Bassett M L, Bennett S A, Goulston K J
Med J Aust. 1979 Jun 30;1(13):589-92.
Clinical presentation, risk factors, investigations, pathology and treatment were examined in a retrospective review of 230 patients with colorectal cancer. Many patients presented with symptoms not usually associated with colorectal cancer, such as pain in the upper part of the abdomen, and rectal bleeding separate from the stool. Iron deficiency anaemia was an uncommon presentation. Over all, one-third of patients had at least one risk factor for colorectal cancer. Risk factors such as adenomatous polyps and family history of colorectal cancer were more common than inflammatory bowel disease and polyposis coli. Although a delay in diagnosis was recorded in one-quarter of patients, the finding of a negative correlation between duration of symptoms and extent of spread suggests that the length of the symptomatic illness is not an important factor in prognosis. Contrary to surgical and medical teaching, only 43% of cancers were in the rectum and rectosigmoid area, and, hence, within reach of the standard sigmoidoscope. Surgical resection was performed in 76% of patients. Forty-three per cent of patients who underwent surgery developed at least one postoperative complication resulting in a longer stay in hospital.
通过对230例结直肠癌患者进行回顾性研究，对其临床表现、危险因素、检查、病理及治疗情况进行了分析。许多患者表现出的症状通常与结直肠癌无关，如中上腹疼痛以及与大便分离的直肠出血。缺铁性贫血并不常见。总体而言，三分之一的患者至少有一项结直肠癌危险因素。腺瘤性息肉和结直肠癌家族史等危险因素比炎症性肠病和结肠息肉病更常见。虽然四分之一的患者存在诊断延迟情况，但症状持续时间与扩散程度之间呈负相关这一发现表明，症状性疾病的时长并非预后的重要因素。与外科和医学教学内容相反，只有43%的癌症位于直肠和直肠乙状结肠区域，因此在标准乙状结肠镜检查的范围内。76%的患者接受了手术切除。接受手术的患者中有43%至少出现了一种术后并发症，导致住院时间延长。
