除と全周切除

著者： 高野重紹¹ 小西孝宜¹ 古川勝規¹ 高屋敷吏¹ 久保木知¹ 鈴木大亮¹ 酒井望¹ 賀川真吾¹ 細川勇¹ 三島敬¹ 大塚将之¹

所属機関： ¹千葉大学大学院医学研究院臓器制御外科学

ページ範囲：P.726 - P.732

【ポイント】
◆局所進行膵癌症例では，しばしば上腸間膜動脈神経叢浸潤を認め，神経叢の半周もしくは全周郭清を要する．
◆浸潤を認めない症例では，極力上腸間膜動脈神経叢の全周温存を心掛け，術後QOLを低下させずに術後補助療法を遂行することが肝要である．
◆病理学的神経叢浸潤陽性症例では，生存期間はR0とR1切除で差を認めず，今後は浸潤傾向の強い膵癌に対する新規治療法の開発が期待される．

参考文献

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