대장암에 의한 장 폐쇄 환자에서 자가팽창형 금속제 스텐트 삽입술의 효과에 대한 다기관 연구 -응급수술군과의 비교를 통한 임상 효과 및 의료 경제학적 분석을 중심으로- |
이기명ㆍ김태일*ㆍ고봉민†ㆍ신성재ㆍ김원호*ㆍ김진홍ㆍ이문성†ㆍ김현수‡ㆍ박영수§ㆍ이강문∥ㆍ박종재¶ㆍ진윤태¶ |
아주대학교 의과대학 내과학교실, *연세대학교 의과대학 내과학교실, †순천향대학교 의과대학 부천병원 내과학교실, ‡연세대학교 원주의과대학 내과학교실, §서울대학교 의과대학 분당병원 내과학교실, ∥가톨릭대학교 의과대학 빈센트병원 내과학교실, ¶고려대학교 의과대학 내과학교실 |
The Effect of Self-Expanding Metallic Stent Insertion for the Treatment ofMalignant Colorectal Obstruction |
Kee Myung Lee, M.D., Tae Il Kim, M.D.*, Bong Min Ko, M.D.†, Sung Jae Shin, M.D., Won Ho Kim, M.D.*, Jin Hong Kim, M.D., Moon Sung Lee, M.D.†, Hyun Soo Kim, M.D.‡, Young Soo Park, M.D.§, Ka |
Department of Internal Medicine, Ajou University College of Medicine, Suwon, *Yonsei University College of Medicine, Seoul, †Soonchunhyang University College of Medicine Bucheon Hospital, Bucheon, ‡Yonsei University Wonju College of Medicine, Wonju, §Seoul National University College of Medicine Bundang Hospital, Seongnam, ∥The Catholic University of Korea College of Medicine, St. Vincent Hospital, Suwon, ¶Korea University College of Medicine, Seoul, Korea |
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Abstract |
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Background/Aims: The aim of this study was to evaluate the clinical and cost effectiveness of the use of stent insertion for malignant colorectal obstruction as compared with performing emergency surgery. Methods: We retrospectively reviewed the medical records of 201 patients. Malignant colorectal obstructions caused by a resectable tumor were treated with preoperative stenting followed by surgery (group A, n=55) or emergency surgery (group B, n=59). Malignant obstructions caused by an unresectable cancer were treated with palliative stenting (group C, n=58) or palliative emergency surgery (group D, n=29). Results: The one-staged radical resection rate was significantly higher in group A patients than in group B patients (87.3% vs. 52.5%, p<0.05). Post-operative complications were more frequent in group A patients than in group B patients (9.1% vs. 32.2%, p<0.05). The admission period was significantly shorter for group A patients than for group B patients (25.0 days vs. 33.7 days, p<0.05). The medical cost was not different for group A and group B patients. Life-long stoma formation was necessary for 15.5% of group C patients and 69% of group D patients, respectively. The admission period was significantly shorter for group C patients than group D patients (10.5 days vs. 22.7 days, p<0.05). The medical cost was not different for group C and D patients. Conclusions: Stent insertion was an effective treatment modality for malignant colorectal obstruction. (Korean J Gastrointest Endosc 2008;36:274- 281) |
Key Words:
Stent insertion, Malignant obstruction, Colon cancer |
주요어:
스텐트 삽입, 악성 장 폐쇄, 대장암 |
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