2)ステント留置術 (2)下部消化管―悪性疾患

Stent Endoprosthesis for Colorectal Cancers

要旨　大腸狭窄に対するアプローチとして経肛門的減圧術が最近は導入され，注目されている．そのうちステント留置術は，他の部位よりも臨床応用が遅れていたが，最近は主に悪性疾患による狭窄への姑息的留置または狭窄型大腸癌に対する術前処置として，欧米を中心に良好な臨床成績の報告が増加している．今後，大腸悪性狭窄患者に対する治療として，姑息的または一時的な人工肛門造設などの過大侵襲を回避し，QOLを向上させるためにステント留置術の果たす役割は大きい．専用ステントとキットの導入および保険適用の獲得が待たれる．

　Self-expandable metallic stent (EMS) treatment and decompression tube insertion have recently seen employed for various diseases related to colorectal obstructions. Use of EMS has been delayed compared with that for other organs. Recently, however, there have been many reports on the use of EMS in colorectal disease, mainly from the West. EMS is generally used as a palliative treatment for malignant strictures of the colon and rectum and as bridging to surgery for obstructing colorectal cancers. EMS treatment can eliminate the need for unnecessary palliative and temporary colostomies for patients with colorectal obstructions. EMS will become the standard treatment for colorectal strictures when exclusive colorectal EMS and delivery kits are developed.