内镜下结直肠神经鞘瘤诊断与治疗

目的:旨在探讨内镜下结直肠神经鞘瘤的诊断与治疗。方法:回顾性分析2011年03月至2017年03月期间中国医科大学附属盛京医院11例结直肠神经鞘瘤患者的临床资料、肿瘤特征、治疗、病理、免疫组化和随访情况。结果:4例结直肠神经鞘瘤位于乙状结肠、3例位于直肠、4例位于横结肠。11例神经鞘瘤患者结肠镜下表现为黏膜下肿物或表面发黄的息肉样改变，其中8例黏膜下神经鞘瘤超声内镜下表现为起源于固有肌层的低回声肿物。11例患者均在内镜下完全切除肿物，其中3例行内镜下黏膜切除术，2例行内镜黏膜下剥离术，6例行内镜下全层切除术，术后均无并发症出现，随访期间均未发现复发或转移。结论:内镜及超声内镜对于诊断结直肠神经鞘瘤有一定的价值，内镜下治疗结直肠神经鞘瘤是安全有效的。

Endoscopic diagnosis and treatment of colorectal schwannomas

Objective:To investigate the value of endoscopy in diagnosis and treatment of colorectal schwannomas.Methods:The clinical data,tumor characteristics,treatment,pathology,immunohistochemistry and follow-up of 11 patients with colorectal schwannoma in Shengjing Hospital Affiliated to China Medical University from March 2011 to March 2017 were analyzed retrospectively.Results:4 cases of colorectal schwannoma were located in the sigmoid colon,3 cases in the rectum and 4 cases in the transverse colon.11 cases of schwannoma were submucous masses or yellowish polyps under colonoscopy,of which 8 submucous cases showed hypoechoic masses originated from the lamina propria under ultrasonography.All the 11 cases of colorectal schwannoma underwent thorough endoscopic resection successfully,among them,3 cases were treated by endoscopic mucosa resection,2 casesby endoscopic submucosal dissection,and 6 cases by endoscopic full-thickness resection.No postoperative complications occurred,and no recurrence or metastasis was found during the follow-up.Conclusion:Endoscopic and endoscopic ultrasonography are valuable in the diagnosis of colorectal schwannoma.Endoscopic treatment of colorectal schwannomas is safe and effective.