폐쇄 및 천공을 동반한 대장암 응급 수술 후 합병증과 사망률 발생 위험인자 분석 (Multivariate Analysis of the Risk Factors Associated with Complications and Mortality after and Emergency Operation for Obstructive, Perforated Colorectal Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 3호 / 165 ~ 171페이지
· 저자명 : 강동백, 신창열, 이정균, 박원철

초록

Purpose: Despite increased effort for the detection of early colorectal cancer, advanced disease presenting as obstruction
or perforation still accounts for 8 to 29% and 3-8% of all colorectal cancers, respectively. The aim of this retrospective study
was to evaluate the clinical characteristics, the surgical methods, the complications, and the risk factors of obstructive or
perforated colorectal cancer that may influence the outcome.
Methods: A retrospective study was carried out in 60 patients with colorectal cancer, who underwent surgery due to obstruction
or perforation from March 2000 to December 2005. The colorectal cancers were considered to be complicated when clinical
signs of peritonitis were observed, the radiologic characteristics of the tumor did not permit preoperative mechanical bowel
preparation, or perforation existed, when these observations were confirmed by operative findings. The following data were
analyzed: clinical characteristics, surgical methods, complications, and risk factors.
Results: Thirty-three patients (55%) had obstruction, and 27 patients (45%) had perforation. Overall, major complications
occurred in 33.3% and 48.5%, respectively. The mortality rates were 6.1% and 14.8%, respectively. Risk factors for major
complication were age, perforation, and transfusion whereas those for mortality were perforation and American Society of
Anesthesiologists (ASA) class.
Conclusion: The risk factors of complication were old age, transfusion, and perforation and those for mortality was perforation
and ASA class. Earlier diagnosis and prompt, intensive, careful management should be attempted in these high-risk patients.

영어초록

Purpose: Despite increased effort for the detection of early colorectal cancer, advanced disease presenting as obstruction
or perforation still accounts for 8 to 29% and 3-8% of all colorectal cancers, respectively. The aim of this retrospective study
was to evaluate the clinical characteristics, the surgical methods, the complications, and the risk factors of obstructive or
perforated colorectal cancer that may influence the outcome.
Methods: A retrospective study was carried out in 60 patients with colorectal cancer, who underwent surgery due to obstruction
or perforation from March 2000 to December 2005. The colorectal cancers were considered to be complicated when clinical
signs of peritonitis were observed, the radiologic characteristics of the tumor did not permit preoperative mechanical bowel
preparation, or perforation existed, when these observations were confirmed by operative findings. The following data were
analyzed: clinical characteristics, surgical methods, complications, and risk factors.
Results: Thirty-three patients (55%) had obstruction, and 27 patients (45%) had perforation. Overall, major complications
occurred in 33.3% and 48.5%, respectively. The mortality rates were 6.1% and 14.8%, respectively. Risk factors for major
complication were age, perforation, and transfusion whereas those for mortality were perforation and American Society of
Anesthesiologists (ASA) class.
Conclusion: The risk factors of complication were old age, transfusion, and perforation and those for mortality was perforation
and ASA class. Earlier diagnosis and prompt, intensive, careful management should be attempted in these high-risk patients.

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