상부위장관암 환자의 난치성 복통에 대한 흉강경적 내장신경절제술
Thoracoscopic Splanchnicectomy for the Relief of Intractable Upper Abdominal Cancer Pain
채윤석, 김경식, 이우정, 김병로, 백효채, 이종훈,
소속 상세정보
채윤석 ( Chae Yoon-Seok )
연세대학교 의과대학 외과학교실
김경식 ( Kim Kyung-Sik )
연세대학교 의과대학 외과학교실
이우정 ( Lee Woo-Jung )
연세대학교 의과대학 외과학교실
김병로 ( Kim Byong-Ro )
연세대학교 의과대학 외과학교실
백효채 ( Paik Hyo-Chae )
연세대학교 의과대학 흉부외과교실
이종훈 ( Lee Jong-Hoon )
연세대학교 의과대학 외과학교실
KMID : 0371320010600010073
Abstract
Purpose: Pain is the most distressing feature of cancer patients. Thoracoscopic splanchnicectomy, first performed in 1993, has caused a resurgence of interest in surgical treatment of such excruciating pain. We wish to introduce a method of splanchnicectomy.
Methods: Five patients underwent a splanchnicectomy for intractable cancer pain, over a period of 11 months. We evaluated the type of splanchnicectomy performed and the results. The procedure was done using a double lumen catheter to deflate the lung at the operation side under general anesthesia with the patient in the lateral decubitus position. A small opening was made with scissors in the pleura of the 5th intercostal space to expose the terminal branch of the greater splanchnic nerve. Six∼Seven branches of splanchnic nerve were cut downward until the splanchnic nerve trunk and then cut. A left thoracoscopic splanchnicectomy was done in one case, and a bilateral thoracoscopic splanchnicectomy in four cases.
Results: The splanchicectomy appears to result in significant reduction of abdominal pain in all cases. There were no postoperative complications.
Conclusion: As a conclusion, thoracoscopic splanchnicectomy is the treatment of choice for intractable intraabdominal cancer pain, affording drug cessation and recovery of daily activity in most patients.
키워드
흉강경;내장신경절제술
Thoracoscopy;Splanchnicectomy
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