精神疾患を有する大腸癌患者17名に対する腹腔鏡下手術の短期成績に関する検討

Short-term outcomes of laparoscopic colorectal resection in psychiatric patients

◆要旨：【目的】精神科患者に対する腹腔鏡下手術の安全性を評価する．【対象・方法】2014年4月から2016年3月までに，腹腔鏡下に大腸癌手術を行った17名を対象とした．17名の精神疾患に関連する特徴，短期治療成績を検討した．【結果】17名はすべて医療保護入院であった．術後身体拘束を必要としたのは15名（88.2％）であった．術後精神疾患の増悪で長期入院を必要とした患者はなかった．また，術後抗精神病薬の内服数が増加した症例はなかった．【結論】腹腔鏡下手術によって精神疾患が増悪する可能性は低い．症例の蓄積により精神科患者に対する腹腔鏡下手術の利点が明らかになる可能性がある．

［Purpose］ The purpose of this study is to investigate the short-term outcomes of laparoscopic colorectal resection in psychiatric patients with colorectal cancer.［Methods］ We retrospectively reviewed the medical records of 17 consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2014 and March 2016. The clinicopathological characteristics, intraoperative outcomes, and postoperative data（including complications and early functional outcomes） were analyzed.［Results］ All the patients were involuntarily admitted to the hospital for medical care and protection under Sections 1 and 3 of the Japanese Mental Health and Welfare Act. Seventeen patients underwent laparoscopic surgery. Temporary physical restraint was required in 15 patients（88.2％）. Anastomotic leakage occurred in 2 patients who underwent low anterior resection. There was no patient who required more psychiatric drugs than before the surgery. No patient necessitated prolonged hospitalization due to psychiatric diseases after surgery.［Conclusion］ Laparoscopic surgery may be safe for psychiatric patients. The benefit of laparoscopic surgery for psychiatric patients may become clear with the accumulation of additional cases.