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결장 및 직장암의 동시성 병변의 분석

Analysis of Colonic Synchronous Lesions in Colorectal Cancer

대한대장항문학회지 2003년 19권 6호 p.367 ~ 371
민병욱 ( Min Byung-Wook ) - 고려대학교 의과대학 외과학교실

이재복 ( Lee Jae-Bok ) - 고려대학교 의과대학 외과학교실
엄준원 ( Um Jun-Won ) - 고려대학교 의과대학 외과학교실
문홍영 ( Moon Hong-Young ) - 고려대학교 의과대학 외과학교실

Abstract


Purpose: The aim of this study is to evaluate the incidence of synchronous colonic lesions and to identify the impact of an incomplete preoperative colonoscopy in colorectal cancer patients.

Methods: We studied 187 patients with colorectal cancer who received colonoscopic examinations pre or postoperatively in our hospital from January 2000 to March 2002. The pre and postoperative colonoscopic findings were reviewed. Most post-operative colonoscopies were performed 12 months after the operation, but in cases of incomplete pre-operative examination, they were performed at 6 months. We analyzed the incidence of synchronous lesions of the colon and the rectum and then compared the findings for complete and incomplete pre-operative examinations.

Results: Complete pre-operative colonoscopic examinations were performed in 152 patients, but in 35 patients, the colonoscopy was performed incompletely. Twenty-two of these 35 patients had obstructive colorectal cancer. In the complete examination group, 23 patients had synchronous lesions preoperatively; 20 cases were benign, and 3 cases were malignant. By postoperative colonoscopic examination, 27 patients had synchronous polyps. In 19 of the 27, the polyps had not been detected preoperatively. The incidence of synchronous lesions in the complete examination group was 27.6% (42/152), and the incidence of synchronous cancer was 2.0% (3/152). In the incomplete examination group, the incidence of synchronous lesions was 37.1% (13/35), and the incidence of malignancy was 2.9% (1/35). The incidence of synchronous lesions in the preoperative incomplete examination group was higher than it was in the complete examination group, but the difference was not statistically significant (P=0.161).

Conclusions: In our study, the incidence of synchronous lesions with colorectal cancer patients was 29.4%, and the incidence of malignancy was 2.1%, these are similar to figures in others reports. Patients with an incomplete preoperative entire-colon examinations should have immediate postoperative colonoscopy. J Korean Soc Coloproctol 2003;19:367-371

키워드

결장직장종양;동시성 병변;결장내시경술
Colorectal neoplasms;Synchronous lesions;Colonoscopy
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