Koyama Motoi, Obana Ayato, Mizuguchi Norio, Kitamura Kenta, Matsumura Tomonori, Okada Keigo, Karikomi Kazuhiro, Suwa Tatsushi
Dept. of Surgery, Kashiwa Kousei General Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):2054-2056.
This study aimed to evaluate the surgical treatment outcome of patients with colorectal cancer having ulcerative colitis (UC).
We examined 112 patients who underwent the surgery from 1998 to 2016. Among the 112 patients, 14 were complicated with malignant tumor(9 with colorectal cancer and 5 with dysplasia-assciated lesion or mass)We performed group comparison between patients with(group A)and without(group B)colorectal cancer.
The median age in group A was 58.1 years, which was significantly older than that in group B. The duration of disease in group A was 13.2 years, which was significantly longer than that in group B. Surgical procedures in group B were as follows; 5 cases had ileoanalanastomosis (IAA), 4 cases had ileo-analcanalanastomosis (IACA), 2 cases had ileorectal anastomosis(IRA), and 1 case had interspincteric resection(ISR) and abdominoperinealresection (APR)Laparoscopic sigmoid colectomy was performed in a patient aged 52 years because he was diagnosed with sporadic sigmoid colon cancer. Periodic endoscopic screening was not performed in 5 patients with pT2 colorectalcancer in group B. endoscopic submucosaldissection (ESD)was performed in 2 patients aged>70 years with rectal pTis cancer.
Elderly patients with UC were often complicated with colorectalcancer, and these patients are indicated for surgicalprocedures other than IAA to preserve defecation function. Patients with UC should undergo periodic endoscopic screening for early detection of malignant tumor and definitive surgicalresection.
本研究旨在评估患有溃疡性结肠炎（UC）的结直肠癌患者的手术治疗结果。
我们检查了1998年至2016年接受手术的112例患者。在这112例患者中，14例合并恶性肿瘤（9例患有结直肠癌，5例患有发育异常相关病变或肿块）。我们对患有（A组）和未患有（B组）结直肠癌的患者进行了组间比较。
A组的中位年龄为58.1岁，显著高于B组。A组的病程为13.2年，显著长于B组。B组的手术方式如下：5例行回肠肛管吻合术（IAA），4例行回肠-肛管-结肠吻合术（IACA），2例行回直肠吻合术（IRA），1例行括约肌间切除术（ISR）和腹会阴联合切除术（APR）。一名52岁的患者因被诊断为散发性乙状结肠癌而接受了腹腔镜乙状结肠切除术。B组5例pT2期结直肠癌患者未进行定期内镜筛查。2例年龄>70岁的直肠pTis癌患者接受了内镜黏膜下剥离术（ESD）。
老年UC患者常合并结直肠癌，这些患者适合采用除IAA以外的手术方式以保留排便功能。UC患者应接受定期内镜筛查，以便早期发现恶性肿瘤并进行确定性手术切除。
