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초저위 직장암의 괄약근간 절제술 및 대장항문 문합술

Other Titles
 Intersphincteric Resection and Coloanal Anstomosis for Very Low Lying Rectal Cancer 
Authors
 김진수  ;  이초록  ;  김남규  ;  허 혁  ;  민병소  ;  안중배  ;  금기창 
Citation
 JOURNAL OF THE KOREAN SURGICAL SOCIETY , Vol.76(1) : 28-35, 2009 
Journal Title
 JOURNAL OF THE KOREAN SURGICAL SOCIETY 
ISSN
 1226-0053 
Issue Date
2009
Keywords
Rectal cancer , Intersphincteric resection , Coloanal anastomosis , Chemoradiotherapy
Abstract
Purpose: Ultralow anterior resection and coloanal anastomosis (hand-sewn) has commonly been used for preserving the anal sphincter in patients with low-lying distal rectal cancer. Preoperative chemoradiation therapy is a contributing factor to preserve the anal sphincter. Intersphincteric resection has been introduced and has begun to be applied to distal rectal cancer for anal sphincter preservation. The aim of this study was to report on patients who underwent intersphincteric resection and coloanal anastomosis for very low-lying rectal cancer. Methods: Intersphincteric resection was performed in 21 patients with very low-lying rectal cancer (within 4 cm from the anal verge) between December 2004 and May 2008. All patients received colonic J pouch anal anastomosis and loop ileostomy. The patients were selected prospectively and followed up for the function of bowel movement and recurrence. Results: Mean tumor distance from anal verge was 2.8 cm (range 2∼4 cm). No postoperative mortality was encountered. One patient developed ischemic colitis of colonic J-pouch after high doses of tomotherapy. Subsequently he received abdominoperineal resection and permanent colostomy. One patient underwent diverting colostomy for severe incontinence after ileostomy takedown. The other cases reported good anorectal function such as frequency of bowel movement and fecal incontinence. There were two local recurrences during a mean follow-up period of 11.6 months. Conclusion: Based on a single surgeon’s experiences, postoperative morbidity and anorectal function after intersphincteric resection with coloanal anastomosis seems acceptable.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Jin Soo(김진수)
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104836
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