乙状结肠癌根治术手辅助腹腔镜与开腹手术围手术期疗效的对比

目的对比手辅助腹腔镜技术和传统开腹技术在乙状结肠癌治疗中的安全性及围手术期疗效。方法回顾性总结2009年1月至2010年6月在北京大学肿瘤医院结直肠外科施行乙状结肠癌根治性手术的115例患者的临床资料,其中手辅助腔镜（HALS组）62例,开腹组53例,对比两组手术的安全性及围手术期疗效。结果HALS组与开腹组术中清扫淋巴结总数分别为（15．1±4．6）枚和（16．8±6．4）枚（P=0．163）;两组的肿块切缘分别为（4．1±1．8）cm和（4．3±1．7）cre（P=0．601）：两组手术时间分别为（122．4±32．0）min和（126．7±37．4）min（P=0．510）。HALS组术中出血量（62．6±35．4）ml,明显少于开腹组的（168．9±137．1）ml（P=0．000）;术后围手术期并发症发生率1．6％（1／62．为肺部感染1例）,明显低于开腹组的11．3％（6／53,分别为吻合口瘘1例．腹盆腔感染2例和切口感染3例）（P=0．030）;术后胃肠功能恢复快[（2．3±0．8）d比（3.3±1．1）d,P=O．000];术后平均住院日缩短[（8．8±2．7）d比（12．6±8．0）d,P=0．001]。结论手辅助腔镜用于乙状结肠癌切除术与开腹手术相比,可达到同样的近期根治效果,并具有安全、微创的优势。     

免腹部切口腹腔镜结直肠切除经肛门拖出术

目的探讨免腹部切口腹腔镜结直肠切除经肛门拖出术的可行性和治疗效果。方法回顾性分析2009年1月至2011年5月间在北京世纪坛医院接受免腹部切口腹腔镜结直肠切除经肛门拖出术的12例患者的临床资料。结果12例患者中男性8例,女性4例,年龄4l。67（平均58）岁：便秘5例,乙状结肠癌3例。直肠癌4例。12例均经腹腔镜完成手术,无中转开腹病例,手术时间（240±45）min,术中出血量（70±40）ml。术后无吻合口瘘和吻合口狭窄等并发症,仅1例便秘患者术后出现顽固性右下腹痛,经解痉对症处理后缓解。术后6个月,5例便秘患者排粪频率3～7次／d,7例乙状结肠和直肠癌患者1-2次／d。术后随访1～20个月,未见局部复发和转移病例。结论免腹部切口腹腔镜结直肠切除经肛门拖出术是一种安全可行、疗效可靠的术式。     

腹腔镜结直肠癌手术的临床分析(附45例报告)

目的：总结行腹腔镜结直肠癌根治术的临床经验。方法：回顾分析2003年5月至2007年5月45例行腹腔镜结直肠癌根治术患者的临床资料。其中右半结肠癌8例,左半结肠癌5例,乙状结肠癌20例,直肠癌12例。按传统根治术的要求术中使用超声刀或同时用结扎束游离结肠或直肠及其相应的肠系膜和淋巴、脂肪等组织。结肠癌根治术：在腹部左侧或右侧做5cm的辅助切口,腹腔外行肠切除和肠吻合。低位直肠癌行Miles手术者在充分游离乙状结肠和直肠后,在左下腹做辅助性小切口（乙状结肠造口处）,切断乙状结肠后,腹部手术组行乙状结肠造口,会阴手术组经会阴行直肠切除术。结果：手助腹腔镜右半结肠癌根治术6例,左半结肠癌根治术3例,乙状结肠癌、直肠中上段癌根治术20例,腹会阴联合直肠切除术6例。腹腔镜手术35例,中转开腹10例,中转率22．2％。无死亡病例。手术时间120～280min,平均180min;出血50～100ml,平均80ml。术后随访6～36个月,平均18个月。8例肿瘤复发、转移死亡,复发率22．9％。未发现腹壁小切口和穿刺孔转移。结论：依据结直肠肿瘤分期和部位选择合适的病例,用腹腔镜完成微创手术安全可行,可以达到根治目的。     

