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.
维普
万方数据