Muto T, Sawada T, Sugihara K
Department of Surgery, University of Tokyo, Japan.
World J Surg. 1991 Jan-Feb;15(1):35-40. doi: 10.1007/BF01658958.
Invasive carcinomas in polyps removed during endoscopy are described. Most of them can be treated adequately by polypectomy alone, but some need additional surgical treatment. Incomplete excision, poorly-differentiated carcinoma, and lymphatic invasion are associated with increased risk of residual carcinoma and lymph node metastases, making colorectal resection more attractive; however, in elderly patients and poor-risk patients, the risks of surgery should be balanced against the possible advantage of curative surgery. Rectal polyps may be large but sphincter preservation can usually be achieved by different types of local excision. Recently described flat adenomas may contain carcinoma, but may also be treated by polypectomy using snare or hot biopsy.
本文描述了在内镜检查期间切除的息肉中的浸润性癌。其中大多数仅通过息肉切除术即可得到充分治疗，但有些则需要额外的手术治疗。切除不完全、低分化癌和淋巴浸润与残留癌和淋巴结转移风险增加相关，这使得结直肠切除术更具吸引力；然而，对于老年患者和高风险患者，手术风险应与根治性手术可能带来的益处相权衡。直肠息肉可能很大，但通常可以通过不同类型的局部切除术来保留括约肌。最近报道的扁平腺瘤可能含有癌，但也可以通过圈套器或热活检进行息肉切除术来治疗。
