大腸癌同時性肝転移に対し完全腹腔鏡下同時切除術を施行した3例の検討

Totally laparoscopic strategies in the management of colorectal cancer with synchronous liver metastases : three case reports

◆要旨：切除可能大腸癌同時性肝転移に対する手術の時期については，現在議論が分かれている．一方，腹腔鏡下手術はその技術の向上に伴い多くの領域において広く受け入れられつつあるが，大腸癌同時性肝転移に対する完全腹腔鏡下同時切除症例は本邦での報告は少ない．今回，大腸癌同時性肝転移に対して完全腹腔鏡下同時切除術を3例経験した．手術時間/出血量の中央値は406分/35mlで，これまでの報告と比べ手術時間はほぼ同等であり，出血量は少ない傾向であった．離床，経口摂取開始時期の中央値は術後それぞれ1日，2日であり早期回復が得られた．さらに医療費軽減に対しても有用であり，腫瘍学的短期成績も許容できると考えられる．

There is no consensus for timing of resection for synchronous liver metastases of colorectal cancer. Laparoscopy is an accepted treatment for many fields such as colorectal cancer and hepatic cancer. However, there are few reports of totally laparoscopic strategies in the management of these cases. Here we experienced 3 cases of totally laparoscopic strategies in the management of colorectal cancer with synchronous liver metastases. Median operating time and blood loss were 406 minutes and 35ml, respectively. Operation time was similar and blood loss was less than previously reported cases. The median days of recuperation and oral intake resumption were on post-operative day（POD） 1 and 2 which were faster than standard operation. In addition, totally laparoscopic strategies in the management of colorectal cancer with synchronous liver metastases can lower medical expenses and are acceptable for short-term oncological outcome.