{"created":"2024-02-13T00:57:19.745221+00:00","id":2000777,"links":{},"metadata":{"_buckets":{"deposit":"c2f19acd-094d-422a-937c-2809c4c2f07e"},"_deposit":{"created_by":17,"id":"2000777","owner":"17","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"2000777"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:02000777","sets":["29:31:1706669033099:1706669223536"]},"author_link":[],"control_number":"2000777","item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Surgery for breast cancer under local anesthesia in consideration of patients’comorbidities","subitem_alternative_title_language":"en"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ジュツゼン ガッペイショウ オ コウリョ シテ キョクショ マスイ デ オコナッタ ニュウガン シュジュツ ショウレイ ノ ケントウ","subitem_alternative_title_language":"ja-Kana"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-02-21","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"15","bibliographicPageStart":"11","bibliographicVolumeNumber":"42","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学","bibliographic_titleLang":"ja"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【背景】　乳癌手術は全身麻酔による定型的な切除が第一選択であるが、術前合併症により、全身麻酔は高リスクと考えられる症例に対しては、局所麻酔での切除が検討される。当院は大学病院ということもあり、術前合併症により、全身麻酔が高リスクとなるような症例の治療を行う機会も多い。当科において術前合併症を考慮して局所麻酔下で手術を行った乳癌症例を検討した。\n【方法】　2010年１月から2021年12月までに、全身麻酔のリスクが高いために局所麻酔下の手術を選択した20例を対象とした。それらをカルテベースで後方視的に検討した。術式、麻酔法の選択は、患者もしくは家族とのShared decision makingにより決定した。全例で、乳房部分切除を行い、明らかに腫大した腋窩リンパ節転移を伴う症例では、局所麻酔で摘出可能なリンパ節のみ摘出した。\n【結果】　年齢中央値は78歳であった。術前合併症はADL低下が９例、心疾患が４例、認知症が３例、低肺機能３例、肝硬変２例、精神疾患２例であった（重複あり）。臨床的にリンパ節転移があるのは３ 例であった。うち２例は可及的に切除したが、非治癒切除となっていた。術後出血、皮弁壊死、創感染、肺炎や臓器不全などの大きな合併症は見られなかった。周術期死亡例もみられなかった。観察期間の長短はあるものの、腫瘍による皮膚潰瘍などのQOLを低下させる再発例は見られなかった。\n【結論】　全身麻酔高リスクの乳癌患者に対する局所麻酔手術は、周術期の合併症を避けて安全に行うことができ、有用な手術手技であると考えられた。","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"names":[{"name":"シバタ,ケンイチ","nameLang":"ja-Kana"}]},{"names":[{"name":"アカバネ,アヤカ","nameLang":"ja-Kana"}]},{"names":[{"name":"カワイ,マサアキ","nameLang":"ja-Kana"}]},{"names":[{"name":"モトイ,フユヒコ","nameLang":"ja-Kana"}]}]},"item_3_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"names":[{"name":"Kenichi,Shibata","nameLang":"en"}]},{"names":[{"name":"Ayaka,Akabane","nameLang":"en"}]},{"names":[{"name":"Masaaki,Kawai","nameLang":"en"}]},{"names":[{"name":"Fuyuhiko,Motoi","nameLang":"en"}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/0002000777","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学","subitem_publisher_language":"ja"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_language":"ja-Kana","subitem_text_value":"ヤマガタ ダイガク"}]},"item_3_text_34":{"attribute_name":"別言語の出版者","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Yamagata University"}]},"item_3_text_43":{"attribute_name":"資源タイプ・ローカル","attribute_value_mlt":[{"subitem_text_value":"紀要論文"}]},"item_3_text_44":{"attribute_name":"資源タイプ・NII","attribute_value_mlt":[{"subitem_text_value":"Departmental Bulletin 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invasive","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"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","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"術前合併症を考慮して局所麻酔で行った乳癌手術症例の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"術前合併症を考慮して局所麻酔で行った乳癌手術症例の検討","subitem_title_language":"ja"}]},"item_type_id":"3","owner":"17","path":["1706669223536"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-02-21"},"publish_date":"2024-02-21","publish_status":"0","recid":"2000777","relation_version_is_last":true,"title":["術前合併症を考慮して局所麻酔で行った乳癌手術症例の検討"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2024-04-11T03:29:43.629164+00:00"}