腹腔镜结直肠肿瘤手术18例报道

目的探讨腹腔镜结直肠肿瘤手术的安全性、有效性、手术方法及其应用价值。方法回顾性分析我院2007年6月至2008年3月期间18例结直肠肿瘤患者施行腹腔镜手术的临床资料和经验。结果本组中直肠癌5例，乙状结肠癌6例，乙状结肠息肉2例，降结肠癌和升结肠癌各2例，升结肠脂肪瘤1例。共15例手术顺利完成，其中施行Dixon手术4例，Miles手术1例，乙状结肠根治性切除5例，乙状结肠部分切除2例，左半结肠切除2例，右半结肠切除1例；3例患者因肥胖或肿瘤侵犯邻近器官而中转开腹手术，术中平均失血量约为110ml，平均清扫恶性肿瘤淋巴结数目13．5枚，术后肠功能恢复时间平均40h，平均住院时间9d，无手术死亡病例，无术后出血、吻合口漏等并发症。结论腹腔镜结直肠肿瘤手术具有创伤小、术后恢复快等优点，只要能严格把握适应证和熟练掌握腹腔镜技术，腹腔镜结直肠肿瘤手术安全、有效，具较好的应用前景。     

结直肠癌并发急性肠梗阻的外科治疗体会

为总结结直肠癌并发急性肠梗阻的外科治疗经验,吲顾分析2000年1月至2012年1月行手术治疗的72例结直肠癌并发急性肠梗阻患者资料,其中右半结肠癌30例．左半结肠癌和直肠癌42例。结果显示,30例右半结肠癌患者中,一期切除28例（一期吻合18例,二期吻合10例）,因肿瘤广泛浸润转移行肠造口1例,行短路手术1例;42例左半结肠癌和直肠癌患者中,一期切除29例（一期吻合10例,二期吻合19例）,行Hartmann术4例,因肿瘤广泛浸润转移行肠造口9例。术后切口感染4例,切口裂开1例,腹腔感染、脓肿形成3例,肺部、泌尿系统感染各1例,肾功能不全1例,心脑血管并发症2例,吻合口漏3例。围手术期死亡1例。本组患者5年生存率为26．4％（19／72）,其中一期切除者中一期吻合者5年生存率为35．7％（10／28）,二期吻合者5年生存率为31．0％（9／29）,两者差异无统计学意义,P〉0．05。结果表明,对于结直肠癌并发急性肠梗阻患者,应根据其自身情况及术中探查情况选择合理的手术时机和手术方式,做好围手术期的处理是减少术后并发症、降低病死率的关键。     

金属支架置入联合腹腔镜手术治疗左半结肠癌、直肠癌梗阻

目的探讨左半结肠癌、直肠癌梗阻患者支架置入后腹腔镜手术的安全性和可行性。方法2009年3月～2013年4月43例左半结肠癌、直肠癌梗阻根据患者及家属意愿选择手术方式,分为支架联合腹腔镜手术25例（支架腹腔镜组）,术中大肠灌洗一期切除吻合术18例（一期吻合组）,比较2组手术时间、住院时间、术中出血量、吻合口漏、切口感染、腹腔感染等。结果支架腹腔镜组术中出血量（40．5±20．1）ml,明显少于一期吻合组（280．8±20．6）ml（t=-38．277,P=0．000）;手术时间（135．2±25．4）rain,明显短于一期吻合组（240．4±30．5）min（t=-12．317,P=0．000）;吻合口漏0例,显著少于一期吻合组4例（Fisher’s检验,P=0．025）;切口感染0例,显著少于一期吻合组8例（Fisher’s检验,P=0．000）;腹腔感染0例,显著少于一期吻合组6例（Fisher’s检验,P=0．003）;住院时间（19．5±3．3）d与一期吻合组（20．2±8．5）d无明显差异（t=0．376,P=0．709）。2组患者术后6。12个月随访,恢复良好,无吻合口复发。结论左半结肠癌、直肠癌梗阻患者支架置入后7—10d腹腔镜手术安全可行,术后恢复快,并发症少。     

