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.99 No.3
- 발행연도
- 2020.9
- 수록면
- 171 - 179 (9page)
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초록· 키워드
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Purpose: A variety of clinical features of anastomotic leak occur during the surgical treatment of rectal cancer. However, little information regarding management of leakage is available and treatment guidelines have not been validated. The aim of this study was to evaluate the validity of currently proposed expert opinions on the management of anastomotic leak, after low anterior resection for rectal cancer.
Methods: A retrospective analysis was conducted for 1,786 patients who underwent sphincter-preserving surgery for rectal cancer between 2005 and 2015. Clinical outcomes including anastomotic leak-associated mortality and permanent stoma were analyzed.
Results: The overall incidence of anastomotic leak was 6.8% (122 of 1,786), including 6.1% (30 of 493 patients) with diverting stoma and 7.1% (92 of 1,293 patients) without diverting stoma (P = 0.505). A majority of patients without diversion were treated with diverting stoma (76 of 88 patients [86.4%]); 1 mortality (0.8%) was observed in this group. Treatments in the diversion group mainly included conservative treatment, local drainage, and/or transanal repair (26 of 30 patients [86.7%]). The anastomotic failure rates were 20.7% (19 of 92 patients) in the no diversion group and 53.3% (16 of 30 patients) in the diversion group. In the multivariate analysis, preoperative chemoradiotherapy (P < 0.001) and delayed diagnosis of anastomotic leak (P = 0.036) were independent risk factors for permanent stoma.
Conclusion: Management of anastomotic leak should be tailored to individual patients. When anastomotic leak occurred, preoperative chemoradiotherapy and delayed diagnosis seemed to be associated with permanent stoma.
Methods: A retrospective analysis was conducted for 1,786 patients who underwent sphincter-preserving surgery for rectal cancer between 2005 and 2015. Clinical outcomes including anastomotic leak-associated mortality and permanent stoma were analyzed.
Results: The overall incidence of anastomotic leak was 6.8% (122 of 1,786), including 6.1% (30 of 493 patients) with diverting stoma and 7.1% (92 of 1,293 patients) without diverting stoma (P = 0.505). A majority of patients without diversion were treated with diverting stoma (76 of 88 patients [86.4%]); 1 mortality (0.8%) was observed in this group. Treatments in the diversion group mainly included conservative treatment, local drainage, and/or transanal repair (26 of 30 patients [86.7%]). The anastomotic failure rates were 20.7% (19 of 92 patients) in the no diversion group and 53.3% (16 of 30 patients) in the diversion group. In the multivariate analysis, preoperative chemoradiotherapy (P < 0.001) and delayed diagnosis of anastomotic leak (P = 0.036) were independent risk factors for permanent stoma.
Conclusion: Management of anastomotic leak should be tailored to individual patients. When anastomotic leak occurred, preoperative chemoradiotherapy and delayed diagnosis seemed to be associated with permanent stoma.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (29)
참고문헌 신청
Rullier E / 1998 / Risk factors for anastomotic leakage after resection of rectal cancer / Br J Surg 85:355~358
Parc Y / 2000 / Management of postoperative peritonitis after anterior resection : experience from a referral intensive care unit / Dis Colon Rectum 43:579~589
Mirnezami A / 2011 / Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak : systematic review and meta-analysis / Ann Surg 253:890~899
Ptok H / 2007 / Impact of anastomotic leakage on oncological outcome after rectal cancer resection / Br J Surg 94:1548~1554
Bittorf B / 2003 / Does anastomotic leakage affect functional outcome after rectal resection for cancer / Langenbecks Arch Surg 387:406~410
Parc Y / 2000 / Management of postoperative peritonitis after anterior resection : experience from a referral intensive care unit / Dis Colon Rectum 43:579~589
Mirnezami A / 2011 / Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak : systematic review and meta-analysis / Ann Surg 253:890~899
Ptok H / 2007 / Impact of anastomotic leakage on oncological outcome after rectal cancer resection / Br J Surg 94:1548~1554
Bittorf B / 2003 / Does anastomotic leakage affect functional outcome after rectal resection for cancer / Langenbecks Arch Surg 387:406~410
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UCI(KEPA) : I410-ECN-0101-2020-514-001167098