가족성 용종증의 치료
Treatment of Familial Adenomatous Polyposis
조수남, 주재환, 김영진, 김신곤,
소속 상세정보
조수남 ( Jo Soo-Nam )
전남대학교 의과대학 외과학교실
주재환 ( Joo Jae-Hwan )
전남대학교 의과대학 외과학교실
김영진 ( Kim Young-Jin )
전남대학교 의과대학 외과학교실
김신곤 ( Kim Shin-Kon )
전남대학교 의과대학 외과학교실
KMID : 0356719960120020231
Abstract
Familial adenomatous Polyposis(FAP) is a genetically determined disease that leads to the development of multiple intestinal polyps that eventually degenerate into carcinoma of the large intestine. Now cytogenetic and linkage studies have localized the gene responsible for FAP to chromosome 5q21. During the screening, prophylactic operation of
FAP should be established. Timing and methods of operation is very important. We analyzed retrospectively 10 Patients of familial adenomatous polyposis who were treated surgically at the Department of Surgery, Chonnam University Hospital.
The results were as follows: Mean age of the patient with colorectal cancer was 46 years, and without colorectal
cancer was 23 years. Overall mean age of these patients at the time of operation was 39 years. The male to female ratio was 1 : 1. Clinical manifestations were mainly bloody stool and bowel habit change. Familial history of colorectal polyposis was positive in 70%. Associated cancer of the colon and rectum was detected in 7 cases of FAP patients. The patients with family history had earlier stage of cancer or did not have any cancerous lesion. The extracolonic features were duodenal polyp (20%), gastric adenoma (10%), and retinal pigmentation (10%). As for operative procedure,
proctocolectomy with ileal pouch ileoanal anastomosis was done in 7 cases, proctocolectomy with Brooke ileostomy in 1 case, proctocolectomy with Kock pouch ileostomy in 1 case, and abdominoperineal resection in 1 case. In proctocolectomy with ileoanal reservoir anastomosis, there was no complication such as pouchitis. Temporary
ileostomy was closed after mean duration of 2 months. Daily frequency was 3-4 times/day after ileostomy closure. The continence was complete after pouch ileoanal anastomosis.
키워드
Familial Adenomatous Polyposis(FAP)
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