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目的探讨结肠镜随访对大肠癌术后复发的临床意义。方法自2000年1月至2008年12月,对138例大肠癌术后患者进行结肠镜随访检查,发现可疑病变取活检,发现息肉则行镜下凝固治疗,秩和检验进行随访结果统计分析。结果 138例患者检出复发癌12例,其中男性10例,女性2例,两者差异显著(P<0.05);升结肠2例,横结肠1例,降结肠2例,乙状结肠3例,直肠4例,三者之间无差异(P>0.05);其中吻合口复发癌8例,原发癌4例,治疗息肉22例,共36枚,其中腺瘤性息肉26例、吻合口炎10例。12例复发癌患者中,正规随访者11例,未正规随访者仅1例,两者差异显著(P<0.001);术后2年内复发11例,1例发生于3.5年,差异显著(P<0.001)。结论大肠癌术后2年内常规进行结肠镜检查可早期发现复发病灶,并可切除腺瘤性息肉,对降低大肠癌复发具有较大的临床价值。
Objective To investigate the clinical significance of colonoscopy follow-up on the recurrence of colorectal cancer. Methods From January 2000 to December 2008, 138 patients with colorectal cancer underwent colonoscopy follow-up examination. Suspicious lesions were collected for biopsy, and polyps were found to be undergone by microsurgical coagulation therapy and rank sum test. The follow-up results were statistically analyzed. Results There were 12 cases of recurrent cancer in 138 cases, including 10 males and 2 females, with significant difference (P <0.05); ascending colon in 2 cases, transverse colon in 1 case, descending colon in 2 cases, sigmoid colon in 3 cases and rectum 4 Cases, no difference between the three (P> 0.05); anastomotic recurrence in 8 cases of cancer, primary cancer in 4 cases, the treatment of polyps in 22 cases, a total of 36, of which 26 cases of adenomatous polyps, 10 cases of anastomotic stomatitis . Among the 12 patients with recurrent cancer, 11 patients were regular follow-up and 1 patient did not follow-up. The difference was significant (P <0.001); 11 patients relapsed within 2 years and 1 patient occurred in 3.5 years (P <0.001). Conclusion Conventional colonoscopy within 2 years after operation of colorectal cancer can detect the recurrence lesion early and remove adenomatous polyps, which has great clinical value in reducing the recurrence of colorectal cancer.