老年大肠肿瘤患者的内镜下黏膜切除治疗

目的 探讨内镜下黏膜切除术（EMR）对老年大肠扁平及广基肿瘤治疗的有效性及安全性。方法 60例老年患者，年龄平均71岁，通过结肠镜检查，非抬举征（non-lifting sign）阳性入选为EMR适应证。46例病变〈2cm行一次性切除；14例病变〉2cm行分次切除（EPMR），创面用夹子缝合，回收后做连续病理切片，证明肿瘤全部切除。结果 60例病变病理学检查结果：腺瘤55例，早期大肠癌5例均为黏膜层癌（m1-m3）。腺瘤55例中，管状腺瘤33例、腺管绒毛腺瘤14、绒毛腺瘤8例。结论 EMR作为内镜下治疗老年人大肠肿瘤是一个令人满意的治疗手段，特别适合高龄、不愿或不宜行外科手术的患者。

Endoscopic mucosal resection of colonic tumor of the elderly patient

Objective] To discuss endoscopic mucosal resection( EMR) to the usefulness and the safety of the elderly colonic applanation and extensive tumor treatment. Methods] 60 cases of elderly patient, average age 71 years old, pass the colonoscopy check. The non- lifting sign positive to select to cure the indications for the EMR, 46 lesion< 2 cm implement to cut off; 14 lesion >2 cm implement to divide an excision( EPMR), wound surface to sew up with the clip. Recovery the specimen does the continuous pathology slice, certificate the tumor all excisions. Results] 60 pathological changes pathology check result: 55 of the adenoma, the earlier period large intestine cancer are all the mucosas layer cancers (m1~m3). In the adenoma case, the tubular adenoma 33, the tubulovillous adenoma 14, the villous adenoma 8. Conclusions] EMR treatment elderly colonic tumor is a satisfactory treating means, special in keeping with advanced age, not wish or not proper sufferer of the surgical operation.