Yasutomi M, Matsuda T, Hatta M, Shindo K
Dept. of Surgery, Kinki University, School of Medicine.
Gan To Kagaku Ryoho. 1988 Jan;15(1):25-32.
Rectal cancer surgery in Japan started to first step of Lisfranc type resection by T. Sato in 1887. Since H. Ito (1902) published in success of three cases of abdominosacral excision (ASE), ASE occupied the main position of rectal cancer surgery in Japan. In 1944, however, M. Kuru reported the superiority of abdominoperineal resection (APR), an orient of surgery had changed to APR from ASE with time. His operative mortality was 2.0% or less, and 5-year survival rate was more than 50%. D. Jinnai (1961) introduced endorectal pull-through operation, and in 1972 he exhibited an excellent survival and satisfying function following sphincter preserving operation, such as anterior resection and pull-through, for mid and upper rectal cancer. T. Kajitani (1975) and Y. Koyama (1977) improved the survivals through an extended pelvic nodes dissection. Today, the principle of rectal cancer surgery in Japan is a limited resection for early cancer, sphincter preserving operations for upper and mid-rectal cancer and extended pelvic nodes dissection for advanced lower rectal cancer.
1887年，日本的直肠癌手术迈出了第一步，即由佐藤哲进行Lisfranc式切除术。自伊藤浩（1902年）发表三例腹骶联合切除术（ASE）成功的报告以来，ASE在日本直肠癌手术中占据了主要地位。然而，1944年，久留猛报告了腹会阴联合切除术（APR）的优越性，随着时间的推移，手术方向从ASE转变为APR。他的手术死亡率在2.0%或更低，5年生存率超过50%。甚内达（1961年）引入了经直肠拖出术，1972年，他展示了保留括约肌手术（如前切除术和拖出术）治疗中高位直肠癌后的良好生存率和令人满意的功能。梶谷敏（1975年）和小山义（1977年）通过扩大盆腔淋巴结清扫提高了生存率。如今，日本直肠癌手术的原则是早期癌症进行有限切除，中高位直肠癌进行保留括约肌手术，低位进展期直肠癌进行扩大盆腔淋巴结清扫。
