结直肠腺瘤切除术后复发息肉的特点分析

Characteristics of recurrence colorectal polyps after resection of colorectal adenoma

目的研究结直肠腺瘤(colorectal adenoma,CRA)切除术后复发息肉的特点。方法收集2005年5月-2012年5月于首都医科大学附属北京朝阳医院消化内科完成结肠镜下息肉切除术、病理组织学确诊为CRA,术后行肠镜复查,并发现复发息肉的患者103例。统计分析初发息肉的大小、数目、病理分型、发生部位、肠镜间隔时间与复发息肉的大小、数目、病理分型、发生部位之间的关系。结果 93%的患者复发息肉大小都在1 cm以内;复发息肉在左半结肠占65%,在右半结肠占12%,在全结肠占22%;初检CRA大小、数目、病理分级与复发息肉的大小、数目、病理分级,经统计分析均无关联,初检发生部位与复发息肉的发生部位有相关性(P<0.05)。结论复发息肉通常是多发、较小、低危的,虽然大部分在第1年已经出现,但在5年之内其镜下特点及病理分型均无统计学意义。初检位于左半结肠的CRA患者,复发息肉更易在左半结肠,而初检位于全结肠的患者复发息肉更易在全结肠。

Objective To determine the characteristics of recurrence colorectal polyps after resection of colorectal adenoma （CRA）. Methods From May. 2005 to May. 2012, the clinical data of CRA patients, who underwent colonoscopic polypectomy in our hospital and then found recurrence polyps, were collected. A total of 103 cases includ- ed 68 cases of male and 35 females. The recurrence polyps and the early polyps in size, number, pathological type, lo- cation and the colonoscopy interval were analyzed. Results 93% of the recurrent polyps＇ size were less than 1 cm; 65% of the recurrent polyps were in the left colon, 12% in right colon, and 22% in entire colon. There was no correlation in size, number and pathology between initial CRA and the recurrence polyps. There was positive correlation in site between the initial CRA and recurrence polyps （P 〈 0.05 ）. Conclusion Recurrence polyps are usually muhiple, small and benign. Although most of the recurrence polyps have appeared in the first year, but within five years, its characteristic and pathological type are not statistically different. CRA in the left colon relapse more often in the left colon, while in entire colon relapse more often in entire colon.