Salvage radical surgery in early-stage colorectal cancer patients undergoing non-curative endoscopic resection
10.3760/cma.j.cn113855-20230918-00147
- VernacularTitle:早期结直肠癌内镜非治愈性切除补充外科根治性手术的必要性分析
- Author:
Shuo FENG
1
;
Weidong DOU
;
Yingchao WU
;
Guowei CHEN
;
Tao WU
;
Yong JIANG
;
Pengyuan WANG
;
Jixin ZHANG
;
Yunlong CAI
;
Long RONG
;
Junling ZHANG
;
Xin WANG
Author Information
1. 北京大学第一医院胃肠外科，北京 100034
- Keywords:
Colorectal neoplasms;
Endoscopic mucosal resection;
Surgical procedues, operative
- From:
Chinese Journal of General Surgery
2024;39(2):81-85
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate whether additional radical surgery is necessary following non-curative endoscopic resection of early colorectal cancer.Method:Clinicopathological data in 104 patients following non-curative endoscopic resection of early colorectal coucer at the Department of General Surgery, Peking University First Hospital between Jan 2011 and Dec 2021.Results:Lymph node metastasis and/or residual cancer was found in 23 patients (22%), including 12 cases of lymph node metastasis, 7 cases of residual cancer and 4 patients with both residual cancer and lymph node metastasis. Univariate analysis indicated that vascular infiltration, positive vertical margin, and female gender were risk factors for lymph node metastasis. Risk factors for residual cancer were tumors ≥2 cm in size, negative lift sign, infiltration depth of ≥1 000 μm, and positive horizontal and vertical margins. Multivariate Logistic regression analysis revealed that vascular invasion, positive vertical margins, and being female were independent risk factors for lymph node metastasis, while positive vertical margins was independent risk factor for residual cancer. Salvage surgery lasted for a median of 184 (156-233) minutes, with an estimated blood loss of 50 (20-100) ml and an average postoperative hospital stay of 9 (8-11) days. Seven cases of Clavein-Dindo Ⅱ or higher complications were observed, including pulmonary embolism in 1 case , anastomotic leakage in one, lymphatic fistula in one, bowel obstruction in 2 cases and urinary tract infection in 2 cases.Conclusion:Salvage surgery is mandatory for early endoscopic non-curative resection of colorectal cancer.
