Christie J P
Am J Gastroenterol. 1976 Jul;66(1):23-8.
Most benign sessile colon polyps can be removed colonoscopically from all reaches of the colon, thus avoiding laparotomy previously required for most of these lesions. Two hundred and fifty colonoscopy procedures were reviewed, revealing 87 sessile colon polyps ranging from 0.5-6.0 cm. in size. Sixty-eight of 87 lesions were excised from 51 patients with just three lesions found to be malignant (invasive adenocarcinoma). Sixteen lesions were felt to be unsuitable for safe colonscopic excision and were, therefore, removed by laparotomy (in 12 patients) and six lesions found to be malignant. Three sessile lesions in this consecutive series were not yet removed at the time of this writing. Thorough bowel preparation and evaluation for other possible lesions are important components of this procedure, which yielded other polyps or cancers in 24 of 66 patients. While most sessile lesions less than 2 cm. in size can be excised endoscopically, certain larger benign sessile lesions can also be removed using piece-meal snare excision technics and radiowave electrocautery (principle of less heat penetration and tissue destruction). Seventy-nine per cent of all sessile colon polyps were excised colonoscopically in this series making abdominal surgery now unnecessary for most colon polyps. Laparotomy is necessary for certain larger benign lesions and all sessile lesions containing invasive cancer.
大多数良性无蒂结肠息肉可通过结肠镜从结肠各部位切除，从而避免了以往对大多数此类病变所需的剖腹手术。回顾了250例结肠镜检查手术，发现87例无蒂结肠息肉，大小从0.5至6.0厘米不等。87个病变中的68个从51例患者中切除，仅发现3个病变为恶性（浸润性腺癌）。16个病变被认为不适合进行安全的结肠镜切除，因此通过剖腹手术切除（12例患者），其中6个病变为恶性。在撰写本文时，该连续系列中的3个无蒂病变尚未切除。彻底的肠道准备和对其他可能病变的评估是该手术的重要组成部分，该手术在66例患者中的24例中发现了其他息肉或癌症。虽然大多数小于2厘米的无蒂病变可通过内镜切除，但某些较大的良性无蒂病变也可使用分次圈套切除技术和射频电灼术（热穿透和组织破坏较少的原理）切除。在该系列中，79%的无蒂结肠息肉通过结肠镜切除，这使得现在大多数结肠息肉无需进行腹部手术。对于某些较大的良性病变和所有含有浸润性癌的无蒂病变，剖腹手术是必要的。
