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阑尾切除术和胆囊切除术在结直肠癌发病机制中的作用。

The role of appendectomy and cholecystectomy in the pathogenesis of colorectal carcinomas.

作者信息

Mándi Miklós, Keleti György, Juhász Miklós

机构信息

General, Vascular and Thoracic Surgery Unit, Bajcsy-Zsilinszky Hospital, Budapest, Hungary 89-91, Maglódi Street, H-1106, Hungary.

出版信息

Ann Med Surg (Lond). 2021 Nov 3;72:102991. doi: 10.1016/j.amsu.2021.102991. eCollection 2021 Dec.

Abstract

BACKGROUND

Several alterations in the gastrointestinal tract which occur after appendectomy or cholecystectomy have been suggested to raise the risk of developing colorectal carcinoma. Given the frequency that these procedures are performed, we sought to determine whether a history of either cholecystectomy or appendectomy increased the risk of future colorectal carcinoma.

METHODS

We determined the number of patients with a history of appendectomy and cholecystectomy who developed colorectal carcinoma between January 2018 and February 2021, as well as the latency time between the two diseases. Secondly, we carried out a data-collection spanning 15 years after the primary surgery (January 2005-December 2006).

RESULTS

The post-cholecystectomy state is significantly more frequently observed in patients treated for colorectal carcinomas (both male and female), especially among those who developed right-sided or left-sided colon cancer, as opposed to anorectal cancer ( = 0.53). However, the time elapsed between the two diseases is 20-25 years, which appears to be markedly long regarding such a multifactorial disease as the colorectal carcinoma. No similar extra risk was observed among patients having appendectomy. Secondly, we found no extra risk during the first 15 years after cholecystectomy.

CONCLUSION

Although a statistically higher risk of colon cancer is observed after the removal of the gallbladder, but the latency time is long. Thus, cholecystectomy may not be an independent risk factor for colorectal carcinogenesis. Altogether, the patient is not exposed to a higher risk of colorectal carcinogenesis after having cholecystectomy.

摘要

背景

阑尾切除术或胆囊切除术后胃肠道发生的一些改变被认为会增加患结直肠癌的风险。鉴于这些手术的实施频率,我们试图确定胆囊切除术或阑尾切除术史是否会增加未来患结直肠癌的风险。

方法

我们确定了2018年1月至2021年2月期间发生结直肠癌的有阑尾切除术和胆囊切除术史的患者数量,以及两种疾病之间的间隔时间。其次,我们进行了一项涵盖初次手术后15年(2005年1月至2006年12月)的数据收集。

结果

在接受结直肠癌治疗的患者(包括男性和女性)中,尤其是那些患右侧或左侧结肠癌而非肛管癌的患者中,胆囊切除术后状态的观察频率明显更高(P = 0.53)。然而,两种疾病之间的间隔时间为20 - 25年,对于像结直肠癌这样的多因素疾病来说,这似乎明显很长。在接受阑尾切除术的患者中未观察到类似的额外风险。其次,我们发现在胆囊切除术后的前15年没有额外风险。

结论

虽然胆囊切除术后观察到结肠癌的统计学风险较高,但间隔时间很长。因此,胆囊切除术可能不是结直肠癌发生的独立危险因素。总体而言,患者在进行胆囊切除术后不会面临更高的结直肠癌发生风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7aa/8599105/08d1ac1d78db/gr1.jpg

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