炎症性肠病会增加结直肠肿瘤的风险。对于接受结肠次全切除术并留下直肠残余物的患者来说，会出现一个特殊的问题。必须准确估计未来患直肠癌的风险，并与进一步手术或监测的风险进行权衡。本研究的目的是估计此类患者的直肠癌 10 年累积发病率。使用英格兰医院管理数据进行了一项全国性研究。确定了 2002 年 4 月至 2014 年 3 月期间接受结肠次全切除术的患者队列。进行竞争风险生存分析以计算直肠癌的累积发病率。使用时间趋势分析研究了 COVID-19 大流行对内窥镜监测的影响。总共纳入了 8120 名患者，其中 61 名患者（0.8%）被诊断患有癌症。 5、10时直肠癌的累积发病率为0.26%（95% c.i. 0.17%至0.39%）、0.49%（95% c.i. 0.36%至0.68%）和0.77%（95% c.i. 0.57%至1.02%）。 、 和 15 年。既往诊断为结肠发育不良（HR 3.34，95% c.i. 1.01 至 10.97；P = 0.047）、原发性硬化性胆管炎（HR 5.42，95% c.i. 1.34 至 21.85；P = 0.018）和择期结肠切除术（HR 1.83，95%） c.i. 1.11 至 3.02；P = 0.018）与直肠癌发病率增加相关。关于内窥镜监测，与 2019 年（585 例手术）相比，2020 年进行的内窥镜手术（333 例）减少了 43%。结肠次全切除术后直肠癌的发病率较低。对于没有直肠发育不良证据的无症状患者，应仔细咨询预防性直肠切除术可能带来的益处和风险。© 作者 2024。由牛津大学出版社代表 BJS 基金会有限公司出版。

Inflammatory bowel disease increases the risk of colorectal neoplasia. A particular problem arises in patients who have undergone subtotal colectomy leaving a rectal remnant. The risk of future rectal cancer must be accurately estimated and weighed against the risks of further surgery or surveillance. The aim of this study was to estimate the 10-year cumulative incidence of rectal cancer in such patients.A nationwide study using England's hospital administrative data was performed. A cohort of patients undergoing subtotal colectomy between April 2002 and March 2014 was identified. A competing risks survival analysis was performed to calculate the cumulative incidence of rectal cancer. The effect of the COVID-19 pandemic on endoscopic surveillance was investigated using time-trend analysis.A total of 8120 patients were included and 61 patients (0.8%) were diagnosed with cancer. The cumulative incidence of rectal cancer was 0.26% (95% c.i. 0.17% to 0.39%), 0.49% (95% c.i. 0.36% to 0.68%), and 0.77% (95% c.i. 0.57% to 1.02%) at 5, 10, and 15 years respectively. A previous diagnosis of colonic dysplasia (HR 3.34, 95% c.i. 1.01 to 10.97; P = 0.047), primary sclerosing cholangitis (HR 5.42, 95% c.i. 1.34 to 21.85; P = 0.018), and elective colectomy (HR 1.83, 95% c.i. 1.11 to 3.02; P = 0.018) was associated with an increased incidence of rectal cancer. Regarding endoscopic surveillance, there was a 43% decline in endoscopic procedures performed in 2020 (333 procedures) compared with 2019 (585 procedures).The incidence of rectal cancer after subtotal colectomy is low. Asymptomatic patients without evidence of rectal dysplasia should be carefully counselled on the possible benefits and risks of prophylactic proctectomy.© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.