胸部外科におけるreduced port surgeryの検討

Reduced port surgery for thoracic disease

◆要旨：［目的］当科胸部外科領域のreduced port surgery（RPS）を，single incision surgery（SIS）とneedlescopic surgery（NSS）に分類し検討した．［対象と方法］RPSは41例で，内訳はSIS 12例，NSS 29例であった．カルテより臨床事項を検討した．［結果］ポート追加は認めたが，他に合併症は認めなかった．また約半数が後期研修医により安全に施行されていた．［結論］胸部には臍にあたる構造物がなく，SISの有用性は限定的である．NSSは従来法に近い質を維持して導入可能であり，周辺器械の発達とともに広がる可能性がある．

【Aim】Reduced port surgery（RPS） has been developed with the aim of further reducing the invasiveness of traditional endoscopic surgery. We report here the clinical RPS for thoracic disease. 【Patients and Methods】Between August 2010 and July 2014, 41 patients underwent RPS for thoracic disease. Single incision surgery（SIS） was performed in 12 patients, and needlescopic surgery（NSS） was performed in 29 patients. We compared clinical elements of these cases. 【Results】SIS and NSS were carried out safely, and the operations by residents accounted for approximately half of the RPS. 【Conclusion】There are no thoracic structures like the umbilicus in laparoscopic surgery. Therefore, the utility of SIS for thoracic disease is limited in contrast to single incision laparoscopic surgery. On the other hand, NSS can be introduced while keeping the quality of conventional VATS. This procedure has the potential to spread more widely with the development of surgical equipment.