선택적 진행성 직장암에서의 요크-메이슨 수술의 효용성 (Feasibility of York-Mason Operation for Selective Advanced Rectal Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 3호 / 178 ~ 185페이지
· 저자명 : 정운경, 백성규, 배옥석

초록

Purpose: The York-Mason operation has been used as local therapy for benign rectal tumors not easily excised with a
conventional transanal excision and for T1 rectal cancers having a low risk of lymph-node metastasis. This study evaluated
whether a York-Mason operation could be an alternative therapy for selected patients with T2 or T3 rectal cancers.
Methods: From February 2004 to March 2008, 11 patients with T2 or T3 rectal cancer, who refused rectal excision due to
fear of abdominal surgery itself and perioperative side effects or unwillingness to have a permanent stoma, underwent a
York-Mason operation. The data on the patients were analyzed retrospectively.
Results: The distance from the anal verge to the tumor was 5 cm (median, 2-8 cm), and the tumor size was 3 cm (median,
1.5-4 cm). Histological examination revealed a pathological tumor (pT) stage 2 in eight patients, stage pT3 in one patient,
and stage pTx in two patients. The distance from the resection margin to the tumor was 0.3 cm (median, 0.1-0.5 cm). Six
patients (55%) had incomplete tumor excision. Radiotherapy was performed in one patient preoperatively and in eight postoperatively.
Postoperative morbidity occurred in four patients (36%). During a median of 38.2 months, two patients (18%)
developed local recurrence and liver metastasis. Postoperative mortality, which was not related to the procedure, occurred
in one patient (9%).
Conclusion: The York-Mason operation could be considered as an alternative therapy for selected T2 or T3 rectal cancer
patients who refuse rectal excision.

영어초록

Purpose: The York-Mason operation has been used as local therapy for benign rectal tumors not easily excised with a
conventional transanal excision and for T1 rectal cancers having a low risk of lymph-node metastasis. This study evaluated
whether a York-Mason operation could be an alternative therapy for selected patients with T2 or T3 rectal cancers.
Methods: From February 2004 to March 2008, 11 patients with T2 or T3 rectal cancer, who refused rectal excision due to
fear of abdominal surgery itself and perioperative side effects or unwillingness to have a permanent stoma, underwent a
York-Mason operation. The data on the patients were analyzed retrospectively.
Results: The distance from the anal verge to the tumor was 5 cm (median, 2-8 cm), and the tumor size was 3 cm (median,
1.5-4 cm). Histological examination revealed a pathological tumor (pT) stage 2 in eight patients, stage pT3 in one patient,
and stage pTx in two patients. The distance from the resection margin to the tumor was 0.3 cm (median, 0.1-0.5 cm). Six
patients (55%) had incomplete tumor excision. Radiotherapy was performed in one patient preoperatively and in eight postoperatively.
Postoperative morbidity occurred in four patients (36%). During a median of 38.2 months, two patients (18%)
developed local recurrence and liver metastasis. Postoperative mortality, which was not related to the procedure, occurred
in one patient (9%).
Conclusion: The York-Mason operation could be considered as an alternative therapy for selected T2 or T3 rectal cancer
patients who refuse rectal excision.

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