The treatment of early cancer of the colon.

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Since Jan. 1982, 231 cases of early carcinoma of the colon were experienced in our hospital. The relationship between their properties and their operational methods and results was analysed. 1. The 231 cases consist of 140 mucosal and 98 submucosal carcinoma. 2. The techniques for the resection were fiberscopic polypectomy in 113 cases, intestinal resection in 96 cases and local resection in 29 cases. The local resection comprises 6 cases of colotomy, 22 cases of transanal and one case of transsacral resection. 3. Secondary resection of the colon was performed in 19 cases, the main reason of which is invasion into the resected margin in 12 cases. 4. Fiberscopic polypectomy was selected on judgement to qe benign in 94 cases, to clarify invasion in 113 cases and on judgement to be confined to the mucosa in 5 cases. Resection of the colon was performed in such cases as difficult in fiberscopic polypectomy in 18 cases, diagnosed as submucosal ca. in 13 cases and diagnosed as progressed ca. in 29 cases. 5. Morhologically, elevated lesions as Isp and Ip tended to be polypectomized and flat or concaved lesion as IIa+IIc were prone to be colectomized. 6. As for the diameter, they were polypectomized when they were less than 2 cm and prone to be colectomized or locally resected when they were over 2cm. 7. As for the invasion, they were polypectomized when they were less than sm2 and were liable to be colectomized when they were over the level. 8. Polypectomy is applied irrelevant to the location of the cancer and the situation is the same with colectomy while transperianal excision is limited to cancer in the rectum. 9. Concerning histological differentiation, well differentiated ca. and moderately differentiated ca. were liable to be coloectomized. 10. Between cancer with adenoma and cancer de novo, there was no difference in the method of resection. 11. As to lymphovascular invasion, cases with lyo and vo were frequency polypectomized and the cases with ly+ and v+ were frequently colectomized. 12. There were 3 cases of lymph node metastasis in which the tumor is large, Rb in location and ly+. 13. There were no case of local rerurrence and 2 cases of hepatic metastasis.
日本大腸肛門病学会の論文

The treatment of early cancer of the colon.

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