第10巻 2014年6月　第3号

■綜説

胸部食道癌に対する外科治療の現況
松谷　毅¹, 野村　務¹, 萩原　信敏¹, 牧野　浩司², 丸山　弘², 宮下　正夫³, 内田　英二^1
1日本医科大学外科学（消化器外科学）
²日本医科大学多摩永山病院外科
³日本医科大学千葉北総病院外科

Current Surgical Treatment for Thoracic Esophageal Cancer
Takeshi Matsutani¹, Tsutomu Nomura¹, Nobutoshi Hagiwara¹, Hiroshi Makino², Hiroshi Maruyama², Masao Miyashita³ and Eiji Uchida^1
1)Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
²⁾Department of Surgery, Nippon Medical School Tama Nagayama Hospital
³⁾Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital

Esophageal squamous cell carcinoma is the sixth most common cause of cancer death in Japan. Surgery was previously the mainstay of treatment, but because of high rates of local and systemic recurrence, multidisciplinary management is being evaluated. In this article, we introduce the recent addition of neoadjuvant chemotherapy to the surgical management of resectable esophageal squamous cell carcinoma, clinical stage II and III, following the randomized control trial JCOG 9907. Neoadjuvant chemoradiotherapy has recently been approved for esophageal squamous cell carcinoma because it offers an opportunity for margin-negative resection, improved locoregional control, and increased survival rate. Less-invasive endoscopic procedures, such as thoracoscopic esophagectomy and laparoscopy-assisted gastric tube reconstruction, are options for the resection of noninvasive esophageal cancer. We performed thoracoscopic esophageal mobilization with the patient in the prone position. Compared with esophagectomy with right trans-thoracotomy, thoracoscopic esophagectomy has the advantage of a lower incidence of respiratory complications, which are a significant predictor of postoperative mortality. Additionally, other recent surgical treatments are described.

日医大医会誌 2014; 10(3), 134-141

Key words
esophageal carcinoma, neoadjuvant chemoradiotherapy, thoracoscopic esophagectomy

Correspondence to
Takeshi Matsutani, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：matsutani@nms.ac.jp

受付：2014年3月24日　受理：2014年5月8日