Kirurško liječenje polipoidnih karcinoma kolorektuma u Klinici za tumore

Treatment of polypoid carcinoma raises the problem of invasiveness to be solved by a competent pathologist. Upon diagnosis of the invasiveness, a radical surgical procedure (resection of the colorectum) is indicated. A problem that occurs is a problem of adequate resection margins, or marking the primary tumor bed (1, 2). In the colorectal resection segment, an ulcer may persist in the area of polypectomy, although without pathohistological signs of malignancy. In 7 patients treated in the University Hospital for Tumors, Zagrb, Croatia, discrete ulcer nishes were verified in resection segments of the colorectum. In none of the patients, pathohistological signs of the primary tumor were found. In 3/7 patients malignant cells in the regional lymph nodes were verified. A year after the surgery, metastatic transformations of the liver were found in 1/7 patients.U liječenju polipoidnih karcinoma postavlja se problem invazivnosti, koji razrješuje ovlašteni patolog. Po dijagnosticiranju invazivnosti indicira se radikalni kirurški zahvat (resekcija pripadajućeg kolorektuma). Tu nastaje problem resekcije adekvatnog segmenta kolorektuma, odnosno markiranja ležišta primarnog tumora (1,2). U reseciranom segmentu kolorektuma može perzistirati ulkus u području polipektomije, ali bez patohistološki tragova maligniteta. U 7 bolesnika liječenih u klinici za tumore verificirane su diskretne ulkusne niše u reseciranim segmentima kolorektuma. Ni u jednog bolesnika nisu nađeni patohistološki tragovi primarnog tumora. U 3 od 7 bolesnica verificirane su maligne stanice u regionalnim limfnim čvorovima. U 1 od 7 bolesnika godinu dana po operaciji su verificirane jetrene metapromjene