机器人手术系统辅助结肠癌手术13例

目的探讨达芬奇机器人手术系统辅助结肠癌手术的安全性与可行性。方法回顾性总结2010年5-11月实施的13例达芬奇机器人手术系统辅助结肠癌手术的治疗效果。结果13例结肠癌患者行右半结肠切除5例、左半结肠切除3例、乙状结肠切除5例。手术均顺利完成,无中转开腹。手术时间（171．5±31．8）min,术中失血量（54．6±21．8）ml,术后肠蠕动恢复时间为（60．9±15．8）h,术后住院时间（6．4±3．6）d。术后除1例切口脂肪液化外,未出现出血、吻合口瘘、吻合口狭窄等并发症。结论达芬奇机器人手术系统应用于结肠癌手术安全可行。     

一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用

目的 探讨一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用。方法 采用改良的淋巴结检出方法——强光直视下顺血管分层检出法对2016年11月~2019年2月在佛山市第一人民医院肛肠外科接受结直肠癌根治手术的100例手术标本进行淋巴结检出。结果 100例结直肠癌手术标本通过改良方法共检出淋巴结2303枚,平均每例（23.03±10.94）枚;阳性淋巴结178枚,平均每例（1.78±2.99）枚;53例直肠癌共检出淋巴结1138枚,平均每例（21.47±8.37）枚;阳性淋巴结91枚,平均每例（1.72±2.82）枚;23例乙状结肠癌共检出淋巴结442枚,平均每例（19.22±7.67）枚;阳性淋巴结43枚,平均每例（1.87±2.60）枚;8例降结肠癌共检出淋巴结130枚,平均每例（16.25±5.44）枚;阳性淋巴结13枚,平均每例（1.63±1.77）枚;16例右半结肠癌共检出淋巴结593枚,平均每例（37.06±13.19）枚;阳性淋巴结31枚,平均每例（1.94±4.42）枚;共7例结直肠癌标本术后淋巴结检出数不足12枚,分别为2例降结肠癌检出淋巴结（0/8）枚、（4/10）枚;3例乙状结肠癌检出淋巴结为（1/8）枚、（1/9）枚、（0/10）枚;2例直肠癌检出淋巴结为（0/6）枚、（1/11）枚。结论 改良淋巴结检出方法——强光直视下顺血管分层检出法是一种可行的淋巴结检出方法,具有在技术操作简单、无额外费用、易于推广等优点,能满足病理分期要求。     

一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用

目的 探讨一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用。方法 采用改良的淋巴结检出方法——强光直视下顺血管分层检出法对2016年11月~2019年2月在佛山市第一人民医院肛肠外科接受结直肠癌根治手术的100例手术标本进行淋巴结检出。结果 100例结直肠癌手术标本通过改良方法共检出淋巴结2303枚,平均每例（23.03±10.94）枚;阳性淋巴结178枚,平均每例（1.78±2.99）枚;53例直肠癌共检出淋巴结1138枚,平均每例（21.47±8.37）枚;阳性淋巴结91枚,平均每例（1.72±2.82）枚;23例乙状结肠癌共检出淋巴结442枚,平均每例（19.22±7.67）枚;阳性淋巴结43枚,平均每例（1.87±2.60）枚;8例降结肠癌共检出淋巴结130枚,平均每例（16.25±5.44）枚;阳性淋巴结13枚,平均每例（1.63±1.77）枚;16例右半结肠癌共检出淋巴结593枚,平均每例（37.06±13.19）枚;阳性淋巴结31枚,平均每例（1.94±4.42）枚;共7例结直肠癌标本术后淋巴结检出数不足12枚,分别为2例降结肠癌检出淋巴结（0/8）枚、（4/10）枚;3例乙状结肠癌检出淋巴结为（1/8）枚、（1/9）枚、（0/10）枚;2例直肠癌检出淋巴结为（0/6）枚、（1/11）枚。结论 改良淋巴结检出方法——强光直视下顺血管分层检出法是一种可行的淋巴结检出方法,具有在技术操作简单、无额外费用、易于推广等优点,能满足病理分期要求。     

腹腔镜乙状结肠癌根治术15例

目的探讨腹腔镜乙状结肠癌根治术的临床价值。方法回顾性分析2008年5月至2013年5月腹腔镜下乙状结肠癌根治术15例的临床资料。结果全组15例均在腹腔镜下完成手术,其中9例经体外行端端吻合,5例经肛门行直肠-乙状结肠端端吻合,1例行降结肠端造瘘。术后无吻合口瘘、吻合口出血等并发症发生,手术时间（192．8±33．5）min,平均186．8min,术中出血量（68．5±14．6）ml,平均59．6ml,术后住院时间（8．6±2．5）d,平均9．1d。结论腹腔镜乙状结肠癌根治术手术创伤小、术后恢复快,是治疗乙状结肠癌安全、可行的方法,但术者需有丰富的腹腔镜手术和结肠外科手术经验。     

Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove: initial experience with 9 cases

Our initial experience of performing a single-incision laparoscopic-assisted (SILS) colectomy using a "home-made" multichannel port system is presented. Nine patients (5 women) with a median age of 67 years (range, 55-72 years) and a median body mass index of 21.2 kg/m(2) (range, 17.8-26.7 kg/m(2)) underwent the SILS colectomy for colon cancer between September 2009 and March 2010. The sites of the primary tumor were the ascending colon (n=2), hepatic flexure (n=1), transverse colon (n=2), and sigmoid colon (n=4). Each trocar was introduced intraperitoneally through each finger of a surgical glove attached to the wound protector, which was applied to a midline fasciotomy made via a ?-circular periumbilical incision. If necessary, one to three radial splits were added to the incision. The colon was mobilized intracorporeally, and the vessels were ligated intra- or extracorporeally. All the patients underwent a curative segmental colectomy without conversion to a standard multiport laparoscopy or open surgery. The median operative time and blood loss were 140 min (range, 135-165 min) and 50 mL (range, 20-225 mL), respectively. The median number of harvested lymph nodes was 18 (range, 6-31). The pathological stages included stage 0 (n=2), stage I (n=6), and stage III (n=1). The median number of postoperative analgesic use was one (range, 0-6). No intra- or postoperative complications occurred in this series. Our SILS colectomy procedure seems feasible and safe in selected patients with colon cancer.     

Laparoscopic surgery for stage III colon cancerrid=""

BACKGROUND: The role of laparoscopic surgery in the management of colorectal cancer is controversial. This study was undertaken to determine the oncological adequacy, in terms of margins of resection, lymph node harvest, and anastomotic and locoregional recurrence of laparoscopic colectomy in patients with stage III (node-positive) colorectal cancer. METHODS: The results of laparoscopic colectomy in 50 consecutive patients with stage III colorectal cancer operated on at a single hospital between 1991 and 1998 were analyzed with respect to postoperative morbidity, mortality, and long-term survival by the Kaplan-Meier method. Methodical patient follow-up was the mainstay of the study. RESULTS: There were 31 men (52%) and 19 women (38%) with a mean age of 67.7 years (range, 40-88). Low anterior resection was performed in 17 cases, abdominal perineal resection in five cases sigmoid colectomy in 10 cases, left hemicolectomy in six cases, right hemicolectomy in seven cases, transverse colectomy in one case, and subtotal colectomy in four cases. Conversion was necessary in three cases (6%). Major complications included one leak, one pelvic abscess, one perineal wound infection, and three anastomotic strictures early in the experience, with none in the past 4 years. One early death occurred due to massive stroke. Median length of stay was 6 days (range, 3-37). Forty-six patients were staged as CII and four as CI colon cancer. The average number of positive nodes was 5.1 (range, 3-58). The margins of resection were adequate in all patients. Follow-up ranged from 3 to 75 months (average, 29.3; median, 24). Overall cancer-related mortality was 34% (17 patients); three patients died of unrelated causes with no detectable cancer. All who died of cancer had distant disease; three of them also had pelvic recurrence. Mean time of death was 21.7 months. There were no anastomotic recurrences or trocar site implants. Overall 3- and 5-year survival was 54.5% and 38.5%, respectively; cancer-adjusted survival was 60.8% and 49.1%. CONCLUSIONS: Based on this study, laparoscopic colectomy in patients with stage III colorectal cancer is oncologically adequate. It results in a long-term outcome comparable to that of traditional open surgery and is associated with low perioperative mortality and morbidity (lower wound infection rate, lower wound recurrences at trocar sites) and a shortened length of stay.     

