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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 215 - 220 (6page)
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초록· 키워드
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Purpose: This study compared a subtotal colectomy to self-expandable metallic stent (SEMS) insertion as a bridge to surgery for patients with left colon-cancer obstruction. Methods: Ninety-four consecutive patients with left colon-cancer obstruction underwent an emergency subtotal colectomy or elective SEMS insertion between January 2007 and August 2014. Using prospectively collected data, we performed a retrospective comparative analysis on an intention-to-treat basis. Results: A subtotal colectomy and SEMS insertion were attempted in 24 and 70 patients, respectively. SEMS insertion technically failed in 5 patients (7.1%). The mean age and rate of obstruction in the descending colon were higher in the subtotal colectomy group than the SEMS group. Sex, underlying disease, American Society of Anesthesiologists physical status, and pathological stage showed no statistical difference. Laparoscopic surgery was performed more frequently in patients in the SEMS group (62 of 70, 88.6%) than in patients in the subtotal colectomy group (4 of 24, 16.7%). The overall rate of postoperative morbidity was higher in the SEMS group. No Clavien-Dindo grade III or IV complications occurred in the subtotal colectomy group, but 2 patients (2.9%) died from septic complications in the SEMS group. One patient (4.2%) in the subtotal colectomy group had synchronous cancer. The total hospital stay was shorter in the subtotal colectomy group. The median number of bowel movements in the subtotal colectomy group was twice per day at postoperative 3–6 months. Conclusion: A subtotal colectomy for patients with obstructive left-colon cancer is a clinically and oncologically safer, 1-stage, surgical strategy compared to SEMS insertion as a bridge to surgery.
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등록된 정보가 없습니다.
참고문헌 (28)
참고문헌 신청
Deans GT / 1994 / Malignant obstruction of the left colon / Br J Surg 81:1270~1276
Biondo S / 2004 / Large bowel obstruction: predictive factors for postoperative mortality / Dis Colon Rectum 47:1889~1897
Käser SA / 2012 / Subtotal colectomy for malignant left-sided colon obstruction is associated with a lower anastomotic leak rate than segmental colectomy / Anticancer Res 32:3501~3505
Park IJ / 2009 / Comparison of one-stage managements of obstructing left-sided colon and rectal cancer: stent-laparoscopic approach vs. intraoperative colonic lavage / J Gastrointest Surg 13:960~965
Torralba JA / 1998 / Subtotal colectomy vs. intraoperative colonic irrigation in the management of obstructed left colon carcinoma / Dis Colon Rectum 41:18~22
Biondo S / 2004 / Large bowel obstruction: predictive factors for postoperative mortality / Dis Colon Rectum 47:1889~1897
Käser SA / 2012 / Subtotal colectomy for malignant left-sided colon obstruction is associated with a lower anastomotic leak rate than segmental colectomy / Anticancer Res 32:3501~3505
Park IJ / 2009 / Comparison of one-stage managements of obstructing left-sided colon and rectal cancer: stent-laparoscopic approach vs. intraoperative colonic lavage / J Gastrointest Surg 13:960~965
Torralba JA / 1998 / Subtotal colectomy vs. intraoperative colonic irrigation in the management of obstructed left colon carcinoma / Dis Colon Rectum 41:18~22
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