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노승무 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1
Total gastrectomized patients frequently suffer from agastric syndromes such as lack of appetite, reduced food intake, malnutrition, weight loss, abdominal pain and other various complications. It is a hot topic to restore the intestinal continuity after total gastrectomy for gastric malignancy and even benign gastric disease. There are many methods for reconstruction and they have been compared since total gastrectomy was developed. I have performed 22 jejunal interposition operations between esophagus and duodenum after total gastrectomy for gastric cancer. The digestive continuity was renewed by an interposition of isoperistaltic jejunal loop, retrocolic fashion. Comparing this jejunal interposition method with Roux-en-Y procedure, I confirmed this reconstruction method is relatively simple and very effective technique. The author can draw a conclusion that interposition of the jejunal loop is one of the optimum reconstruction procedures after total gastrectomy in terms of the quality of life of the patients.
위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구
노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1
Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.