Naranjo Rodríguez A, López Rubio F, Sánchez del Río A, Miño Fugarolas G
Reina Sofía Regional University Hospital, Córdoba, Spain.
Rev Esp Enferm Dig. 1997 Jun;89(6):435-44.
Fifty-seven adenomas containing adenocarcinoma were removed endoscopically from the colons of 56 patients (36 males and 20 females) with a mean age of 64.5 years. The 13 polyps containing carcinoma in situ were satisfactorily treated by endoscopic resection. In 29 cases, the carcinoma had invaded the head, neck or stalk of the polyp. The outcome was good in every case, including one involving invasion of the resection margin. Follow-up or intraoperative studies disclosed the presence of residual lesion in only 4 patients out of 15 with submucosal invasion. All four had invaded resection margins and incomplete endoscopic excision. Endoscopic polypectomy is a suitable therapeutic option for most colonic adenomas containing a carcinoma provided a complete resection is achieved with wide resection margins, particularly in those cases in which the submucosa is not reached.
从56例患者（36例男性和20例女性）的结肠中经内镜切除了57个含腺癌的腺瘤，患者平均年龄为64.5岁。13个含原位癌的息肉经内镜切除得到了满意的治疗效果。在29例病例中，癌已侵犯息肉的头部、颈部或蒂部。每例结果均良好，包括1例侵犯切缘的病例。随访或术中研究发现，15例黏膜下侵犯患者中仅4例存在残留病变。这4例均侵犯了切缘且内镜切除不完全。对于大多数含癌的结肠腺瘤，只要能实现完整切除且切缘足够宽，尤其是未累及黏膜下层的病例，内镜下息肉切除术是一种合适的治疗选择。
