教室における肺癌切除例の検討

Surgical treatment is still a main therapeutic modality in the treatment of non-small cell lung cancer, although the 5-year survival rate remains low.We retrospectively evaluated 570 resected cases of lung cancer from April 1982 to March 1998 with reference to patient age,operative method,histologic type,pathological stage, tumor size, relationship between tumor size and lymph node metastasis and survival rate. Surgical treatment for patients older than 70 years was gradually increased.Limited resection has done in 24 cases, and video-assisted techniques were performed in some cases. Histological diagnoses were adenocarcinoma in 324 cases,squamous cell carcinoma in 209 cases and others in 37 cases.Almost 60% of all 570 cases were pathological stage I disease,and the rate gradually increased.The average tumor size of all resected cases was 33.8mm,and cases with tumor size within 20mm increased,reaching half of cases in recent years. In the evaluation of the relationship between tumor size and lymph node metastasis,cases with tumor size within 10mm had no metastasis and the positive rate was higher according to the size.The 5-year survival rate in stage IA disease was 76.7%, reaching statistically significant differences compared with other stages. It was suggested that small-sized early disease was gradually increased in the resected cases of lung cancer. Although limited resection for early stage lung cancer remains controversial, a reliable alternative limited surgical procedure for selected patients with early disease will be necessary in the near future.Article信州医学雑誌 48(4): 243-248(2000)journal articl

肺野末梢腺癌における高分解能ＣＴ上の充実影とスリガラス影の比率が非浸潤癌の予測因子となる)

浜松医科大学学位論文　医博論第405号(平成１７年９月１６日

Surgical Application of DNA Ploidy to Non-small-cell Lung Carcinoma

長崎大学学位論文 [学位記番号]博(医)乙第1047号 [学位授与年月日]平成3年3月31

イガン セツジョレイ ノ リンショウ ビョウリガクテキ ケントウ

We studied clinicopathological characteristics of 760 cases of gastric cancer. Distal, proximal and totalgastrectomy were done in 459, 63, and 229 cases respectively. We have performed ileocolon interpositionas a gastric substitution in 34 cases. The five year survival of resected gastric cancer cases was 62.6%. Elevatedmucosal cancers less than 2 cm and ulcerative types less than 1 cm had no lymph node involvement.The prognosis of the cases whose depth of invasion were se(serosa exposed) or si(serosa infiltrating) was verypoor. The cases of n 3 or n 4 in lymph node involvement disclosed also poor prognosis

80歳以上の高齢者肺癌に対する肺癌切除症例の検討

金沢大学医薬保健研究域医学系Seventeen lung cancer patients over 80 years of age were treated surgically at Kanazawa University Hospital from 1973 to 1991. The operative procedures were lobectomy (six patients), segmentectomy (seven patients), partial resection (three patients) and exploratory thoracotomy (one patient). Absolutely curative resection was done in two patients, relatively curative resection in two, relatively non-curative resection in ten, absolutely non-curative resection in two. The three-year survival rate after operation for all seventeen patients was 60.2%. Postoperative complication developed in eleven patients (64.7%). Patients who had lobectomy with mediastinal lymph node dissection had a high incidence of postoperative complications. In recent years, pulmonary resections have been performed in patients over 80 years of age who have been managed with pulmonary rehabilitation, resulting in better course. It is concluded that the limited resections produce good prognosis in patients over 80 years of age with lung cancer.

小型肺癌の画像診断と外科治療

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 瀬戸 泰之, 東京大学教授 長瀬 隆英, 東京大学准教授 長谷川 潔, 東京大学講師 田中 剛, 東京大学講師 縄田 寛University of Tokyo(東京大学

スイタイブ ヒシンジュンセイ スイカンナイ ニュウトウセンガン ニ タイシ ヒ オンゾン スイタイ ビブ セツジョジュツ オ シコウ シタ 1レイ

We report a case of non-invasive intraductal papillary-mucinous carcinoma that was performed spleen-preserving distal pancreatectomy. A 74-year-old man was admitted to our hospital because he was pointed out a cystic tumor of the pancreatic body by near doctor. Abdominal ultrasonography and endoscopic ultrasonography showed a cystic tumor with papillary elevated lesion. But there were no evidence of infiltration to another organs. Based on these various examinations a diagnosis non-invasive intraductal papillary-mucinous carcinoma was determined. Then we determined to perform a minimal invasive operation, and underwent spleen-preserving distal pancreatectomy. After the operation there were no major complications and he discharged on 45th post operative days. To determine the surgical procedure of non-invasive intraductal papillary-mucinous carcinoma, because of the high incidence of postoperative infections after splenectomy, we should try to preserve the organ function. It was considered that this procedure was a useful method for non-invasive intraductal papillary-mucinous carcinoma of the pancreas body