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[2013-4-26. ´ë±¸. ´ëÇÑÀ§¾ÏÇÐȸ 34ȸ Çмú´ëȸ Áö»óÁß°è. Special lecture of Dr. Keiichi Maruyama]
´ëÇÑÀ§¾ÏÇÐȸ 34ȸ Çмú´ëȸ¿¡¼ ¸ÚÁø Ư°ÀÌ ÀÖ¾ú½À´Ï´Ù. °»ç´Â µ¿°æ¾Ï¼¾ÅÍ¿¡¼ ¸¹Àº Çѱ¹¿Ü°úÀǻ縦 ÁöµµÇϱ⵵ Çϼ̴ø À¯¸íÇÑ ¿Ü°úÀÇ»ç Keiichi Maruyama ¼±»ý´ÔÀ̼̽À´Ï´Ù. ¼±»ý´ÔÀº Çѱ¹À» ¸Å¿ì »ç¶ûÇÑ´Ù°í ¾ð±ÞÇÏ½Ã¸é¼ "Necessity is the mother of invention"À̶ó´Â ¸»·Î °ÀǸ¦ ½ÃÀÛÇϼ̽À´Ï´Ù.
°ÀÇ Á÷Àü 'Surgical treatment of gastric cancer'¶ó´Â Á¦¸ñÀÇ Ã¥À» ÇѱǾ¿ ³ª´©¾î Áּ̽À´Ï´Ù. ¼±»ý´Ô²²¼ °³¹ßÇÏ°í »ç¿ëÇϽŠ¼ú±â¸¦ ¸¹Àº ±×¸²°ú ÇÔ²² »ó¼¼È÷ ¼³¸íÇÑ ³»¿ëÀ̾ú½À´Ï´Ù. ³î¶ø°íµµ °¨»çÇÑ ÀÏÀÌ ¾Æ´Ò ¼ö ¾ø½À´Ï´Ù.
Maruyama ¼±»ý´Ô °ÀÇ key slide´Â Á¦¸ñÀº "How I dveloped my original procedures for gastric cancer"¿´½À´Ï´Ù. ¿Å±é´Ï´Ù.
In developing a new procedure, we have to trace the following 5 steps.
1. Get fundamental knowledge from textbook and literature
2. Improve surgical skilll by observation of experts' operation
3. Collect data and achieve a new idea
4. Make basic experiments and clinical trial
5. Evaluation at meetings and publications
2. Abstract from the program book
I spent all my career for the treatment of gastric cancer since 1962; 10 years in the Keio University, 30 years in the National Cancer Center Tokyo, and 10 years in the University of Health and Welfare Sanno Hospital. I improved my surgical techniques by fundamental education and practice, textbooks and literatures, observation of surgeries by experts, and my own clinical ana basic researches. In this experiences, I understood the importance of the old proverb "Necessity is the mother of invention" to realize a new and original procedure. I prepare "Blue booklet, titled Surgical treatment of gastric cancer" to explain my surgical procedures using my own illustrations. I hope th booklet would be instructive for you.
In my lecture, I would like to show my experiences "how I developed my new procedures". The procedures includes 1) systemic lymph node dissection under intraoperative lymphography, 2) pancreas preserving total gastrectomy, and 3) wound healing of the anastomosis and Gambee's one layer mattress suture techniques. You will understand the details of these techniques from the videos and the illustrations.
3. ³»°úÀǻ簡 º» Èï¹Ì·Î¿î ³»¿ë
¿ª½Ã surgeon´ä°Ô ÀÚ½ÅÀÌ ¼ö½Ê³â°£ »ç¿ëÇÑ µµ±¸µéÀ» º¸¿©ÁÖ¸é¼ "I always use my instruments"¶ó°í ¸»¾¸Çϼ̽À´Ï´Ù.
°ÀÇ ³»¿ëÀÇ ¸¹Àº ºÎºÐÀÌ ÇغÎÇаú Á¶Á÷Çп¡ ´ëÇÑ ³»¿ëÀ̾ú½À´Ï´Ù. ¼ö¼ú ¹æ¹ýÀ» °³¹ßÇϱâ À§Çؼ´Â ÇغÎÇÐÀÌ ±âÃÊÁßÀÇ ±âÃʶó´Â °ÍÀ» ´À²¼½À´Ï´Ù.
ÀÚ½ÅÀÌ °³¹ßÇÑ (1) systemic lymph node dissection, (2) pancreas-preserving total gastrectomy with splenectomy, (3) wound healingÀ» À§ÇÑ layer-to-layer approximation µîÀÇ ¹æ¹ýÀ» »ó¼¼È÷ ¼³¸íÇØ Áּ̽À´Ï´Ù. ³»°úÀÇ»çÀÎ Á¦°Ô´Â »ó´çÈ÷ ¾î·Á¿ü½À´Ï´Ù¸¸ ¼±»ý´ÔÀÇ ¿Á¤ÀÌ ´À²¸Á® ÁÁ¾Ò½À´Ï´Ù.
¸¶Áö¸·À¸·Î Maruyama ¼±»ý´Ô²²¼´Â ÀǹÌÀÖ´Â comment¸¦ ³²±â¼Ì½À´Ï´Ù. "¿äÁò ÀϺ»ÀÎ surgeonµéÀÌ »ó´çÈ÷ lazyÇØÁ³´Ù. ÃÖ±Ù¿¡´Â Çѱ¹°ú ÀÌÅ»¸®¾Æ ÀÇ»çµéÀÌ °¡Àå activeÇÏ´Ù. ¿©·¯ºÐµéÀº ½º½º·Î¸¦ proudÇÏ°Ô »ý°¢Çصµ ÁÁ´Ù." À§¾ÏÀ» ¼ö¼úÇÏ´Â ¿ì¸®³ª¶ó ¿Ü°úÀÇ»çµéÀÌ Á¤¸» ÀÚ¶û½º·´½À´Ï´Ù.
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