| 结直肠侧向发育型肿瘤内镜下诊治的临床研究 |
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| 引用本文： | 胡红娜,章礼久,宋莎莎. 结直肠侧向发育型肿瘤内镜下诊治的临床研究[J]. 中华全科医学, 2021, 19(7): 1103-1106,1195. DOI: 10.16766/j.cnki.issn.1674-4152.001995 |
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| 作者姓名： | 胡红娜 章礼久 宋莎莎 |
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| 作者单位： | 1.安徽医科大学第二附属医院消化内科，安徽 合肥 230601 |
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| 基金项目： | 2017年安徽省自然科学基金1708085QH192 |
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| 摘 要： | 目的 研究结直肠侧向发育型肿瘤(laterally spreading tumor,LST)的内镜病理特征及内镜下治疗方法.方法 回顾性分析安徽医科大学第二附属医院2014年1月-2019年12月经内镜诊断并行内镜下治疗的48例LST患者的临床病理资料.按病变部位将其分成直肠组(27例)和结肠组(21例),分别记录直径...
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| 关 键 词： | 侧向发育型肿瘤 内镜病理特征 内镜下诊治技术 |
| 收稿时间： | 2020-11-18 |
Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor |
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| Affiliation: | Department of Gastroenterology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China |
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| Abstract: | Objective To study the endoscopic pathological features and endoscopic treatment method of laterally spreading tumor (LST). Methods The clinic pathological data of 48 LST patients diagnosed and treated with endoscopy in the Second Affiliated Hospital of Anhui Medical University from January 2014 to December 2019 were retrospectively analyzed. According to the lesion site, the patients were divided into the rectal group (27 cases) and the colon group (21 cases), and their diameters, lesion subtypes and postoperative pathological Results were recorded respectively. Twenty-seven cases underwent endoscopic mucosal dissection (ESD), 19 cases underwent endoscopic mucosal resection (EMR/EPMR), and 2 cases underwent expected mucosal resection (pre-cut-off EMR). The residual rate, bleeding rate, perforation rate and recurrence rate of endoscopic treatment were observed. Results There was no significant difference in age and gender between the two groups (all P > 0.05). In the rectal group, the diameter of the lesions was (3.27±1.29) cm, and the nodules were mainly of mixed type, while in the colon group the diameter was (2.61±0.78) cm, and the main particles were all of the homogeneous type, with statistically significant differences (all P < 0.05). Compared with the colon group, the proportion of high-grade intraepithelial neoplasia and cancerization in the rectal group was significantly increased (P < 0.05). Rectal LST was mainly treated with ESD (74.1%), while colon LST was mainly treated with EMR/EPMR (61.9%). One case of colon LST was unable to receive effective complete resection with ESD due to excessive length of lesion length, and was transferred to surgical operation. The remaining 47 cases were all completely removed. Postoperative hemorrhage in 1 case (2.1%) was improved by endoscopic hemostasis therapy again. One patient recurred 4 years after operation and underwent complete endoscopic resection again. None of the patients in this group had residual or perforation complications. Conclusion Rectal LST lesions have a large range, mainly nodular mixed type, with relatively high malignant potential, mainly ESD therapy. Colonic LST is commonly treated with granular homogeneous type, and EMR/EPMR treatment is more common. Pre-cut-EMR treatment may be considered in some cases. |
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