结肠镜提示大肠癌致不全梗阻病例术后肠镜复诊情况分析

目的 对术前行结肠镜检查提示因大肠癌致不全梗阻的病例进行汇总分析,从而更好地指导该类患者术后肠镜复查.方法 汇总2009年4月至2019年4月在吉林大学第一医院胃肠内科·内镜中心行肠镜检查并提示因大肠癌致不全梗阻的208例病例,研究纳入患者的基本资料,并按肿瘤位置进行左(L组)右(R组)半结肠分组,对比分析术前肠镜结果...

Follow-up of colonoscopy after curative surgical resection for colorectal cancer with incomplete obstruction

Objective To study the cases of colorectal cancer with incomplete obstruction which was revealed by preoperative colonoscopy.Methods All included cases of colorectal cancer with incomplete obstruction which was revealed by preoperative colonoscopy were studied retrospectively between April 2009 and April 2019 in the First Hospital of Jilin University.According to the location of the tumors,all cases were divided into two groups:right-sided group(group R)and left-sided group(group L),and the relevant clinical and pathological data were compared and analyzed.Results Totally 208 cases were included,with group R and group L including 66 and 142 cases respectively.For the quality of colon cleansing of preoperative colonoscopy,group L was better than that of group R(χ²=52.905,P<0.01).A total of 77 cases were reexamined by colonoscopy,accounting for only 37.0%,and the median follow-up time was 8.0(6.0~12.0)months.In group L,one case of primary colorectal cancer was found.There was no significant difference between the two groups in terms of the proportion of newly discovered polyps(53.8%vs.56.9%,χ²=0.064;P=0.801).For the distribution of polyps on the anal side of the anastomosis,the incidence of cases in group R was significantly higher than that in group L(53.8%vs.7.8%,χ²=20.346;P<0.01).The local recurrence rate of middle and low rectal cancer was 11.8%,which was higher than that of other colorectal cancer(χ²=7.247,P<0.05).Conclusion For patients suffering from colorectal cancer with incomplete obstruction which was revealed by preoperative colonoscopy, early post-operative colonoscopy should beoffered. Missed polyps should be noted in the follow-up of colonoscopy after right hemicolectomy. For theleft-sided colorectal cancer, the possibility of multiple primary cancers should be excluded. Especially, for themiddle and low rectal cancer, local recurrence of the anastomosis should be paid attention to after anuspreserving operation, so as to improve the survival of such patients.