大肠癌合并大肠息肉的外科治疗体会

为探讨大肠癌合并大肠息肉的手术处理方法及疗效，回顾分析56例大肠癌合并大肠息肉病例的诊治资料。结果显示，2004年3月至2009年7月收治的255例大肠癌患者中共发现并存大肠息肉者56例，其中45例行术前息肉摘除手术，7例行术中结肠息肉切除，4例在术后进行结肠息肉摘除。全组无手术并发症发生，息肉切除部位无残留、恶变或癌种植转移。结果表明，术前应用内镜切除是治疗大肠癌合并大肠息肉的主要手段；不宜内镜切除者，尽量采用扩大切除术；远离大肠癌常规切除范围、较分散的息肉和不宜扩大切除的患者，可在内镜定位下行局部切除，如为恶性息肉则行结肠次全或全切除。双镜联合可提高大肠息肉的诊治水平。

Experience on the Surgical Treatment of Large Intestinal Carcinoma Associated with Large Intestinal Polyps

In order to investigate the operative decision for large intestinal carcinoma associated with large intestinal polyps,and its therapeutic effect,author retrospectively analysed the diagnosis ＆ treatment data from 56 patients with this diseases. As results,among the 255 patients with large intestinal carcinoma ad- mitted from March 2004 yr. to July 2009 yr. 56 patients were associated with large intestinal polyps, in- cluded 45 subjected to preoperative removal of polyps,7 to intraoperative resection of large intestinal polyps,and 4 to postoperative removal of large intestinal polyps ; In the 56 patients no operative complication, no residual tissue, carcinomatous conversion or metastasis of a cancer at resected sites of polyps were found. Results show that preoperative endoscopic resection is of main measures for treating the concurrent disease; for the patients unfit for endoscopic resection, as possible as using extended resection is done; for the patients unfit to extended resection,and the more interspersed polys more far from routine resection range of large intestinal carcinoma ,performing local resection under endoscope could be done;if malignant polyps, must be pancolectomy or sub-resection of colon;using double-endoscope can enhance the level of diagnosis ＆ treatment of large intestinal polyps.