좌측 대장암 폐쇄의 일차적 절제와 문합술
One-Stage Resection and Anastomosis of Left Colon Cancer Obstruction
김명환, 이도상, 성기영, 송무형, 김욱, 박일영, 원종만,
소속 상세정보
김명환 ( Kim Myung-Hwan )
가톨릭대학교 성가병원 외과학교실
이도상 ( Lee Do-Sang )
가톨릭대학교 성가병원 외과학교실
성기영 ( Sung Gi-Young )
가톨릭대학교 성가병원 외과학교실
송무형 ( Song Moo-Hyung )
가톨릭대학교 성가병원 외과학교실
김욱 ( Kim Wook )
가톨릭대학교 성가병원 외과학교실
박일영 ( Park Il-Young )
가톨릭대학교 성가병원 외과학교실
원종만 ( Won Jong-Man )
가톨릭대학교 성가병원 외과학교실
KMID : 0356719980140020179
Abstract
Although the obstruction of the right colon is usually handled by primary anastomosis following resection, fear of the increased incidence of septic complication, especially anastomotic leakage with sepsis has turned surgeons away from doing anastomosis in the face of acute obstruction of the left colon. However, from recent reports, enough experiences have been accumulated to show that primary anastomosis is associated with minimum morbidity and mortality in the acute obstruction of the left colon. We experienced 54 cases of colon cancer obstruction at Holy Family Hospital from January 1988 to December 1997. Twenty six cases of them were right colon cancers, 24 cases were left colon cancers and 4 cases were rectal cancers. We reviewed these three groups for evaluation of the safety of one-stage resection and anastomosis of left colon cancer obstruction. The postoperative complication rate was 18% in right colon obstruction versus 38% in left colon obstruction. The most common complication was wound infection(43%). In using of primary resection and anastomosis, complication of right colon revealed 15% and left colon was 29%. But in a method of primary resection and anastomosis with decompression, complication of right colon was 17% and left colon was 13%. Especially on the left colon, primary resection and anastomosis with decompression revealed lower complication(13%) than that without decompression(67%). The mortality of colon cancer obstruction was 2% but this was a patient who had a
poor general condition and took a primary resection and anastomosis without decompression. In cases of left colon cancer obstruction primary resection and anastomosis with decompression of left colon cancer obstruction can be a safe operation method with low morbidity and mortality.
키워드
Cancer;Obstruction;One stage resection and anastomosis;Decompression
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