Dauer U, Haas I, Stock W
Chirurgische Abteilung des Marien-Hospitals, Düsseldorf.
Dtsch Med Wochenschr. 1987 Nov 27;112(48):1860-4. doi: 10.1055/s-2008-1068343.
From 1980 to 1985, 319 adenomatous colorectal polyps were removed in 297 patients. All patients were entered into a computerized follow-up programme with yearly follow-up. The recommended follow-up was rejected by 58 patients (22.1%). 93 new adenomatous polyps were found in the course of the follow-up in 53 patients (35.8%), five of them histologically invasive carcinomas. The proportion of carcinomas was lowered from 10.6% at first examination to 5.4% in the follow-up period. Size of polyp correlated significantly with carcinomatous change. Size of the adenomas removed at follow-up was markedly smaller than that removed at first examination (69.4% smaller than 1 cm compared with 44.2% at follow-up). In six patients with early invasive carcinoma, further resections were undertaken, while in six others only the polyps were removed. But local recurrences occurred in both groups. Regular follow-up after polypectomy of colorectal adenoma is thus essential.
1980年至1985年期间,297例患者切除了319枚结直肠腺瘤性息肉。所有患者均进入计算机化随访程序,每年进行随访。58例患者(22.1%)拒绝了推荐的随访。随访期间,53例患者(35.8%)发现93枚新的腺瘤性息肉,其中5例为组织学浸润性癌。癌的比例从首次检查时的10.6%降至随访期间的5.4%。息肉大小与癌变显著相关。随访时切除的腺瘤大小明显小于首次检查时切除的腺瘤(小于1 cm的腺瘤,首次检查时为44.2%,随访时为69.4%)。6例早期浸润癌患者进行了进一步切除,另外6例仅切除了息肉。但两组均出现局部复发。因此,结直肠腺瘤切除术后定期随访至关重要。