대장암의 외과적 치료

Abstract

In Korea, the incidence of colorectal cancer has rapidly increased in both men and women during recent two decades, and now it is the third most common cancer Deaths related to colorectal cancer has also rapidly increased. Currently. the fourth most common cause of cancer related death is that originated from colon cancer. Over the past several years. there was a significant improvement in survival of patients who suffered from colorectal cancer and it is partly due to the introduction of newer chemotherapeutic agents such as oxaliplatin innotecan. zumab and cetuximab, and refined radiotherapy which can be delivered preoperatively or postoperatively. However, surgery still remains the only curative modality for early stage colorectal cancer and the principal one for locally advanced colorectal cancer The goal in surgical treatment for colorectal cancer is to maximize not only the oncologic outcome through performing wide excision of the tumor bearing area and associated lymphatics with attention to the blood supply to that segment. but also to enhance the functional outcomes including preservation of bowel, anorectal and genitourinary function. The purpose of this article is to provide an overview of standard strategies in surgical management of colorectal cancer as well as a discussion of some of the important issues pertaining to the surgery. 대장암에 대한 치료는 수술 요법, 항암 화학 요법, 면역 요법, 방사선 요법 등이 단독 혹은 병합되어 이루어지고 있다. 최근 들어 외과적 수술 방법의 발달, 적극적인 수술 방법의 도입, 수술 전 후 처치의 발달 등으로 인하여 수술을 통한 절제 예가 증가한 반면, 수술에 따른 사망률 및 합병증은 감소하였다. 또한 대장암의 경우에도 다른 장기 암과 마찬가지로 조기 발견 후 근치적 절제 수술이 생존율을 높일 수 있는 가장 확실한 방법이기 때문에 외과적 수술 요법은 대장암의 치료에 있어서 중추적 역할을 한다고 할 수 있다.