직장암에 대한 간괄약근 절제술과 자동봉합기 결장항문 문합술의 비교

이봉화; 김종완; 장미영; 박형철; 이해완

추천

검색

자료유형: 학술저널

저자정보: 이봉화 (한림대학교) 김종완 (한림대학교) 장미영 (한림대학교) 박형철 (한림대학교) 이해완 (한림대학교)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.24 No.2

발행연도: 2008.1

수록면: 113 - 120 (8page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

이 논문의 연구 히스토리 (3)

2008

직장암에 대한 간괄약근 절제술과 자동봉합기 결장항문 문합술의 비교

이봉화 , 김종완 , 장미영 외 2명 Annals of Coloproctology 2008.01 학술저널

2004

직장암 간괄약근절제- 결장낭- 항문문합술(Intersphincteric CPAA)과 문합재발 절제

이봉화 , 엄태익 , 박성국 외 11명 대한외과학회 학술대회 초록집 2004.10 학술대회자료

1998

452. 직장암의 경천골 절제

이봉화 , 박근동 , 허준 외 8명 대한외과학회 학술대회 초록집 1998.11 학술대회자료

이 논문의 후속연구가 궁금하신가요?
연관 학술논문 또는 학술발표를 통해 보다 발전된 연구결과를 확인하실 수 있습니다.
이 논문의 연구 히스토리 확인하기

초록· 키워드

오류제보하기

Local control and functional results of an intersphincteric resection are controversial in Asian, low BMI patients, even though it might a provide a chance to avoid a permanent colostomy. We tried to evaluate the potential risk of an intersphincteric resection, compared with a stapled coloanal anastomosis, in patients with low rectal cancer. Methods: Patients with low rectal cancer, who underwent a intersphincteric resection with a hand- sewn anastomosis (ISR) or a coloanal anstomosis with staples (stapled CAA), were analyzed. Results: From 1999 to 2006, 85 patients were enrolled. The distance between the anal verge and the lower margin of the tumor was 3.4±0.8 cm (range: 2∼5 cm) in the ISR group and 4.9±0.8 cm (range: 3∼7 cm) in the stapled CAA. The mean body mass index was 23 (range: 18∼32). The patients complained postoperatively of intolerable anal incontinence (Kirwan’s class ＞ 2) in 35% of the ISR group and in 9% as the stapled CAA group, (P＜0.02). The local recurrence rate was greater in the ISR group (15%) than in the stapled CAA group (2%, P＜0.04). There was no significant difference in distant metastasis between the two groups. The disease-free survival rates were 80.8% and 91.2% at three years in the ISR group and the stapled CAA group, respectively. Complications, such as urinary incontinence and sexual dysfunction in male patients, were not significantly different between the two groups. Conclusions: An intersphincteric resection with hand-sewn anastomosis could be worse than a stapled coloanal anastomosis in function and local recurrence. This may indicate that careful selection is required for a intersphincteric resection even when a stapled anastomosis cannot be applied due to a narrow margin.

#직장암 #간괄약근 절제술 #결장항문 문합술 #재발 #변실금

참고문헌 (17)

참고문헌 신청

Ricciardi R / 2007 / The status of radical proctectomy and sphincter-sparing surgery in the United States / Dis Colon Rectum 50:1119~1127

Tilney HS / 2008 / Extending the horizons of restorative rectal surgery: intersphincteric resection for low rectal cancer / Colorectal Dis 10:3~15

Saito N / 2006 / Intersphincteric resection in patients with very low rectal cancer: a review of the Japanese experience / Dis Colon Rectum 49:13~22

Salerno G / 2006 / Defining the rectum: surgically, radiologically and anatomically / Colorectal Dis 8:5~9

Yamada K / 2007 / Functional results of intersphincteric resection for low rectal cancer / Br J Surg 94:1272~1277