内镜黏膜剥离结合圈套器治疗大型浅表结直肠肿瘤

目的探讨采用内镜黏膜剥离结合圈套器治疗大型浅表结直肠肿瘤的价值。方法前瞻性研究36例大型浅表结直肠肿瘤（直径／〉2．0cm），非随机分为2组，采用黏膜剥离结合圈套器治疗21例（A组），黏膜剥离术治疗15例（B组），比较两组手术的临床指标及术后结肠镜随访情况。结果两组患者的一般资料相似，差异无统计学意义（P〉0．05），具有可比性。A组在手术时间和术中出血量方面优于B组，差异有统计学意义（P〈0．05）；而两组在肿瘤直径、术后出血量、术后复发等方面，差异无统计学意义（P〉0．05）。结论内镜黏膜剥离结合圈套器治疗大型浅表结直肠肿瘤，可缩短手术时间，减少术中出血，安全可行。

Endoscopic submucosal dissection in combination with snare for large superficial sessile colorectal tumors

Objective To explore the efficacy of endoscopic submucosal dissection （ESD） in combination with snare for large superficial sessile colorectal tumors. Methods As a prospective study,36 patients with large（ diameter ≥2.0 cm）superficial sessile colorectal tumors were divided into two groups according to the patients＇ willingness. In group A,21 patients were treated by ESD in combination with snare. In group B, 15 patients were treated by ESD alone. The in -hospital data and data of follow -up by endoscopy were compared. Statistical analysis was carried out using SAS8.2 for Windows. According to the data types, X2 test, two - sample Wilcoxon t test or rank sum test was ehosed, and statistical significance was defined as P 〈0.05. Results There were no significant differences in the demographics of patients between two groups. In group A,operating time was shorter and intraoperative blood loss was less than in group B（P 〈0.05 ）,but there were no significant differences in the size of tumors, postoperative blood loss, the recurrence rate of tumors between two groups（P 〉 0.05）. Conclusion The technique of ESD in combination with snare is a simple and easy accessed procedure for resecting large superficial sessile colorectal tumors. It is feasible,effective and safe.