[Techniques of endoscopic treatment of malignant colorectal adenomas with respect to the subsequent prognosis of the patients].
Since 1981 we detected in 45 patients (28 men, 17 women) 31 adenomas with severe dysplasia (ATD; formerly intramucous carcinoma) and 22 invasive carcinomas in the adenoma (IK penetrating beneath the muscularis mucosae). 95% of all findings were in the left colon before the lienal flexure. Patients with ATD were subjected only to endoscopic operation; of 22 of the subjects with IK 15 were recommended for surgery, and endoscopic treatment alone was provided to seven patients. Forty subjects were followed up on a long-term basis (on average for 34 months). Of 23 patients with ATD one female patient died from ischaemic heart disease, the remainder survive without signs of colorectal carcinoma. Of 17 subjects with IK followed up on a long-term basis five died (all after surgery as a result of generalization of the disease). All 7 patients with IK who had only endoscopic treatment survive without signs of relapse of the disease. In patients with ATD the authors consider EP as the definite therapeutic method, if it is feasible from the technical aspect. Patients with ATD and IK who were subjected to EP are checked after 6 weeks. A total coloscopic check-up is made subsequently in subjects with IK during the first year twice a year and in later years once a year, in subjects with ATD after annual intervals for a period of 5-6 years.
Dosedĕl
J
J
Interní oddĕlení Fakultní polikliniky, 1. lékarské fakulty Univerzity Karlovy, Praha.
Fric
P
P
Dvoráková
H
H
Zádorová
Z
Z
Jirásek
A
A
Capek
P
P
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Taktika endoskopického osetrení maligních kolorektálních adenomů s prihlédnutím k dalsímu osudu nemocných.