臨床外科78巻2号

2023年02月発行

特集 最新医療機器・材料を使いこなす

下部消化管

大腸癌手術における蛍光尿管ナビゲーション—蛍光尿管カテーテル使用法のコツ

著者： 柳舜仁¹ 北川隆洋¹ 後藤圭佑¹ 永嶌惇¹ 小林毅大¹ 島田淳一¹ 伊藤隆介¹ 中林幸夫¹

所属機関： ¹川口市立医療センター消化器外科

ページ範囲：P.185 - P.189

文献概要

【ポイント】
◆蛍光尿管カテーテルは近赤外観察で尿管を鮮明に描出できるため，他臓器浸潤癌，再発癌に特に有用である．
◆デバイスへの過信は禁物で，剝離による尿管熱損傷に対する注意や術前の重複尿管の有無を確認することが重要である．
＊本論文中、［▶動画］マークのある図につきましては、関連する動画を見ることができます（公開期間：2026年2月末まで）。

参考文献

1）Lezina MAST, Stoller ML：Surgical ureteral injuries. Urology 38：497-506, 1991

2）Nam YS, Wexner SD：Clinical value of prophylactic ureteral stent indwelling during laparoscopic colorectal surgery. J Korean Med Sci 17：633-635, 2002

3）Larach SW, Patankar SK, Ferrara A, et al：Complications of laparoscopic colorectal surgery. Dis Colon Rectum 40：592-596, 1997

4）Chahin F, Dwivedi AJ, Paramesh A, et al：The implications of lighted ureteral stenting in laparoscopic colectomy. J Soc Laparoendosc Surg 6：49-52, 2002

5）Scala A, Huang A, Dowson HMP, et al：Laparoscopic colorectal surgery? Results from 200 patients. Colorectal Dis 9：701-705, 2007

6）Fry DE, Milholen L, Harbrecht PJ：Iatrogenic ureteral injury：options in management. Arch Surg 118：454-457, 1983

7）Goodno JA, Powers TW, Harris VD：Ureteral injury in gynecologic surgery：a ten-year review in a community hospital. Am J Obstet Gynecol 172：1817-1822, 1995

8）Palaniappa NC：Incidence of iatrogenic ureteral injury after laparoscopic colectomy. Arch Surg 147：267-271, 2012

9）Marcelissen TAT, Den Hollander PP, Tuytten TRAH, et al：Incidence of iatrogenic ureteral injury during open and laparoscopic colorectal surgery：a single center experience and review of the literature. Surg Laparosc Endosc Percutan Tech 26：513-515, 2016

10）Chou MT, Wang CJ, Lien RC：Prophylactic ureteral catheterization in gynecologic surgery：a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct 20：689-693, 2009

11）Kuno K, Menzin A, Kauder HH, et al：Prophylactic ureteral catheterization in gynecologic surgery. Urology 52：1004-1008, 1998

12）Schaafsma BE, Mieog JSD, Hutteman M, et al：The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image-guided oncologic surgery. J Surg Oncol 104：323-332, 2011

13）Ris F, Hompes R, Cunningham C, et al：Near-infrared（NIR）perfusion angiography in minimally invasive colorectal surgery. Surg Endosc 28：2221-2226, 2014

14）Jafari MD, Lee KH, Halabi WJ, et al：The use of indocyanine green fluorescence to assess anastomotic perfusion during robotic assisted laparoscopic rectal surgery. Surg Endosc 27：3003-3008, 2013

15）Sherwinter DA：Transanal near-infrared imaging of colorectal anastomotic perfusion. Surg Laparosc Endosc Percutan Tech 22：433-436, 2012

16）Kudszus S, Roesel C, Schachtrupp A, et al：Intraoperative laser fluorescence angiography in colorectal surgery：a noninvasive analysis to reduce the rate of anastomotic leakage. Langenbecks Arch Surg 395：1025-1030, 2010

17）Jafari MD, Wexner SD, Martz JE, et al：Perfusion assessment in laparoscopic left-sided/anterior resection（PILLAR II）：a multi-institutional study. J Am Coll Surg 220：82-92, 2015

18）Wada T, Kawada K, Takahashi R, et al：ICG fluorescence imaging for quantitative evaluation of colonic perfusion in laparoscopic colorectal surgery. Surg Endosc 31：4184-4193, 2017

19）Ryu S, Suwa K, Kitagawa T, et al：Evaluation of anastomosis with ICG fluorescence method using VISERA ELITE2 during laparoscopic colorectal cancer surgery. Anticancer Res 40：373-377, 2020

20）Watanabe J, Ota M, Suwa Y, et al：Real-time indocyanine green fluorescence imaging-guided complete mesocolic excision in laparoscopic flexural colon cancer surgery. Dis Colon Rectum 59：701-705, 2016

21）Ryu S, Suwa K, Kitagawa T, et al：Real-time fluorescence vessel navigation using indocyanine green during laparoscopic colorectal cancer surgery. Anticancer Res 39：3009-3013, 2019

22）Anayama T, Sato T, Hirohashi K, et al：Near-infrared fluorescent solid material for visualizing indwelling devices implanted for medical use. Surg Endosc. https://doi.org/10.1007/s00464-020-07634-0, May2019, 2020

23）Ryu S, Hara K, Kitagawa T, et al：Fluorescence vessel and ureter navigation during laparoscopic lateral lymph node dissection. Langenbecks Arch Surg 407：305-312, 2022 doi：10.1007/s00423-021-02286-7. Epub 2021 Aug 11. PMID：34378079.

24）Ryu S, Hara K, Okamoto A, et al：Fluorescence ureteral navigation during laparoscopic surgery for clinically suspected stage T4 colorectal cancer：A cohort study. Surg Oncol 40：101672, 2022　doi：10.1016/j.suronc.2021.101672. Epub 2021 Nov 10. PMID：34891060.

25）Ryu S, Hara K, Goto K, et al：New Technique of Laparoscopic Paraaortic Lymph Node Dissection for Colorectal Cancer Using Fluorescence Navigation. Cancer Diagn Progn 1：317-322, 2021　doi：10.21873/cdp.10042. PMID：35403145；PMCID：PMC8988955.