원발성 소장암의 임상적 고찰
A Clinical Analysis of Primary Small Bowel Cancer
대한암학회지 1997년 29권 5호 p.899 ~ 905
길기선, 안승일,
소속 상세정보
길기선 ( )
충남대학교 공과대학 화학공학과
안승일 ( )
충남대학교 의과대학 외과학교실
KMID : 0360319970290050899
Abstract
서론
소장은 전체 위장관의 약 75%를 차지하고 점막표면의 90%이상을 차지함에도 불구하고
소장종양은 드물어 모든 위장관 종양의 5%이며 악성종양은 이보다 휠씬 적어 1∼2%에 불
과하다. 또한 증상이 불분명하고 비특이적이며 이학적 소견 및 방사선 검사로도 결정적인
진단을 내리지 못하는 경우가 대부분이다.
따라서 정확한 진단과 조기 발견이 어려워 수술시행 당시 이미 진행된 상태이거나, 합병
증으로 인하여 치료에도 불구하고 예후가 불량하다. 이에 저자들은 원발성 소장암 환자 24
예를 대상으로 임상적 특성을 분석하고 문헌을 고찰하여 보고하고자 한다.
#초록#
Purpose : Primary small bowel cancer is rare. In many cases, the diagnosis is difficult
especially in jejunum and ileum, confirmed in advanced state with poor prognosis. This
study was intended to clarify the characteristics of primary small bowel cancer.
Material and method : We have reviewed 24 patients with primary small bowel cancer
that have been operated at the Department of Surgery, hospital from Jan. 1990 until
Dec. 1996. The clinical feature, diagnostic method, location and histologic finding of
tumor, prognosis were analyzed.
Results : 1. The ratio of male to female was 1:1.18. The mean age was 53 years and
the most prevalent age group was 6th decade(13 cases, 54.1%). 2. The most common
primary site was jejunum(9 cases), followed by duodenum(8 cases) and ileum(7 cases).
Leiomyosarcoma occurred most frequently in jejunum, adenocarcinoma in duodenum, and
lymphoma in ileum. 3. The most common symptom was abdominal pain(66.7%), followed
by anemia(54.2%), palpable mass(50%). 4. The accuracy rate of preoperative diagnosis or
suspicion was 45,8%, and diagnostic measures were endoscopy in duodenum, small
bowel series and/or abdominal CT, in jejunum and ileum. 5. Curative resection was
performed in 14 cases(58.3%), and the cancer in which palliative resection was
undertaken most frequently was leiomyosarcoma. 6. The mean follow-up period of 23
cases except 1 was 33 months, during this time 9 cases were dead, of whom 5 cases
had leiomyosarcoma.
Conclusion : Frequently, small bowel cancer is difficult in diagnosis, confirmed in late
stage. High degree of suspicion and more endeavor to discover it is important and
needed to bring a better result.
키워드
Small bowel cancer;
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