大肠腺瘤的诊断及外科处理（附406例报告）

Diagnosis and Surgical Treatment of Colorectal Adenoma：Report of 406 Cases

探讨大肠腺瘤的诊断及外科处理方法。对1994年10月至2005年4月406例大肠腺瘤患者的临床资料进行回顾性分析。在直肠镜下行直肠腺瘤局部切除102例，剖腹行肠壁楔形及肠段切除241例，肠段及系膜的根治性切除48例，腹腔镜下行肠段切除5例，经骶尾部行肠壁、肠段切除10例。346例获得1～5年的随访，其中腺瘤术后复发17例，恶变4例。结果表明，大肠腺瘤作为癌前病变，一经发现均应行外科手术完整切除，这是大肠腺瘤最彻底的治疗方法。

The objective of the study was to probe into the diagnosis and surgical treatment of colorectal adenoma. The clinical data of 406 patients with colorectal adenoma,who had been hospitalized and had undergone surgical treatment from Oct. 1994 to Apr. 2005, were analised retrospectively. The data showed that rectoscopic-assisted partial resection of rectal adenoma was performed in 102 cases; transabdominal wedge-shaped and partial intestinal resection in 241 cases; radical resection of intestinal segment and mesentery in 48 cases;laparoscopic resection of intestinal segment in 5 cases;and trans-sacrococcygeal resection of intestinal wall and segment in 10 cases. Follow-up of 1-5 years was conducted for 346 cases, in which postoperative recurrence of adenoma was found in 17 cases,with malignant change in 4 cases. It is suggested that colorectal adenoma is a precancerous lesion,surgical treatment should be done so long as it is detected for the sake of cancerization development.