Muto T, Konishi F, Sawada T, Adachi M, Morioka Y
Department of Surgery, University of Tokyo, Japan.
Ann Acad Med Singap. 1987 Jul;16(3):427-31.
Over the past 14 years 1,000 polyps were removed via colonscope and histologically examined. There were 869 neoplastic polyps including 125 carcinomas. Non-neoplastic polyps included 32 inflammatory polyps, 32 metaplastic polyps, 27 juvenile polyps and 17 Peutz-Jeghers type polyps. Ninety-eight focal carcinomas were adequately treated by polypectomy only, whereas 9 out of 26 invasive carcinoma required further operations with one residual carcinoma in the pararectal tissue and colonic wall respectively. The criteria requiring additional surgery in invasive carcinoma are 1) lymphatic permeation of the submucosa, 2) poorly differentiated carcinoma or 3) massive invasion close to the cut end. Not only polypoid adenomas but also flat adenomas were found to exist and seem to play an important role in the adenoma-carcinoma sequence. It became clear that colonscopic polypectomy was a useful tool for the management of colonic polyps.
在过去14年里，通过结肠镜切除了1000个息肉并进行了组织学检查。其中有869个肿瘤性息肉，包括125个癌。非肿瘤性息肉包括32个炎性息肉、32个化生息肉、27个幼年性息肉和17个黑斑息肉综合征型息肉。98例局灶性癌仅通过息肉切除术得到充分治疗，而26例浸润性癌中有9例需要进一步手术，分别有1例残留癌位于直肠旁组织和结肠壁。浸润性癌需要额外手术的标准是：1）黏膜下层淋巴管浸润；2）低分化癌；3）切端附近大量浸润。不仅发现了息肉样腺瘤，扁平腺瘤也存在，并且似乎在腺瘤-癌序列中起重要作用。很明显，结肠镜息肉切除术是处理结肠息肉的一种有用工具。
