Korean Journal of Gastrointestinal Endoscopy 2000;20(3): 177-182.
비만곡 근위부 대장암에 동반된 대장 용종의 의의 ( The Significance of Synchronous Colorectal Polyps in Colon Cancer Proximal to the Splenic Flexure )
김진석(Jin Suk Kim),김원호(Won Ho Kim),김중선(Jung Sun Kim),조용석(Yong Suk Cho),김남규(Nam Kyu Kim),김호근(Hoguen Kim),박인서(In Suh Park)
Abstract
Background/Aims: The aim of this study was to evaluate the characteristics of colorectal polyps, especially distal colorectal polyps and their frequency in patients with colon cancer located proximal to the splenic flexure. Methods: Among 1,250 patients with colorectal cancer, 269 patients (21.5%) had colon cancer located proximal to the splenic flexure. Of these, 183 patients were involved in this study because complete colonoscopic evaluations to the cecum or to the level of proximal colon cancer were possible. Results: 54 patients (29.5%) had one or more distal colorectal polyps, 33 patients (18.1%) had one or more adenomatous distal polyps, and 3 patients (1.6%) had synchronous distal carcinoma. The percentage of patients without distal polyps was 70.5% of 183 patients with proximal colon cancer, and 80.3% of patients without distal neoplastic lesions. The percentage of patients with advanced lesions (villous component, high-grade dysplasia, or ≥1 cm in diameter) was 40.7% of 54 patients with distal colorectal polyps. Conclusions: Flexible sigmoidoscopy is insensitive and ineffective for the detection of proximal colon cancer. Ongoing evaluation of colonoscopy as a general screening test is appropriate.
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