臨床婦人科産科71巻3号

2017年04月発行

今月の臨床 婦人科がん低侵襲治療の現状と展望〈特別付録web動画〉 卵巣がん，外陰がん，再発悪性腫瘍

卵巣がんに対する腹腔鏡下手術

著者： 山下剛¹ 西澤庸子¹ 馬場敦志¹ 浅野拓也¹

所属機関： ¹市立函館病院産婦人科

ページ範囲：P.350 - P.356

●卵巣がんでは進行がん患者が多く術前確定診断が困難なことにより，試験的腹腔鏡を除けば腹腔鏡下手術の適応は限定される．

●施設あるいは術者条件によるが，早期がんでのstaging surgeryについては適応となる可能性がある．

●現状では健康保険上算定困難だが，臨床試験の結果によっては子宮体がんのように限定された条件での先進医療は考慮される．

参考文献

1）国立がん研究センターがん対策情報センター : 全国がん罹患モニタリング集計2012年罹患数・率報告．http://ganjoho.jp/reg_stat/statistics/brochure/monitoring.html

2）国立がん研究センターがん対策情報センター : 全国がん罹患モニタリング集計2006─2008年生存率報告．http://ganjoho.jp/reg_stat/statistics/brochure/monitoring.html

3）National Institute for Health and Clinical Excellence（NICE） : Ovarian Cancer. NICE clinical guideline 122 ; Available at www.nice.org.uk/guidance/CG122 ; April, 2011, issue Developed by the UK National Collaborating Centre for Cancer

4）Mettler L, et al : The value of laparoscopic surgery to stage gynecological cancers : present and future. Minerva Ginecol 61 : 319─337, 2009

5）Colomer AT, et al : Laparoscopic treatment and staging of early ovarian cancer. J Minim Invasive Gynecol 15 : 414─419, 2008

6）Ghezzi F, et al : Laparoscopy staging of early ovarian cancer : our experience and review of the literature. Int J Gynecol Cancer 19（Suppl 2） : S7─S13, 2009

7）Nezhat FR, et al : Laparoscopic management of early ovarian and fallopian tube cancers : surgical and survival outcome. Am J Obstet Gynecol 200 : e1─6, 2009

8）Park JY, et al : Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer. Ann Surg Oncol 15 : 2012─2019, 2008

9）Park JY, et al : Laparoscopic management of early stage epithelial ovarian cancer. J Minim Invasive Gynecol 17 : S90, 2010

10）Hua KQ, et al : Evaluation of laparoscopic surgery in the early stage-malignant tumor of ovary with lower risk. Zhonghua Yi Xue Za Zhi 85 : 169─172, 2005

11）Lee M, et al : Comparisons of surgical outcomes, complications, and costs between laparotomy and laparoscopy in early-stage ovarian cancer. Int J Gynecol Cancer 21 : 251─256, 2011

12）Park JY, et al : Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer : a comparison of feasibility and safety. Int J Gynecol Cancer 18 : 1202─1209, 2008

13）Chi DS, et al : The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers. Am J Obstet Gynecol 192 : 1614─1619, 2005

14）Ghezzi F, et al : Laparoscopy versus laparotomy for the surgical management of apparent early stage ovarian cancer. Gynecol Oncol 105 : 409─413, 2007

15）Park JY, et al : Laparoscopic versus laparotomic surgical staging for early-stage epithelial ovarian cancer. Gynecol Oncol 120 : S72, 2011

16）Fagotti A, et al : Introduction of staging laparoscopy in the management of advanced epithelial ovarian, tubal and peritoneal cancer : impact on prognosis in a single institution experience. Gynecol Oncol 131 : 341─346, 2013

17）Bogani G, et al : Laparoscopic and open abdominal staging for early-stage ovarian cancer : our experience, systematic review, and meta-analysis of comparative studies. Int J Gynecol Cancer 24 : 1241─1249, 2014

18）Gallotta V, et al : Laparoscopic staging of apparent early stage ovarian cancer : results of a large, retrospective, multi-institutional series. Gynecol Oncol 135 : 428─434, 2014

19）Koo YJ, et al : Comparison of laparoscopy and laparotomy for the management of early-stage ovarian cancer : surgical and oncological outcomes. J Gynecol Oncol 25 : 111─117, 2014

20）Gallotta V, et al : Laparoscopic versus laparotomic surgical staging for early-stage ovarian cancer : a case-control study. J Minim Invasive Gynecol 23 : 769─774, 2016

21）Gallotta V, et al : Laparoscopic management of ovarian cancer patients with localized carcinomatosis and lymph node metastases : results of a retrospective multi-institutional series. J Minim Invasive Gynecol 23 : 590─596, 2016