乳がん手術と術後機能障害

• Published in: Japanese Journal of National Medical Services Vol. 36; no. 12; pp. 1233 - 1236
• Main Authors: TAKASHIMA Shigemitsu, YOSHIZAWA Junichi, HIRAI Ryuji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1982; 一般社団法人 国立医療学会
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.36.1233

By sending questionnaires to cases subjected to operation by us, we tried to hold the entity of postoperative disorders of the breast cancer, studying their etiologies.Among 657 cases of the primary breast cancer which were opeyated during the past 14 years at Shikoku Cancer Hospital, 355 cases were served as subjects excluding death and recurrence cases.Lymphedema of the arm was observed in 54.9%, it is significantly frequent in cases of postoperative radiation to the axilla, and infrequent in cases of modified operation.Limitation of movement of arm was seen in 10.4% frequent in advanced cases of TNM stage III and those of standard operation. Pain of the arm occured in 44.8% showing high level in standard operation.In addition, size of tumor, age, obesity, etc. might be said to be the etiologies of postoperative disorders.To lessen postoperative disorders of the breast cancer, it is important to find cases in an early stage, in which period it is able to be cured by conservative operation as well as to take meticulous care of postoperative management, applying the mind to considerable etiolgies of postoperative disorders. 癌治療後の機能保全が重要視されるようになり, 乳癌においても縮小手術の適応が拡大されるようになつてきた.私たちは乳癌術後の障害を把握し, その発生要因を検討するためにアンケート調査を行つた. 過去14年間の初治療手術例657例のうち, 死亡, 再発例を除いた355例を対象とした. 上肢浮腫は54.9%に出現しており, 腋窩への術後照射例に有意に多く, 非定型手術例には少なかつた.上肢運動障害は10.4%にみられ, TNM stage IIIの進行例と定型手術例に多く, 疼痛は44.8%に発生し, 定型手術例に高率であつた.このほか腫瘍の大きさ, 年令, 肥満なども障害発生要因になり得る.乳癌術後障害を少なくするためには, 縮小手術で治癒可能な早期例の発見に努めるとともに, 術後障害発生要因を念頭におき, 手術, 術後管理に細心の注意を払うべきである.