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Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition) ›› 2021, Vol. 08 ›› Issue (01): 13-17. doi: 10.3877/cma.j.issn.2095-7157.2021.01.002

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical study on the timing of endoscopic therapy for colorectal cancer combining with high-risk adenoma

Xiaojing Li1, Xiaozhong Gao2,(), Yanliu Chu2, Jianming Sun3, feng Liu2, Junwei Song3   

  1. 1. Clinical College of Binzhou Medical College. Binzhou 256622, China; Central Hospital of Zibo Mining Group Co., Ltd. Zibo 255120, China
    2. Clinical College of Binzhou Medical College. Binzhou 256622, China
    3. Central Hospital of Zibo Mining Group Co., Ltd. Zibo 255120, China
  • Received:2020-10-13 Online:2021-02-15 Published:2021-03-23
  • Contact: Xiaozhong Gao

Abstract:

Objective

To explore the appropriate time of endoscopic treatment for colorectal cancer patients with high-risk adenomawho could be operated on electively.

Methods

A total of 88 patients with colorectal cancer complicated with high-risk adenoma in Weihai Municipal Hospital from January 2013 to June 2018 were collected and divided into two groups.There were 52 patients in group A, with 96 high-risk adenomas. Patients in this group underwent surgery for colorectal cancer first, and endoscopic treatment for high-risk adenomas within six months after the operation; There were 36 patients in group B, with 54 high-risk adenomas. Patients in this group were first treated with colorectal high-risk adenomas under endoscopic treatment, and then received surgical treatment for colorectal cancer 1 to 2 weeks later. And record the patient's preoperative condition, surgery-related condition, Colonoscopy and tumor recurrence were followed up 3-36 months after operation.

Results

In group A, the adenoma was resected after surgery, among which 4 patients developed cancerous adenomas and underwent secondary surgical resection.The other 4 patients had anastomotic recurrence and underwent secondary surgery. In group B, 1 case of perforation occurred during adenoma resection. and surgical section resection was performed, the other 2 cases also showedthe adenoma became cancerous and submucosa >1 000 μm, and underwent surgical segmental resection, and no recurrence of anastomotic stoma was found in postoperative reexamination. The incidence of secondary surgical operations between the two groups was statistically significant (P<0.001).

Conclusion

For patients with colorectal cancer combined with high-risk adenomas that can be surgically operated on, endoscopic treatment of colorectal adenomas first and colorectal cancer surgery 1 to 2 weeks latercan effectively reduce the occurrence of secondary surgical operations, is worthy of widespread clinical promotion.

Key words: Colorectal cancer, High risk adenoma, Endoscopic therapy, Secondary surgery

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