【作者】 周晓黎； 杨林； 滕晓丽； 时昭红；

【Author】 Zhou Xiaoli;Yang Lin;Teng XiaoLi;Shi Zhaohong;Department of Gastroenterology,Wuhan first hospital;

【机构】 武汉市第一医院消化内科；

【摘要】 目的:探讨内镜下粘膜剥离术(ESD)治疗结直肠侧向发育型肿瘤的安全性和有效性。方法:回顾性分析武汉椒第一人民医院2016年1月到2017年2月采用ESD治疗结直肠侧向发育型肿瘤患者的临床资料、手术过程、病理学结果、随访情况等。结果:共有36例患者纳入研究。分布部位分别为回盲部6例,升结肠16例,直肠10例,其它4例。侧向发育型肿瘤直径约2～6cm,平均约3.2cm。均成功进行了ESD。手术时间30～120min。术中并发出血20例,使用热止血钳电凝止血。术后病理结果提示:23例(63.9%)为腺瘤伴低级别上皮内瘤变,10例(27.8%)为腺瘤伴高级别上皮内瘤变,3例(8.3%)为早期结肠癌。病灶切除完整。病灶切除的基底部及侧切缘均为阴性。患者术后随访时间1～2年。无局部复发及远处转移。结论:ESD治疗结直肠侧向发育型肿瘤安全有效。更多还原

【Abstract】 Objective To evaluate the safety and effectiveness of endoscopic submucosal dissection(ESD) in the treatment of colorectal lateral developmental tumors.Methods The clinical data, surgical process, pathological results and follow-up status of ESD treatment of patients with colorectal lateral developmental tumor in the Wuhan first hospital r from January 2016 to February 2017 were retrospectively analyzed.Results A total of 36 patients were included in the study.6 cases were located in ileocecal region, 16 cases in ascending colon, 10 cases in rectum, and 4 cases in others.The laterally developed tumor was about 2 ～ 6 cm in diameter, with an average of about 3.2 cm.All of them successfully conducted ESD.The operation time is 30 ～ 120 min.Heat hemostatic forceps was used to electrocoagulation and stop bleeding in 20 patients.Postoperative pathology revealed that 23 cases(63.9%) were adenomas with low-grade intraepithelial neoplasia, 10 cases(27.8%) were adenomas with high-grade intraepithelial neoplasia, and 3 cases(8.3%) were early-stage colon cancer.Complete resection of the lesion.The base and lateral cutting margin of the lesion were negative.The patients were followed up for 1 ～ 2 years.There was no local recurrence or distant metastasis.Conclusion ESD is safe and effective in the treatment of colorectal lateral developmental tumors更多还原