摘要
目的 探讨大肠癌病人同时合并息肉的诊断、处理。方法 对 1995年 1月至 2 0 0 0年 12月 132例大肠癌合并大肠息肉病人的临床资料进行回顾性分析。结果 大肠癌合并息肉者发生率高达 18% ,息肉术前确诊率低 (2 0 % ) ,在切除大肠癌同时一期处理大肠息肉者 10 1例 (77% ) ,术后二期处理息肉者 2 6例 (18% )。 85例获得随访 ,其中一期处理息肉者 6 5例中术后息肉复发 5例 ,恶变 1例 (1 5 % ) ,二期处理息肉者 2 0例中 ,12例息肉明显增大 ,其中恶变 4例 (2 0 % ) ,两者差异有显著意义。结论 息肉在大肠癌中漏诊率高 ,并有明显的恶变倾向。因此 ,应尽可能术前明确诊断 ,力争在根治大肠癌的同时处理息肉。术中仔细探查与纤结镜结合 ,可明确息肉诊断提高切除率。术后应加强随访 。
ObjectiveTo study the diagnosis and treatment of cancer of the large intestine patients accompanied by polyps.Methods132 patients with cancer of the large intestine accompanied by polyps admitted from January 1995 to December 2000 were reviewed.Results18% of the patients had polyps.The rate of preoperative confirmed diagnosis was low (20%).In 101 cases, the tumor and the polyp were in one stage,resected in 26 cases, the resection of the polyp was delayed.85 cases were followed up.5 cases had the polyp relapse and 1 case cancerated(canceration rate was 1.5%) in 65 patients who had the polyp resection immediately after surgery.In the 20 cases of delayed resection,12 cases had the polyp grown up,4 cases cancerated,the canceration rate was 20%.There was significant difference between them.ConclusionSince the rate of failure to diagnose the polyp in colonic carcinomas and the canceration of the polyp was higher,the confirmed diagnosis should be obtained before the surgery.The polyps resection should be done at the same time with the tumor management.The intraoperative exploration and fiberoptic colonoscopy will be helpful for the diagnosis.Follow-up is of much benefit to the patients, the recurrent polyp should be treated immediately after being discovered.
出处
《中国实用外科杂志》
CSCD
北大核心
2002年第2期88-90,共3页
Chinese Journal of Practical Surgery
关键词
大肠息肉
大肠癌
诊断
外科手术
Colorectal polypCancer of the large intestine
