黏膜切除术治疗结直肠广基隆起性腺瘤性息肉98例临床研究

目的探讨内镜下黏膜切除术(endoscopic mucosal resection,EMR)治疗结直肠广基隆起性腺瘤性息肉患者的疗效。方法回顾性分析98例结直肠广基隆起性腺瘤性息肉(息肉直径0.6~2.0 cm)患者的临床资料并行EMR治疗。结果 98例均经电子结肠镜检查及术前病理诊断为腺瘤性息肉,均为广基隆起性病变,共120枚,行EMR,留取完整标本病理检查,创面均给予钛夹封闭。术后病理诊断为腺瘤性息肉113例,高级别瘤变4例,局部癌变3例,7例切缘均无癌细胞,未追加外科手术。1个月后复查见病变部位黏膜光滑,未见息肉及病变黏膜残留。高级别瘤变及局部癌变7例随访3年,未见肿瘤复发及它处转移。结论对于广基隆起性腺瘤性息肉行EMR较既往单纯的高频电灼或氩离子凝固术有助于发现早期癌,改善患者的预后。

Effect of endoscopic mucosal resection in the treatment of colorectal sessile uplift adenomatous polyps in 98 cases

Objective To investigate the the effect of endoscopic mucosal resection （EMR） in the treatment of colorectal sessile uplift adenomatous polyps in 98 cases.Methods Retrospective analysis was used to study the clinical data of 98 patients with colorectal sessile uplift adenomatous polyps （0.6 ～ 2.0 cm in diameter）.Results Ninety-eight cases were confirmed by endoscopy and pathology with 120 colorectal sessile uplift adenomatous polyp,and endoscopic mucosal resection was used to resect polyps.Complete specimen was taken to proceed pathology examination,and wound was treated with titanium clip closure.One hundred and thirteen cases were diagnosed as adenomatous,4 cases as highgrade neoplasia,3 cases as localized canceration.Lesion mucosa was smooth after 1 month,no polyps and mucosa residue were found.High-grade neoplasia and localized canceration 7 cases were followed up for 3 years,no recurrence and metastasis were found.Conclusion For wide base uplift adenomatous polyps,EMR is superior to pure high frequency electrocautery or argon plasma coagulation in finding early cancer,and improve the patients prognosis.