机器人辅助多脏器切除在治疗结直肠癌中的应用

目的探讨机器人辅助多脏器切除治疗结直肠癌的安全性及可行性。 方法回顾分析2014年11月至2017年12月吉林省肿瘤医院收治的13例结直肠患者的临床资料,选择机器人辅助联合多脏器切除术作为治疗策略。分析患者的一般资料、手术结果及肿瘤学结果。 结果全组患者中男7例、女6例,中位年龄60岁,其中直肠癌5例、乙状结肠癌8例;行整块切除7例,联合肝部分切除2例、小肠部分切除3例、子宫切除3例、卵巢切除4例、膀胱及输尿管部分切除1例、右半结肠切除1例。全组中位手术时间为225 min(90～360 min)、中位出血量50 ml(15～600 ml),无术中输血。全组共中转手术5例,其中计划性中转手术3例、非计划性中转手术2例。所有患者均达到R0切除,无围手术期死亡,发生术后并发症2例。 结论机器人辅助多脏器切除治疗结直肠癌是安全、可行的。     

"Fast-track" and elective, laparoscopic colo-rectal surgery

The aim of this prospective clinical evaluation was to investigate the influence of "Fast-track"-treatment in patients undergoing laparoscopic colorectal operations and its effect on morbidity, hospital stay and recovery. PATIENTS AND METHODS: Bowel cleaning under enteral hypercaloric nutrition (Biosorb Energie, Fa. Nutricia, Germany) was achieved with Fleet (Ferring Arzneimittel, Germany) one day prior to surgery. A peridural catheter was placed preoperatively. Intraoperative electrolyte substitution should not exceed 12 ml/kg KG/h. In case of decreasing intraoperative blood pressure hydroxyethylstarch 6% was substituted. The nasogastric tube was removed immediately after the operation, the urinary catheter was removed on the first postoperative day. The patients stayed on the intermediate care department for one night and started already there with oral feeding and mobilisation (for 2 h). The following days mobilisation increased to 4 h daily under normal enteral nutrition without infusions. RESULTS: Between June 2003 and January 2006, 147 patients undergoing elective colorectal surgery were included in this study. Diverticulitis (n = 114), malignant tumors of the sigmoid colon (n = 6) or rectal cancer (n = 13), colonic adenomas (n = 5), stenotic Crohn's disease (n = 4) and small bowel carcinoid (n = 1), rectal prolaps (n = 1) and elongated colon sigmoideum (n = 4) were indications for surgical treatment. Laparoscopic sigmoid resection (n = 117), left hemicolectomy (n = 11), ileocecal resection (n = 8), anterior resection with total mesorectal excision (n = 9), abdomino-perineal exstirpation (n = 1) and anterior-segmental resection of the rectum (n = 1) were performed. Drainages were removed on the 2nd, peridural catheter on the 3rd postoperative day. Defecation occurred in all patients until the 2 (nd) postop. day. Early postoperative complication rate was 15% (22/147 patients) without mortality. 8 patients (5%) with anastomotic leakage were reoperated. The mean hospital stay was 6 days. The re-admission rate was 3% (4/147 patients) and included one patient with anastomotic leakage. CONCLUSION: "Fast-track"-treatment in combination with minimal-invasive surgery is a safe and comfortable perioperative treatment for patients with elective colorectal operations.     

腹腔镜下治疗直肠癌同时伴右半结肠癌手术体会

目的探讨腹腔镜下同时行右半结肠癌与直肠癌手术治疗的可行性。方法对13例右半结肠癌与直肠癌并存的患者,采用腹腔镜下同时手术。13例患者中3例进行腹腔镜下全大肠切除,回肠J型储袋肛管吻合术,10例行Ⅰ期行右半结肠根治术联合直肠癌根治术(CME)。CME原则均行D3手术,直肠手术遵循全直肠系膜切除术原则。行直肠前切除9例,经腹会阴联合直肠癌根治术1例。中转开腹1例。结果术前肠镜探查符合率69.23%(9/13),腹腔镜手术探查发现4例。12例Ⅰ期愈合,无切口感染,无吻合口瘘,无肠黏连肠梗阻。手术后中位进流食时间1~3天,进食固体食物的时间6~9天,手术后平均住院时间(8.7±0.8)天。9例完成3年随访,7例无瘤存活。结论对于同时伴有右半结肠癌和直肠癌的患者,腹腔镜是一种比较好的探查和手术根治方式,Ⅰ期切除安全、有效。     

