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[SMC experience]

´Ù¼Ò ¿À·¡µÈ ÀÚ·áÀÔ´Ï´Ù¸¸ Àúµµ gastric tube cancer ÀڷḦ ¹ßÇ¥ÇÑ ¹Ù ÀÖ½À´Ï´Ù (Kim. Hepatogastroenterology 2008). ¼ö¼ú ÈÄ ÃßÀû°üÂû±â°£ÀÌ Âª¾Ò±â ¶§¹®¿¡ Niigata ´ëÇÐó·³ ´©Àû¹ß»ý·üÀ» ±¸Çϱâ´Â ¾î·Á¿ü½À´Ï´Ù. ´Ù¸¸ ½Äµµ¾Ï ¼ö¼ú ȯÀÚ 728¸í Áß 11¸í(1.1%)¿¡¼­ ¹ß°ßÇÑ gastric tube cancer¿¡ ´ëÇÑ À̾߱⿴½À´Ï´Ù. ½Äµµ¾Ï¿¡¼­ À§¾Ï±îÁöÀÇ °£°ÝÀº 8 - 85 °³¿ù(median : 37)À̾ú½À´Ï´Ù.

Hepatogastroenterology 2008

BACKGROUND/AIMS: With the improvement of the outcome after esophagectomy for esophageal cancer, patients with metachronous gastric cancer (MGC) in the reconstructed thoracic stomach have been observed in clinical practice. This study is a report of experiences with MGC with an emphasis on clinical pictures and treatment results. METHODOLOGY: Medical records were reviewed of 728 patients who underwent surgery for esophageal cancer at Samsung Medical Center between 1994 and 2004. MGC was defined as follows; (1) diagnosed more than 6 months after esophagectomy, (2) squamous cell carcinoma in histology of the surgically resected esophagus, (3) adenocarcinoma in histology of the stomach biopsy or surgical specimen. The clinicopathologic characteristics of MGC were evaluated. RESULTS: Eight patients (1.1%) of 728 patients were diagnosed with MGC. All patients were male and had a history of active smoking and drinking. The median age at the time of diagnosis of MGC was 67.8 years old (range: 62-76). Three patients (37.5%) were asymptomatic. Two patients (25%) complained of epigastric pain and 3 patients (37.5%) complained of obstructive symptoms including regurgitation, aspiration, dysphagia, and vomiting. The median interval between diagnosis of MGC and esophagectomy was 37 months (range: 8-85). Three MGCs (37.5%) were detected by endoscopic examination but not by computed tomography (CT). Three patients (37.5%) received surgery and were alive without recurrence for 12, 18 and 63 months respectively. One patient (12.5%) received radiation therapy and was alive for 69 months. Four patients (50%) received no treatment because of follow-up loss in 2 patients (25%) and death within days of MGC diagnosis in 2 patients (25%). CONCLUSIONS: Favorable outcomes can be obtained by active treatment in patients with MGC after esophagectomy. Regular endoscopic follow-up is important for early detection and more effective treatment of MGC, especially in areas where the incidence of gastric cancer is high.


ÁßÇϺΠ½Äµµ¾ÏÀÇ ´ëÇ¥ÀûÀÎ ¼ö¼úÀû Ä¡·á¹æ¹ý¹ýÀº Ivor-Lewis operationÀÔ´Ï´Ù. ÁßÇϺνĵµ¸¦ ÀýÁ¦ÇÑ ÈÄ À§¸¦ ´ç°Ü¼­ ³²¾ÆÀÖ´Â ½Äµµ¿Í ¿¬°áÇÏ´Â ¼ú½ÄÀÔ´Ï´Ù. Screening endoscopy°¡ º¸ÆíÈ­µÇ¸é¼­ Á¶±â¿¡ ¹ß°ßµÇ´Â ½Äµµ¾Ï ȯÀÚ°¡ Áõ°¡ÇÏ°í ÀÖ½À´Ï´Ù. ƯÈ÷ ½Äµµ¾Ï ¼ö¼ú ÈÄ Àå±â »ýÁ¸Çϴ ȯÀÚ°¡ ¸¹¾ÆÁö¸é¼­ gastric tube cancer°¡ ¹®Á¦°¡ µÇ°í ÀÖ½À´Ï´Ù. ´ÙÇེ·´°Ô Á¶±â¿¡ ¹ß°ßµÇ¸é ³»½Ã°æ ÀýÁ¦¼úÀ» ½ÃÇàÇÒ ¼ö ÀÖ°ÚÁö¸¸ ÁøÇàµÈ »óÅ¿¡¼­ ¹ß°ßµÇ¸é ¼ö¼úÀ» ÇÇÇÒ ¼ö ¾ø½À´Ï´Ù. À̶§ÀÇ ¼ö¼úÀº colonic interpositionÀÏ ¼ö ¹Û¿¡ ¾øÀ¸¸ç »ó´çÇÑ morbidity¿Í mortality°¡ µ¿¹ÝµÉ ¼ö ¹Û¿¡ ¾ø´Ù°í »ý°¢µË´Ï´Ù.

¾Æ·¡ Áõ·Ê´Â ½Äµµ¾Ï ¼ö¼ú ÈÄ 5³â¸¸¿¡ ¹ß°ßµÈ intra-thoracic stomachÀÇ ¾ÏÀÔ´Ï´Ù. ½Äµµ¾Ï ¼ö¼ú ÈÄ º¸´Ù ºñ±³Àû À̸¥ ½Ã±â¿¡ À§¾ÏÀÌ ¹ß°ßµÈ ¿¹µµ ¾øÁö ¾Ê½À´Ï´Ù. ½Äµµ¾Ï Áø´Ü½Ã À§µµ ÀÚ¼¼È÷ °üÂûÇÒ ÇÊ¿ä°¡ ÀÖ½À´Ï´Ù.


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