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재발성 부인암의 수술적 치료

Surgical Management for Recurrent Gynecologic Malignancy

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주제분류산부인과학

초록

=재발성 부인암 치료에 있어 수술은 매우 중요한 역할을 하고 있다. 국소 재발한 종양에 대해서는 수술치료 단독으로도 완치를 기대할 수 있으며, 더욱 진행된 재발암에서는 항암제치료, 방사선치료 등과 함께 유용하게 사용될 수 있다. 국소 재발암에 대한 골반장기적출술은 수술기구, 수술기술 및 골반 해부학에 대한 이해로 더욱 광범위한 수술로 발달하였다. 재발암에 대한 종양축소술의 임상연구 보고가 증가하고 있으나 전향적 무작위 임상연구 결과가 나올 때까진 수술의 이점을 최대화하고 유병율을 최소화하기 위하여 조심스럽게 시도되어야 할 것이다. 광범위 수술후의 합병증은 환자마다의 개별화된 수술적 치료를 통해 감소될 수 있으며, 다양한 재건수술의 사용으로 삶의 질을 향상시킬 수 있다. 수술적 치료는 간단한 종양절제술에서부터 광범위 장기 적출술에 이르기까지 다양하며, 여성생식기이외의 장기적출을 필요로 하는 경우가 많다. 따라서, 부인종양학이라는 전문분야가 생겨났으며, 성공적인 수술적 치료를 위해서는 전문분야에서의 수련과 폭 넓은 경험이 필요하다. 본 저자는 2001년 4월부터 재발성 부인암의 수술적 치료에 대한 전향적 연구를 진행 중으로 본문에서 자궁경부암, 난소암, 자궁체부암 등 재발성 부인암에 있어서 수술적 치료의 발전, 현황 및 저자의 경험을 각각 기술하였다.

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