전직장간막 절제술과 골반 측부 림프절 절제술이 직장암의 국소 재발과 생존율에 미치는 영향
Effect on the Local Recurrence and the Survival of Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection in Rectal Cancer
최병관, 김형수, 서경원, 주재균, 류성엽, 박영규, 김형록, 김동의, 김영진,
소속 상세정보
최병관 ( Choi Byung-Gwan )
전남대학교 의과대학 외과학교실
김형수 ( Kim Hyung-Soo )
전남대학교 의과대학 외과학교실
서경원 ( Seo Kyeong-Won )
전남대학교 의과대학 외과학교실
주재균 ( Ju Jae-Kyun )
전남대학교 의과대학 외과학교실
류성엽 ( Ryu Seong-Yeop )
전남대학교 의과대학 외과학교실
박영규 ( Park Young-Kyu )
전남대학교 의과대학 외과학교실
김형록 ( kim Hyeong-Rok )
전남대학교 의과대학 외과학교실
김동의 ( Kim Dong-Yi )
전남대학교 의과대학 외과학교실
김영진 ( Kim Young-Jin )
전남대학교 의과대학 외과학교실
KMID : 0356720070230010046
Abstract
Purpose: One of the most common sites of recurrence after a curative resection of rectal cancer is the pelvis, and local control is a major goal of surgical treatment. The advantages of lateral pelvic lymph node dissection are regarded as questionable because lateral pelvic lymph node metastasis does not occur so frequently and because a lateral lymphadenectomy has a negative influence on the postoperative quality of life. The aim of this study was to clarify if lateral pelvic lymph node dissection (LPLD) conferred any benefit.
Methods: A total of 769 patients who underwent curative surgery for rectal cancer between 1981 and 2005 at the Department of Surgery, OOO Hospital, were reviewed retrospectively. One hundred ninety-three of these patients underwent a lateral pelvic lymph node dissection, and 576 patients had a total mesorectal excision with high ligation of the IMA.
Results: There was no difference in pathological characteristics between the two groups. Patients who underwent a lateral pelvic lymph node dissection had no statistically significant difference in terms of the 5-year survival rate at stage II and III (64% vs 65% at stage II, P=0.391; 49% vs 47% at stage III, P=0.815).
Conclusion: A lateral pelvic lymph node dissection has no advantage as part of a standard operation for rectal cancer. A total mesorectal excision alone has good local control and survival compared with a lateral pelvic lymph node dissection. J Korean Soc Coloproctol 2007;23:46-52
키워드
직장암;전직장간막 절제술;골반측부림프절 절제술;재발
Rectal cancer;Total mesorectal excision;Lateral pelvic lymph node dissection;Recurrence
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