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직장 감각능이 저하된 기능성 변비 환자에 대한 직류 전기 자극 및 바이오피드백 치료 효과

Effect of Electrical Stimulation and Biofeedback Therapy for Constipated Patients with Impaired Rectal Sensation

대한대장항문학회지 2007년 23권 4호 p.232 ~ 236
김영규 ( Kim Young-Kyu ) - 서울위생병원 외과

황용희 ( Hwang Yong-Hee ) - 서울위생병원 외과
정용환 ( Jung Yong-Hwan ) - 서울위생병원 외과

Abstract


Purpose: More than 80% of colorectal cancers are known to occur from adenomas, but only a subset of adenomas undergoes malignant transformation. The aim of this retrospective study was to assess clinicopathologic characteristics of synchronous adenomas associated with metachronous malignant neoplasms in colorectal cancer patients.

Methods: Three hundred sixty-eight colorectal cancer patients with synchronous adenomas who underwent a complete polypectomy were consecutively enrolled between 1995 and 2002. The patients with familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), and synchronous colorectal cancers with invasion beyond the submucosa, and patients who underwent a total colectomy were excluded.

Results: The mean age were 60 years (range, 27∼83), and the male- to-female ratio was 2.6:1. The mean number of synchronous adenomos was 2.4 (1∼22). The incidence of metachronous adenomas was 44.3% (163 patients), and that of metachronous malignant neoplasms was 5.2% (19 patients), consisting of 9 carcinomas and 10 malignant polyps (or adenomas with malignant change). In the multivariate analysis, the variables associated a metachronous adenoma were sex (male), location of the primary tumor, and multiple synchronous adenomas. The independent risk factors of metachronous malignant neoplasms were synchronous neoplastic adenomas (OR, 3.8; 95% CI, 1.24~11.83) and large adenomas (OR, 3.64; 95% CI, 1.17~11.27). The mean free-inverval of matachronous malignant neoplasms was 24 months (range, 12∼52).

Conclusions: Colorectal cancer patients with synchronous adenomas are prone to be at risk for recurrent adenomas and malignant tumors. High- risk patients for metachnonous malignant neoplasms should be considered for frequent colonoscopy follow-up. J Korean Soc Coloproctol 2007;23:237-244

키워드

대장암;동시성 선종;이시성 악성종양;위험인자
Colorectal cancer;Synchronous adenoma;Metachronous malignant neoplasm;Risk factors
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