目的: 探讨结直肠腺瘤患者内镜术后肿瘤复发的潜在危险因素。方法: 选取2020年1月1日至2022年12月31日在莆田学院附属医院消化内镜中心接受结直肠腺瘤内镜手术治疗的患者,对其进行2年随访后,依据术后是否复发分为腺瘤复发组和腺瘤未复发组。收集入组患者的临床及病理信息,包括年龄、性别、体质指数(BMI);总胆固醇、甘油三酯、尿酸水平;腺瘤数目、最大直径、形态(山田分型)、病理类型、位置和切除方式,应用单因素和多因素Logistic回归分析研究术后腺瘤复发的相关危险因素。结果: 612例患者中术后腺瘤复发组189例(30.88%),腺瘤未复发组423例(69.12%);年龄、腺瘤数量、腺瘤最大直径、病理类型(均P＜0.05)为结直肠腺瘤内镜术后复发的危险因素。结论: 年龄、腺瘤数目、腺瘤最大直径和病理类型是结直肠腺瘤内镜手术治疗后复发的关键危险因素,临床可基于上述因素,为患者制定更具有针对性的随访计划,从而使结直肠腺瘤术后患者的结肠镜随访措施更加科学、合理。
Objective: To investigate the potential risk factors of tumor recurrence in patients with colorectal adenoma after endoscopic surgery. Methods: Patients who underwent endoscopic surgery for colorectal adenomas at the Digestive Endoscopy Center of the Affiliated Hospital of Putian University from January 1,2020 to December 31,2022 were selected. After 2 years of follow-up, they were divided intoadenoma recurrence group and adenoma non-recurrence group according to whether they relapsed after surgery. The information of the enrolled patients was collected, including age, gender, body mass index (BMI), total cholesterol, triglyceride, uric acid, number of adenomas, maximum diameter of adenomas, morphology (Yamada classification), pathological type, location and resection method. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of adenoma recurrence after endoscopic surgery for colorectal adenomas. Results: Among the 612 patients, 189 (30.88%) were in the adenoma recurrence group, and 423 (69.12%) were in the non-recurrence group. The analysis indicated that age, number of adenomas, maximum adenoma diameter, and histopathological type (all P＜0.05) were identified as risk factors for recurrence after endoscopic surgery for colorectal adenomas. Conclusion: Age, number of adenomas, maximum diameter of adenomas and pathological type are risk factors for recurrence of colorectal adenomas after endoscopic surgery. Based on these factors, clinicians can make more targeted follow-up plans, so as to take more scientific and reasonable measures in colonoscopy follow-up of patients after colorectal adenoma surgery.
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