直腸肛門部におけるCryosurgery

Cryosurgery in Anorectal Region

　われわれの教室でcryosurgeryの実験と臨床応用に取り組んで今日まで，7年の経過に至っている．この間にあって，凍結療法のもつ特性と利点および欠点につき，おおよその理解と把握をなし得た段階であろうと思っている．この間にあって，1つの解決は新たな問題を提起することにもなり，現在，数多くの解明すべきものを残している．

　手技的には凍結装置の改良開発は凍結領域の拡張，深達度の進展を伴い，これは本療法の適応選択の拡大に連り，治療手段としての新たな道を拓くことにもなると思われる．

　We have described here cryosurgery for anorectal lesions based on our experiences for the past seven years.

　In this area it is especially important to avoid any postoperative functional disorders, for which the merits of freezing therapy can be displayed to the full. It is indeed one of the most appropriate treatments for lesions in this area. However, the problem still remains how to tackle with malignant neoplasms, a problem not limited to this area.

　Cryosurgery is indicated for all benign lesions although not of the same precedence. First comes internal hemorrhoid. We have treated more than 1,000 such patients with this therapy. Usually treatment in the out-patient clinic is sufficient. Hardly any complications or untoward accidents have been encountered so far. It has merits not to be seen in other methods of management. It can also be used to excellent advantage in mucosal prolapse and fissure of the anal region but not in external hemorrhoid or rectal prolapse. For anal fistulas and polyps we have chosen individual cases personally regarded as fit for this type of treatment.

　The biggest problem for cryosurgery of malignant neoplasms in this area would be how to cope with adverse effects that could take place by this treatment. At present, we apply it to only recurred or fatal cases. It has a noticiable effect as a palliative measure. Prolongation of the patient's life is also expected. To be clarified in years to come is its immunological effects. At present we are trying to freeze and destroy lesions as completely as possible. Cryosurgery is still faced with many problems such as how to co-employ cancer chemotherapy or how to use it to best advantage during surgical intervention, Further studies are therefore eagerly expected.