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복회음 절제술시 Taurolin관주에 관한 전향적 임상실험

Prospective Trial of Taurolin Irrigation in Abdominoperineal Resection

대한대장항문학회지 1992년 8권 1호 p.29 ~ 33
서경석 (  ) - 서울대학교 의과대학 외과학교실

유창식 (  ) - 서울대학교 의과대학 외과학교실
조삼제 (  ) - 서울대학교 의과대학 외과학교실
백남종 (  ) - 서울대학교 의과대학 외과학교실

Abstract

41명의 복회음 절제술을 받은 환자를 대상으로 Taurolin의 복부관주의 임상적 효과에 대
하여 연구하였다. 그 결과 창상 감염으로 Taurolin을 사용한 군에서 5%, 사용 안한 군에서
는 14%의 감염율을 보였지만 통계학적으로는 차이가 없었다. 그러나 배액관을 통한 세균
배양에서는 Taurolin을 사용한 군에서 20예중 5예(25%)에서, 사용하지 않은 군에서는 21예
중 11예(52%)에서 장내 세균이 배양되어서 Taurolin을 사용한 군에서 유의하게 장내 세균
의 배양율을 낮았다. 따라서 창상감염이 호발하는 복회음 절제술에서 Taurolin의 관주요법
은 창상감염 및 이것에 의한 유병율을 줄이는데 기여하리라 기대된다
#초록#
Taurolin is a new chemotherapeutic agent, a derivative of endogenous amino-sulphonic
acid, taurine. Taurolin apparently acts on the micro-organisms by the transfer of
methylol molecules to the wall of the bacteria, causing their destruction and, at the
same time, denaturing the peptide-oligosaccharides and the lido-polysaccharides that
constitute the Gram-negative bacterial endotoxins. It may be administered at an
appropriate concentration by the intraperitoneal rout without toxic effect.
The aim of this study is to examine the effect of Taurolin irrigation in
abdominoperineal resection. From June 1991 to February 1992, 41 patients who
underwent abdominoperineal resection for rectal cancer entered the trial. Two percents of
Taurolin was instilled into the Pelvic cavity prior to closure of abdomen after saline
irrigation in 20 patients. Only saline was instilled in 21 patients. Complete blood count
and liver function study were checked Preoperatively and postoperative 7th
day.
Abdominal and Perineal wounds were closely examined postoperatively and the fluid
from Hemo-vac catheter was cultured.
There were no differences in complete blood count and liver function study.
The wound infection was found in one out of 20 patients(5% ) in Taurolin instilled
group and three out of 21 patients(14%) in saline instilled group. It was not statistically
different. In saline instilled group, the enteric bacteria were cultured in 11 out of 21
Patients(52%) and in Taurolin instilled group, 5 out of 20 patients(25% ). So culture rate
was significantly lower in Taurolin instilled group.
Although we could not find any statistically significant difference in wound
complication in this small number of patients, the culture rate of the enteric bacteria
decreased in Taurolin instilled group and 5% of wound infection rate in Taurolin
instilled group is relatively low infection rate in abdominoperineal resection as compared
to other reports.

키워드

Miles' Operation; Taurolin;
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