후방 접근으로서의 경 천골 국소절제
Trans-Sacral Local Resection as a Posterior Approach
이봉화, 안창남, 장미영, 박형철, 이해완, 엄태익, 김병섭, 임영아, 김수형, 조성욱,
소속 상세정보
이봉화 ( Lee Bong-Hwa )
한림대학교 의과대학 외과학교실
안창남 ( An Chang-Nam )
한림대학교 의과대학 외과학교실
장미영 ( Chang Mi-Young )
한림대학교 의과대학 외과학교실
박형철 ( Park Hyoung-Chul )
한림대학교 의과대학 외과학교실
이해완 ( Lee Hae-Wan )
한림대학교 의과대학 외과학교실
엄태익 ( Eum Tae-Ik )
한림대학교 의과대학 외과학교실
김병섭 ( Kim Byoung-Sup )
한림대학교 의과대학 외과학교실
임영아 ( Lim Young-A )
한림대학교 의과대학 외과학교실
김수형 ( Kim Soo-Hyoung )
한림대학교 의과대학 외과학교실
조성욱 ( CHo Sung-Wook )
서울 적십자병원 외과
KMID : 0356720100260030197
Abstract
Purpose: Surgical removal for a mass in the pre-sacral space or mid rectum through a posterior approach is not frequent. We would like to present the technique of trans-sacral local resection as a posterior approach. We analyzed the follow up of patients who underwent surgery using the proposed technique.
Methods: A total of 21 patients who had undergone a trans-sacral local resection with lower sacrectomy between January 1997 and December 2006 were enrolled in this study. The diagnoses were large epidermal cyst, gastrointestinal stromal tumor, high grade adenoma, and early cancers in the mid rectum. We analyzed the surgical complications and disease recurrences. The mean follow up for tumors of the rectum was 53±35 mo.
Results: Epidural anesthesia was appropriate for all whole procedures. Among the 21 cases, there was one case of a rectocutaneous fistula as a postoperative complication (4.9%). In one case among the submucosal cancers, there was a systemic metastasis at 24 mo without local recurrence.
Conclusion: In our experience, a trans-sacral resection with a lower sacrectomy is a good option and provides a wide and direct surgical exposure for the removal of a pre-sacral or a mid-rectal mass. Good bowel preparation is mandatory.
키워드
국소절제;직장암;경천골절제술;천골절제;후방접근
Local excision;Rectal cancer;Trans-sacral resection;Sacrectomy;Posterior approach
원문 및 링크아웃 정보
등재저널 정보