장창냄술을 시행받은 난소암 환자의 임상적 특징
Clinical characteristics of ovarian cancer patients who underwent enterostomy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 본 연구의 목적은 장창냄술을 시행받은 난소암 환자들의 임상적 특징을 살펴보고자 함이다. 방법: 1990년 1월부터 2006년 12월까지 장창냄술을 시행받은 51명의 난소암 환자를 수술의 시기와 적응증에 따라 일차종양감 축술군, 이차종양감축술군, 임시수술군으로 분류하여 임상적 특징을 비교하였다. 또한, 예후 인자를 찾기 위하여 임상적 특 징 간의 관련성을 조사하였다. 결과: 일차종양감축술군, 이차종양감축술군, 임시수술군의 순서로 나이가 많았고 (P=0.061), 상부소화기증상이 드물었으며 (P=0.000), 공장창냄술이나 회장창냄술보다는 결장창냄술을 시행받았으며 (P=0.037), 수술 후 항암화학요법을 받는 환자가 많았다 (P=0.000). 나이가 많을수록 장창냄술과 관련된 합병증이 증가하였다 (P=0.035). 일차종양감축술군에서 나이가 많을 수록 수술 후 잔여 병변이 1 cm 미만일 확률이 낮았다 (P=0.020). 임시수술군에서 수술 전 상부소화기증상이 있는 경우 공장 창냄술이나 회장창냄술을 시행받는 경우가 많았고 (P=0.021), 하부소화기증상이 있는 경우에는 모든 환자에서 결장창냄술을 시행받았다 (P=0.005). 결론: 장창냄술을 시행받은 난소암 환자에서 수술의 시기와 적응증에 따라 임상 양상은 차이를 보였다. 임상적 특징들과 수술 전 소화기증상을 주의 깊게 관찰함으로써 장창냄술을 시행받은 난소암 환자들의 수술 후 삶의 질 예측에 도움이 되리라고 생각된다.
Abstract
Objective: The aim of this study was to examine the clinical characteristics of patients with ovarian cancer who underwent enterostomy. Methods: Via medical record review, we obtained clinical information of 51 ovarian cancer patients who underwent enterostomy in our hospital, from 1990 to 2006. We compared the clinical characteristics according to the indication of enterostomy: primary cytoreduction (PC), secondary cytoreduction (SC), and palliative only (PO). In addition, we investigated the correlations among clinical characteristics to find prognosticators. Results: Patients were older (P=0.061), had less upper gastrointestinal symptoms (P=0.000), underwent colostomy rather than ileostomy (P=0.037), and received more postoperative chemotherapy (P=0.000) according to the following order: PC, SC, PO groups. Older patients had more postoperative complications (P=0.035). In the PC group, older patients had less chance of optimal debulking (P=0.020). In the PO group, preoperative gastrointestinal symptoms were associated with the type of enterostomy. Conclusions: Clinical characteristics of patients were different according to the indication of enterostomy. Careful examination of clinical characteristics and gastrointestinal symptoms might be helpful to predict the postoperative quality of life.
참고문헌 (9)
- Zang RY, "Secondary cytoreductive surgery for patients with relapsed epithelial ovarian carcinoma: who benefits?", Cancer, 100, pp.1152~1161 (2004)
- Diaz-Montes TP, "Secondary cytoreduction for patients with recurrent ovarian cancer", Curr Oncol Rep, 7, pp.451~458 (2005)
- Berek JS, "Rectosigmoid colectomy and reanastomosis to facilitate resection of primary and recurrent gynecologic cancer", Obstet Gynecol, 64, pp.715~720 (1984)
- Heintz AP, "Cytoreductive surgery in ovarian carcinoma: feasibility and morbidity", Obstet Gynecol, 67, pp.783~788 (1986)
- Krebs HB, "Surgical management of bowel obstruction in advanced ovarian carcinoma", Obstet Gynecol, 61, pp.327~330 (1983)
- Zoetmulder FA, "Management of bowel obstruction in patients with advanced ovarian cancer", Eur J Cancer, 30A, pp.1625~1628 (1994)
- Sharma S, "Characterization of neutropenic fever in patients receiving first-line adjuvant chemotherapy for epithelial ovarian cancer", Gynecol Oncol, 103, pp.181~185 (2006)
- Mäkelä JT, "Stoma care problems after stoma surgery in Northern Finland", Scand J Surg, 95, pp.23~27 (2006)
- Gooszen AW, "Quality of life with a temporary stoma: ileostomy vs. colostomy", Dis Colon Rectum, 43, pp.650~655 (2000)