직장암의 국소 절제술
Local Excision of Rectal Carcinoma
신동규, 심강섭, 김광호, 박응범,
소속 상세정보
신동규 ( Shin Dong-Kyu )
이화여자대학교 의과대학 외과학교실
심강섭 ( Sim Kang-Sub )
이화여자대학교 의과대학 외과학교실
김광호 ( Kim Kwang-Ho )
이화여자대학교 의과대학 외과학교실
박응범 ( Park Eung-Bum )
이화여자대학교 의과대학 외과학교실
KMID : 0356719990150010073
Abstract
Purpose: Curative local excision of the rectal cancer had been advocated by many surgeons over the standard abdominoperineal resection (APR) for lower rectal cancer due to its low complication rate and improved quality of life. The aim of this study was to evaluate the result of the local excision for rectal cancer.
Methods: We prospectively analyzed 31 rectal cancer patients (including 2 patients of carcinoid tumor) who were suitable indication for local excision between Oct. 1993 and Dec. 1998 at Mokdong Hospital.
Results: The age of the patients ranged from 39 to 81 years (＞60 years: 77.8%) while sex ratio was 1：5 (M：F). Of 31 patients, 29 patients were located below 4 cm from anal verge. Other two were in between 7 cm and 10 cm from the anal verge. The tumor size ranged from 0.7 cm to 5 cm, most commonly within 3 cm. Invasion depth by tumor were as follows: 12 patients in mucosa; 7 patients in submucosa; 4 patients in inner muscle layer; 6 patients in outer muscle layer; and 2 patients in whole layer. Ten patients had well-differentiated tumors and 17 patients had moderately differentiated tumors, while one patient had mucinous histologic type. Seventy percent of patients with muscular layer invasion received adjuvant radiation therapy. Six patients received oral chemotherapeutic agent and 4 received immunopotentiator. During the follow-up period (mean: 18.4 months, range: 1∼54 months), no local recurrence was found in the patients who were operated under curative intent.
Conclusion: We concluded that this method can be favorabe choice for the treatment of early rectal cancer without lymph node involvement if strict indication of the local excision for rectal cancer could be applied.
키워드
Local excision;Early rectal cancer
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