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大腸 및 直腸에서 發生되는 腫瘍의 臨床的 考察

A Clinical Review on the Tumor of the Colon and Rectum

최신의학 1968년 11권 8호 p.31 ~ 39
조명하,
소속 상세정보
조명하 (  ) - 서울대학교 의과대학 외과학교실

Abstract


This report is a clinical review of the experience with 99 cases of tumor of the colon and rectum which were treated at Department of Surgery, Seoul National Universitiy Hospital in the last 92 months (from Jan. 1955 to Aug. 1962).
The incidence of polyps on the resected specimen, clinical symptoms and findings, pathological examination, operative procedure,. complication and mortality and resectability rates were descrided and discussed. The results are as follows:
1) The sex distribution was 1.7 males to one female. The youngest patient was 19 years of age and the oldest 78 years of age. The average years of age were 46.4 years.
2) The location of tumors, as shown in table 1, consisted of 53 cases(52.5%) in rectum,r15 cases(14.9%)

in rectosigmoid, 9 cases(8.9%) in sigmoid, 7 cases(6.9%) in transverse colon and 6 cases(5.9%) in J cecum. The most common sites of the tumor locations in this series was the rectum and rectosigmoid,

in 67.4 per cent of the tumors.
3) There were two cases of multiple tumor on the colon and rectum. One case was the adenocarcinoma on rectum and rectosigmoid and the other case was the squamous cell carcinoma on the cecum and hepatic flexura.
4) The clinical symptoms, as shown in table 3, revealed the difference compare with the colon group and rectum group. On the rectum group, main symptoms consisted of Imeiena in 89.8%, constipation in 46.4% and mucus in stool 37.7%. On the left colon group, main symptoms consisted of abdominal pain in 75%, melena in 55% and abdominal distension in 43.7%. On the right colon group, main symptoms consisted of abdominal pain in 86.6%. abdominal mass in 78.5% and diarrhea in 50%.

5) Diagnosis was seldom difficult. Sigmoidoscopy and rectoscopy was performed in 81.3% of the patient who has been complained the melena. Digital examination of the rectum and the sigmoidoscopy and proctoscopy was considered as the simple and valuable method for diagnosis of the rectum tumors. On the tumors of the colon, X-ray-study with barium enema was also considered as the favorable method to be choice for the diagnostic procedure.
6) As shown in table 4, ´ histological examination on 89 slides consisted of 71 cases(79.3%) of adenocarcinoma, 4 cases(4.5%) of squamous cell carcinoma and one case(1.1%) of carcinoma

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