腹腔鏡下大腸切除術のクリニカルパス

Clinical Paths for Laparoscopic Colectomy

　腹腔鏡下胆嚢摘出術が導入されて以来，腹腔鏡下大腸切除術をはじめとする低侵襲手術が広く普及している．本法では術創が小さいため癒着が軽微で，腸管運動の回復が早いため，経口摂取の開始が早くなり，入院日数も減少した，今まで標準と思われていたことを見直し，無駄を省いたコストパフォーマンスの高い，かつよい医療を提供することは重要である．クリニカルパスの導入は，医療側だけでなく患者側も腹腔鏡下大腸切除術の標準的な術後経過を知るよい機会であり，これが入院期間減少の一助となってくれると期待されている．

Since laparoscopic cholecystectomy was introduced, minimally invasive approaches including laparoscopic colectomy are more popular. Early resume of intestinal motility and less postoperative adhesion due to small wound in laparoscopic surgery resulted in early resumption of solid diet and short hospital stay. It is important to review what used to be the standard medical care and establish the slim care of good quality. Introduction of a clinical path will provide patients as well as medical care teams with the standard postoperative course, which is expected to reduce the length of hospital stay.