局所進行直腸癌に対するロボット支援他臓器合併切除および骨盤内臓全摘の手技のポイントと短期成績

目的：他臓器浸潤を伴う原発性直腸癌に対するロボット支援手術の短期成績について報告する．方法：2017～2023年に当科でロボット支援手術を施行した原発性直腸癌のうち，他臓器合併切除を施行した34例を対象とし短期成績につき後方視的に解析した．成績：年齢68歳，男：女26：8例，RS/Ra/Rb/P 7/5/20/2例，cStageII/III/IV 7/25/2例，直腸切断術16例，低位前方切除術8例，骨盤内臓全摘術（PE）が5例に施行された．手術時間はPE以外/PEで各334/617（分），出血量は各40/367（mL），術後在院日数は各7/14（日）．Clavien-Dindo GradeI...

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Published in日本大腸肛門病学会雑誌 Vol. 77; no. 1; pp. 1 - 12
Main Authors 絹笠, 祐介, 高岡, 亜弓, 佐々木, 恵, 山内, 慎一, 花岡, まりえ
Format Journal Article
LanguageJapanese
Published 日本大腸肛門病学会 2024
Subjects
ロボット支援手術
他臓器合併切除
局所進行直腸癌
短期成績
骨盤内臓全摘
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ISSN0047-1801
1882-9619
DOI10.3862/jcoloproctology.77.1

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Abstract 目的：他臓器浸潤を伴う原発性直腸癌に対するロボット支援手術の短期成績について報告する．方法：2017～2023年に当科でロボット支援手術を施行した原発性直腸癌のうち，他臓器合併切除を施行した34例を対象とし短期成績につき後方視的に解析した．成績：年齢68歳，男：女26：8例，RS/Ra/Rb/P 7/5/20/2例，cStageII/III/IV 7/25/2例，直腸切断術16例，低位前方切除術8例，骨盤内臓全摘術（PE）が5例に施行された．手術時間はPE以外/PEで各334/617（分），出血量は各40/367（mL），術後在院日数は各7/14（日）．Clavien-Dindo GradeII以上の合併症は全体で6例（17％）．剥離面陽性はPE以外2例（7％），PEは全例陰性であった．結論：当科における他臓器浸潤直腸癌に対するロボット支援手術の短期成績は良好であった．
AbstractList 目的：他臓器浸潤を伴う原発性直腸癌に対するロボット支援手術の短期成績について報告する．方法：2017～2023年に当科でロボット支援手術を施行した原発性直腸癌のうち，他臓器合併切除を施行した34例を対象とし短期成績につき後方視的に解析した．成績：年齢68歳，男：女26：8例，RS/Ra/Rb/P 7/5/20/2例，cStageII/III/IV 7/25/2例，直腸切断術16例，低位前方切除術8例，骨盤内臓全摘術（PE）が5例に施行された．手術時間はPE以外/PEで各334/617（分），出血量は各40/367（mL），術後在院日数は各7/14（日）．Clavien-Dindo GradeII以上の合併症は全体で6例（17％）．剥離面陽性はPE以外2例（7％），PEは全例陰性であった．結論：当科における他臓器浸潤直腸癌に対するロボット支援手術の短期成績は良好であった．
Author 花岡, まりえ
山内, 慎一
佐々木, 恵
高岡, 亜弓
絹笠, 祐介
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References_xml – reference: 10) Klaver CEL, Kappen TM, Borstlap WAA, et al: Laparoscopic surgery for T4 colon cancer: a systematic review and meta-analysis. Surg Endosc 31:4902-4912, 2017
– reference: 12) Emile SH, Horesh N, Freund MR, et al: Outcomes of laparoscopic versus robotic-assisted resection of T4 rectal cancer: propensity score-matched analysis of a national cancer database. Br J Surg 110:242-250, 2023
– reference: 17) PelvEx C: Surgical and Survival Outcomes Following Pelvic Exenteration for Locally Advanced Primary Rectal Cancer: Results From an International Collaboration. Ann Surg 269:315-321, 2019
– reference: 2) Uehara K, Ito Z, Yoshino Y, et al: Aggressive surgical treatment with bony pelvic resection for locally recurrent rectal cancer. Eur J Surg Oncol 41:413-420, 2015
– reference: 9) Harris DA, Davies M, Lucas MG, et al: Multivisceral resection for primary locally advanced rectal carcinoma. Br J Surg 98:582-588, 2011
– reference: 13) Meccariello G, Faedi F, AlGhamdi S, et al: An experimental study about haptic feedback in robotic surgery: may visual feedback substitute tactile feedback? J Robot Surg 10:57-61, 2016
– reference: 16) PelvEx C: Minimally invasive surgery techniques in pelvic exenteration: a systematic and meta-analysis review. Surg Endosc 32:4707-4715, 2018
– reference: 4) Konstantinidis IT, Chu W, Tozzi F, et al: Robotic Total Pelvic Exenteration: Video-Illustrated Technique. Ann Surg Oncol 24:3422-3423, 2017
– reference: 6) Williams M, Perera M, Nouhaud FX, et al: Robotic pelvic exenteration and extended pelvic resections for locally advanced or synchronous rectal and urological malignancy. Investig Clin Urol 62:111-120, 2021
– reference: 1) Yang TX, Morris DL, Chua TC: Pelvic exenteration for rectal cancer: a systematic review. Dis Colon Rectum 56:519-531, 2013
– reference: 3) Lim PC: Robotic assisted total pelvic exenteration: a case report. Gynecol Oncol 115:310-311, 2009
– reference: 8) Crawshaw BP, Augestad KM, Keller DS, et al: Multivisceral resection for advanced rectal cancer: outcomes and experience at a single institution. Am J Surg 209:526-531, 2015
– reference: 5) Kazi M, Kumar NAN, Rohila J, et al: Minimally invasive versus open pelvic exenterations for rectal cancer: a comparative analysis of perioperative and 3-year oncological outcomes. BJS Open 5:zrab074, 2021
– reference: 15) Ishiguro S, Akasu T, Fujita S, et al: Pelvic exenteration for clinical T4 rectal cancer: oncologic outcome in 93 patients at a single institution over a 30-year period. Surgery 145:189-195, 2009
– reference: 11) Hino H, Yamaguchi T, Kinugasa Y, et al: Robotic-assisted multivisceral resection for rectal cancer: short-term outcomes at a single center. Tech Coloproctol 21:879-886, 2017
– reference: 7) 大腸癌研究会編:大腸癌治療ガイドライン医師用2022年度. 金原出版, 東京, 2022
– reference: 14) Moriya Y, Akasu T, Fujita S, et al: Aggressive surgical treatment for patients with T4 rectal cancer. Colorectal Dis 5:427-431, 2003
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SubjectTerms ロボット支援手術
他臓器合併切除
局所進行直腸癌
短期成績
骨盤内臓全摘
Title 局所進行直腸癌に対するロボット支援他臓器合併切除および骨盤内臓全摘の手技のポイントと短期成績
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