腹腔鏡補助下大腸切除術の有用性

Utility of Laparoscopic-Assisted Colectomy

　腹腔鏡補助下大腸切除術（LAC）症例29例と開腹下大腸切除術（OC）症例27例を，周術期成績と術後合併症につき比較検討した．さらに，リンパ節郭清度がLACの周術期成績に与える影響を検討した．LACでは，消化管機能の早期回復，疼痛の軽減が認められ，術後入院日数も短縮された．リンパ節郭清度が増すにつれて手術時間は延長し，排ガスは遅れたが，出血量，鎮痛剤使用日数，入院日数には影響しなかった．LACはOCよりも周術期成績が良好であり，D2郭清も含めて積極的に施行すべきと考えられた．

A comparison of peri- and postoperative course of laparoscopic-assisted colectomy (LAC) (n=29) and open colectomy (OC) (n=27) was carried out. The impact of lymphadenectomy on the perioperative course of LAC was investigated. LAC showed earlier recovery of gastrointestinal function and less pain. The postoperative stay was shortened. As the degree of lympadenectomy increased, the operative time was elongated and first flatus became later. But the estimated blood loss, the requirement of pain control and postoperative stay were not affected. Perioperative course was better in LAC than in OC.