Kronborg O, Fenger C, Deichgraeber E
Odense Sygehus kirurgisk gastroenterologisk afdeling K, patologisk afdeling og radiologisk afdeling.
Ugeskr Laeger. 1991 Feb 11;153(7):503-6.
Experience from ten year colonoscopic follow-up in patients after radical surgery for colorectal cancer is presented. In all, 309 patients below 76 years were included from 1978 to 1983. All had preoperative proctoscopy and barium enema. Colonoscopy was performed perioperatively, every six months the first three years, four and five years, seven to eight years and ten years after surgery. A minority had double-contrast barium enemas. Synchronous adenomas were removed during surgery and at perioperative colonoscopy and these patients had the same risk of metachronous cancer as those without synchronous adenomas. Five patients with six metachronous cancers, all had new curative surgery. Patients with synchronous adenomas had a higher risk of metachronous adenomas, but had a better prognosis than those without synchronous adenomas. Colonoscopically demonstrated intraluminal local recurrence in the colon could not be treated with new radical surgery in contrast to four out of eight intraluminal recurrences in the rectum. Most local recurrences were extraluminal and were diagnosed by other means.
本文介绍了对接受结直肠癌根治性手术后的患者进行十年结肠镜随访的经验。1978年至1983年期间，共纳入了309名76岁以下的患者。所有患者术前均接受了直肠镜检查和钡灌肠检查。结肠镜检查在围手术期进行，术后前三年每六个月进行一次，术后四年、五年、七年至八年以及十年各进行一次。少数患者接受了双重对比钡灌肠检查。同步腺瘤在手术期间和围手术期结肠镜检查时被切除，这些患者发生异时性癌的风险与没有同步腺瘤的患者相同。五名患者发生了六例异时性癌，均接受了新的根治性手术。有同步腺瘤的患者发生异时性腺瘤的风险较高，但预后比没有同步腺瘤的患者好。与直肠内八例复发中的四例不同，结肠镜检查显示结肠内的腔内局部复发无法通过新的根治性手术治疗。大多数局部复发是腔外的，通过其他方法诊断。
