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결장 및 직장암의 수술에서 복강경 술식이 적합한가?

Is Laparoscopic Procedure Adequate for Colorectal Cancer Surgery?

대한대장항문학회지 1999년 15권 5호 p.434 ~ 442
김재황 ( Kim Jae-Hwang ) - 영남대학교 의과대학 외과학교실

허진명 ( Huh Jin-Myung ) - 영남대학교 의과대학 외과학교실
윤성수 ( Yun Sung-Soo ) - 영남대학교 의과대학 외과학교실
김상운 ( Kim Sang-Woon ) - 영남대학교 의과대학 외과학교실
심민철 ( Shim Min-Chul ) - 영남대학교 의과대학 외과학교실
권굉보 ( Kwun Koing-Bo ) - 영남대학교 의과대학 외과학교실

Abstract


Purpose: To evaluate the possibility that laparoscopic procedure could perform surgeries keeping the principle of oncologic surgery.

Methods: From July 1993 to June 1996, thrity patients undergone laparoscopic assisted colon and rectal resections (LR) for malignant disease at Yeungman university hospital. Margins of resection and lymph nodes (LNs) recovered were compared with those of thirty stage matched open resection cases (OR, n=30) retrospectively. There was no operative mortality in both group. Operative techniques used in LR vs OR were colectomy, 5:6; anterior resection, 6:5; low anterior resection, 11:12 and abdominoperineal resection, 8:7. Parameters were analgesic use, duration of postoperative ileus, operative time, hospital stay, margins of rescetion, lymph node yield (LNs), and recurrence.

Results: Patients who underwent LR had less pain, a shorter period of postoperative ileus and hospital stay than patients who underwent OR. But, the length of operative time was greater for patients undergoing LR. Mean lymph node yield in the laparoscopic group was 16 compared with 18.1 in the open group (P=0.560). Average margins of resection in LR vs OR were 13.9 cm vs 14.1 cm proximally (P=0.823), 3.6 cm vs 5.2 cm distally (P=0.498). In no case did the margins contain tumor. There was no statistical significance in dissected LNs and the length of both resection margins in both groups. Recurrence was similar in both groups.

Conclusion: In this study, there is no evidence that laparoscopic technique is inadequate in following the cancer surgery principle.

키워드

Laparoscopic surgery;Oncologic surgery;Colon cancer;Rectal cancer;Resection margins;Lymph nodes
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