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为了提高同时性大肠多原发癌的正确诊断率。方法对422例大肠癌病人进行术前纤维结肠镜检查、钡灌肠检查及术中纤维结肠镜检查。结果发现16例同时性多原发性大肠癌,占同期大肠癌病人的2.9%。钡灌肠检查的正确诊断率在75%以上,纤维结肠镜检查的正确诊断率90%以上,同时性多原发大肠癌常因临床医生重视不够或发现一个病灶而忽视多发病状的存在,从而造成术前漏诊。结论我们主张大肠癌病人术前钡灌肠检查及纤维结肠镜检查应做为常规,对于术前未能行纤维结肠在检查的病人应做术中结肠镜检查,以减少同时性多发癌的漏诊。手术中应将切下的标本剖开检查,从而决定手术切除的范围是否合理。
In order to improve the accuracy of simultaneous diagnosis of multiple primary colorectal cancers. Methods 422 patients with colorectal cancer were examined by preoperative colonoscopy, barium enema and intraoperative colonoscopy. The results found that 16 cases of simultaneous multi-primary colorectal cancer, accounting for 2.9% of patients with colorectal cancer in the same period. The correct diagnosis rate of barium enema examination is above 75%, and the correct diagnosis rate of colonoscopy is more than 90%. Simultaneous multi-primary colorectal cancer often results from the insufficient attention of clinical doctors or the discovery of one lesion while ignoring the presence of multiple cases. Missed before surgery. Conclusions We advocate that preoperative barium enema examination and colonoscopy should be used as routine. Colonoscopy should be performed for patients who cannot undergo fiber colonoscopy before surgery to reduce missed diagnosis of simultaneous multiple cancers. Surgical specimens should be cut open to determine whether the scope of surgical resection is reasonable.