肺癌に対する低侵襲手術と周術期化学療法の現状

Abstract

肺癌に対する胸腔鏡手術は一般化され，ロボット支援手術も普及してきている．また，今までは肺葉切除が標準術式であっ たが，小型肺癌に対しては区域切除や部分切除等の縮小手術が標準になる可能性がある．そして周術期治療に免疫チェックポ イント阻害剤，EGFR-TKIも使用可能となった．呼吸器外科医は外科的技術向上に加え，患者個々の病状に応じた手術アプロー チと術式の選択，そして最新の周術期治療の知識が必要である．

Recently, video-assisted thoracoscopic surgery has become a common procedure for the treatment of lung cancer; moreover, the use of robotic-assisted thoracoscopic surgery has substantially increased. Although lobectomy is the standard procedure for lung cancer treatment, limited resection techniques, such as segmentectomy and partial resection, are being used for treating small lung lesions. More recently, immune checkpoint inhibitors and epidermal growth factor receptor protein tyrosine kinase inhibitor (EGFR-TKI) have been used as perioperative therapies for these patients. With increasing options for surgical approaches, procedures, and perioperative therapies, thoracic surgeons need to improve their techniques, choose the best surgical procedure for each individual patient, and update their knowledge regarding perioperative therapies.