폐쇄성 좌측 대장암에서 스텐트 삽입 후 단단계 복강경 대장 절제술의 단기 예후: 비폐쇄성 좌측 대장암의 복강경 대장 절제술군과의 비교 (Short-Term Outcome of Curative One-Stage Laparoscopic Resection for Obstructive Left-Sided Colon Cancers Followed by Stent Insertion: Comparative Study with Non-Obstructive Left-Sided Colon Cancers)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 6호 / 417 ~ 422페이지
· 저자명 : 김현실, 김성근, 안창혁, 강원경, 이윤석, 이인규, 김형진, 이상철, 조현민, 박종경, 오승택, 김준기

초록

Purpose: Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent
insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative
bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage
laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for nonobstructive
left-sided colon cancer.
Methods: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive
patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and
the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone
a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the
perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate.
Results: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8±5.3 vs. 14.0±
8.7, P=0.036), and distal resection margin (5.5±3.0 cm vs. 3.6±2.4 cm, P=0.011). There were no significant differences
in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two
groups.
Conclusion: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option
for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the
long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer.

영어초록

Purpose: Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent
insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative
bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage
laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for nonobstructive
left-sided colon cancer.
Methods: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive
patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and
the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone
a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the
perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate.
Results: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8±5.3 vs. 14.0±
8.7, P=0.036), and distal resection margin (5.5±3.0 cm vs. 3.6±2.4 cm, P=0.011). There were no significant differences
in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two
groups.
Conclusion: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option
for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the
long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer.

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