[对结肠直肠癌内镜切除后手术额外切除病例的研究]
Shohei Hayashi1, Kazuyoshi Shiga, Haruka Shigemori
1Dept. of Gastroenterological Surgery, Nagoya City University Graduate School of Medicine.
Gan to kagaku ryoho. Cancer & chemotherapy
|January 17, 2026
概括
对于pT1结直肠癌,通常建议在内镜切除后进行外科切除. 然而,淋巴结转移很罕见,特别是在表现不佳的老年患者中.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 在内镜切除后的pT1结直肠癌携带淋巴结转移的风险.
- 对于表现不佳的老年患者来说,进行额外手术的决策是复杂的.
- 大多数病例 (约. 90%) 没有表现为淋巴结转移.
研究的目的:
- 为了评估pT1结直肠癌患者淋巴结转移的发病率,在内镜切除后进行外科额外切除.
- 在这个患者队列中确定与淋巴结转移相关的危险因素.
主要方法:
- 35名接受外科外科切除后内镜切除的患者的回顾性审查 (2019年1月 - 2024年12月).
- 根据切除和切除边缘状态的指示,分析淋巴结转移率.
- 对复发的后续行动.
主要成果:
- 整体淋巴结转移率为8.6% (3/35例).
- 在多种风险因素 (15.0%, 3/20) 和积极切除边缘 (25.0%, 2/8) 的病例中观察到更高的转移率.
- 在随访期间没有发现复发.
结论:
- 对于具有多个风险因素的pT1结直肠癌或由于淋巴结转移的发病率较高而具有积极的切除边缘,建议进行外科额外切除.
- 该研究支持在选定的病例中进行手术管理的风险分层方法.
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