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대장·직장암의 임상적 고찰

A Clinical Study on Colorectal Cancer

대한대장항문학회지 1995년 11권 3호 p.275 ~ 284
김해종/Hae Jong Kim
문덕진/박주섭/Duk Jin Moon/Ju SuP Park

Abstract

Colorectal cancer is secondly prevalent malignant disease in America and is now 4th
prevalent malignant disease in Korea and has increasing tendency together with
improvement of economical status and change in diet.
We studied 144 Patients who had been diagnosed to colorectal cancer and operated at
our department of surgery, Kwangju Christian Hospital for 5 years from July, 1989 to
June, 1994 and get following results.
1) Male and female ratio was 1: 1.1(male 69,47.9%, female 75, 52.1%).
2) On account of age distribution, 6th decade was most prevalent-58 patients(40.3%),
followed by 5th decade-40 Patients(27.8%), and 5 patients(3.5%) was below 3rd decade.
3) The most comon site of occurrence was rectum-71 cases(49.3%) and followed by
sigmoid colon-28 causes(19.4% ), ascending colon-23 cases(16.0% ), transverse colon-10
case지6.9% ), cecum-7 cases (4.9% ), and descending colon-5 cases (3.5% ) in order.
4) Common symptoms and signs according to site were abdominal pain, palpable
abdominal mass, weight loss in the right colon cancer; abdominal pain, weight loss,
change in bowel habits in the left colon cancer; and hematochezia, constipation, and
abdominal pain in the rectal cancer in order.
5) Diagnostic methods were digital rectal exam, barium enema, colonoscopy, abdominal
sonogram, and computed tomogram: and stool occult blood test and serum CEA level
were checked routinely.
6) The site of cancer and its relation with CEA was negligible.
7) Classfied by modified Dukes' stage: stage C1 was 44 cases(30.5%)
-most common, B2-42 cases(29.1%), D-27 cases(18.8%), C2
-21 cases(15.3%), B1-8 case(6.3%) in order; but stage A was not found.
8) In pathologic finding, adenocarcinoma was most common-138 cases(95.5%): well
differentiated type-60 cases(41.7%), moderately differentiated type -58 cases(38.9% ); and
metastatic adenocarcinoma was 3 cases, and submucosal leiomyosarcoma
and
adenosquamous carcinoma were found 1 case each on rectum.
9) The most common site of distant metastasis was liver -15 cases(10.4%), and other
pelvic organs in 8 cases(5.5%).
10) Surgical resection rate was 84.7% and operation methods were right
hemicolectomy-35 cases(24.3%), and low anterior resection-31 cases
21.5%),
abdominoperineal resection-29 cases(20.1%) and followed by colostomy,
sigmoidal
resection, etc..
11) The most common postoperative complications were wound infection-12
cases(8.3% ), currence-10 cases(6.9%), bowel obstruction-5 cases(3.5%) and others.
12) Operation with immunochemotherapy was 112 patients(77.8%) and operation with
chemotherapy was 3 cases(2.8%), but in 29 patients(20.1%) were received only operation.
13) Postoperative radiation therapy was done in only 5 Patients(2.8%).
14) The period of Postoperative follow-up was below 6 month in 66 patients(45.8%)-
most common; and until 12 months in 23 patients(16.0% ); and until 18 months in 20
patients(13.9%); and over 30 months in 11 patients(7.6%).

키워드

Colorectal Neoplasms;
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