内镜切除后对高危 T1 结直肠癌患者进行额外的外科切除。
Additional Surgical Resection After Endoscopic Resection for Patients With High-risk T1 Colorectal Cancer.
机构信息
Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
出版信息
In Vivo. 2019 Jul-Aug;33(4):1243-1248. doi: 10.21873/invivo.11596.
BACKGROUND/AIM: The purpose of this study was to reveal the safety and efficacy of additional surgical resection (ASR) for high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER).
PATIENTS AND METHODS
We retrospectively analyzed 191 patients with high-risk T1 CRC after ER.
RESULTS
The ASR was performed in 176 (92.1%) patients and 15 (7.9%) rejected ASR. All patients that underwent ASR experienced R0 resection; laparoscopic surgery was performed in 159 (90.3%) patients. Clavien-Dindo complications ≥grade II occurred in 33 patients (18.8%). Anastomotic leakage (8.5%) and ileus (5.7%) were the most frequent complications. The anus function was preserved in all patients. Metastatic lymph node was detected in 21 (11.9%) patients. There were no deaths or relapses in patients with ASR. One patient without ASR (6.7%) had a lymph node recurrence.
CONCLUSION
ASR was safe and effective and is recommended for high-risk T1 CRC patients after ER. A satisfactory long-term outcome can be achieved.
背景/目的：本研究旨在揭示内镜下切除（ER）后对高危 T1 结直肠癌（CRC）进行辅助性手术切除（ASR）的安全性和有效性。
患者和方法
我们回顾性分析了 191 例 ER 后高危 T1 CRC 患者。
结果
176 例（92.1%）患者进行了 ASR，15 例（7.9%）患者拒绝 ASR。所有接受 ASR 的患者均行 R0 切除；159 例（90.3%）患者行腹腔镜手术。33 例（18.8%）发生 Clavien-Dindo 并发症≥Ⅱ级。最常见的并发症为吻合口漏（8.5%）和肠梗阻（5.7%）。所有患者肛门功能均得以保留。21 例（11.9%）患者检测到转移性淋巴结。接受 ASR 的患者均无死亡或复发。未行 ASR 的 1 例患者（6.7%）出现淋巴结复发。
结论
ASR 安全有效，推荐用于 ER 后高危 T1 CRC 患者。可获得满意的长期预后。
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