대장암에서 가상대장내시경의 초기경험
The Early Experience of Virtual Colonoscopy on Colorectal Cancer
이한일, 이태순, 정순재, 박기혁, 최동락, 주대현, 박성환, 유용운, 박기호, 이영환, 김진천,
소속 상세정보
이한일 ( Lee Han-Il )
대구가톨릭대학교 의과대학 외과학교실
이태순 ( Lee Tae-Soon )
대구가톨릭대학교 의과대학 외과학교실
정순재 ( Jung Soon-Jai )
대구가톨릭대학교 의과대학 외과학교실
박기혁 ( Park Ki-Hyuk )
대구가톨릭대학교 의과대학 외과학교실
최동락 ( Choi Dong-Lak )
대구가톨릭대학교 의과대학 외과학교실
주대현 ( Joo Dae-Hyun )
대구가톨릭대학교 의과대학 외과학교실
박성환 ( Park Sung-Hwan )
대구가톨릭대학교 의과대학 외과학교실
유용운 ( Yoo Young-Oon )
대구가톨릭대학교 의과대학 외과학교실
박기호 ( Park Ki-Ho )
대구가톨릭대학교 의과대학 외과학교실
이영환 ( Lee Young-Hwan )
대구가톨릭대학교 의과대학 방사선과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0356720040200030133
Abstract
Purpose: Virtual colonoscopy (VC) is a newly developing non-invasive technique used to detect polyps and cancers of the colon. The aim of this study is to assess the efficacy of VC in the detection of synchronous polyps or cancers in preoperative patients as well as metachronous polyps of postoperative colorectal cancer patients.
Methods: Both V and conventional colonoscopy (CFS) were performed on 40 patients with colorectal cancer (10 cases of preoperative state and 30 cases of postoperative follow-up) during Sep. 2002 to June 2003 in Daegu Catholic Medical Centre, Catholic University of Daegu, Republic of Korea. The success rate and the detection rate of polyps or cancers along with the locations and sizes of masses and the findings of anastomotic site were compared between VC and CFS.
Results: The entire colon was clearly visualized by CFS in all cases. In the preoperative group, VC was successfully performed in 8 out of 10 cases (80%). 8 out of 10 cancers, 4 out of 4 polyps (5 mm or more in diameter) and 3 out of 6 polyps (5 mm or less in diameter) were identified. The success rate of VC in the postoperative group were 58% of low anterior resection (LAR) from cecum to hepatic flexure, 89% of LAR, 45% of right hemicolectomy (RHC) from hepatic flexure to splenic flexure, 63% of LAR, 45% of RHC from splenic flexure to sigmoid colon, and 53% of LAR, 72% of RHC in rectum. The causes of failure were inadequate bowel distension and retained fluid. In postoperative group, VC identified only 3 of 7 polyps(5 mm or more in diameter), 1 of 10 polyps (5 mm or less in diameter) and 1 of 1 recurrent cancer. The anastomotic site was clearly seen by VC in 9 of 19 cases (47%) of LAR and 3 of 11 cases (27%) of RHC. VC also identified 28 extracolonic findings.
Conclusions: Although the efficacy of VC in postoperative colorectal cancer follow up seems to be disappointing, but it can be used as an alternative method for patients with incomplete conventional colonoscopy due to anastomotic site stricture or for other failed cases. Further technological advancement of VC is needed in order for it to replace conventional colonoscopy as a postoperative follow-up test. J Korean Soc Coloproctol 2004;20: 133-137
키워드
가상대장내시경;대장직장종양
Virtual colonoscopy;Colorectal neoplasm
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