早期大肠癌的内镜临床应用研究

目的：探讨内镜对早期大肠癌的诊断及治疗价值。方法：对1984年1月－2000年1月经病理确诊的105例（106个病变）早期大肠癌的临床资料、诊断及治疗方式进行分析。结果：早期大肠癌多见于乙状结肠及直肠，肉眼形态以隆起型多见。大肠腺瘤癌变多具有以下特点：腺癌＞2cm；广基型；表面不平、糜烂；组织易破碎出血。对早期大肠癌先进行内镜下摘除，病理证实有下列之一者追加肠段切除或行根治性手术：切缘有癌组织；癌组织侵犯粘膜下层深层；癌组织分化程度差。结论：心便患者首选内镜检查。粘膜层早期大肠癌的内镜治疗与手术治疗有同样的效果，且损伤小、安全、方便。

Endoscopy for Early Colorectal Carcionma

Objective:To investigate the value of endoscopic diagnosis and treatment of early colorectal carcinoma.Methods:The clinical documents and diagnoses as well as treatment of 105 patients with early colorectal carinoma proved pathologically between 1984 to 2000 were analysed.Results:Early colorectal carcinoma mainly lay in sigmoid colon and rectum,the macroscopic type was mainly protuberant.The canceration of colorectal adenoma was usually characteristic as follows:(1) the adenoma size is bigger than 2cm,(2) broad fundus,(3) the surface is uneven and erosive,(4) the tissue is fragile.Early colorectal carcinoma should removed under endoscope first,and colectomy or radical operation should be added if one of the following situations occurred:(1) there is cancerous tissue at the edge of cutting,(2) cancerous tissue invades deeply in submucosa,(3) the differentiation of cancerous tissue is poor.Conclusions:Patients with hemafecia should be examined by endoscope first,the endoscopic treatment of early colorectal carcinoma limited to mucosa has the same effect as operation.