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我院自1990～1998年,经结肠镜检查、手术探查和病理确诊,多发性大肠癌41例,现对其临床诊治情况报告如下: 1 临床资料 1.1 一般资料 男26例、女15例,年龄20～78岁:41例多发性大肠癌有癌灶87个,分布于直肠、乙状结肠癌灶61个(70％)。癌灶为2个昔共37例,3个3例,4个1例:癌位于同一肠段者21例,相邻段12例,相距甚远者8例。 1.2 病灶大小及病理类型 87个病灶,直径在2.5cm以上者45个(52％),1cm以下者15个(17％),其余在1～2.5cm之间。癌灶经病理学诊断:管状腺癌61个,低分比腺癌16个,粘液腺癌10个。 1.3 癌伴腺瘤及腺瘤癌变 41例多发性大肠癌中,多发癌伴腺瘤有27例(65.8％),另有12例18个癌灶为腺瘤癌变(29.2％):18个腺瘤癌变灶中管状腺瘤6个,绒毛状腺瘤8个,混合性腺瘤4个。 1.4 纤维肠镜检查及手术方式 41例多发癌38例由纤维肠镜诊断,3例因肿物阻塞引起肠腔狭窄,纤镜不能通过,后经术中探查证实。36例行根治术,2例姑息切除,3例改道手术。
Our hospital from 1990 to 1998, colonoscopy, surgical exploration and pathological diagnosis, 41 cases of multiple colorectal cancer, is now its clinical diagnosis and treatment are reported as follows: 1 Clinical data 1.1 General Information 26 males and 15 females, age 20 ~ 78 years old: 41 cases of multiple colorectal cancer with 87 lesions, located in the rectum, sigmoid colon foci 61 (70%). Focal lesions in 2 were a total of 37 cases, 3 in 3 cases, 4 in 1 case: cancer located in the same segment of the bowel in 21 cases, adjacent segments in 12 cases, far apart in 8 cases. 1.2 lesions and pathological types of 87 lesions, more than 2.5cm in diameter 45 (52%), less than 1cm 15 (17%), the rest between 1 ~ 2.5cm. Pathological diagnosis of foci: tubular adenocarcinoma 61, 16 low-grade adenocarcinoma, mucinous adenocarcinoma 10. 1.3 Carcinoma with adenoma and adenoma Carcinoma in 41 cases of multiple colon cancer, multiple adenocarcinoma with adenoma in 27 cases (65.8%), and another 12 cases of 18 cancerous adenoma (29.2%): 18 glands Tubular tumor in focus tubular adenoma 6, villous adenoma 8, mixed adenoma 4. 1.4 fiber colonoscopy and surgical approach 41 cases of multiple cancers 38 cases diagnosed by fiberoscopy, 3 cases of intestinal obstruction caused by stenosis, fibrinoscopy can not pass after confirmed by intraoperative exploration. Thirty-six patients underwent radical surgery, two patients underwent palliative resection and three patients underwent surgery.