위암 천공의 임상적 고찰
Clinical Analysis of Perforated Gastric Cancer
조항주, 김승남, 박조현, 박승만, 전해명, 진형민, 김욱, 임근우, 안창준, 박우배,
소속 상세정보
조항주 ( Cho Hang-Joo )
가톨릭대학교 의과대학 외과학교실
김승남 ( Kim Seung-Nam )
가톨릭대학교 의과대학 외과학교실
박조현 ( Park Cho-Hyun )
가톨릭대학교 의과대학 외과학교실
박승만 ( Park Seung-Man )
가톨릭대학교 의과대학 외과학교실
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 외과학교실
진형민 ( Chin Hyung-Min )
가톨릭대학교 의과대학 외과학교실
김욱 ( Kim Wook )
가톨릭대학교 의과대학 외과학교실
임근우 ( Lim Keun-Woo )
가톨릭대학교 의과대학 외과학교실
안창준 ( Ahn Chang-Joon )
가톨릭대학교 의과대학 외과학교실
박우배 ( Park Woo-Bae )
가톨릭대학교 의과대학 외과학교실
KMID : 0371320030640010028
Abstract
Purpose: Generalized peritonitis caused by a free perforation of gastric cancer is a rare condition, which occurs in 1∼4% of all gastric cancer patients. To assess the characteristics of the patients and investigate the optimal treatment of
choice, the data from 51 patients previous recent 10 years were retrospectively analyzed.
Methods: Between 1988 and 1997, 51 patients underwent surgical treatment for perforated gastric cancer. The clinicopathological features and survival rates of the resected group (n=39) and the non-resected group (n=12) were analyzed.
Results: The incidence was 0.78% and the mean age was 57 years. The most common tumor location was in the lower 1/3 in the resected group (n=21, 53.8%) and in the upper 1/3 in the non-resected group (n=6, 50%). Borrmann type 3, the poorly differentiated type, and a positive serosa invasion were more common in both groups. Liver and peritoneal metastases were observed in 2 cases (5.2%) and 7 cases (14.3%) in the resected group, and 4 cases (33.4%), and 3 cases (25%) in the non-resected group, respectively. Resectability found in 76.5%: 27 cases of a subtotal gastrectomy and 12 cases of a total gastrectomy. A limited lymph node dissection (D0,D1) was performed in 14 cases (35.9%) and an extended dissection (D2,D3) was performed in 25 cases (64.1%). The 5-year survival rate of stage Ⅰ was 80%, 40% in stage Ⅱ, 14% in stage Ⅲ and 0% in stage Ⅳ, and the overall 5 year survival rate was 20.5% in the resected group and 0% in the non-resected group. The depth of invasion, lymph node metastasis and tumor stage significantly influenced the survival rate of the patients.
Conclusion: Because a perforation of the gastric cancer may develop in every stage, surgeons must take care of these patients by the same way as with non-perforation cases.
키워드
위암;천공;외과적 치료
Gastric cancer;Perforation;Surgical treatment
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