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- 저자 : 권강안 ( Kang An Kwon ) (검색결과 1 건)
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대장 및 직장의 악성 폐색 환자에서 자가확장형인공관 삽입술에 대한 연구
유창범 ( Chang Beom Ryu ),김환열 ( Hwan Yeol Kim ),권강안 ( Kang An Kwon ),정인섭 ( In Sup Jung ),홍수진 ( Su Jin Hong ),김진오 ( Jin Oh Kim ),조주영 ( Joo Young Cho ),이준성 ( Joon Sung Lee ),이문성 ( Moon Sung Lee ),심찬섭 ( Cha 대한장연구학회 2003 Intestinal Research Vol.1 No.1
Background/Aims: The optimal palliative treatment of unresectable colorectal malignant obstruction is still debated. Recently, successful short-term palliation of malignant colorectal obstruction using self-expandable metal stents has been reported by several groups of investigators. Aims: The aim of this study was to evaluate the clinical usefulness of these self-expandable metal stents (SEMS) through the scope for the treatment of malignant colorectal cancer. Methods: Between May 1999 and December 2002, 35 patients (M:F=19:16) with malignant colorectal obstruction were treated for relief from the obstruction with endoscopically guided intubation of a SEMS through the working channel of an endoscope. Uncovered stents were intserted in 29 patients and covered stents in 6 patients. The technical and clinical success rates and complication were evaluated. Results: The sites of obstructions were on the rectum (n=3), sigmoid colon (n=9), descending colon (n=9), transverse colon (n=8) and ascending colon (n=6). SEMS insertion was successful in 34 of 35 patients (97%). In 31 of 34 patients with successful placement of the stent, symptoms of obstruction resolved within 72 hours. Two patients underwent the formal bowel preparation and elective single-stage surgery without complication 10 and 60 days after stent placement. Perforation occurred in 1 patients during stent placement and died. The mean follow up was 144 days (5-610 days). Stent migration occurred in 7 patients during follow-up who were 2 (33.3%) of 6 patients with covered stent and 5 (17.8%) of 28 patients with uncovered stent. After migration of stents, another stent was reinserted in 3 of 7 patients. Obstruction of the stent because of tumor ingrowth and overgrowth was observed in 4 patients with uncovered stent. Conclusions: SEMS placement through the working channel of an endoscope provide not only palliative decompression in cases with inoperable malignant colorectal obstruction but preoperative decompression to undergo the one-step surgery in patients with malignant colorectal obstruction. (Intestinal Research 2003;1:45-50)
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