폐쇄성 결직장암에서 스텐트 삽입 후 시행한 복강경 결직장 절제술의 경험 (Laparoscopic Colorectal Resection after Endoscopic Stent Insertion in Cases of Malignant Colorectal Obstruction: the Experience of a Single Center)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 3호 / 172 ~ 177페이지
· 저자명 : 이정임, 이인규, 강원경, 조현민, 박종경, 오승택, 김준기, 김병욱, 이보인, 이윤석

초록

Purpose: Laparoscopic surgery has been considered to be contraindicated for obstructive colorectal cancer. However,
endoscopic stent insertion for obstructive colorectal cancer has recently allowed elective laparoscopic surgery. The aim of
this study is to evaluate the feasibility and the short-term clinical outcomes of laparoscopic surgery following endoscopic
stent insertion for management of malignant colorectal obstruction at a single center.
Methods: The medical records of patients who had undergone endoscopic stent insertion for colorectal cancer obstruction,
followed by laparoscopic colorectal resections, from August 2004 to August 2008 were reviewed. To evaluate the surgical
and clinical outcomes, we analyzed the clinical and pathologic data.
Results: Thirty-six endoscopic stent insertions were successfully performed during the study period. Of those 36, the 28
treated by laparoscopic surgery were enrolled in this study. The mean interval between stent insertion and surgery was 7.4
±2.3 days. Two cases were converted to open surgery. The mean operative time was 185.5±53.1 min, and the mean
blood loss was 77.0±72.9 mL. Flatus was passed on the mean 2nd postoperative day, and patients started to eat on the
mean 4th postoperative day. The mean postoperative hospital stay was 11.2±4.4 days. Anastomosis leakages occurred
in two cases and were treated by a secondary operation with a transient ileostomy. There were morbidities in five cases,
but no mortalities.
Conclusion: A combined endoscopic stent insertion and laparoscopic surgery is an effective and safe, minimally invasive
operation for malignant colorectal obstruction.

영어초록

Purpose: Laparoscopic surgery has been considered to be contraindicated for obstructive colorectal cancer. However,
endoscopic stent insertion for obstructive colorectal cancer has recently allowed elective laparoscopic surgery. The aim of
this study is to evaluate the feasibility and the short-term clinical outcomes of laparoscopic surgery following endoscopic
stent insertion for management of malignant colorectal obstruction at a single center.
Methods: The medical records of patients who had undergone endoscopic stent insertion for colorectal cancer obstruction,
followed by laparoscopic colorectal resections, from August 2004 to August 2008 were reviewed. To evaluate the surgical
and clinical outcomes, we analyzed the clinical and pathologic data.
Results: Thirty-six endoscopic stent insertions were successfully performed during the study period. Of those 36, the 28
treated by laparoscopic surgery were enrolled in this study. The mean interval between stent insertion and surgery was 7.4
±2.3 days. Two cases were converted to open surgery. The mean operative time was 185.5±53.1 min, and the mean
blood loss was 77.0±72.9 mL. Flatus was passed on the mean 2nd postoperative day, and patients started to eat on the
mean 4th postoperative day. The mean postoperative hospital stay was 11.2±4.4 days. Anastomosis leakages occurred
in two cases and were treated by a secondary operation with a transient ileostomy. There were morbidities in five cases,
but no mortalities.
Conclusion: A combined endoscopic stent insertion and laparoscopic surgery is an effective and safe, minimally invasive
operation for malignant colorectal obstruction.

참고자료

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