Clinical Analysis on Endoscopic and Surgical Treatment Outcome of Colonic Lipomas: A 12-year Study in Southern Taiwan

結腸脂肪瘤以內視鏡及手術處理的臨床分析；南台灣12年研究

盧龍生(Lung-Sheng Lu) ； 盧建璋(Chien-Chang Lu) ； 戴維震(Wei-Chen Tai) ； 蔡鎧隆(Kai-Lung Tsai) ； 黃昭誠(Chao-Cheng Huang) ； 吳耿良(Keng-Liang Wu) ； 邱逸群(Yi-Chun Chiu) ； 蔡成枝(Seng-Kee Chuah)

《中華民國大腸直腸外科醫學會雜誌》 26卷1期 (2015/03) Pp. 1-7

https://doi.org/10.6312/SCRSTW.2015.26(1).10321

摘要

背景　結腸脂肪瘤為一種相對少見的腫瘤，此次研究目的在分析使用內視鏡與手術方式治療結腸脂肪瘤之臨床結果分析。方法　回顧12年間，共納入16例確診病例，可分為手術治療組（9例）與內視鏡治療組（7例），結腸脂肪瘤的診斷均基於病理組織確診。結果　大多數有臨床症狀的病例均歸在手術治療組；內視鏡治療組的脂肪瘤大小較手術治療組為小；共有六位患者接受腹腔鏡手術，其中有三位接受單一切口腹腔鏡手術，在目前的研究中並未發現有與手術相關之併發症或死亡病例。結論　在適當的選擇下，不論手術或內視鏡治療結腸脂肪瘤均有不錯的結果，一般較大的無莖型脂肪瘤應該採用手術切除，特別是扁平病灶或底部較寬的病灶、內視鏡觀察下懷疑惡性腫瘤、或病患合併有臨床症狀例如腸套疊或嚴重出血。

關鍵字

結腸脂肪瘤 ； 內視鏡治療 ； 手術治療 ； 治療結果

並列摘要

Background. Colonic lipomas are relatively uncommon tumors.We aimed to analyze the clinical outcome of colonic lipomas and discuss the controversial issues on surgery or endoscopic treatments. Methods. Over 12 years period, six-teen confirmed diagnoses of colonic lipomas were enrolled. They were analyzed by dividing into surgical (n=9) and endoscopic treated group (n=7). Diagnosis of colonic lipoma was made based on pathological report. Results. More symptomatic patients were observed in the surgical group (p=0.001). Patients in the endoscopic treated group had smaller size lipoma than the surgical group (median (interquartile range, IQR) size of 0.9 (0.6-3.5) cm vs. 3.3 (2.75-4.1) cm, p=0.016). Six patients received laparoscopic surgery and three of them by single-incision laparoscopic surgery. There were no immediate procedure-related morbidity and mortality in current study. Conclusions. Treatment outcome of colonic lipomas are good for both surgical resection and endoscopic treatments with appropriate decisions. Generally, larger colon lipomas without stalk should be treated by surgical resection, especially the sessile or broadly-based ones, malignant appearance on endoscope examination, and in symptomatic patients like intussusception or severe bleeding.

並列關鍵字

Colonic lipomas ； Endoscopic treatment ； Surgical resection ； Treatment outcome

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