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논문 기본 정보

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학술저널
저자정보
Son Jung Tak (Department of Surgery H Plus Yangji Hospital) Kim Yong Bog (Kangbuk Samsung Hospital) Kim Hyung Ook (Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine) Min Chungki (Kangbuk Samsung Hospital) Park Yongjun (Kangbuk Samsung Hospital) Lee Sung Ryol (Department of Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Korea.) 정경욱 (성균관대학교) Kim Hungdai (Kangbuk Samsung Hospital)
저널정보
대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.39 No.3
발행연도
2023.6
수록면
260 - 266 (7page)
DOI
10.3393/ac.2022.00101.0014

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Purpose: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC. Methods: This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed. Results: Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%. Conclusion: The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

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