大腸ポリペクトミー後の経過―腺腫および癌の新生について

Courses after Colorectal Polypectomy: Metachronous Adenoma and Carcinoma

要旨　大腸ポリペクトミー後1年以上，平均4年の経過が明らかな151例を対象とし，初回注腸X線フィルムの見直しなど厳密な意味での腺腫あるいは癌の新生について検討した．腺腫の新生は12例（7.9％）で，新生したポリープのほとんどは径10mm以下の無茎性ないし亜有茎性で，長期経過観察例および初回多発例で新生率が高い傾向がみられた．経過観察中，進行癌1例を含め3例の大腸癌が発生したが，明らかな新生例は広基性の早期直腸癌1例のみであった．

　Developing subsequent colorectal adenoma or carcinoma, in the strict sense of the word, has been studied in 151 cases who were closely followed up on an average of four years at least one year after polypectomy. Frequency of subsequent additional adenoma was seen in 12 cases (7.9%). Mostly these polyps were sessile or semipedunculated less than 10 mm in diameter. They were more often found in those cases followed up for a long time or in those which showed multiple occurrence at the outset. In the course of follow-up three cases of carcinoma including a case of advanced cancer developed, but strictly metachronous carcinoma was seen in only one case of broad-based early carcinoma of the rectum.