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상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교
노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-
Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)
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위암 수술시 위주위 임프절의 착색에 관한 연구 : 위 수술 방법의 개선을 중심으로 An Advanced technique in Gastric Surgery
노승무 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2
Surgical resection is the only hope for cure in gastric cancer, and surgical objectives in gastric cancer must be to maximize chances for cure in patients with localized tumor and to provide maximal function to patients. The importance of the lymphatic system in the spread of gastric cancer has been acknowledged for many years, and extensive regional lymph node dissection is also believed to have contributed to the improved survival of patients with advanced gastric cancer. So, it is very important to identify perigastric lymph nodes during gastric cancer surgery. The purposes of lymph node identification are extended lymph node dissection for gastric cancer, avoidance of perigastric nerve and ganglion damage, and functional surgery in the localized patients. I had intraoperative perigastric lymph node stain by means of activated charcoal (CH-40) emulsion, or patent blue solution during gastric cancer surgery. The effect of intraoperative perigastric lymph node stain with activated charcoal emulsion or patent blue solution, was valuable in identification of the lymph nodes followed by extended lymph node dissection, and preservation of the vagus nerve and ganglions in gastric surgery.
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