イレウスをともなう大腸癌の臨床病理学的検討

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  • A Clinicopathological Study of Colorectal Cancer with Bowel Obstruction.

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One hundred thirty-six patients with resectable annular colorectal cancer were classified as Group A (obstructive colorectal cancer) if they had severe large bowel obstruction. Group B if they had any symptom of mild bowel obstruction, and Group C if they had no symptom of bowel obstruction. Clinicopathological characteristics and surgical results of Group A were comparted with those of other two groups. Group A had a higher rate of peritoneal dissemination. However there were no significant differences among the three groups with respect to age, sex, gross type of tumor, tumor differentiation, liver metastasis, lymph node metastasis, involvement of vessels, microscopic stage and surgical treatment. In comparison of tumor size, Group A had a significantly smaller transverse diameter and transverse diameter/longitudinal diameter ratio than those of the other two groups (p<0.01). These findings suggest that large bowel obstruction is caused by growth of the tumor along the transverse axis. The incidence of obstruction according to location in Group a was higher for colonic tumors than for rectal tumors, but there was no significant difference in that incidence between tumors of the right sided colon and those of the left sided colon. The five-year survival rate for patients after resection and curative resection in Group A was as good as in the other two groups, so it is necessary to try resection of the tumor and lymph node dissection also in the patients with obstructive colorectal cancer.

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