폐쇄성 좌측 대장암의 치료
Management for Obstructed Carcinoma of the Left Colon
김현철, 백무준, 박내경, 이문수, 장용석, 송옥평,
소속 상세정보
김현철 ( Kim Hyun-Chul )
순천향대학교 천안병원 외과학교실
백무준 ( Baek Moo-Jun )
순천향대학교 천안병원 외과학교실
박내경 ( Park Nae-Kyung )
순천향대학교 의과대학 천안병원 외과학교실
이문수 ( Lee Moon-Soo )
순천향대학교 천안병원 외과학교실
장용석 ( Jang Yong-Seok )
순천향대학교 천안병원 외과학교실
송옥평 ( Song Ok-Pyung )
순천향대학교 의과대학 천안병원 외과학교실
KMID : 0356719980140020209
Abstract
The management of malignant left colon obstruction remains a difficult problem. Conventional surgical treatment is muti-staged and each stage carries its own morbidity and mortality. The purpose of this study is to identify the feasibility and safety of one stage operation in patients presenting with acute obstruction of the left colon. From January 1991 to June 1996, 29 patients received one stage resection for acutely obstructed carcinoma of the left colon at Soonchunhyang University Chunan Hospital. Subtotal colectomies were performed in 9 patients(31.0%), left hemicolectomies in 6(20.7%), low anterior resection in 6(20.7%), sigmoid colectomy in 4(13.8%), anterior resection in 4 patients(13.8%). Subtotal colectomy was performed in patients with massively distended colon of dubious viability and to contain ischemic lesions at proximal colon. Total operative mortality was 6.9%: 5% in the immediate resection with anastomosis group, 11.1% in subtotal colectomy group. Complications included wound infection(4), fecal incontinence(2), intestinal obstruction(2), anastomotic leakage(1), upper G-I bleeding(1), postoperative bleeding(1), pulmonary complication(1). Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in patients with acute malignant obstruction of the left colon.
키워드
Malignant left colon obstruction;One stage resection
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