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악성 질환에 의한 급성 대장 폐색에서 자가팽창형 금속스텐트를 이용한 치료법

Self-expandable Metallic Stent for the Management of Acute Malignant Large-bowel Obstruction

대한대장항문학회지 2006년 22권 1호 p.34 ~ 40
박윤아, 이광훈, 이선일, 손승국,
소속 상세정보
박윤아 ( Park Yoon-Ah ) - 연세대학교 의과대학 외과학교실
이광훈 ( Lee Kwang-Hoon ) - 연세대학교 의과대학 영상의학교실
이선일 ( Lee Sun-Il ) - 연세대학교 의과대학 외과학교실
손승국 ( Sohn Seung-Kook ) - 연세대학교 의과대학 외과학교실

Abstract


Purpose: The purpose of this study was to review our experience with the use of self-expandable metallic stents as the initial interventional management for acute malignant large-bowel obstruction.

Methods: The records of 35 patients who underwent placement of a colonic stent for acute malignant obstruction at our institution between January 2003 and December 2004 were reviewed.

Results: Stents were placed for palliation in 19 patients and as bridge to surgery in 16 patients. Technical success of stent placement was achieved in all patients (100%), but clinical failure occurred in two patients due to limited expansion of the metallic stent. One of them who had clinical failure underwent an emergency operation, and the other needed no further procedure because of his death. Complications occurred in 4 patients (12%), including one pelvic abscess associated with colon perforation, two minor bleedings, and one anal pain. All the patients in the bridge-to-surgery group underwent an elective colon resection without stoma. In the palliative group, stent reocclusion was observed in three patients during the follow-up (median: 65 days; range: 27∼440 days), two of which were managed by reinsertion of a stent. In the remaining patients, the stent was patent until death or the last follow up date (median: 65 days).

Conclusions: Placement of a self- expandable metallic stent is a safe and effective procedure for immediate decompression of acute malignant large- bowel obstruction. It provides a chance of elective surgery for patients with resectable disease, as well as relief of symptoms for those with unresectable disease. J Korean Soc Coloproctol 2006;22:34-40

키워드

악성 질환;급성 대장 폐색; 자가팽창형 금속스텐트
Malignant;Acute malignant large-bowel obstruction;Self-expandable metallic stent

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