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중·저위 직장암의 외과적 절제에 대한 임상적 고찰

Clinical Analysis of Surgical Treatment for Mid and Lower Rectal Cancers

대한대장항문학회지 2000년 16권 6호 p.451 ~ 455
문양주 ( Moon Yang-Joo ) - 광주기독병원 외과

김병석 ( Kim Byung-Seok ) - 광주기독병원 외과
문덕진 ( Moon Duk-Jin ) - 광주기독병원 외과
박주섭 ( Park Joo-Seok ) - 광주기독병원 외과

Abstract


Purpose: The aim of this retrospective study was to evaluate the risk of local recurrence such as patients who were treated for Dukes stage B and C low rectal cancer by abdominoperineal resection (APR) or low anterior resection (LAR).

Methods: From 1985 to 1995, 81 patients with low rectal cancers which were within 3∼8 cm from the anal verge were treated by curative resection, 38 by APR and 43 by LAR. The present study examined clinical and tumor characteristics, type of intervention as potential predictors of local recurrence. Retrospective data were analysed by univariate Chi-square tests.

Results: Local recurrence was diagnosed in 17 of 81 patients with a median follow-up period of 24 months. The local recurrence rate was 23.6% (9 of 38) after APR and 18.6% (8 of 43) after LAR. There was no difference in local recurrence between patients who had APR and LAR (P=0.58). Also we could not find any significant differences among age (≤65 vs >65 years, P=0.53), sex (M vs F, P=0.57), sized of tumors (≤5 vs >5 cm, P=0.32), distance from anal verge (≤5 vs >5 cm, P=0.57), Dukes stage (B vs C, P=0.22), histological grade (well and moderate vs poorly, P=0.17), distance from distal resection margin (≤2 vs >2 cm, P=0.35).

Conclusion: The tumor factors such as Dukes’ stage were more critical for pelvic recurrences than other patient factors.

키워드

저위 직장암;국소 재발;복회음 절제술;저위 전방 절제술
Low rectal cancer;Local recurrence;Abdominoperineal resection;Low anterior resection
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