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[大肠息肉。治疗与临床病程]

[Colorectal polyps. Treatment and clinical course].

作者信息

Méndez L, Muñoz-Calero Peregrín A, De Tomás Palacios J, Escat Cortés J L, Trinchet Hernández M

机构信息

Servicio de Cirugía General I, Hospital General Gregorio Marañón, Madrid.

出版信息

Rev Esp Enferm Dig. 1994 Mar;85(3):180-4.

PMID:8204382
Abstract

We report the results of the treatment and follow up of 61 patients with polyps of the colon and rectum, who underwent surgical intervention between 1983 through 1991. The mean age was 56 years (range from 41 to 56 y.) and 53% of the patients were males. The majority of the polyps were located in the anorectal region, n = 32 (52.4%) and sigmoid colon n = 17 (27.8%). Tubular adenomas in n = 38 patients and villous adenoma in n = 19, were the most frequent histological types. We have found polyps with invasive carcinoma in 15 (24.6%) cases. The polyps were resected by transanal resection in 15 patients, by colectomies in 11, and 10 patients underwent colectomy for removal of their polyps. Surgery was indicated when the polyp had a base too wide to be removed by colonoscopy or when malignancy was demonstrated by biopsy. There were 10 (19.6%) recurrences during the first three years of follow up. The histological examination showed malignant changes in 4 polyps. Villous adenomas, n = 7 constituted the histological type with more recurrences. Recurrences were treated by local resection in half of the cases. The morbidity was 9.8% and mortality was 3.3%. Surgery when indicated, allows to obtain free margins from tumor, to determine lymph node involvement and to establish the stage.

摘要

我们报告了1983年至1991年间接受手术干预的61例结肠和直肠息肉患者的治疗及随访结果。平均年龄为56岁(范围41至56岁),53%的患者为男性。大多数息肉位于肛门直肠区域,n = 32(52.4%),乙状结肠n = 17(27.8%)。38例患者为管状腺瘤,19例为绒毛状腺瘤,是最常见的组织学类型。我们在15例(24.6%)病例中发现了伴有浸润性癌的息肉。15例患者通过经肛门切除术切除息肉,11例行结肠切除术,10例患者因息肉切除而接受结肠切除术。当息肉基底过宽无法通过结肠镜切除或活检显示为恶性时,则需进行手术。在随访的前三年中有10例(19.6%)复发。组织学检查显示4例息肉有恶性变化。7例绒毛状腺瘤是复发率较高的组织学类型。一半的复发病例通过局部切除进行治疗。发病率为9.8%,死亡率为3.3%。在有指征时进行手术,能够获得肿瘤的切缘阴性,确定淋巴结受累情况并明确分期。

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