Department of Hepatobiliary Surgery, Qilu Hospital, Shandong University, Jinan 250012, China.
Department of Clinical Pharmacology, Qilu Hospital, Shandong University, Jinan 250012, China.
Int J Surg. 2014;12(5):408-11. doi: 10.1016/j.ijsu.2014.03.002. Epub 2014 Mar 12.
To explore the diagnosis of rectal carcinoid tumors and to adopt the best method of treatment.
A group of 312 cases of pathologically confirmed rectal carcinoid were analyzed retrospectively. Data were obtained retrospectively from a database of all colorectal malignancies at Qilu Hospital from January 2004 to December 2012. 4072 colorectal malignant tumors and 312 rectal carcinoid tumors were diagnosed. Endoscopic resection was performed on 44 patients, while the other 248 underwent anus partial extended radical polypectomy. We evaluated the clinical manifestations, diagnosis, treatment and follow-ups regarding carcinoids and the relation between tumor diameter and the rate of recurrence or metastasis after surgery.
There is no recurrence or metastasis after the transanal local resection in 284 cases with the tumor diameter less than 2 cm, 6 months to 7 years' follow-up. While, in 12 cases with the tumor diameter more than 2 cm radical surgery was performed, 8 cases had liver metastases at the time of the diagnosis of rectal carcinoid, 4 cases had no recurrence or metastasis after two and a half years' of follow ups, there is no recurrence or metastasis in 4 cases of multiple rectal carcinoids, whom all underwent radical surgery, follow ups continued for 2 years.
Early diagnosis and treatment is important for rectal carcinoids, local resection is a simple, safe and effective treatment for carcinoids with a tumor diameter less than 2 cm.
探讨直肠类癌的诊断方法,选择最佳的治疗方案。
回顾性分析经病理证实的直肠类癌患者 312 例,资料来源于 2004 年 1 月至 2012 年 12 月齐鲁医院所有结直肠恶性肿瘤数据库,共诊断结直肠恶性肿瘤 4072 例,直肠类癌 312 例。44 例行内镜下局部切除,248 例行经肛门局部扩大根治性息肉切除术。评估类癌的临床表现、诊断、治疗及随访情况,分析肿瘤直径与术后复发或转移的关系。
肿瘤直径<2cm 的 284 例患者经经肛门局部扩大根治性息肉切除术治疗后随访 6 个月至 7 年均未见复发或转移,肿瘤直径>2cm 的 12 例行根治性手术,其中 8 例诊断时已有肝转移,4 例随访 2 年半未见复发或转移,4 例直肠多发类癌患者均行根治性手术,随访 2 年未见复发或转移。
直肠类癌早期诊断和治疗非常重要,对于肿瘤直径<2cm 的患者,经肛门局部扩大根治性息肉切除术是一种简单、安全、有效的治疗方法。