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首页> 外文期刊>Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland >Colorectal surveillance after segmental resection for young‐onset colorectal cancer: is there evidence for extended resection?
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Colorectal surveillance after segmental resection for young‐onset colorectal cancer: is there evidence for extended resection?

机译：结直肠监测节段切除术后对于年轻必经发生结直肠癌:有evidence扩大切除吗?

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Abstract Aim Although sporadic colorectal cancer (CRC) usually occurs in patients aged over 50, recent evidence suggests that the incidence is increasing in younger patients. Such patients are theoretically at high risk of metachronous neoplasia and may be candidates for extended prophylactic colectomy. This study aimed to define the risk of metachronous cancer/adenomas during follow‐up of younger patients who underwent segmental colectomy for CRC. Method A CRC database was used to identify patients aged under 50 who underwent surgery for CRC between 1994 and 2010. Patients diagnosed with hereditary cancer or inflammatory bowel disease were excluded. The primary end‐points were frequency of extended resection and the rates of metachronous cancer and high‐risk adenomas during follow‐up. Results There were 284 young patients with a resectable primary tumour, of whom 280 (98.6%) underwent segmental resection, 3 (1%) extended resection and 1 (0.4%) local resection. Endoscopic follow‐up was available for 150 of the patients who had segmental colectomy, with a mean age of 42.6 (±5.8) years at diagnosis and median follow‐up time of 68?months (interquartile range 45–105). Out of these 150 patients, 4 (2.7%) developed metachronous colonic adenocarcinoma at 24, 71, 151 and 228?months after index surgery. Thirty additional patients had at least one adenoma identified during surveillance, and three had sessile serrated polyps. Out of the three patients undergoing extended resection, none had metachronous cancer or advanced adenomas at an average follow‐up of 17?years. Conclusion A segmental colectomy or proctectomy is adequate treatment for patients presenting with CRC under the age of 50.
机译：抽象的目的虽然零星的结肠直肠癌(CRC)通常发生在超过50岁的病人最近的证据表明,发病率增加在年轻病人。理论上metachronous高危瘤和可能的候选扩展预防结肠切除术。定义metachronous癌症/腺瘤的风险在遵循必经的年轻患者接受了CRC节段结肠切除术。CRC数据库被用来识别患者年龄50岁以下的人之间的CRC动了手术1994年和2010年。癌症和炎症性肠病排除在外。扩展的切除和利率的metachronous癌症和高期间腺瘤风险遵循优先。可切除的原发性肿瘤,其中有280(98.6%)进行节段切除,3例(1%)扩大切除和当地切除1例(0.4%)。内窥镜遵循优先用于150年的患者节段结肠切除术,的意思42.6(±5.8)岁时诊断和中位数遵循68年的时间了吗?45 - 105)。开发metachronous结肠腺癌24日,71年,151年和228年?三十个额外的患者至少有一个在监测、腺瘤鉴别,三人无柄锯齿状息肉。接受扩大切除的患者,没有metachronous癌症或在一个先进的腺瘤遵循量平均17吗?。节段性结肠切除术或直肠切除术是足够的CRC患者治疗50岁。

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