左半结肠癌肠梗阻术中排便一期切除吻合术的应用

目的 探讨术中排便一期切除吻合在左半结肠癌肠梗阻中的应用价值.方法 回顾分析我院2000年1月至2008年1月收治的39例左半结肠癌合并肠梗阻行术中排便一期切除吻合患者的临床资料.结果 39例患者中男性25例,女性14例,年龄57～78岁,平均年龄68.5岁.肿瘤位于结肠脾曲3例(7.7%),降结肠8例(20.5%),乙状结肠15例(38.5%),直肠、乙状结肠交界8例(20.5%),直肠上段5例(12.8%).全部行术中排便一期切除吻合,左半结肠切除18例,乙状结肠切除13例,骶前切除8例.术后切口感染4例,其中1例切口裂开;肺部感染5例.1例吻合口瘘并发腹腔脓肿,二次手术后死于肿瘤转移.1例患者死于肺部感染呼吸衰竭.并发症和病死率分别为25.6%和5.1%.结论 术中排便一期切除吻合术是左半结肠癌肠梗阻可行的手术方式,效果满意.     

Minimally invasive surgery is safe and effective for urgent and emergent colectomy

Objective There are a limited number of studies describing the role of minimally invasive colectomy for urgent or emergent conditions of the large bowel. We hypothesize that laparoscopic colectomy in urgent and emergent setting can be performed safely in select settings. Method A cohort of patients treated at a single institution from 2001 to 2006 was identified from a prospective database. Patients who underwent open or minimally invasive surgery (MIS), including laparoscopic (LAP) or hand‐assisted laparoscopic surgery (HALS) colectomy for urgent and emergent conditions were included. Results A total of 68 [open 32, MIS 36 [HALS 22, LAP 14)] patients underwent urgent or emergent colectomy on our colorectal service during the 5‐year time period. Patients with toxic colitis were more often selected for MIS. Patients with colon perforation or large bowel obstruction were more often selected for open surgery. The MIS group had a lower body mass index (BMI), lower American Society of Anesthesiologists fitness grade and was more likely to have been immunosuppressed. There was no difference in patient morbidity between the open and MIS groups. The MIS group had a longer median operative time and fewer cases of prolonged hospitalization. Conclusion We conclude that minimally invasive colectomy by experienced surgeons appears to be safe and effective for appropriately selected patients with emergent and urgent conditions of the large bowel.     

Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases.

Schwannomas of the colon and rectum are uncommon and incompletely characterized tumors, and only a small number of cases have been reported. This study was undertaken to determine the clinicopathologic profile of such tumors. A total of 20 colorectal schwannomas were identified and analyzed in a review of 600 mesenchymal tumors of the colon and rectum from the files of the Armed Forces Institute of Pathology. The schwannomas occurred equally in men (n = 9) and women (n = 11) in a wide age range (18-87 years; median age 65 years). The most common location was cecum (n = 7), followed by sigmoid and rectosigmoid (n = 6), transverse colon (n = 3), descending colon (n = 2), and rectum (n = 1); the location of one tumor had not been specified. The tumors commonly presented as polypoid intraluminal lesions, often with mucosal ulceration. Rectal bleeding, colonic obstruction, and abdominal pain were the most common presenting symptoms. The most common histologic variant (n = 15) was a spindle cell schwannoma with a trabecular pattern and vague or no Verocay bodies. These tumors ranged from 0.5 to 5.5 cm in diameter. A lymphoid cuff with germinal centers typically surrounded these tumors and focal nuclear atypia was often present, but mitotic activity never exceeded 5 per 50 HPF. All four epithelioid schwannomas occurred in the descending colon or sigmoid, three of them as small submucosal tumors. There was one plexiform schwannoma in the sigmoid composed of multiple nodules of prominently palisading schwann cells similar to those seen in conventional soft tissue schwannomas. All tumors studied were strongly positive for S-100 protein and also for low affinity nerve growth factor receptor (p75), collagen IV, and GFAP. Three tumors had CD34-positive cells, but all were negative for CD117 (KIT), neurofilament proteins, smooth muscle actin, and desmin. The percentage of MIB-1-positive cells was usually less than 1% and never higher than 3%. Colorectal schwannomas behaved in a benign fashion with no evidence of aggressive behavior or connection with neurofibromatosis 1 or 2, based on follow-up information on 18 patients.