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结直肠肿瘤的内镜诊断与治疗(作者译)

[Endoscopic diagnosis and therapy of colorectal tumours (author's transl)].

作者信息

Löffler A, Thon H J, Frotz H, Gheorghiu T

出版信息

Rontgenblatter. 1979 Jun;32(6):299-303.

PMID:36656
Abstract
  1. If endoscopy leads to the suspicion of an exulcerated and/or polypous carcinoma of the colon, surgical intervention is the primary therapy. Histological classification of the tumour should be effected by means of endoscopic biopsy. 2. (Familial) adenomatosis of the colon requires colectomy. 3. Broad-based polypi resembling a lawn where a large wound area must be expected by electrocoagulation (risk of perforation), and pediculate polypi of the (rare) size of 3 cm and more (risk of haemorrhage) should not be resected via endoscopy but by surgery. 4. Solitary or multiple polypi of the colon not covered by points 1 to 3 above, are primarily for reasons of diagnosis an indication for endoscopic polypectomy. Biospy in the case of adenomas to clarify the histological structure and to obtain qualitative and quantitative information regarding malignant degeration, must be discouraged (""partial diagnosis''.) 5. Basing on the current state of knowledge it is assumed that effective prohylaxis of cancer is achieved by the endoscopic removal of benign adenomas of the colon. 6. It is also assumed that effective cancer therapy can be realised by the endoscopic removal of adenomas which have already undergone malignant degeration (adenoma with severe cellular atypia, invasive differntiated adenocarcinoma in the head of the adenoma.)
摘要
  1. 若内镜检查怀疑为结肠溃疡性和/或息肉状癌,手术干预是主要治疗方法。肿瘤的组织学分类应通过内镜活检进行。2. (家族性)结肠腺瘤病需要行结肠切除术。3. 基底较宽的息肉形似草坪,电凝时预计会有大面积创面(有穿孔风险),以及(罕见的)直径3厘米及以上的带蒂息肉(有出血风险),不应通过内镜切除,而应手术切除。4. 上述1至3点未涵盖的结肠单发或多发息肉,主要出于诊断目的,是内镜下息肉切除术的适应证。对于腺瘤,不应进行活检以明确组织结构并获取有关恶性退变的定性和定量信息(“部分诊断”)。5. 根据目前的知识水平,认为通过内镜切除结肠良性腺瘤可实现有效的癌症预防。6. 还认为通过内镜切除已发生恶性退变的腺瘤(具有严重细胞异型性的腺瘤、腺瘤头部的浸润性分化腺癌)可实现有效的癌症治疗。

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