左側閉塞性大腸癌に対するステント留置後の腹腔鏡補助下手術の短期成績の検討

Short-term outcomes of laparoscopy- assisted surgery after self-expandable metallic stent for left-sided obstructive colorectal cancer

◆要旨：【目的】左側閉塞性大腸癌に対するステント留置後の腹腔鏡補助下手術の短期成績を検討する．【方法】2012年4月～2013年1月に，ステント留置後に腹腔鏡補助下手術を施行した8例（ステント群）と腹腔鏡補助下大腸切除術42例（コントロール群）を対象に，短期成績の比較検討を行った．【結果】ステント群ではPS3以上，開腹移行が多く，腫瘍径が大きかった．手術時間，出血量，術後合併症の有無，入院期間に有意差は認めなかった．【結論】左側閉塞性大腸癌に対するステント留置後の腹腔鏡補助下手術の短期成績は良好で，安全かつ妥当性のある治療手段と考えられた．

［Purpose］ Safety and validity of performing laparoscopy-assisted surgery after preoperative lavage using the self-expandable metallic stent for left-sided obstructive colorectal cancer were examined. ［Patients and Methods］ Patients with left-sided colorectal cancer treated by either laparoscopy-assisted surgery with stent placement（n＝8） or laparoscopy-assisted surgery only（n＝42） in our hospital between April, 2012 and January, 2013 were identified, and short-term outcomes were compared with the two groups. ［Results］ Except for Performance Status and tumor size in the patient characteristic parameters, there was no statistically significant difference between the two groups. Conversion rate to laparotomy was higher in the stent group（2 versus 1, P＝0.013）. There was no difference in operation time, blood loss during the operation and postoperative complications between the two groups. ［Conclusion］ Although the long-term oncological result requires further investigation, laparoscopy-assisted surgery after self-expandable metallic stent is a safe and feasible treatment for left-sided obstructive colorectal cancer.