超高齢者(95歳)の進行盲腸癌に対して腹腔鏡下回盲部切除を施行した1例 Successful laparoscopic resection of a cecal tumor in a 95-year-old man

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著者

    • 渡邉 彩子 Watanabe Ayako
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 母里 淑子 Mori Yoshiko
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 岸本 浩行 [他] Kishimoto Hiroyuki
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 藤原 俊義 Fujiwara Toshiyoshi
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 稲田 涼 Inada Ryo
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学|関西医科大学 外科学講座 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences|Department of Surgery, Kansai Medical University
    • 永坂 岳司 Nagasaka Takeshi
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 八木 朝彦 Yagi Tomohiko
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 松本 聖 Matsumoto Hijiri
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 戸嶋 俊明 Toshima Toshiaki
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 菊池 覚次 Kikuchi Satoru
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 黒田 新士 Kuroda Shinshi
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
    • 近藤 喜太 Kondo Yoshitaka
    • 岡山大学大学院医歯薬学総合研究科 消化器外科学 Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

抄録

We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.

We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.

収録刊行物

  • 岡山医学会雑誌

    岡山医学会雑誌 127(2), 117-121, 2015

    岡山医学会

各種コード

  • NII論文ID(NAID)
    130005096253
  • NII書誌ID(NCID)
    AN00032489
  • 本文言語コード
    JPN
  • 資料種別
    Journal Article
  • 雑誌種別
    大学紀要
  • ISSN
    0030-1558
  • NDL 記事登録ID
    026689787
  • NDL 請求記号
    Z19-269
  • データ提供元
    NDL  IR  J-STAGE 
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