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[结肠腺瘤性息肉切除术后内镜随访的结果]

[The yield of endoscopic follow-up after removal of adenomatous polyps from the colon].

作者信息

Hackmann R J, van der Putten A B, Loffeld R J

机构信息

Ziekenhuis De Heel, afd. Interne Geneeskunde, Zaandam.

出版信息

Ned Tijdschr Geneeskd. 1998 Jul 25;142(30):1720-3.

PMID:9763868
Abstract

OBJECTIVE

To determine the results of follow-up endoscopy after resection of adenomatous polyps from the colon.

DESIGN

Retrospective.

SETTING

De Heel Hospital, department of Internal Medicine, Zaandam, the Netherlands.

PATIENTS AND METHOD

The 124 patients, 66 males and 58 females, with a mean age of 53 years (range: 23-74), in whom a colonpolyp had been removed endoscopically, who had no colonic carcinoma and no positive family history, were registered for follow-up after one year and after 3 or 5 years. In 1997, data were collected on the polyps found and removed at follow-up.

RESULTS

At the original coloscopy, 68 patients (55%) had one polyp, 46 (37%) had two to four polyps and 10 (8%) > or = five polyps. The localizations of the polyps were: rectum 17%, sigmoid 66%, descending colon 12%, transverse colon 3%, ascending colon 1% and caecum 1%. Over one-third of the polyps were larger than 1.5 cm. Ninety-eight patients underwent a first follow-up endoscopy after an average of 12 months (range: 0.4-57); one or more polyps were found and removed in 37 of them (38%). At a second follow-up endoscopy after an average of 28 months (range: 5.4-68 months), polyps were again found and removed in 26 of the 57 patients (46%). If two or more polyps had been removed at an earlier coloscopy, the risk of polyps being found again at the next coloscopy was larger (p < 0.001).

摘要

目的

确定结肠腺瘤性息肉切除术后的随访内镜检查结果。

设计

回顾性研究。

地点

荷兰赞丹市De Heel医院内科。

患者与方法

124例患者,男性66例,女性58例,平均年龄53岁(范围:23 - 74岁),这些患者经内镜切除结肠息肉,无结肠癌且无阳性家族史,登记进行1年、3年或5年的随访。1997年收集随访时发现并切除的息肉数据。

结果

在初次结肠镜检查时,68例患者(55%)有1个息肉,46例(37%)有2至4个息肉,10例(8%)有≥5个息肉。息肉的部位分布为:直肠17%,乙状结肠66%,降结肠12%,横结肠3%,升结肠1%,盲肠1%。超过三分之一的息肉直径大于1.5厘米。98例患者平均在12个月(范围:0.4 - 57个月)后接受了首次随访内镜检查;其中37例(38%)发现并切除了1个或多个息肉。在平均28个月(范围:5.4 - 68个月)后的第二次随访内镜检查中,57例患者中有26例(46%)再次发现并切除了息肉。如果在早期结肠镜检查时切除了2个或更多息肉,在下一次结肠镜检查时再次发现息肉的风险更大(p < 0.001)。

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