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< 舌先三寸 | メイン | “犯人”をさがせ >
2010.09.11 18:06 |  診療  |  映画 / 音楽 / 読書  |  その他（医療関連）  |  おかだ  | 推薦数 : 0

胃癌取り扱い規約

　私が最初にこの規約を覚えたのは……大学の５年か６年の時だったでしょうか。病棟実習をしていて担当になった患者さんが胃癌の手術を受けるので、術式とか病気のことは教科書で読むにしても、もっと詳しいことや実際に手術で何が目標とされるのかを知りたくて、図書館に行ってじっくり読みました。胃癌の肉眼的な分類とか、胃のまわりのリンパ節の分類とリンパ節転移があった場合にどこまで広がっていたら癌のステージがどうなるのか（その場合に、どこまでリンパ節を郭清するべきか）、など細かいことが書いてあってとても覚えきれませんでした。初版は1962年だそうで、最新版は2010年の第14版です。　不思議なことにアマゾンでは、夏前には古本扱いでしたが、今は通常の取り扱い（ただし発送には２〜５週間）のようです。
　ともかく最新版の規約では、胃癌の治療については分離して「胃癌治療ガイドライン」にまかせてしまい、腫瘍の状態評価と治療の評価を記録するためのものになったのだそうです。
「胃癌取扱い規約の改訂で胃癌治療ガイドラインとの棲み分けが明確に 【胃癌学会2010】」（日経メディカル）

　幸い私は外科医でもなければ胃癌の手術をするわけでもないから、こうやって取り扱い規約や胃癌治療ガイドラインがどんどん変わっていってもそれほど困りはしませんが、たとえばブラックジャックなんかは困るんじゃないですかねえ。彼がまめに学会に参加して最新の治療法について勉強しているとか最新のエビデンスについて情報をまめにキャッチしているとかの姿は、ちょっと想像しにくいものですから（偏見かな？）。


人気ブログランキングに参加中です。励みになりますので、クリックをよろしく。


 

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