위선종성용종의 수술적 치료결과 분석
Analysis of Surgical Outcome of Gastric Adenomatous Polyp
박형철, 이건욱, 최국진, 양한광, 김우호, 김윤호, 이현국, 조삼제, 김진복, 김용일,
소속 상세정보
박형철 ( Park Hyung-Chul )
서울대학교 의과대학 외과학교실
이건욱 ( Lee Kuhn-Uk )
서울대학교 의과대학 외과학교실
최국진 ( Choi Kook-Jin )
서울대학교 의과대학 외과학교실
양한광 ( Yang Han-Kwang )
서울대학교 의과대학 외과학교실
김우호 ( Kim Woo-Ho )
서울대학교 의과대학 병리학교실
김윤호 ( Kim Yoon-Ho )
서울대학교 의과대학 외과학교실
이현국 ( Lee Hyeon-Kook )
서울대학교 의과대학 외과학교실
조삼제 ( Cho Sam-Je )
서울대학교 의과대학 외과학교실
김진복 ( Kim Jin-Pok )
서울대학교 의과대학 외과학교실
김용일 ( Kim Yong-Il )
서울대학교 의과대학 병리학교실
KMID : 0371320010600020180
Abstract
Purpose: Adenomatous polyps in the stomach are rather uncommon, however are related to a malignant transformation. So, in such cases it is important to predict cancer risk and to select an appropriate surgical method. The aim of this study is to examine clinicopathologic factor for predicting malignancy and determine appropriate surgical management of gastric adenomatous polyps.
Methods: A total 41 patients who underwent surgery from 1996 to 1999 for gastric adenomatous polyps at the Department of Surgery, Seoul National University Hospital were included this study. All patients had undergone preoperative endoscopic biopsy and histology was confirmed. Authors analyzed the clinicopathologic factors associated with malignancy and the outcome of surgical treatment.
Results: Of the 41 patients, 17 patients had an a denomatous polyp alone, 24 patients had an adenomatous polyp associated with malignancy. The location, number, size and morphology of the polyp were not associated with malignancy. Only cellular atypism in the preoperative biopsy was significantly associated with malignancy. 31 patients underwent subtotal gastrectomy whereas 10 patients wedge resection. All lymph nodes resected in patients with adenocarcinoma were negative. Recurrence of polyp or adenocarcinoma had not occurred in any patients after follow-up of mean 22 months.
Conclusion: Cellular atypism detected in preoperative histology was associated with malignancy in gastric adenomatous polyp. Lymph node metastasis was negative in patients with malignancy. Our findings support the wedge resection with safe margin as being appropriate in surgical management of gastric adenomatous polyps.
키워드
위선종성용종;세포비정형성;쐐기 절제술
Gastric adenomatous polyp;Cellular atypism;Wedge resection
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