결장 전절제술 및 회장 직장 문합술 후 합병증, 사망률 및 배변 기능변화
Complications, Mortality and Functional Outcome following a Total Colectomy and Ileo-rectal Anastomosis
김도윤, 오승엽, 이재만, 서광욱,
소속 상세정보
김도윤 ( Kim Do-Yoon )
아주대학교 의과대학 외과학교실
오승엽 ( Oh Seung-Yeop )
아주대학교 의과대학 외과학교실
이재만 ( Lee Jae-Man )
아주대학교 의과대학 외과학교실
서광욱 ( Suh Kwang-Wook )
아주대학교 의과대학 외과학교실
KMID : 0356720070230060448
Abstract
Purpose: This study reviews the feasibility of a total colectomy with ileo-rectal anastomosis (TCIRA) and the functional outcome following the operation.
Methods: The cases of a total of 50 patients (31 men and 19 women) with a median age of 61 who underwent a TCIRA were reviewed retrospectively. The median follow-up time was 28 months (4∼72). The clinical records were reviewed to analyze the postoperative complications and bowel function. The clinical outcomes were examined directly from patients’ scoring.
Results: The indications of TCIRA were metachronous or synchronous colorectal cancer (34 percent), multiple polypoid lesions (22 percent), malignant colon obstruction (24 percent), ischemic colitis (2 percent), Crohn’s disease (6 percent), and tuberculosis colitis (2 percent). The overall mortality and morbidity rates were 0 and 31 percent, respectively. The morbidity included postoperative bleeding, obstruction, intra-abdominal abscess formation, pneumonia, and wound complications. We used the CCIS index to evaluate postoperative functional bowel habit change. The CCIS index evaluation revealed perfect continence in 57 percent of the patients with short-term follow up (＜6 months) and in 83 percent of the patients who had undergone a TCIRA more than 2 years ago.
Conclusions: Most patients were satisfied with their bowel function on long-term follow up, and we think the TCIRA is a safe operation, and the clinical outcomes are relatively satisfactory. J Korean Soc Coloproctol 2007;23:448-453
키워드
결장 전 절제술;회장-직장 문합술;합병증;배변기능
Total colectomy;Ileorectal anastomosis;Complication;Incontinence
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