재건대장직장절제술 후 회장낭 실패의 위험 인자
Risk Factors of Pouch Failure after a Restorative Proctocolectomy
신의섭, 유창식, 김대동, 김진천, 윤상남,
소속 상세정보
신의섭 ( Shin Ui-Sup )
울산대학교 의과대학 서울아산병원 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김대동 ( Kim Dae-Dong )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
윤상남 ( Yoon Sang-Nam )
울산대학교 의과대학 서울아산병원 외과학교실
KMID : 0356720080240040252
Abstract
Purpose: The aim of this study was to analyze the risk factors of pouch failure after a restorative proctocolectomy.
Methods: A restorative proctocolectomy was performed in 169 patients between November 1989 and May 2007. A retrospective review was done for postoperative complications and follow-up results of pouch failure, and the risk factors of pouch failure were analyzed. Pouch failure was defined as having occurred when a permanent ileostomy was constructed, regardless of pouch removal. The median follow-up was 48 (3∼155) months.
Results: Among the 169 cases, 86 cases involved ulcerative colitis (UC group), 70 cases involved familial adenomatous polyposis or attenuated adenomatous polyposis coli (FAP group), and the remaining 13 involved hereditary nonpolyposis colorectal cancer or synchronous colon and rectal caner (CRC group). The sex ratios and the incidences of comorbidity were not significantly different between the groups, but the mean ages were. Complications occurred in 61 patients (36.1%): pelvic sepsis (28 cases), pouchitis (23 cases), desmoid tumor (12 cases), wound infection (10 cases), and anastomosis stricture (4 cases). The 5-year cumulative rate of pouch failure was 9.8%. Presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture were risk factors of pouch failure.
Conclusions: The cumulative pouch failure rate after a restorative proctocolectomy was 9.8% for 5 years, and pouch failure was associated with the presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture. J Korean Soc Coloproctol 2008;24:252-259
키워드
재건대장직장절제술;회장낭실패;유건종;골반패혈증
Restorativeproctocolectomy;Ilealpouchfailure;Desmoidtumor;Pelvicsepsis
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