3．代謝性疾患・内分泌疾患合併患者の周術期管理の留意点

Perioperative Management for Patients with Metabolic and Endocrine Disorders

近年の高齢化社会を反映し，内科併存疾患を合併した手術症例は著しく増加している．このような背景の中で，外科医は手術にあたり，併存疾患における内服・治療内容，そして現在のコントロール状況についての評価および適切な周術期管理を行うことが求められている．本稿では，代謝性疾患・内分泌疾患合併患者の中でも高頻度に遭遇する，①糖尿病，②甲状腺機能障害，さらに希少疾患ではあるものの呼吸器外科医にとって特に注意が必要な③パラガングリオーマにフォーカスを当てて解説する．

In recent years, the number of surgical cases involving patients with comorbidities has been increasing due to the aging society. Such patients may have a higher risk of postoperative morbidity or mortality. Therefore, surgeons are required to evaluate the current control status of the comorbidity, and perform appropriate perioperative management to decrease perioperative risk. This article focuses on the preoperative evaluation and management, as well as intraoperative and postoperative management of diabetes mellitus, thyroid dysfunction, which are frequently encountered among patients with metabolic and endocrine disorders, and paraganglioma, which is a rare disease but requires special attention in the field of thoracic surgery.