摘要
Purpose. This study aims to review our hospital experience of adult intussusception of the colon to assess the clinical features, diagnosis, malignant predictive factors, and management. Methods. From February 2004 to January 2018, 26 patients aged ＞ 18 years were diagnosed with colonic intussusception because of colonic lesions and underwent surgical intervention at Mackay Memorial Hospital. Using SPSS version 22.0 with binary logistic regression analysis, we collected data about medical parameters in this study. Results. Abdominal computed tomography confirmed intussusception in 96.2% of patients. The leading symptom in all cases was abdominal pain. All colonic leading points of 19 patients who underwent colonoscopy were proved by the procedure. A majority of operation pathology results were malignant, and none of our patients received the preoperative reduction, although 2 patients had a perioperative reduction. Furthermore, patients' sex, anemia, and lesion size exhibited statistical significance about the malignant pathology. Conclusions. While abdominal computed tomography is the preferred preoperative diagnostic modality, colonoscopy is a reliable procedure to confirm colon lesions preoperatively. Radical operation without preoperative reduction was suggested because of the high incidence of malignant lesions in the adult group. Furthermore, female patients, anemia, and large lesion size favor malignant pathology results statistically, implying that laparoscopic surgery could be performed in selected patients.
並列摘要
目的：此研究的目的，藉由分析本院過去關於關於成人大腸腸套疊的案例，以分析臨床特徵、診斷、適當的處置以及惡性病灶的預測因子。方法：從2004年2月到2018年1月，這十四年來在馬偕醫院共有26位年齡超過18歲的成人大腸腸套疊患者被診斷，我們應用第22版的統計分析軟體SPSS，並使用二元羅吉斯迴歸分析以分析統計我們的臨床醫學數據。結果：腹部電腦斷層掃描確認了96.2%患者的腸套疊診斷，而最常見的臨床症狀是腹痛。在我們的研究中，19個有接受大腸鏡檢查的病人，其大腸病灶皆可經由大腸鏡檢觀察到；大部分患者的手術病理結果為惡性，我們研究中沒有任何病人接受術前的腸套疊復位，而有兩位病人在手術中有做腸套疊的復位。患者的性別、貧血以及病灶尺寸對於惡性病理的預測，有統計學上的意義。結論：成人腸套疊大部份的術前診斷是藉由腹部電腦斷層確診，而術前的大腸鏡對於大腸病灶的確認是個可靠的檢查；由於成人族群的高惡性率，根除性手術並且不做術前的套疊復位，為比較建議的治療；根據統計結果，女性、貧血及大尺寸病灶的腸套疊患者，其病理報告較可能為惡性；而我們也可以在適當的案例，選擇以腹腔鏡做根除性手術。
參考文獻
被引用紀錄
延伸閱讀
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