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目的：探讨结肠镜及时发现多原发癌的意义。方法：1987年1月至1995年12月，589例大肠癌患者，术前常规行结肠镜全结肠检查，其中241例（40．8％）行全结肠检查。另348例（59．2％）因病灶堵塞无法行全结肠检查，其中128例术前结肠镜诊断与钡灌肠X线检查有疑问而行术中结肠镜检查。220例术后1～18个月内无症状结肠镜行全结肠随访检查。结果：241例术前行全结肠检查者，发现同时第二原发癌10例（4．1％），腺瘤早期癌变3例（1．2％），腺瘤49例（20．3％）。128例行术中结肠镜检查，发现2例（1．6％）三处同时原发癌，同时第二原发癌11例（8．5％），同时存在腺瘤31例（24．2％）。结论：术前不能行全结肠检查者．术中的结肠镜行全结肠检查能及时发现和彻底治疗同时多个原发病灶。
Objective: To explore the significance of colonoscopy to detect multiple primary cancers in time. METHODS: Between January 1987 and December 1995, 589 patients with colorectal cancer underwent routine colonoscopy with total colonoscopy, of whom 241 (40.8%) underwent total colon examination. Another 348 patients (59.2%) were unable to perform a full-column examination because of focal obstruction. Among them, 128 patients had preoperative colonoscopy diagnosis and barium enema X-ray examination with questionable intraoperative colonoscopy. A total of 220 follow-up examinations were performed in 220 cases with asymptomatic colonoscopy within 1 to 18 months after operation. RESULTS: A total of 241 patients who underwent total colon examination before operation were found to have 10 primary tumors (4.1%) at the same time, 3 early cancers (1.2%), and 49 adenomas (20.3%). ). Intraoperative colonoscopy performed 128 cases and found two cases (1.6%) of three simultaneous primary cancers, while the second primary cancer was in 11 cases (8.5%), and there were 31 cases of adenomas (24.2). %). 4. Conclusion: Patients who cannot undergo full colon examination before surgery Intraoperative colon colonoscopy can detect and thoroughly treat multiple primary lesions simultaneously.