8．胸壁の切除と再建

Chest Wall Resection and Reconstruction

胸壁浸潤肺癌は肺癌全体の5％程度とされており，日常的に遭遇しうる病態である1）．外科治療が標準治療として認識されており，完全切除が予後を改善するため，外科治療の役割は大きい．本稿では，肺尖部胸壁浸潤肺癌を除いた胸壁浸潤肺癌に対する外科治療成績をレビューし，胸壁合併切除・再建術の要所，外科治療の役割を考察する．

Lung cancer invasion of the chest wall is considered to occur in approximately 5％ of all patients who had undergone lung cancer resection. Surgical resection is recognized as a standard treatment, and surgical treatment plays a major role because survival is highly dependent on the completeness of the resection. On the other hand, prognosis is still poor in cases with mediastinal lymph node involvement, and the indications for surgery remain controversial in such cases, with increasing number of reported perioperative chemoradiotherapy cases. In addition, the use of minimally invasive surgery combined with thoracoscopy has become widespread in recent years, and indications are being considered for chest wall resection cases. In this paper, we review the results of operation for lung cancer with chest wall invasion other than those for superior sulcus tumors and discuss the role of surgical treatment and surgical resection and reconstruction techniques.