폐쇄성 구불결장암이 대장 길이에 미치는 영향

Abstract

Background and purpose In the case of obstructive colon cancer, colonic distension can be observed in an operative field. However, there was no study of the effect of obstruction on colon length. Our aims were to measure the length of colon in patients with obstructive sigmoid colon cancer using CT colonography(CTC) and to compare the colon lengths with patients with non-obstructive sigmoid colon cancer. Methods We retrospectively reviewed the data of patients who performed CTC between January 2004 and April 2017. The propensity score matching was performed in two groups by 1: 1 ratio : obstructive sigmoid colon cancer and non-obstructive sigmoid colon cancer. Age, sex, height, and BMI were used for adjusted variables. Colon length was measured using PACS (Picture Archiving and Communication System) program. Results A total of 650 patients who performed CTC at Seoul National University Hospital were included. Of these, 125 patients had no obstruction and 525 patients had obstruction. In each arm, 99 patients were assigned after propensity score matching. Total colon length was significantly shorter in the obstructive sigmoid colon cancer group than in the non-obstructive sigmoid colon cancer group (155.3 ± 23.0 vs 65.1 ± 22.2, p=0.003). When the length of each segment was analyzed, the length of sigmoid colon was statistically significant different between two groups. (53.1 ± 15.9 vs 58.0 ± 15.8, p=0.032). Multivariable analysis using a multiple linear regression test showed that the presence of obstruction was a statistically significant factor affecting total colon length even after adjusting for age, sex, BMI, and height between the two groups. (β=-9.347, 95% confidence interval -15.267 - -3.427, p=0.002) Conclusion Sigmoid colon cancer with obstruction is associated with shortening of the colon length. Further research is needed to clarify the mechanism.