Mella J, Datta S N, Biffin A, Radcliffe A G, Steele R J, Stamatakis J D
Audit and Epidemiology Unit, Royal College of Surgeons of England, London.
Ann R Coll Surg Engl. 1997 May;79(3):206-9.
Consultant surgeons in two United Kingdom Health Regions were invited to complete a questionnaire on details of their personal management of patients with colon and rectal cancer, with particular emphasis on follow-up. Replies from 140 (94%) were analysed by the surgeon's subspecialty of colorectal and gastrointestinal surgery (group 1) and all others (group 2). There was a wide variation in the duration of followup, but no difference between the two groups. More group 1 surgeons carried out investigations as a routine after colonic (P < 0.01) and rectal (P < 0.01) resection. Colonoscopy was used more frequently by group 1 (P < 0.0001) and barium enema by group 2 surgeons (P < 0.05). Investigations to detect asymptomatic metastases were used as a routine by 33.3% of surgeons, in whom there was no concordance over the choice or combination of tests and no difference between the two groups of surgeons. There is no consensus among surgeons as to the ideal duration, intensity and method of follow-up after resection for colorectal cancer and little difference between the practice of colorectal and gastrointestinal surgeons and that of other specialists, except in the use of colonoscopy and barium enema. These results reflect the continuing lack of evidence on which to base the follow-up of patients after surgery for colorectal cancer.
英国两个卫生区域的外科顾问被邀请填写一份关于他们对结肠癌和直肠癌患者个人管理细节的问卷，特别强调随访情况。根据外科医生的结直肠和胃肠外科亚专业（第1组）和其他所有医生（第2组）对140份回复（94%）进行了分析。随访时间差异很大，但两组之间没有差异。第1组中更多的外科医生在结肠（P < 0.01）和直肠（P < 0.01）切除术后将检查作为常规操作。第1组更频繁地使用结肠镜检查（P < 0.0001），而第2组外科医生更常使用钡灌肠（P < 0.05）。33.3%的外科医生将检测无症状转移的检查作为常规操作，在这些医生中，对于检查的选择或组合没有一致性，两组外科医生之间也没有差异。对于结肠癌切除术后随访的理想持续时间、强度和方法，外科医生之间没有共识，除了在结肠镜检查和钡灌肠的使用方面，结直肠和胃肠外科医生与其他专科医生的做法几乎没有差异。这些结果反映了在结肠癌手术后患者随访依据方面仍然缺乏证据。
