腺瘤性大肠息肉切除术后肠镜随访时间间隔的比较观察

A comparative study of the time interval of enteroscopic follow-up after polypectomy

目的评估腺瘤性大肠息肉切除术后1年复查肠镜的必要性,分析影响息肉复发的相关因素。方法回顾性分析885例大肠腺瘤性息肉患者的病例资料,按照术后首次随访时间不同(0. 5年、1. 0年、1. 5年)分为A、B、C三个组,第二次随访的时间均为首次息肉切除术后的第3年,分析三组间首次与第二次肠镜监测下息肉复发率的差异及影响复发的因素。结果首次肠镜随访,A组息肉的复发率为4. 15%,B组的息肉复发率为18. 79%,C组的息肉复发率为21. 62%,A组与B组、C组比较,差异均有统计学意义(P <0. 01),B组与C组比较,差异无统计学意义(P> 0. 05)。第二次肠镜随访,A组息肉的复发率为39. 9%,B组的息肉复发率为26. 11%,C组的息肉复发率为25. 41%,A组与B组、C组比较,差异均有统计学意义(P <0. 01),B组与C组比较,差异无统计学意义(P> 0. 05)。结论建议大肠腺瘤性息肉切除术后进行肠镜初次监测的时间为1. 0～1. 5年,随后第二次肠镜随访的时间为首次息肉切除术后的第3年。

Objective To evaluate the necessity of colonoscopy follow-up at 1 year after polypectomy, and to analyze the potential influencing factors for recurrent polyps.Methods Retrospective analysis was performed on the clinical data of 885 patients with adenomatous colorectal polyps. Patients were devided into group A, B or C respectively depending on the time of initial postoperative follow-up （0.5, 1.0, or 1.5 years after polypetomy）. The second follow-up was scheduled 3 years apart from the first follow-up for all the groups; the 3 groups were compared for the difference between the first and second follow-ups in the enteroscopic polyps recurrence rate, and the potential influencing factors for recurrence were analyzed.Results At the initial follow-up, the polyps recurrence rates were 4.15%, 18.79% and 21.62% , respectively, in group A, B and C, with statistically significant differences between group A and group B and C （ P 〈0.01）, and no statistically significant difference between group B and C （ P 〉0.05）. At the second follow-up, the polyps recurrence rates were 39.9%, 26.11% and 25.41%, respectively, in groups A, B and C, with statistically significant differences between group A and group B and C （ P 〈0.01）, and no statistically significant difference between group B and C （ P 〉0.05）.Conclusion We proposed that the timing of initial colonoscopy follow-up following resection of adenomatous colorectal polyps will be 1.0-1.5 years postoperatively. The second colonoscopy was followed for the third year of the first surgery.