| Safety of Multivisceral Resection for Locally
advanced Colorectal Cancer |
| Dae Ro Lim1, Young Ki Hong2, Ho Huh2, Chi Young Lim2, Yoon Jung Choi3, Jung Gu Kang2 |
1Department of surgery, Yonsei University College of Medicine, Seoul, Korea
2Department of Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
3Department of Pathology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea |
| 국소 진행성 대장암에 대한 병합절제의 안전성에 대한 연구 |
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임대로1, 홍영기2, 허호2, 임치영2, 최윤정3, 강중구2 |
1연세대학교 의과대학 외과학 교실
2국민건강보험 일산 병원 외과
3국민건강보험 일산 병원 병리과 |
| Corresponding Author:
Jung Gu Kang ,Tel: +82-31-900-0216, Fax: +82-31-900-0343, Email: kangski@nhimc.or.kr |
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Received: November 20, 2010; Accepted: December 23, 2010. |
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| ABSTRACT |
Purpose: About 10% of colorectal cancers are known to have already invaded contiguous organs or had
inflammatory adhesion to adjacent structures. Under such circumstances, combined resections of involved
structures may be considered. The aims of this study were to investigate true incidence of cancer invasion and
surgical outcomes in patients where a multivisceral resection was performed for locally advanced colorectal
cancer.
Methods: Nine hundreds two patients with colorectal cancer submitted to surgical treatment between March 2000
and December 2007 were reviewed retrospectively, and multivisceral resection was performed in 68 patients. We
reviewed the clinicopathologic characteristics of multivisceral resections for locally advanced colorectal cancer
Results: The incidence of multivisceral resection was 7.5%. The positive predictive values of cancer invasion were
60.0% in CT and 57.1% in MRI. The rate of true cancer invasion in multivisceral resection was 46.4%. In TMN stage,
stage IIIB was the most common (27.9%) and followed by stage IIIC (20.6%). Rectal cancer was 29 cases (42.6%),
sigmoid colon cancer was 18 cases (26.4%). In combined resection, female reproductive organ were the most
commonly involved organ (27.2%) and followed by small bowel (16.3%) and bladder (9.8%). In number of organs,
one organ in the combined resection was 41 cases (60.3%) and there was 1 case in which 6 neighboring structure
involved in combined resection. There was no postoperative death and complications in postoperative period
occurred in 23.5% including wound infection, intestinal obstruction, and pneumonia.
Conclusions: When adhesion to neighboring organ by primary colorectal cancer was found intraoperatively,
multivisceral resection would be mandatory regardless of the preoperative assessment. Every effort to reduce
postoperative complication may be necessary to justify multivisceral resection. |
| Keywords:
Colorectal cancer | Multivisceral resection | Postoperative complication |
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