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KMID : 0356719960120020277
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 2 p.277 ~ p.283
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Advanced Rectal Cancer in the Female: Rectal Resection on bloc with Hysterectomy and Posterior Vaginectomy
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Yang Jin-Sung
Koo Young-Moo
Song Ok-Pyung
Cho Moo-Sik
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Abstract
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This report is a clinical review and analysis of 34 female patients of rectal cancers below the peritoneal reflection that were treated at Soon Chun Hyang Chonan Hospital during 3 years from Jan. 1988 to Dec. 1990. The authors report our experience with 19 female patients with rectal cancer in whom Miles’ operation and 15 female Patients combined with concomitant hysterectomy and posterior vaginectomy. The results are as follows: 1) The age distribution was ranged from 3rd decade to 7th decade, the peak incidence occured in 6th decade(38%) and mean age was 57.6. 2) The serum level of preoperative CEA revealed 9 cases below 5 ng/ml and 25 cases over 5. 3) The histopathologic classification were well differentiation 7 cases, moderate differentiation 24 cases, poorly differentiation 2 cases, signet ring cell 1 case.
4) According to type of surgical procedure, patients who had Miles’ operation was 19 cases and combined with hysterectomy and posterior vaginectomy was 15 cases. 5) The number of patients who had combined hysterectomy and posterior vaginectomy by stave was as follows: Stage Bl: 2 cases, B2: 4, Cl: 5, C2: 4. 6) The most common complication was urinary problem(18 cases), followed by respiratory problem. In a case of Miles’ operation with hysterectomy and posterior vaginectomy, rectovaginal fistula was developed.7) The overall 5 year survival rate by stage was as follows: Stage A: 100%, Bl: 75%, B2: 50%, Cl: 33.3%, C2: 16.7%. 8) In cases that had combined with hysterectomy and posterior vaginectomy, the recurrence rates by stage was as follows: Stage A and Bl: 0%, B2: 25%, Cl: 40%, C2: 50%.
9) In surgical procedure, the 5 year survival rate showed 47.4% in Miles’ operation and 53.3% in Miles’ operation with hysterectomy and posterior vaginectomy.
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KEYWORD
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Hysterectomy, Rectal Neoplasms, Posterior Vaginectomy
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