【摘要】 目的探讨内镜黏膜下剥离术(ESD)治疗早期结肠肿瘤的临床疗效。方法回顾性分析自2014年1月至2017年6月收治的69例临床确诊为早期结肠肿瘤患者临床资料,根据治疗术式将患者分为内镜黏膜切除(EMR)组(n=38)与ESD组(n=31)。记录并比较两组患者手术时间、病灶切除情况及并发症发生情况;术后随访6~12个月,比较两组患者术后肿瘤复发及生存质量结果。结果 ESD组病灶平均直径为(3. 82±0. 65)cm、手术时间为(52. 22±7. 51)min,均长于EMR组的(2. 98±0. 71)cm、(43. 51±6. 99)min,而ESD组住院时间为(6. 42±1. 23)d,短于EMR组的(9. 01±1. 42)d,两组间比较,差异均有统计学意义(P <0. 05)。两组患者术中出血量比较,差异无统计学意义(P> 0. 05)。ESD组患者病灶整块切除率为83. 9%(26/31)、治愈性切除率为71. 0%(22/31),均明显高于EMR组的60. 5%(23/38)、47. 4%(18/38),两组间比较,差异有统计学意义(P <0. 05)。两组患者并发症发生率比较,差异无统计学意义(P> 0. 05)。术后随访6~12个月,ESD组患者无复发,EMR组患者5例(13. 2%)出现复发,两组间比较,差异有统计学意义(P <0. 05);ESD组患者生存质量评分均显著高于EMR组,差异有统计学意义(P <0. 05)。结论 ESD治疗早期结肠肿瘤,临床疗效确切,适应范围广,预后较好。更多还原

【Abstract】 Objective To explore the clinical value of endoscopic submucosal dissection( ESD) in the treatment of early colon tumor. Methods A retrospective analysis was performed in 69 cases of clinical diagnosis of early colon tumor in our hospital from January 2014 to June 2017. All patients were randomly divided into the ESD group( 31 cases) and the endoscopic mucosal resection(EMR) group(38 cases). The clinical data,operative time,lesion resection and complications were compared between the two groups. The recurrence and quality of life in 6 months after operation were compared between the two groups. Results Compared with EMR group,the patients in ESD group had greater focus and shorter hospitalization time( P < 0. 05). The total resection rate(83. 9%)and the cure rate(71. 0%) of the ESD group were significantly higher than those in the EMR group(60. 5% and 47. 4% respectively),P < 0. 05. The incidence of complications in group ESD was lower than that in group EMR,and the recurrence rate in group ESD was lower than that in group EMR at 6 months follow-up,and the score of quality of life in ESD group was significantly higher than that in EMR group( P < 0. 05). Conclusion Compared with submucosal resection,endoscopic submucosal dissection for early colon tumor is effective,with wider adaptation and better prognosis,which is more suitable for clinical promotion.更多还原