• Title/Summary/Keyword: 악성 장폐쇄증

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The Surgical Treatment of Malignant Bowel Obstruction Caused by Recurrent Gastric Cancer (재발된 위암 환자에서 발생한 악성 장폐쇄증의 수술적 치료)

  • Yoo, Byung-Eun;Park, Joong-Min;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.148-153
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    • 2008
  • Purpose: Malignant bowel obstruction caused by recurrent gastric cancer must be treated appropriately to improve the effects of treatment and to prolong survival. We reviewed the surgical treatments for malignant bowel obstruction caused by recurrent gastric cancer. Materials and Methods: The subjects were patients with malignant bowel obstruction caused by recurrent gastric cancer and these patients were treated by surgical procedures at our hospital from 1998 to 2008. The patients were treated by resection, ostomy or bypass. The success of treatment was decided when the patients were able to tolerate more than a liquid diet. Results: 42 patients were treated 46 times by surgical procedures. Resection was done12 times, ostomy was done 24 times and bypass was done 10 times. The hospital stay and the period to liquid diet after the operation were shorter in the ostomy group. The post operative morbidity rate was 21.7% and the post operative death rate was 8.7%. There was no significant difference in survival according to the type of surgery. Conclusion: Ostomy is good choice for selected patients because it has a shorter hospital stay and period to liquid diet. There was no significant difference in survival according to the type of surgery because curative resection is difficult to perform in patients with malignant bowel obstruction.

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Clinical Characteristics of Elderly Patients with Pulmonary Tuberculosis (고령자 폐결핵에 대한 임상적 관찰)

  • Kim, Chung-Tae;Um, Hye-Suck;Lee, Hyang-Ju;Rhu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.432-440
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    • 2000
  • Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

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