{"created":"2023-05-15T11:23:38.586634+00:00","id":3384,"links":{},"metadata":{"_buckets":{"deposit":"ef4548c0-f130-414c-b161-dd2855179873"},"_deposit":{"created_by":1,"id":"3384","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"3384"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00003384","sets":["1:6:273:274"]},"author_link":["11459","11462","11463","11464","11461","11460","11465","11458"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-06"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"6","bibliographicPageStart":"1","bibliographicVolumeNumber":"80","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"直腸癌手術では，腹膜翻転部以下での切離に際して，従来の点墨法による術前マーキングは視認性が悪く術中内視鏡の併用を余儀なくされることも少なくない．教室では腹腔鏡下大腸癌手術において腫瘍占拠部位確定や血流評価としてICG蛍光法の有用性を報告してきた．腹膜翻転部以下での肛門側腸管切離部位確定の有用性について，点墨法とICG蛍光法の視認性の視点から前向きに比較・検討した．2014年8月から2015年7月の1年間に当科で待機的に腹腔鏡下手術が予定され，切離部位が腹膜翻転部以下と想定された直腸癌18例である．全例に手術当日以前に内視鏡下に通常の点墨（腫瘍肛門側腹側の粘膜下層に0.2ml局注）に併せ，腫瘍直下の粘膜下層に0.25％ICG溶液を0.5ml局注した．術中にPINPOINTを用いて可視光ならびにoverlayモード（蛍光画像とHigh Vision画像のイメージを重ね合わせ表示する方法）により，墨とICG蛍光の視認性を比較・検討した．また，Priceらが使用したvisibility scaleを用いて点墨とICG蛍光の視認性の程度を数値化し，各々を比較・検討した．統計学的処理はMann-Whitney’s U testならびにWilcoxon signed-rank testを用い，p＜0.05をもって有意差ありとした．男女比は10：8で，平均年齢は67.0歳（47-81）であった．癌の占居部位はRaが14例，Rbが4例であった．局注時期は，手術前日が7例，手術3日前が9例，5日以前が2例であった．点墨ならびにICG局注による有害事象は認めなかった．ICG蛍光の視認率は88.9（16/18）％で，点墨の視認率50.0（9/18）％に比して有意に良好であった（p＝0.0293）．点墨（＋）ICG蛍光（＋）症例は8例（44.4％），点墨（＋）ICG蛍光（−）が1例（5.56％），点墨（−）ICG蛍光（＋）が8例（44.4％）であり，点墨（−）ICG蛍光（−）が1例（5.56％）であった．点墨のvisibility scaleの中央値は0.94（0-2）で，ICG蛍光のvisibility scaleの中央値は1.5（0-2）であり，ICG蛍光の視認の程度が有意に高かった（p＝0.0370）．腹腔鏡下直腸癌手術におけるICG蛍光法を用いた術前マーキングは点墨法にかわる有用な手法であると考えられた．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.80.1"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2188-529X"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"小沢, 慶彰"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"村上, 雅彦"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"渡辺, 誠"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大野, 浩平"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"藤井, 智徳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"北島, 徹也"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉澤, 宗大"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"青木, 武士"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-06-25"}],"displaytype":"detail","filename":"80_1.pdf","filesize":[{"value":"368.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"80_1.pdf","url":"https://showa.repo.nii.ac.jp/record/3384/files/80_1.pdf"},"version_id":"2da9099f-3daa-4ece-bf23-2fa9ba3a860a"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper"}]},"item_title":"腹腔鏡下直腸癌手術における術前マーキング法の検討―点墨法とICG蛍光法の比較―","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"腹腔鏡下直腸癌手術における術前マーキング法の検討―点墨法とICG蛍光法の比較―"}]},"item_type_id":"10002","owner":"1","path":["274"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-06-25"},"publish_date":"2020-06-25","publish_status":"0","recid":"3384","relation_version_is_last":true,"title":["腹腔鏡下直腸癌手術における術前マーキング法の検討―点墨法とICG蛍光法の比較―"],"weko_creator_id":"1","weko_shared_id":1},"updated":"2023-05-15T12:31:41.986321+00:00"}