Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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Role of Interventional Managements for Malignant Colorectal Obstruction

소화관 폐색을 동반한 대장암 환자에서 중재적 치료의 역할

  • Eun Soo Kim (Department of Internal Medicine, Keimyung University College of Medicine)
  • 김은수 (계명대학교 의과대학 내과학교실)
  • Received : 2012.11.06
  • Accepted : 2012.12.12
  • Published : 2013.03.31
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Abstract

Incidence of colorectal cancer has been increasing in Korea probably due to the westernized life style. Although the technical development of colonoscopy and introduction of screening examination has led to the detection of early colorectal cancer, considerable patients still have clinical symptoms of colorectal obstruction. Most of these patients are old and they have advances stage of cancer or severe co-morbidities. In addition, the emergency operation under poor preparation state of colon can lead to serious mortality or complications. Since the introduction of colorectal stent, there have been a large number of studies for recent 10 years. It seems that the role of colorectal stent in the palliative indication or bridge to surgery has been recognized. A well designed, randomized prospective study with long term data is necessary to support the role of colorectal stent in the malignant colorectal obstruction.

서구화된 식생활 등의 영향으로 국내에서 대장암의 빈도가 증가하고 있다. 건강에 대한 관심의 증가와 대장내시경 기술의 발달 및 건강검진의 영향으로 조기대장암의 진단 또한 증가하고 있지만, 상당수의 대장암 환자들이 대장 폐쇄의 임상적 증상을 호소한다. 이러한 환자들은 진행된 병기, 고령, 동반 질환 등으로 수술을 시행하기가 어려운 경우가 많고 대장이 불결한 상태에서의 응급 수술은 수술과 관련한 심각한 사망률 및 합병 이환율을 초래한다. 악성 대장 폐쇄에서 스텐트가 도입된 이래 최근 10여 년간 많은 연구들이 있었고 고식적 목적, 수술 전 감압 목적으로 그 역할이 인정되고 있는 듯하다. 대장 스텐트의 역할이 좀 더 구체화되기 위해서는 향후 잘 디자인 된 무작위 전향 연구가 필요하며, 특히 장기간에 걸친 연구 결과들이 뒷받침되어야 할 것으로 생각된다.

Keywords

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