하부 직장암의 서혜부 림프절전이시 근치적 서혜부 림프절절제술 술식 및 4예 보고
Curative Groin Dissection of Inguinal Lymph Node Metastasis from Lower Rectal Cancer The Operative Technique and a Report of Four Cases
김진천, 조영규,
소속 상세정보
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
조영규 ( Cho Young-Kyu )
울산대학교 의과대학 외과학교실
KMID : 0371320010610020183
Abstract
Purpose
Inguinal lymph node metastasis from rectal adenocarcinoma occurs infrequently and is generally considered as a manifestation of systemic metastasis. The prognosis is limited with all modalities of chemotherapy and radiotherapy.
Methods
Four of 610 patients with lower rectal cancer underwent curative groin dissection following identification of no other systemic metastasis.
Results
All patients had previously undergone abdomino- perineal resection and adjuvant chemo-radiotherapy as primary rectal cancer treatment. A synchronous inguinal lymph node metastasis was identified in one patient, whereas metachro
nous metastasis was found at seven, 12, and 14 months postoperatively in the remainly three patients. The survival time was from 2 to 22+ months after curative groin dissection. One patient remains alive 22 months after the curative groin
dissection
showing neither perirectal lymph node nor systemic metastasis on primary surgery.
Conclusion
Although radical groin dissection is rarely indicated in lower rectal cancer metastasis, it can be efficiently performed in cases without systemic metastasis. As the technique is also useful in other malignant metastasis, we introduce our
operative
procedure in addition to the report of the four cases.
키워드
직장암; 서혜부림프절; 전이; 근치적 서혜부 림프절절제술; Rectal cancer; Inguinal lymph node; Metastasis; Radical groin dissection;
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