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当科において,1995年8月までに55例の腸疾患に対して腹腔鏡下手術を施行した.男性33例,女性22例で,平均年齢は57.6歳であった.このなかで,腹腔鏡下に根治度Aの手術を施行し得たS状結腸および直腸癌の24症例を対象に,手術手技および通常の開腹手術との差を検討した.D1郭清を施行した症例は9例,D2郭清が9例,D3郭清が6例であった.手術時間は通常の開腹手術よりも長時間を要した.D3郭清の施行にはUltrasonic Surgical Unitがきわめて有効であった.摘出したリンパ節の個数は腹腔鏡手術と開腹手術で差はなかった.したがって,D3郭清によって根治手術が可能となるS状結腸,上部直腸進行癌は腹腔鏡下手術の適応と考えられた.
Laparoscopic surgery had been performed for 55 colorectal diseases in our department. Twelve cases (21.8%) were benign and 43 cases (78.2%) were malig-nant. There were consisted of 33 cases of males and 22 cases of females. Mean age of them was 57.6 years old. Cases with sigmoid colon carcinoma and rectal car-cinoma with systematic lymphadenectomy was made in 22. Curative operation was defined by the side of arteries ligated and divided, and location of lymphnodes involved by carcinoma (D1 ; 9 cases, D2 ; 9 cases and D3 ; 6 cases).
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