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題名 | Clinical Outcomes of Polypectomy and Colectomy: Management of Malignant Colorectal Polyps=經大腸鏡息肉切除術或結腸切除術治療惡性結腸直腸息肉的臨床結果 |
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作者姓名(中文) | 鐘紹維; 許詔文; 王瑞和; 金台明; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 23:1 2012.03[民101.03] |
頁次 | 頁32-38 |
分類號 | 416.245 |
關鍵詞 | 惡性息肉; 結腸直腸息肉; 息肉切除術; 結腸切除術; Malignant polyps; Colorectal polyps; Polypectomy; Colectomy; |
語文 | 英文(English) |
中文摘要 | 目的 這項研究旨在評估以經大腸鏡息肉切除術或結腸切除術治療惡性結腸直腸息肉的臨床結果。 方法 從2000 年1 月至2008 年12 月,我們追蹤67 例患者 (37 名男性和30 名女性) 以經大腸鏡息肉切除術或結腸切除術治療有蒂或無蒂惡性結腸直腸息肉的預後。 結果 67 例患者中,29 位有蒂息肉皆以大腸鏡息肉切除術切除。而其中13 位更進一步接受結腸切除術。另外38 位無蒂息肉以大腸鏡息肉切除術切除後,其中17 位後來再接受結腸切除術。平均追蹤時間從2 年至5 年 (平均3 年)。所有的患者不論是只接受息肉切除術或是更進一步接受結腸切除術,兩年的存活率都是100%。然而,隨著時間的推移,有一位有蒂息肉患者 (3.3%) 當初接受結腸切除術,四年後被診斷出癌擴散。三位(8.1%) 只接受大腸鏡息肉切除術患者,被發現有遠處轉移。其中兩位無蒂息肉患者兩年後被發現有肝轉移,另一位有蒂息肉患者有肺轉移並於三年後去世。 結論 根據我們的結果,對於發現有蒂或無蒂惡性結腸直腸息肉患者,接受結腸切除術患者比只接受經大腸鏡息肉切除術患者有更好的臨床結果。因為,接受結腸切除術患者有比只接受經大腸鏡息肉切除術患者更少的遠端轉移機率 (3.3%) 及減少了淋巴轉移的機會。 |
英文摘要 | Purpose. This study was designed to evaluate the outcomes of patients treated for malignant colorectal polyps by polypectomy or colectomy. Materials and Methods. From January 2000 to December 2008, we followed the survival outcomes of 67 patients (37 men and 30 women) who had received either polypectomies or colectomies to treat malignant colorectal pedunculated or sessile polyps. Results. Twenty-nine of the 67 patients had pedunculated polyps, all of which were removed colonoscopically. Thirteen of these 29 patients received subsequent colectomies. Thirty-eight patients had sessile polyps, all of which were removed colonoscopically. Seventeen of the 38 patients had subsequent colectomies.We followed these patients from 2 years to 5 years (median 3 years). Patients in the colectomy and the polypectomy groups had 100 percent two-year survival rates. However, as time passed, of these patients who had received colectomies, one with pedunculated lesion (3.3%) was diagnosed with carcinomatosis four years from initial colonoscopy. Among those who had received polypectomies only, three (8.1%) were found to have distant metastasis: two with sessile lesions were found to have liver metastasis two years later and one with pedunculated lesion found to have lung metastasis died three years later. Conclusion. Based on our experience, patients who received operative management had better long-term results than those managed by polypectomy alone because of the lower distant metastasis rate (3.3%) and the decreased possibility of lymph node metastasis in malignant sessile lesions. |
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