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원위부 대장폐쇄 환자에서 개방형 맹장루(Open Cecostomy)의 효용성

Usefulness of an Open Cecostomy in the Treatment of a Distal Colon Obstruction

대한대장항문학회지 2010년 26권 2호 p.111 ~ 115
국중철 ( Kuk Jung-Cheol ) - 한국원자력의학원 원자력병원 외과

정은주 ( Jung Eun-Joo ) - 건국대학교 의학전문대학원 외과학교실
유춘근 ( Ryu Chun-Geun ) - 건국대학교 의학전문대학원 외과학교실
황대용 ( Hwang Dae-Yong ) - 건국대학교 의학전문대학원 외과학교실
문선미 ( Moon Sun-Mi ) - 한국원자력의학원 원자력병원 외과

Abstract


Purpose: Stoma formation has usually been used for bowel decompression or fecal diversion. For these, a cecostomy is rarely performed because of disadvantages such as incomplete fecal diversion or fatal complications. The aim of this study was to evaluate the usefulness of an open cecostomy in treating patients with colonic obstruction.

Methods: Between May 2005 and August 2008, 20 patients underwent an open cecostomy because of colonic obstruction. All information on the patients was reviewed retrospectively for underlying disease, obstruction site, diameter of the cecum and transverse colon, and complications.

Results: Of the 20 patients, 14 had colorectal cancer, 3 had stomach cancer, 1 had cervical cancer, 1 had a carcinoid tumor, and 1 had an osteosarcoma. The cause of the obstruction was the primary tumor in 7 patients, peritoneal carcinomatosis in 7 patients, local recurrence in 5, and tissue edema after cyberknife treatment in 1 patient. All patients, except for 1 patient with a hopeless discharge due to rapid disease progression, were discharged on the tenth day postoperatively. No fatal complication developed. In 2 patients, the cecostomy closed spontaneously at 5.5 mo postoperatively after the distal obstruction had been resolved.

Conclusion: An open cecostomy may be a useful and simple method for the decompression of a colonic obstruction, even though the diversion may not be complete.

키워드

개방형 맹장루;장루조성술;대장폐쇄
Open cecostomy;Stoma;Colonic obstruction
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