Gordon M S, Cohen A M
Department of Surgery, Memorial Sloan-Kettering Cancer Center.
Oncology (Williston Park). 1989 Jul;3(7):99-104; discussion 104-5.
Management of patients with endoscopically removed pedunculated colorectal polyps found to contain invasive carcinoma is controversial. When the endoscopist is confident that the polyp has been completely removed and the margins are pathologically clear, the salient issue which should guide subsequent management is the likelihood of lymph node metastases. Analysis of several institutional reviews has led the authors to conclude that the incidence of lymph node metastases is negligible in those patients in whom careful pathologic examination discloses free margins of resection, absence of lymphatic invasion, and well-differentiated or moderately well differentiated histology. Adhering to these criteria, pedunculated polyps containing invasive carcinoma can be safely managed by endoscopic polypectomy alone.
对于经内镜切除的带蒂结直肠息肉被发现含有浸润性癌的患者，其管理存在争议。当内镜医师确信息肉已被完全切除且切缘在病理上清晰时，指导后续管理的关键问题是淋巴结转移的可能性。对几项机构回顾性研究的分析使作者得出结论，在那些经仔细病理检查显示切除切缘阴性、无淋巴血管浸润且组织学为高分化或中分化的患者中，淋巴结转移的发生率可忽略不计。遵循这些标准，对于含有浸润性癌的带蒂息肉，仅通过内镜下息肉切除术即可安全地进行处理。
