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폐쇄성 대장암 수술에 있어서 스텐트 삽입술의 유효성

Usefulness of Self-expandable Metallic Stents for Malignant Colon Obstruction

대한대장항문학회지 2009년 25권 2호 p.113 ~ 116
김호현, 김호군, 조상혁, 허정욱, 류성엽, 김형록, 김동의, 김영진, 주재균,
소속 상세정보
김호현 ( Kim Ho-Hyun ) - 전남대학교 의과대학 외과학교실
김호군 ( Kim Ho-Goon ) - 전남대학교 의과대학 외과학교실
조상혁 ( Choi Sang-Hyuk ) - 전남대학교 의과대학 외과학교실
허정욱 ( Huh Jung-Wook ) - 전남대학교 의과대학 외과학교실
류성엽 ( Ryu Seong-Yeop ) - 전남대학교 의과대학 외과학교실
김형록 ( kim Hyeong-Rok ) - 전남대학교 의과대학 외과학교실
김동의 ( Kim Dong-Yi ) - 전남대학교 의과대학 외과학교실
김영진 ( Kim Young-Jin ) - 전남대학교 의과대학 외과학교실
주재균 ( Ju Jae-Kyun ) - 전남대학교 의과대학 외과학교실

Abstract


Purpose: Treatment for malignant colonic obstruction consists of a multiple-staged emergency operation. In recent years,some authors have reported low morbidity and mortality rates using self-expandable metallic stents. This study is designed to evaluate the usefulness of self-expandable metallic stents in patients with malignant colonic obstruction.

Methods: The records of 38 patients who had undergone surgery for malignant colonic obstruction at our institution between January 2004 and August 2006 were reviewed retrospectively. Seventeen patients were treated with elective surgery after stent insertion, bowel decompression, and bowel preparation (stent group), and 21 patients were treated with emergency surgery without stent insertion (control group).

Results: There were no significant differences in age, sex, tumor node metastasis (TNM) stage, or cancer position between the two groups (elective operation after stent insertion vs. emergency operation). Of the 17 patients who underwent elective operation after stent insertion, primary anastomosis was possible in 15 (88.2 vs. 57.1% in the control group), with a lower need for a colostomy (11.8 vs. 42.9% in the control group, P=0.036). Also, the number of patients with severe complications (17.6 vs. 47.6% in the control group, P=0.048) and the hospital stay (10.82 vs. 13.43 days in the control group, P=0.032) were significantly lower in the study group.

Conclusions: Placement of a self-expandable metallic stent for malignant colonic obstruction is a safe and effective procedure. It can reduce the colostomy, mortality, and morbidity rates and the hospital fee for treatment.

키워드

폐쇄성 대장암;자가팽창 스텐트
Malignant colon obstruction;Self-expandable metallic stent

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