ポリサージャリー : 精神身体医学症例 (8)

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Polysurgery is an important clinical concept meaning the condition in which unnecessary surgical procedures being repeatedly carried out inspite of the absence of pathologic findings. In course of serial psychosomatic case studies of irritable colon syndrome, the authors encountered 9 cases of polysurgery, that is unnecessary abdominal operation of more than three times as we defined it. There were 8 cases of female and one of male all being unmarried because of long years' continuance of abdominal distress. All cases except one had undergone appendectomy at first operation followed usually by surgery of intestinal abhesion which resulted from the previous operation. The operation for the correction of anatomical abnormalities, such as falling of the stomach, movable cecum and falling of the colon, were not rare at the second and later surgery. All the patients had been treated from the purely somatic point of view and under somatic diagnoses differing from doctor to doctor. The authors were impressed by the astonishing ill effects of traditional somatic-oriented approach regardless of the nature of diseases on the part of medical profession and the miserable life conditions on the part of the patients. After careful case studies, the authore were inclined to consider that the personality traits of the patients and the lack of psychosomatic approach on the part of doctors were main causes of polysurgery, but other factors, doctor-patient relationship in respective cases and the attitudes of family members toward the patient and the general social attitude toward abdominal diseases were also to be considered as contributory factors for the emergence of polysurgery phenomenon. From above-mentioned facts, the authors again felt keenly the importance of the disease concept of "irritable colon" which advocates the holistic understanding of the functional colonic disturbance. All of our cases were proved to be suffering from irritable colon syndrome and most of them were successfuly treated by psychotherapy. If the disease concept of irritable colon were accepted more commonly among Japanes medical world and psychosomatic approach were routinely done in this condition, the tragedy of polysurgery would become decreased.
日本心身医学会の論文

ポリサージャリー : 精神身体医学症例 (8)

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