Korean J Gastrointest Endosc > Volume 36(5); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;36(5): 274-281.
대장암에 의한 장 폐쇄 환자에서 자가팽창형 금속제 스텐트 삽입술의 효과에 대한 다기관 연구 -응급수술군과의 비교를 통한 임상 효과 및 의료 경제학적 분석을 중심으로-
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

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.
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).
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.
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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