Dowling K, Watne A, Foshag L, Vargish T
Surgery. 1985 Oct;98(4):684-8.
There is evidence that patients with adenocarcinoma of the colon and synchronous adenomatous polyps are at an increased risk for developing metachronous colon cancer. A retrospective study was made of all patients with colon cancer at our institution and the associated Veterans Administration Hospital between 1974 and 1983 to help assess the need for more extensive colon resection in patients with colon cancer and synchronous adenomatous polyps. At our hospitals 470 new cases of colon cancer were identified. Nine percent (44/470) had colon cancer and concurrent adenomatous polyps. Seven (16%) of these 44 patients developed metachronous colon cancer, as compared with four of 426 patients without polyps at the initial surgery (p less than 0.001). Four patients without polyps at the initial surgery developed polyps at a later date; three of the four patients developed metachronous colon cancer. We believe that more extensive colon resection, such as total colectomy and ileoproctostomy, may play a role in preventing the occurrence of metachronous colon cancer in patients with colon cancer and synchronous adenomatous polyps. In addition, if adenomatous polyps develop after colon surgery, close endoscopic follow-up is required.
有证据表明，患有结肠癌并伴有同步腺瘤性息肉的患者发生异时性结肠癌的风险增加。对1974年至1983年间在我们机构以及相关退伍军人管理局医院的所有结肠癌患者进行了一项回顾性研究，以帮助评估对患有结肠癌和同步腺瘤性息肉的患者进行更广泛结肠切除术的必要性。在我们医院共确定了470例结肠癌新病例。其中9%（44/470）患有结肠癌并伴有同期腺瘤性息肉。这44例患者中有7例（16%）发生了异时性结肠癌，而初次手术时无息肉的426例患者中有4例发生了异时性结肠癌（p<0.001）。初次手术时无息肉的4例患者后来长出了息肉；这4例患者中有3例发生了异时性结肠癌。我们认为，更广泛的结肠切除术，如全结肠切除术和回肠直肠吻合术，可能在预防患有结肠癌和同步腺瘤性息肉的患者发生异时性结肠癌方面发挥作用。此外，如果结肠手术后出现腺瘤性息肉，则需要密切的内镜随访。
