지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.93 No.4
- 발행연도
- 2017.10
- 수록면
- 195 - 202 (8page)
이용수
초록· 키워드
오류제보하기
Purpose: Tumors at the level of the anorectal junction had required total levator-ani muscle excision to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle and intact external sphincter, en bloc resection of rectum with levator-ani muscle including tumor would be possible. This hemilevator excision (HLE) technique enables preserving the anal sphincter function while obtaining oncologic clearance and avoiding permanent colostomy in those patients. This study aimed to evaluate the surgical outcomes and feasibility of HLE.
Methods: Data on 13 consecutive patients who underwent HLE for pathologically proven low rectal cancer were retrospectively collected. All 13 patients presented low rectal cancer at the anorectal ring level that was suspected to invade or abut to the ipsilateral side of the levator-ani muscle.
Results: A secure resection margin was achieved in all cases, and anastomotic leakage occurred in 2 patients. During follow-up, 3 patients experienced tumor recurrence (2 systemic and 1 local). Among 6 patients who underwent diverting ileostomy closure after the index operation, 2 complained of fecal incontinence. The other 4 patients without fecal incontinence showed <10 times of bowel movement per day. Accessing their incontinence scale, mean Wexner score was 9.4.
Conclusion: HLE is a novel sphincter-preserving technique that can be a treatment option for low rectal cancer invading ipsilateral levator-ani muscle, which has been an indication for abdominoperineal resection (APR) or extralevator APR. However, the long-term oncologic and functional outcomes of this procedure still need to be assessed to confirm its validity.
Methods: Data on 13 consecutive patients who underwent HLE for pathologically proven low rectal cancer were retrospectively collected. All 13 patients presented low rectal cancer at the anorectal ring level that was suspected to invade or abut to the ipsilateral side of the levator-ani muscle.
Results: A secure resection margin was achieved in all cases, and anastomotic leakage occurred in 2 patients. During follow-up, 3 patients experienced tumor recurrence (2 systemic and 1 local). Among 6 patients who underwent diverting ileostomy closure after the index operation, 2 complained of fecal incontinence. The other 4 patients without fecal incontinence showed <10 times of bowel movement per day. Accessing their incontinence scale, mean Wexner score was 9.4.
Conclusion: HLE is a novel sphincter-preserving technique that can be a treatment option for low rectal cancer invading ipsilateral levator-ani muscle, which has been an indication for abdominoperineal resection (APR) or extralevator APR. However, the long-term oncologic and functional outcomes of this procedure still need to be assessed to confirm its validity.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
[학술지(정기간행물)] - Marr R / 2005 / The modern abdominoperineal excision : the next challenge after total mesorectal excision / Ann Surg 242 : 74 ~ 82
[학술지(정기간행물)] - Heald RJ / 1997 / Abdominoperineal excision of the rectum--an endangered operation. Norman Nigro Lectureship / Dis Colon Rectum 40 : 747 ~ 751
[학술지(정기간행물)] - Nagtegaal ID / 2005 / Low rectal cancer: a call for a change of approach in abdominoperineal resection / J Clin Oncol 23 : 9257 ~ 9264
[학술지(정기간행물)] - Holm T / 2007 / Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer / Br J Surg 94 : 232 ~ 238
[학술지(정기간행물)] - West NP / 2008 / Evidence of the oncologic superiority of cylindrical abdominoperineal excision for low rectal cancer / J Clin Oncol 26 : 3517 ~ 3522
[학술지(정기간행물)] - Heald RJ / 1997 / Abdominoperineal excision of the rectum--an endangered operation. Norman Nigro Lectureship / Dis Colon Rectum 40 : 747 ~ 751
[학술지(정기간행물)] - Nagtegaal ID / 2005 / Low rectal cancer: a call for a change of approach in abdominoperineal resection / J Clin Oncol 23 : 9257 ~ 9264
[학술지(정기간행물)] - Holm T / 2007 / Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer / Br J Surg 94 : 232 ~ 238
[학술지(정기간행물)] - West NP / 2008 / Evidence of the oncologic superiority of cylindrical abdominoperineal excision for low rectal cancer / J Clin Oncol 26 : 3517 ~ 3522
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UCI(KEPA) : I410-ECN-0101-2018-514-001328150