Unniversity of Texas MD Anderson Cancer Center, Houston, TX, USA.
Fam Cancer. 2013 Jun;12(2):295-300. doi: 10.1007/s10689-013-9626-y.
The surgical management of the Lynch syndrome patient with colorectal cancer needs to be individualized. Because of the increased incidence of synchronous and metachronous colorectal neoplasms, most favor an extended resection at the time of diagnosis of colorectal cancer. Age of diagnosis, stage of the tumor, co-morbidities, surgical expertise, surgical morbidity, and patient wishes should be taken into account when considering a surgical procedure. There are no prospective randomized trials or retrospective trials suggesting that patients undergoing an extended procedure have a survival advantage compared to those undergoing segmental resection. In retrospective studies it has been demonstrated that patients undergoing extended procedures will develop less metachronous colorectal neoplasms and will undergo less subsequent surgical procedures related to colorectal cancer. In females abdominal hysterectomy and bilateral salpingoophorectomy should be considered at the time of surgery for colorectal cancer.
林奇综合征患者的结直肠癌的手术治疗需要个体化。由于同时性和异时性结直肠肿瘤的发生率增加，大多数人赞成在结直肠癌诊断时进行扩大切除术。在考虑手术方法时，应考虑诊断时的年龄、肿瘤分期、合并症、手术专业知识、手术发病率和患者意愿。目前尚无前瞻性随机试验或回顾性试验表明，与节段性切除术相比，接受扩大手术的患者具有生存优势。回顾性研究表明，接受扩大手术的患者发生异时性结直肠肿瘤的风险较低，且与结直肠癌相关的后续手术较少。对于女性，在进行结直肠癌手术时应考虑行腹部子宫切除术和双侧输卵管卵巢切除术。
