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斯堪的纳维亚地区对恶性大肠息肉患者的监测随访项目。

Scandinavian surveillance follow-up programmes in patients with malignant colorectal polyps.

作者信息

Asheer Zain Elabedin, Bisgaard Thue, Mjåland Odd, Angenete Eva, Bulut Orhan, Souzani Katarina Levic

出版信息

Dan Med J. 2021 Jan 15;68(2):A07200559.

PMID:33543697
Abstract

INTRODUCTION

Following endoscopic removal of malignant colorectal polyps, patients may undergo completion radical resection or surveillance. The optimal surveillance strategy remains unknown. This study included colorectal departments in Scandinavian countries with a focus on follow-up periods and examination modalities for patients with endoscopically removed malignant polyps with a resection margin > 1 mm.

METHODS

This study was conducted as an internet-based survey. A questionnaire was sent to all Scandinavian surgical departments performing > 20 colorectal procedures annually. Questions differed between follow-up on rectal and colonic malignant polyps with presence or absence of histological risk factors. The follow-up period was defined as short (one year), intermediate (three years) or long (five years).

RESULTS

The majority of the departments used a long (five years) (38-59%) or intermediate (three years) (26-38%) follow-up programme. In patients with rectal malignant polyps and presence of histological risk factors, a significant difference was observed in the use of endoscopy according to length of follow-up. No difference in the use of the different modalities was seen according to length of follow-up in patients with colonic malignant polyps.

CONCLUSIONS

The follow-up on patients with endoscopically removed malignant polyps and a surveillance strategy varies both in terms of length and performed modalities. Future studies should compare long-term patient outcomes in departments employing different follow-up strategies.

FUNDING

none.

TRIAL REGISTRATION

not relevant.

摘要

引言

在内镜切除恶性大肠息肉后,患者可能需要进行根治性切除或接受监测。最佳监测策略仍不明确。本研究纳入了斯堪的纳维亚国家的结直肠科,重点关注内镜切除的切缘>1mm的恶性息肉患者的随访期和检查方式。

方法

本研究以网络调查的形式开展。向斯堪的纳维亚地区每年进行超过20例结直肠手术的所有外科科室发送了一份调查问卷。根据是否存在组织学危险因素,对直肠和结肠恶性息肉随访的问题有所不同。随访期分为短期(一年)、中期(三年)或长期(五年)。

结果

大多数科室采用长期(五年)(38%-59%)或中期(三年)(26%-38%)的随访方案。在有组织学危险因素的直肠恶性息肉患者中,根据随访时间长短,在内镜检查的使用上观察到显著差异。在结肠恶性息肉患者中,根据随访时间长短,不同检查方式的使用未见差异。

结论

内镜切除恶性息肉患者的随访和监测策略在随访时间长短和执行方式上均有所不同。未来的研究应比较采用不同随访策略的科室中患者的长期预后。

资金来源

无。

试验注册

不相关。

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1
Scandinavian surveillance follow-up programmes in patients with malignant colorectal polyps.斯堪的纳维亚地区对恶性大肠息肉患者的监测随访项目。
Dan Med J. 2021 Jan 15;68(2):A07200559.
2
Clinical investigation of colorectal cancer detected by follow-up colonoscopy after endoscopic polypectomy.内镜下息肉切除术后随访结肠镜检查发现的结直肠癌的临床研究
Dis Colon Rectum. 1997 Oct;40(10 Suppl):S16-22. doi: 10.1007/BF02062015.
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Rectum versus colon: should malignant polyps be treated differently?直肠与结肠:恶性息肉是否应区别对待?
ANZ J Surg. 2021 May;91(5):927-931. doi: 10.1111/ans.16437. Epub 2020 Nov 11.
4
[Endoscopic resection of colorectal polyps].[大肠息肉的内镜切除术]
Dtsch Med Wochenschr. 1987 Feb 6;112(6):210-3. doi: 10.1055/s-2008-1068031.
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Risk factor assessment of endoscopically removed malignant colorectal polyps.经内镜切除的恶性大肠息肉的危险因素评估
Gut. 1998 Nov;43(5):669-74. doi: 10.1136/gut.43.5.669.
6
Polyp guideline: diagnosis, treatment, and surveillance for patients with nonfamilial colorectal polyps. The Practice Parameters Committee of the American College of Gastroenterology.息肉指南:非家族性结直肠息肉患者的诊断、治疗及监测。美国胃肠病学会实践参数委员会
Ann Intern Med. 1993 Oct 15;119(8):836-43. doi: 10.7326/0003-4819-119-8-199310150-00010.
7
Surgical pathology of endoscopically removed malignant polyps of the colon and rectum.经内镜切除的结肠和直肠恶性息肉的外科病理学
Am J Surg Pathol. 1983 Oct;7(7):613-23. doi: 10.1097/00000478-198310000-00002.
8
[Treatment of malignant colorectal polyps: removal by endoscopic polypectomy].[恶性大肠息肉的治疗:内镜下息肉切除术切除]
Harefuah. 1986 Oct;111(7-8):169-71.
9
Colorectal polyps: an endoscopic experience.结直肠息肉:内镜检查经验
Aust N Z J Surg. 1986 Sep;56(9):717-22.
10
Short- and long-term results of colonoscopic polypectomy in children.儿童结肠镜息肉切除术的短期和长期结果
Gastrointest Endosc. 1986 Dec;32(6):389-92. doi: 10.1016/s0016-5107(86)71917-2.

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World J Gastrointest Endosc. 2024 Sep 16;16(9):502-508. doi: 10.4253/wjge.v16.i9.502.
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Long-term outcomes after endoscopic removal of malignant colorectal polyps: Results from a 10-year cohort.内镜切除恶性大肠息肉后的长期结局:一项10年队列研究的结果
World J Gastrointest Endosc. 2024 Apr 16;16(4):193-205. doi: 10.4253/wjge.v16.i4.193.