摘要
目的：探讨结肠镜及时发现多原发癌的意义。方法：1987年1月至1995年12月，589例大肠癌患者，术前常规行结肠镜全结肠检查，其中241例（40．8％）行全结肠检查。另348例（59．2％）因病灶堵塞无法行全结肠检查，其中128例术前结肠镜诊断与钡灌肠X线检查有疑问而行术中结肠镜检查。220例术后1～18个月内无症状结肠镜行全结肠随访检查。结果：241例术前行全结肠检查者，发现同时第二原发癌10例（4．1％），腺瘤早期癌变3例（1．2％），腺瘤49例（20．3％）。128例行术中结肠镜检查，发现2例（1．6％）三处同时原发癌，同时第二原发癌11例（8．5％），同时存在腺瘤31例（24．2％）。结论：术前不能行全结肠检查者．术中的结肠镜行全结肠检查能及时发现和彻底治疗同时多个原发病灶。
Purpose: To study early detection of colorectal multi - primary cancer by colonoscopy. Methods: 589 cases with colorectal cancer were performed by preoperative colonoscopy. The whole colon examination was unsatisfactory in 348(59. 2% ) cases be cause of tumor obstruction. Colonoscopy was carried out intraoperation and postoperation in 128 and 220 cases respectively. Results: In 241 with whole colon examination in preoperative colonoscopy, 10(4.1%) cases with synchronous multi- primary cancer and 3 cases with evolution from adenoma to early cancer, 49(20. 3%) cases with adenoma were found. 2 cases with three synchronous multi primary cancer, 11(8. 5% ) cases with second primary cancer and 31(24. 2% ) cases with adenoma were found by inoperative colonoscopy.Conclusions, To those patient with colorectal cancer who couldn't be examined whole colon in preoperative colonoscopy. it is very im-portant to detect large bowel multi primary lesions timely with inoperative and postoperative colonoseopy.
