遗传性非息肉病性结直肠癌的外科治疗

Surgical treatment for colorectal carcinoma in hereditary nonpolyposis colorectal cancer (HNPCC) kindreds

目的:探讨遗传性非息肉病性结直肠癌(HNPCC)患者行预防性全结肠切除或全结肠直肠切除治疗的合理性。方法:分析近年来连续诊治的12例HNPCC患者结直肠癌常规部分结直肠切除治疗后发生异时原发结直肠癌的风险。结果:HNPCC患者初次结直肠癌常规手术治疗后发生异时原发结直肠癌的10年累积风险达52%,第一次异时结直肠癌常规手术治疗后发生异时原发结直肠癌的5年累积风险达50%。结论:HNPCC患者结直肠癌常规部分结直肠切除治疗后发生异时原发结直肠癌的风险很高,行预防性全结肠切除或全结肠直肠切除治疗具有合理性。

Objective：To investigate the rationale of prophylactic total colectomy or total proctocolectomy for colorectal carcinoma in hereditary nonpolyposis colorectal cancer（HNPCC）kindreds.Methods：The risk of metachronous primary colorectal carcinoma after conventional partial proctocolectomy in 12 consecutive patients with HNPCC in our hospital was analyzed.Results：After conventional surgical treatment for the first colorectal carcinoma,the 10-year accumulated risk for metachronous primary colorectal cancer was estimated at 52%.The 5-year accumulated risk for metachronous primary colorectal cancer after conventional surgical treatment for the first metachronous primary colorectal carcinoma was 50%.Conclusion：There is high risk for metachronous primary colorectal cancer after conventional surgical treatment for colorectal cancer in HNPCC kindreds.It is reasonable to consider a prophypactic total colectomy or proctocolectomy for colorectal carcinoma in HNPCC kindreds.