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우측 대장암 환자에서 복강경 보조수술과 개복 수술 후 장운동 회복의 비교: Sitz-markerTM를 이용한 위 배출 시간과 수술 중 복강내 온도의 변화

Comparison of Recovery of Bowel Motility after Laparoscopic-assisted and Open Surgery for Right Colon Cancer: A Study of Gastric Emptying by Using Sitz-markerTM and Changes of Intraperitoneal Temperature

대한대장항문학회지 2004년 20권 6호 p.351 ~ 357
박찬욱 ( Park Chan-Wook ) - 경북대학교 의과대학 외과학교실

최규석 ( Choi Gyu-Seog ) - 경북대학교 의과대학 외과학교실
전수한 ( Jun Soo-Han ) - 경북대학교 의과대학 외과학교실

Abstract


Purpose: Early recovery of gastrointestinal motility is one of the main advantages of laparoscopic intestinal surgery. However, the reasons for this advantage are still not well known. To compare recovery of bowel motility after laparoscopic-assisted and open surgery for right colon cancer, we analyzed early clinical results, including both the gastric emptying time by using a Sitz-markerTM and the intraperitoneal temperature.

Methods: From January 1996 to December 1999, 80 curative right hemicolectomies, which were divided into a laparoscopic-assisted surgery group (LS) with 36 patients and an open surgery group (OS) with 44 patients, were prospectively, but not randomly, studied for recovery of bowel motility. Clinical results, such as the pain score, the time to gas passage, the time to resumption of meals the hospital stay and the gastric emptying time obtained by using a Sitz-markersTM, were evaluated. At the beginning and the end of the operation, the intraperitoneal temperature was checked at three different points.

Results: In the LS and OS groups, the first flatus passed at the 3.0 and the 3.67 postoperative day (POD) and oral intake resumed at the 3.9 and the 5.2 POD, respectively (P<0.05). The numbers of Sitz-markersTM remaining in the stomach after surgery were 15.0 and 18.7 at the 1st POD (P<0.0001), 6.4 and 10.8 at the 2nd POD (P>0.05), 1.7 and 4.2 at the 3rd POD (P<0.05) and 0 and 1.1 at the 4th POD (P<0.05), respectively. No difference in intraperitoneal temperature was noted.

Conclusions: We found earlier recovery of bowel function after laparoscopic surgery than after open surgery, but could not identify any relationship between bowel function and the possible parameter of intraperitoneal temperature. J Korean Soc Coloproctol 2004;20:351-357

키워드

우측 대장암;복강경 수술;장운동;복강내 온도;
Sitz- markerTM;Right colon cancer;Laparoscopic surgery;Bowel motility;Sitz-markerTM;Intraperitoneal temperature
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