대한대장항문학회

Between Jan. 1980 and Dec. 1989, 419 patients underwent Miles' operation due to<br>rectal cancer in Seoul National University Hospital. We performed a<br>retrospective<br>analysis on medical records of 407 patients to examine the drainage method of pelvic<br>cavity and postoperative radiation therapy as the causes of intestinal obstruction. The<br>intestinal obstruction was developed in 42 patients(10%). Of the 42 patients with<br>intestinal obstruction, 18 Patients(43%) underwent operative treatment and<br>24<br>patients(57%) underwent conservative treatment. Four patients out of 51 (8%) with<br>natural drainage of pelvic cavity developed intestinal obstruction and 38 patients out of<br>356(11%) with closed suction drainage developed intestinal obstruction.<br>The incidence of intestinal obstruction in relation with rectal<br>cancer<br>stage(Astler-Coller staging) and radiation therapy was as follows:<br>The patients with stage B<sub>2</sub>, who did not underwent radiation therapy<br>developed intestinal obstruction in 1% and the patients with stage B<sub>1</sub>, who<br>underwent radiation therapy developed intestinal obstruction in 19%(p<0.005).<br>The patients with stage B<sub>2</sub>, who did not underwent radiation therapy<br>developed intestinal obstruction in 5% and the patients who underwent radiation therapy<br>developed intestinal obstruction in 20% (p<0.05). The Patients with stave<br><sub>2</sub>, who did not underwent radiation therapy developed intestinal obstruction<br>in 9% and the patients underwent radiation therapy developed intestinal obstruction in<br>12%(p>0.05). The patients with stage C<sub>2</sub>, who did not underwent radiation<br>therapy developed intestinal obstruction in 4% and the patients underwent radiation<br>therapy developed intestinal obstruction in 16%(P<0.05).<br>In conclusion, there is no statistical difference in the incidence of intestinal obstruction<br>between the two drainage methods but the incidence of intestinal obstruction increase<br>after radiation therapy. Since the elect of radiation therapy is still debatable in patients<br>with stage B, we suggest that these patients should be selected carefully to reduce the<br>rate of intestinal obstruction.<br>