Ryan R, Neary P, Stone J, Mulcahy H, O'Donoghue D, Sheahan K, Hyland J
Centre For Colorectal Disease, St Vincents University Hospital, Elm Park, Dublin 4, Ireland.
Ir Med J. 2004 Feb;97(2):41-3.
The detection of a left-sided polyp on flexible sigmoidoscopy has been suggested as providing a heralding sign for right-sided tumours. We assessed our own experience with right-sided colonic cancers with reference to detection modality, surgical intervention and their association with left-sided polyps. We performed a retrospective review of a prospectively collected colorectal cancer database, with endoscopic and radiological records. Patients were subcategorised on the basis of the presence or absence of left-side polyps. Ninety-one consecutive patients who underwent curative surgery for right-sided colonic cancers were studied. Endoscopy was used to detect right-sided carcinomas in 10 (83%) of the 12 cases with synchronous left-sided polyps and radiological imaging utilised in 2 cases. In patients without evidence of left sided disease endoscopy was used in 40 (51%) of the 79 patients. In our experience most right sided cancers do not have a synchronous polyp evident on the left side 79 (87%).
在乙状结肠镜检查中发现左侧息肉被认为是右侧肿瘤的一个先兆迹象。我们参照检测方式、手术干预及其与左侧息肉的关联,评估了我们自己在右侧结肠癌方面的经验。我们对一个前瞻性收集的结直肠癌数据库进行了回顾性研究,该数据库包含内镜和放射学记录。根据左侧息肉的有无对患者进行亚分类。对91例接受了右侧结肠癌根治性手术的连续患者进行了研究。在12例伴有同步左侧息肉的病例中,10例(83%)通过内镜检查发现右侧癌,2例使用了放射学成像。在没有左侧疾病证据的患者中,79例患者中有40例(51%)使用了内镜检查。根据我们的经验,大多数右侧癌症在左侧没有明显同步息肉,79例(87%)。