结肠脂肪瘤的诊断和治疗

Diagnosis and treatment of colonic lipomas

目的提高结肠脂肪瘤的术前诊断率和疗效。方法结合有关文献,对1971～2002年我院收治的10例结肠脂肪瘤诊治过程进行回顾性分析。结果本组10例患者,术前确诊率为60%。9例行结肠节段切除或半侧结肠切除术,1例行电子结肠镜电灼切除肿瘤,疗效满意,均痊愈出院,治愈率为100%。结论钡剂灌肠、电子结肠镜、腹部CT、MRI等均为结肠脂肪瘤诊断的重要手段,其中CT对确诊的意义较大。对于有症状者应行手术治疗,主要行结肠节段切除术或电子结肠镜电灼切除术。

Objective To improve the preoperative diagnostic accuracy and therapeutic effect on colonic lipoma. Methods Data of 10 symptomatic colonic lipoma cases aged from 24 to 75 in our hospital during 1971～2002 were reviewed, including the illness history, imaging results and therapeutic procedure. Results All the cases had clinic symptoms. The size of the masses varied from 3 5 to 8 cm. Barium enema confirmed the right diagnosis preoperatively in 1 case (1/8), while colonoscopy in 2 cases (2/5), and CT in 3 cases (3/3). The total preoperative diagnostic accuracy was 60% (6/10). 9 cases underwent segmental colonic resection or hemi colectomy, and 1 case underwent colonoscopic removal by snare electrocautery. All the cases were cured. Conclusions Among all the preoperative diagnostic methods of colonic lipoma, CT is the most valuable. The symptomatic cases should receive segmental colonic resection or colonoscopic removal by snare electrocautery.