Woolfson I K, Eckholdt G J, Wetzel C R, Gathright J B, Ray J E, Hicks T C, Timmcke A E, Ferrari B T
Department of Surgery, Ochsner Clinic, New Orleans, Louisiana 70121.
Dis Colon Rectum. 1990 May;33(5):389-93. doi: 10.1007/BF02156264.
This retrospective study defines a population with neoplastic colonic polyps who have had colonoscopic polypectomy and, in follow-up within one year, a repeat colonoscopic evaluation. The population was broken down into two groups, one group that had polyps at the second examination and one group that did not. This study determined which factor(s) were significant among this population in distinguishing whether new polyps would be found at one year follow-up. The authors found that among the many variables studied, only polyp multiplicity was significant in predicting polyp recurrence. More than one polyp found at index colonoscopy led to a significant chance of having a new polyp after only one year. Also, it was demonstrated that these "new" polyps were unlikely to have been "missed" polyps from the initial colonoscopy. Because of the shifting location, smaller size, and fewer instances of histologic atypia in these polyps compared with those at index examination, the authors believe that polyps found after one year may be assumed to have arisen de novo. Finally, the authors show that a significant number of polyps occur beyond the reach of the flexible sigmoidoscope (approximately 60 cm). The authors recommend that patients who have polyps undergo a colonoscopic examination. When patients are re-evaluated after having colonoscopic neoplastic polypectomy, they should undergo repeat colonoscopy.
这项回顾性研究定义了一组患有结肠肿瘤性息肉且已接受结肠镜息肉切除术，并在一年内进行了随访结肠镜复查的人群。该人群被分为两组，一组在第二次检查时发现有息肉，另一组则没有。本研究确定了在这一人群中哪些因素对于区分一年随访时是否会发现新息肉具有显著意义。作者发现，在研究的众多变量中，只有息肉的多发性在预测息肉复发方面具有显著意义。初次结肠镜检查时发现多个息肉会导致在仅仅一年后出现新息肉的可能性显著增加。此外，研究表明这些“新”息肉不太可能是初次结肠镜检查时“遗漏”的息肉。由于与初次检查时的息肉相比，这些息肉位置改变、尺寸较小且组织学异型性情况较少，作者认为一年后发现的息肉可能被认为是新发的。最后，作者表明相当数量的息肉出现在乙状结肠镜（约60厘米）检查范围之外。作者建议患有息肉的患者接受结肠镜检查。当患者在接受结肠镜肿瘤性息肉切除术后重新评估时，应再次进行结肠镜检查。
