Winkler R, Grabbe E
Abteilung Allgemeinchirurgie des Martin-Luther-Krankenhauses Schleswig.
Rontgenblatter. 1988 May;41(5):197-203.
Aftercare following surgery of colorectal tumours aims mainly at early detection of a relapse for the purpose of curative re-intervention. Improvement of diagnostic possibilities, especially by means of tumour markers, flexible endoscopy, computed tomography, magnetic resonance and ultrasound, increased the efficacy of aftercare; however, diagnosis of tumour recurrence has always been too late to perform repeated surgery with the expected measure of success. In relation to all cases of failure of therapy, the proportion of potentially curative re-interventions was about 10%. Whereas operations at the frame of the colon are practically free from a specific therapeutic co-morbidity, problems of continence may be expected in deep rectal surgery; especially after extirpation of the rectum, we can expect stoma problems and urogenital complaints as well as difficulties with the rectal excision wound. In case of adjuvant radiotherapy there may be irradiation sequels such as adhesion difficulties or radiogenic proctitis. The occurrence of metachronous secondary tumours is a special aspect of colorectal carcinomas, so that aftercare always includes prevention as well. Further aftercare measures follow from the context of psychosocial rehabilitation. Principally it is possible to achieve the ideal goal of complete reinstatement in the family, in society and in professional life after colorectal cancer surgery.
结直肠肿瘤手术后的随访主要旨在早期发现复发以便进行根治性再次干预。诊断可能性的提高，特别是通过肿瘤标志物、可弯曲内镜检查、计算机断层扫描、磁共振成像和超声检查，提高了随访的效果；然而，肿瘤复发的诊断一直都太晚，无法进行有预期成功几率的再次手术。相对于所有治疗失败的病例，潜在可根治性再次干预的比例约为10%。虽然结肠手术实际上不存在特定的治疗合并症，但深部直肠手术可能会出现控便问题；特别是在直肠切除术后，我们可能会遇到造口问题、泌尿生殖系统不适以及直肠切除伤口愈合困难等情况。在辅助放疗的情况下，可能会出现诸如粘连困难或放射性直肠炎等放疗后遗症。异时性继发性肿瘤的发生是结直肠癌的一个特殊方面，因此随访始终包括预防。进一步的随访措施源自心理社会康复的背景。原则上，结直肠癌手术后有可能实现完全恢复家庭、社会和职业生活的理想目标。
