부인과 암수술에 있어서 외과의사의 역할

• Published in: Annals of surgical treatment and research Vol. 74; no. 4; pp. 237 - 242
• Main Authors: 최평화(Pyong Wha Choi), 유창식(Chang Sik Yu), 정상훈(Sang Hun Jung), 김대동(Dae Dong Kim), 홍동현(Dong Hyun Hong), 김희철(Hee Cheol Kim), 김진천(Jin Cheon Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.04.2008
• Subjects: 일반외과학; Gynecologic oncology surgery; Tumor debulking; Role of general surgeon
• ISSN: 2288-6575; 2288-6796

Purpose: Resection of the bowel or solid organs may be required for pelvic tumor surgery. The present study was performed to assess combined surgical procedures and determine the role of the general surgeon in gynecologic oncology surgery Methods: We performed a retrospective study of 135 patients with gynecologic malignancy who underwent a combined operation with a general surgeon between January 2000 and December 2005 at Asan Medical Center. The purpose of the combined operation was categorized into 3 groups: a tumor debulking operation, a resolution of intraoperative complications by a gynecologic surgeon, or an intraoperative diagnostic change. Results: The incidence of combined operations for debulking, resolution of intraoperative complications, and intraoperative diagnostic changes were 103 cases (76.3%), 22 cases (16.3%), and 10 cases (7.4%), respectively. Ovarian cancer was the most common gynecologic malignancy (74.1%) and the rate of a combined operation with a general surgeon in ovarian cancer was 18.5% during the time period. Colorectal resection was the most common procedure by a colorectal surgeon (61.5%). Twenty four patients (17.8%) experienced postoperative complications, including ileus, wound infection, pancreas leakage, and stomal necrosis, with no significant differences according to the purpose of combined operation, pathologic diagnosis, or bowel preparation. The rate of a preoperative consultation to a general surgeon by gynecologic surgeons in cases with colorectal or solid organ invasion preoperatively was 53.2%. Conclusion: A general surgeon is an important consultant in a debulking operation of gynecologic malignancies, especially ovarian cancer, or treatment of complications. Thorough preoperative evaluation, bowel preparation, and preoperative consultation to a general surgeon is important in gynecologic oncology surgery. (J Korean Surg Soc 2008;74:237-242) KCI Citation Count: 0