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大肠癌术后结肠镜随访的临床分析 被引量:3

Clinical analysis of postoperative colonoscopy on patients subjected to follow-up of Colorectal Cancer
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摘要 目的探讨结肠镜随访对大肠癌术后复发的临床意义。方法自2000年1月至2008年12月,对138例大肠癌术后患者进行结肠镜随访检查,发现可疑病变取活检,发现息肉则行镜下凝固治疗,秩和检验进行随访结果统计分析。结果 138例患者检出复发癌12例,其中男性10例,女性2例,两者差异显著(P<0.05);升结肠2例,横结肠1例,降结肠2例,乙状结肠3例,直肠4例,三者之间无差异(P>0.05);其中吻合口复发癌8例,原发癌4例,治疗息肉22例,共36枚,其中腺瘤性息肉26例、吻合口炎10例。12例复发癌患者中,正规随访者11例,未正规随访者仅1例,两者差异显著(P<0.001);术后2年内复发11例,1例发生于3.5年,差异显著(P<0.001)。结论大肠癌术后2年内常规进行结肠镜检查可早期发现复发病灶,并可切除腺瘤性息肉,对降低大肠癌复发具有较大的临床价值。 Objective To discuss the clinical value of colonoscopy follow-up on the postoperative re-currence of colon cancer.Methods From 2000.Jan to 2008.Dec, 138 cases of colorectal cancer were postoperatively followed-up by colonoscopy, with suspicious lesions biopsy, polyps being coagulated, rank sum test for statistical analysis.Results 12 of 138 cases were relapsed in colorectal cancer, with 10 cases of men, and 2 cases of women, in significant difference (P〈0.05); the cancer situs were ascending colon of 2 cases, transverse colon of 1, descending colon of 2, sigmoid colon of 3, the rectum of 4 cases, were in no difference among them(P〉 0.05); 8 cases were anastomotic cancer, other 4 cases in situ; 36 polyps in all of 22 patients were treated, with 26 adenomatous polyps, 10 cases of anastomotic inflammation. 11 of 12 relapsed cases were regularly followed-up, while only 1 case in group without regular following-up , in significant differences (P〈0.001); 11 cases recurred within 2 years after surgery, while 1 case in 3.5 years postoperatively, that was significantly different (P〈0.001).Conclusion Conventional colonoscopy within 2 years postoperatively is important for the early detection of recurrent lesions, and removal of adenomatous polyps to reduce the recurrence of colorectal cancer have greater clinical value.
作者 袁五一
出处 《中国实用医药》 2010年第15期67-69,共3页 China Practical Medicine
关键词 大肠癌 结肠镜 随访 复发 Colorectal cancer Colonoscopy follow-up Recurrence
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参考文献4

  • 1Northover J.Follow-up after curative surgery for colorectal cancer.Scand J Surg,2003:92(1):84-89.
  • 2Devesa J M,Morales V,Enriquez J M,et al.Colorectal cancer-The base of comprehensive follow-up.Discolor Rectum,1998,31(8):636-652.
  • 3Wichmann MW,Jauch KW.Fast track concepts and multimodal rehabilitation in colorectal surgery.Rozhl Chir,2005;84(4):163-167.
  • 4Engaras B.Individual cutoff levels of carcinoembryonic antigen and CA 242 indieate recurrence of colorectal cancer with high sensitlvity.Dis Colon Rectum,2003;46:313-321.

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