@article{oai:kanazawa-u.repo.nii.ac.jp:00026811,
 author = {宮崎, 逸夫},
 issue = {3},
 journal = {日本消化器外科学会雑誌 = The Japanese journal of gastroenterological surgery},
 month = {Mar},
 note = {膵頭部癌痛における根治手術について神経浸潤を中心に述べた.病理組織学的検索をもとに1973年より郭清範囲を広げ,1977年にはtranslateral retroperitoneal approachによる膵頭部癌の拡大手術を開発した.膵癌根治手術のうえで重要な神経浸潤の成立機序ならびに進展様式,神経浸潤と臨床病理学的諸因子との関連に加え,膵後方浸潤の詳細な検索結果について述べた.膵後方浸潤の3次元解析によると,浸潤様式は浸潤方向による差異がみられることが明らかになるとともに,とくに神経浸潤は上腸間膜動脈方向に強くみられることが判明した.また,正常例における上腸間膜動脈周囲組織構造検索結果より,神経叢温存リンパ節郭清の可能性についても述べたが,現時点では膵癌の根治手術という点からは神経叢完全切除は不可欠な要因であることを強調した. The clinical significance of radical surgery for carcinoma of the head of the pancreas was reviewed from the standpoint of neural invasion. Since 1973 extended radical pancreatectomy has been performed for pancreatic cancer in our institute on the basis of clinicopathologic study. Pancreatectomy by a translateral retroperitoneal approach was developed in 1977. Based on the three dimensional analysis, the main mode of tumor invasion was neutral invasion around the superior mesenteric artery. Desmoplastic cancer infiltration was observed mainly around the portal vein and inferior vena cava. A detailed chinicopathologic study of carcinoma of the head of the pancreas indicated that it is necessary to perform complete dissection of the extrapancreatic plexus around the superior mesenteric artery, including extensive lymph node dissection of the superior mesenteric nodes and para aortic lymph nodes. The mechanism of neural invasion of pancreatic cancer, modes of tumor spread, and the correlation between neural invasion and other clinicopathologic factors were reviewed. Three dimensional studies of the retroperitoneal invasion by pancreatic cancer were reviewed on the basis of complete histologic serial section analyses. The main mode of tumor invasion was neural invasion around the superior mesenteric artery. These findings suggest that it is necessary to perform complete resection of extrapancreatic Plexus.},
 pages = {670--676},
 title = {膵頭部癌の根治手術 : 神経浸潤を中心に},
 volume = {29},
 year = {1996}
}