大腸早期癌の治療方針

The Treatment of Early Cancer of Large Intestine

　大腸早期癌の治療方針については，現時点では，ほぼ一定の基準が一般化しつつあるがなお種々なる問題点があり，かつ不明確な点も多い，ここでは大腸の早期の癌の特徴を少しでも明らかにすることを目的として，現在一般に考えられている大腸早期の癌とその治療法を幅広くとらえてみようとする．

　まず，それ以前の問題として，大腸早期癌の概念のとらえ方について論ずる．そして，現在の早期癌の概念とその治療法の問題点を提示し，これに対する考察を症例をもって論じてみる．

　Cancer of m, sm invasion, cancer with a stalk, cancer less than 2.0 cm in diameter and cancer classified to Dukes A would be defined as the early cancer of the large intestine, because these cancers are clinically discovered with sufficient frequency and completely cured by appropriate treatments. There is quite different idea about the definition of early cancer between gastric and intestinal cancer. Recognizing the above mentioned things, we believe it would be understood easily that correlation of three characteristics of small lesions of large intestine, shape, size and depth of invasion, must be discussed, when we search for a general rule of treatment of early intestinal cancer.

　The most desirable line of treatment of early cancer can be devided into four procedures, these are diagnosis of shape of lesion, treatment for defining histological diagnosis, difinitive histological diagnosis and radical surgery. Some discussions were done being based on the experience of Surgical Department of Cancer Institute Hospital.

　The discussion could be focussed to the following two points: what is the indication and how is the efiicasy of endoscopic polypectomy, and what kind of operation should be adopted if need be.