【摘要】 目的使用绝缘头电切刀行直肠肿瘤黏膜下层剥离术,以求切除一次性大于1.5cm的肿瘤。方法使用绝缘头电切刀(Insulation-tipped,IT)对12例直肠肿瘤(平均病变范围为3.4cm)行黏膜下层注射美蓝肾上腺素液,再用IT刀进行黏膜下层剥离术。结果12例直肠肿瘤均被完整切除,病理结果为绒毛腺管状腺瘤并中度或重度不典型增生,其中4例癌变,基底无残留癌灶。术中1例发生小动脉破裂出血,给予钛夹止血,达到止血目的,该组无穿孔者。结论IT刀可顺利进行直肠肿瘤完整黏膜下层剥离术。更多还原

【Abstract】 [Objective] Insulation-tipped electrosurgical knife was used to perform endoscopic submucosal dissection (ESD) for tumors of rectum. [Methods] 12 cases of tumors of rectums (mean size was 3.4 cm) were injected Methylene blue solution added with epinephine into the submucosal layer, then IT knife was used to perform submucosal dissection. [Results] 12 cases of tumors of rectums were resected en bloc. Pathologic results were tubuvillous adenoma with moderate or severe atypia hyperplasia, including 4 cases with cancerization. There was no residual cancer focus on the basis. In one case, arteriole bleeded during the operation. Titanium clips were used to attain the aim of stopping bleeding. No perforation occurred in this group. [Conclusions] A reliable en bloc resection of large tumors of rectums could be successfully performed through endoscopic submucosal dissection using insulation-tipped electrosurgical knife.更多还原