内容紹介
Summary
Introduction: Many cases of terminal cancer develop ileus symptoms such as vomiting and abdominal distension. The causes of ileus symptoms include peritoneal dissemination, localized recurrence, etc. The treatments include octreotide acetate, decompression measures such as ileus tube, and surgical treatment. We evaluated the results of cases that underwent surgical methods to reduce ileus symptoms. Methods: The subjects were 31 patients comprising 38 cases with ileus symptoms between January 2013 and January 2018. The surgical procedures included bypass(17 cases), tumor extirpation(7 cases), stoma(11 cases), and other(3 cases). Results: Dietary intake information was available for 27 of the 38 cases; in cases that underwent tumor excision, all meals were able to be ingested and there were many cases of long-term survival. Discussion: Surgical procedures can allow patients to eat food and should be considered as dietary intake after treatment is associated with survival duration.
要旨
癌の終末期には,嘔吐・腹部膨満などのイレウス症状をもつ症例は多い。イレウス症状の原因には腹膜播種・局所再発などがあり,治療法には酢酸オクトレオチド・イレウス管などの減圧処置・外科的処置があるが,本稿では,イレウス症状の緩和目的で施行した外科的処置症例の成績について検討する。対象は2013年1月～2018年1月までの腹膜播種・局所再発に伴うイレウス症状を有する外科的処置施行例31例38手術で,原疾患は胃癌8例,大腸癌9例,膵癌6例,食道癌1例,その他7例で,外科的処置の内訳はバイパス手術17例,腫瘍摘出術7例,人工肛門造設術11例,その他3例であった。食事摂取可能となった症例は38例中27例で,腫瘍摘出例では全例食事摂取可能となり長期生存例が多かった。複数回の外科的処置により,生存期間が延長できた症例もあった。処置後の食事摂取状態が生存日数に大きく関与しており,食事摂取可能が期待できる外科的処置は積極的に行うべきと考える。
目次
Introduction: Many cases of terminal cancer develop ileus symptoms such as vomiting and abdominal distension. The causes of ileus symptoms include peritoneal dissemination, localized recurrence, etc. The treatments include octreotide acetate, decompression measures such as ileus tube, and surgical treatment. We evaluated the results of cases that underwent surgical methods to reduce ileus symptoms. Methods: The subjects were 31 patients comprising 38 cases with ileus symptoms between January 2013 and January 2018. The surgical procedures included bypass(17 cases), tumor extirpation(7 cases), stoma(11 cases), and other(3 cases). Results: Dietary intake information was available for 27 of the 38 cases; in cases that underwent tumor excision, all meals were able to be ingested and there were many cases of long-term survival. Discussion: Surgical procedures can allow patients to eat food and should be considered as dietary intake after treatment is associated with survival duration.
要旨
癌の終末期には,嘔吐・腹部膨満などのイレウス症状をもつ症例は多い。イレウス症状の原因には腹膜播種・局所再発などがあり,治療法には酢酸オクトレオチド・イレウス管などの減圧処置・外科的処置があるが,本稿では,イレウス症状の緩和目的で施行した外科的処置症例の成績について検討する。対象は2013年1月～2018年1月までの腹膜播種・局所再発に伴うイレウス症状を有する外科的処置施行例31例38手術で,原疾患は胃癌8例,大腸癌9例,膵癌6例,食道癌1例,その他7例で,外科的処置の内訳はバイパス手術17例,腫瘍摘出術7例,人工肛門造設術11例,その他3例であった。食事摂取可能となった症例は38例中27例で,腫瘍摘出例では全例食事摂取可能となり長期生存例が多かった。複数回の外科的処置により,生存期間が延長できた症例もあった。処置後の食事摂取状態が生存日数に大きく関与しており,食事摂取可能が期待できる外科的処置は積極的に行うべきと考える。