硬性直肠乙状结肠镜检查在直肠癌定位中有多重要？
How important is rigid proctosigmoidoscopy in localizing rectal cancer?
作者信息
Schoellhammer Hans F, Gregorian Armen C, Sarkisyan Grant G, Petrie Beverley A
机构信息
Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson St., Torrance, CA 90509, USA.
出版信息
Am J Surg. 2008 Dec;196(6):904-8; discussion 908. doi: 10.1016/j.amjsurg.2008.08.005.
BACKGROUND
Colonoscopic localization of rectal and rectosigmoid tumors may be inaccurate. Rigid proctosigmoidoscopy has been suggested as an adjunctive technique to accurately localize rectal tumors as it may alter treatment options.
METHODS
A retrospective review was performed of patients with rectal and rectosigmoid cancer from 2001 to 2006. Patients were stratified into 1 of 4 anatomic regions based on colonoscopic localization of the tumor. The distances of the tumor from the anal verge by colonoscopy were compared with distances obtained via rigid proctosigmoidoscopy.
RESULTS
Rigid proctosigmoidoscopy localization likely changed the treatment options in 21% of lower rectal tumors, 14% of middle rectal tumors, 38% of upper rectal tumors, and 29% of rectosigmoid tumors. Overall, this modality impacted 25% of patients.
CONCLUSIONS
Rigid proctosigmoidoscopy localization of rectal tumors can significantly change treatment options and should be performed on all patients with colonoscopic localization of a cancer thought to be in the rectosigmoid or rectum.
背景
直肠和直肠乙状结肠肿瘤的结肠镜定位可能不准确。硬性直肠乙状结肠镜检查已被建议作为一种辅助技术，用于准确地定位直肠肿瘤，因为它可能会改变治疗方案。
方法
对2001年至2006年期间患有直肠和直肠乙状结肠癌的患者进行回顾性研究。根据肿瘤的结肠镜定位，将患者分为4个解剖区域中的1个。将结肠镜检查测得的肿瘤距肛缘的距离与通过硬性直肠乙状结肠镜检查获得的距离进行比较。
结果
硬性直肠乙状结肠镜检查定位可能改变了21%的低位直肠肿瘤、14%的中位直肠肿瘤、38%的高位直肠肿瘤和29%的直肠乙状结肠肿瘤的治疗方案。总体而言，这种方式影响了25%的患者。
结论
直肠肿瘤的硬性直肠乙状结肠镜检查定位可显著改变治疗方案，应对所有经结肠镜定位为直肠乙状结肠或直肠癌症的患者进行此项检查。
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