内容紹介
Summary
The clinical condition of oncologic emergency associated with colorectal cancer includes hemorrhage, perforation and obstruction. Obstructive colorectal cancer is an oncologic emergency commonly observed in our daily clinical practice. Colonic stent placement for obstructive colorectal cancer is relatively easy and safe and may be considered as an effective treatment method that enables favorable intestinal decompression preoperatively and one-stage resection. Colonic stent use can be a bridge to surgery, enabling shorter duration of hospitalization, and reduced postoperative complications, and colostomy rates, as compared to emergency surgery. From January 2009 to December 2016, this study was designed to evaluate the clinical outcomes of 68 patients who underwent surgery for obstructive colorectal cancer. The patients were divided into 2 groups: 32 cases receiving colonic stent placement(the S group), 36 cases receiving ileus tube and emergency surgery(the NS group). There was no significant difference in terms of morbidity or survival rate between the 2 groups. For the S group, 31 out of 32 could one-stage resection(94%). The colostomy rate in the S group was significantly lower than that in the NS group(3% vs 33%). In the S group, number of dissected lymph nodes was significantly larger and the duration of postoperative stay was shorter than that in the NS Group.
要旨
大腸癌のoncologic emergencyの病態としては,出血,穿孔,閉塞などがあり,特に閉塞性大腸癌は臨床上経験することが多い。閉塞性大腸癌に対する大腸ステント留置は比較的安全かつ簡便で,術前に良好な腸管減圧が得られ,一期的切除可能となる有効な手段である。また,緊急手術と比較して入院期間の短縮,合併症の低下や人工肛門造設の回避などが期待できる。2009年1月～2016年12月に閉塞性大腸癌に対して手術を施行した68例について比較検討した。術前ステント留置群(S群)と術前ステント非留置群(NS群)の2群間比較では,短期予後に有意な差はなかった。S群ではほぼ全例一期的吻合が可能であったが,NS群では1/3の症例で人工肛門造設を行った。S群では有意にリンパ節郭清個数が増加し,術後在院日数が短縮した。
目次
The clinical condition of oncologic emergency associated with colorectal cancer includes hemorrhage, perforation and obstruction. Obstructive colorectal cancer is an oncologic emergency commonly observed in our daily clinical practice. Colonic stent placement for obstructive colorectal cancer is relatively easy and safe and may be considered as an effective treatment method that enables favorable intestinal decompression preoperatively and one-stage resection. Colonic stent use can be a bridge to surgery, enabling shorter duration of hospitalization, and reduced postoperative complications, and colostomy rates, as compared to emergency surgery. From January 2009 to December 2016, this study was designed to evaluate the clinical outcomes of 68 patients who underwent surgery for obstructive colorectal cancer. The patients were divided into 2 groups: 32 cases receiving colonic stent placement(the S group), 36 cases receiving ileus tube and emergency surgery(the NS group). There was no significant difference in terms of morbidity or survival rate between the 2 groups. For the S group, 31 out of 32 could one-stage resection(94%). The colostomy rate in the S group was significantly lower than that in the NS group(3% vs 33%). In the S group, number of dissected lymph nodes was significantly larger and the duration of postoperative stay was shorter than that in the NS Group.
要旨
大腸癌のoncologic emergencyの病態としては,出血,穿孔,閉塞などがあり,特に閉塞性大腸癌は臨床上経験することが多い。閉塞性大腸癌に対する大腸ステント留置は比較的安全かつ簡便で,術前に良好な腸管減圧が得られ,一期的切除可能となる有効な手段である。また,緊急手術と比較して入院期間の短縮,合併症の低下や人工肛門造設の回避などが期待できる。2009年1月～2016年12月に閉塞性大腸癌に対して手術を施行した68例について比較検討した。術前ステント留置群(S群)と術前ステント非留置群(NS群)の2群間比較では,短期予後に有意な差はなかった。S群ではほぼ全例一期的吻合が可能であったが,NS群では1/3の症例で人工肛門造設を行った。S群では有意にリンパ節郭清個数が増加し,術後在院日数が短縮した。