内容紹介
Summary
Objective: To determine whether to perform decompression prior to resection in cases of bowel obstruction due to colorectal cancer. Subjects: There were 83 patients who underwent resection to treat a bowel obstruction due to colorectal cancer from January 2006 to August 2016. Clinical aspects and the prognosis for colorectal cancer were examined in patients who underwent decompression prior to resection and those who did not. Results: Of the 83 patients, 50 underwent decompression whereas 33 did not. Patients who did not undergo decompression most often had cancer in the right colon. Surgery took longer for patients who underwent decompression; some had extensive blood loss. Patients who underwent decompression were hospitalized for significantly longer. Patients who did not undergo decompression with an obstruction of the left colorectum due to cancer had more severe complications. DFS and OS did not differ significantly in patients with a bowel obstruction due to colorectal cancer. OS did not differ significantly for patients with an obstruction of the left colorectum due to cancer, but DFS was better for patients who underwent decompression. Conclusion: Patients with an obstruction of the left colorectum due to cancer should undergo decompression prior to resection.
要旨
目的: 大腸癌イレウスにおいて,病変を切除するに当たり減圧を先行すべきか否かを明らかにする。対象: 2006年1月～2016年8月に大腸癌イレウスに対して切除を行った83例を対象とした。十分な減圧を行った後に切除を行った群(以下,減圧群)と減圧されずに切除を行った群(以下,非減圧群)に分け,① 大腸癌周術期の臨床学的因子,② StageⅡ,Ⅲの予後について検討を行った。結果: ① 減圧群50例,非減圧群は33例であった。非減圧群で右側大腸が多く,減圧群で手術時間が長く,出血量が多く,入院期間が長かった。また,左側大腸癌イレウスでは重症合併症は非減圧群で有意に多かった。② DFS,OSは,ともに有意差は認めなかった。左側大腸癌イレウスに限るとOSは有意差を認めないものの,DFSは減圧群で良好であった。結語: 左側大腸癌イレウスでは減圧してからの切除が望ましい。
目次
Objective: To determine whether to perform decompression prior to resection in cases of bowel obstruction due to colorectal cancer. Subjects: There were 83 patients who underwent resection to treat a bowel obstruction due to colorectal cancer from January 2006 to August 2016. Clinical aspects and the prognosis for colorectal cancer were examined in patients who underwent decompression prior to resection and those who did not. Results: Of the 83 patients, 50 underwent decompression whereas 33 did not. Patients who did not undergo decompression most often had cancer in the right colon. Surgery took longer for patients who underwent decompression; some had extensive blood loss. Patients who underwent decompression were hospitalized for significantly longer. Patients who did not undergo decompression with an obstruction of the left colorectum due to cancer had more severe complications. DFS and OS did not differ significantly in patients with a bowel obstruction due to colorectal cancer. OS did not differ significantly for patients with an obstruction of the left colorectum due to cancer, but DFS was better for patients who underwent decompression. Conclusion: Patients with an obstruction of the left colorectum due to cancer should undergo decompression prior to resection.
要旨
目的: 大腸癌イレウスにおいて,病変を切除するに当たり減圧を先行すべきか否かを明らかにする。対象: 2006年1月～2016年8月に大腸癌イレウスに対して切除を行った83例を対象とした。十分な減圧を行った後に切除を行った群(以下,減圧群)と減圧されずに切除を行った群(以下,非減圧群)に分け,① 大腸癌周術期の臨床学的因子,② StageⅡ,Ⅲの予後について検討を行った。結果: ① 減圧群50例,非減圧群は33例であった。非減圧群で右側大腸が多く,減圧群で手術時間が長く,出血量が多く,入院期間が長かった。また,左側大腸癌イレウスでは重症合併症は非減圧群で有意に多かった。② DFS,OSは,ともに有意差は認めなかった。左側大腸癌イレウスに限るとOSは有意差を認めないものの,DFSは減圧群で良好であった。結語: 左側大腸癌イレウスでは減圧してからの切除が望ましい。