在显著的直肠息肉中对隐性恶性瘤的风险进行基层化:专家多学科团队 (MDT) 的结果
Douglas Penman1, Ashley Keogh1, Shakil Ahmed1
1The Department of Colorectal Surgery, Liverpool University Hospitals Foundation Trust, Liverpool, UK.
概括
一个专业的多学科团队准确地分层了直肠多,改善了大多数恶性病例的治疗. 然而,错误的分类导致了12名患者的不良结果,突出了需要更好的评估策略的需要.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 在瘤学瘤学.
背景情况:
- 在直肠中评估显著的息肉或早期结肠癌 (SPECC) 是具有挑战性的,因为潜在的恶性瘤和缺乏标准化的评估.
- 英国国家卫生和护理卓越研究所 (NICE) 建议多学科团队 (MDT) 会议,以提高这些患者的治疗结果.
研究的目的:
- 评估早期直肠癌 (SERC) 专家MDT在风险分层直肠病变中的表现.
- 确定对经历不良结果的患者进行分期调查的局限性.
主要方法:
- 在2014年至2019年期间由SERC MDT评估的350个SPECC病变的回顾性审查.
- 病变被分为低风险,中等风险或高风险组,基于切除前恶性瘤风险.
- 切除前的类别与切除方法和最终组织学进行了比较.
主要成果:
- 总体癌症发病率为15.5% (4.8%低风险,8.3%中等风险,53%高风险).
- 八个低风险病变是切割后的恶性病变;五个高风险病变是手术后的良性病变.
- 12名患者因错误分类而经历了不良结果.
结论:
- 该SERCMDT成功地对83%的恶性息肉进行了适当的切除,并避免了大多数良性病变的手术.
- 尽管取得了成功,但错误分类导致了12个糟糕的结果,表明需要改进评估策略.
- 需要进一步的研究来确定直肠SPECC病变的最佳评估策略.
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