目的:大腸癌に対する腹腔鏡補助下大腸切除手術(LAC)と開腹手術(OPEN)のリンパ節郭清が同等の質であるかをリンパ節の採取個数で比較検討した.対象と方法:右半結腸切除,S状結腸切除,直腸高位前方切除が施行された大腸癌手術症例77例.リンパ節採取個数を各リンパ節領域ごとに比較検討した.結果:右半結腸切除21例(LAC:OPEN;12例:9例),S状結腸切除41例(26例:15例),前方切除15例(8例:7例)であった.腫瘍径による補正後の摘出リンパ節個数は(以下LAC:OPEN),右半結腸切除;1群(15.4±1.3:17.5±3.6),主幹2群(8.7±1.0:8.2±0.7),壁在2群(10.8±1.6:15.3±2.9),主幹3群(7.5±1.0:7.6±0.8),S状結腸切除;1群(12.3±1.3:13.1±1.5),主幹2群(8.2±1.2:8.1±1.2),壁在2群(7.0±1.4:5.7±0.9),主幹3群(6.8±1.0:6.4±1.3),前方切除;1群(12.5±2.3:12.4±2.7),主幹2群(9.3±1.4:9.7±2.3),壁在2群(6.8±2.4:5.6±1.3),主幹3群(5.0±0.9:5.3±1.3)であった.考察:LACとOPENで以上の3種類の術式においてリンパ節郭清はほぼ同等であることが示唆された.Aim: This study was conducted to evaluate. The number of dissected lymph nodes between laparoscopyassisted colectomy (LAC) and open colectomy (OPEN). Methods: Seventy-seven patients who underwent hemi-colectomy (LAC: OPEN; 12cases: 9cases), sigmoidectomy (LAC: OPEN; 26cases: 15cases) and high anterior resection (LAC: OPEN; 8cases: 7cases) at Kanagawa Cancer Center were entered in this study. The number of dissected lymph nodes at each N1, paracolic N2, central N2, and central N3 area was compared. Results: In Hemi-colectomy, N1 area was LAC: OPEN =15.4±1.3 : 17.5±3.6 (p = 0.548), Central N2 was 8.8±1.0 : 8.2±0.7 (p = 0.684) , Paracolic N2 was 10.8±1.6 : 15.3±2.9 (p = 0.176), and Central N3 was 7.5±1.0 : 7.6 ± 0.8 (p = 0.966) . In sigmoidectomy, Nl was 12.3±1.3 : 13.1±1.5 (p = 0.675) , Central N2 was 8.2±1.2 : 8.1±1.2 (p = 0.945) , Paracolic N2 was 7.0±1.4 : 5.7±0.9 (p = 0.522) , Central N3 was 6.8±1.0 : 6.4±1.3 (p = 0.808) . In Anterior resection, N1 was 12.5±2.3 : 12.4±2.7 (p = 0.969) , Central N2 was 9.3±1.4 : 9.7±2.3 (p = 0.863) , Paracolic N2 was 6.8±2.4 : 5.6±1.3 (p = 0.689) , and Central N3 was 5.0±0.9 : 5.3±1.3 (p=0.879). Conclusion: The results suggested that quality of lymph node dissection in LAC was equal to that of OPEN
