原発性肺癌に対する胸腔鏡下手術

Strategy for thoracoscopic surgery on primary lung cancer

　胸腔鏡下手術は低侵襲性を特徴とする新しい手術であり，原発性肺癌の治療にも積極的に取り入れていくことが望ましい．現在の胸腔鏡下手術は適切に行えば安全性は高く，比較的早期の原発性肺癌に対しても良好な成績が報告されている．しかし操作性が劣るため開胸手術と同等の手術操作の困難性も指摘され，直視を併用した手術も行われている．今後，安全性と確実な手術操作を兼ね備え，開胸手術と胸腔鏡下手術を包含した新しい手術体系の確立が求められる．

Thoracoscopic surgery is a new surgery characterized by minimal invasiveness, which will hopefully innovate the surgery of primary lung cancer. So far, thoracoscopic surgery has been assumed safe if appropriately per-formed, and favorable results have been reported on relatively early lung cancer surgery. Nevertheless, thora-coscopic surgery is inferior in maneuverability to conventional open surgery, and surgery is performed often using direct vision. Hence, establishment of a new surgical system that comprehends both open and thoraco-scopic surgery, equipping safety and secure maneuverability is awaited.