摘要
目的探讨内镜下黏膜剥离术在早期直肠癌和癌前病变治疗中的应用效果。方法选取2015年6月至2016年12月间中山市黄圃人民医院收治的120例早期直肠癌及癌前病变患者为研究对象,采用内镜下黏膜剥离术治疗,观察患者手术情况、病灶情况及术后并发证。结果患者均完成内镜下黏膜剥离手术,其中2例因黏膜下注射抬举征阴性而中转开腹手术治疗,未见腹腔淋巴受侵犯。手术平均用时为(62.5±2.8)min,术中平均出血量为(120.5±3.9)ml,一次性病灶整块切除率为87.5%,组织学治愈性切除率为97.5%。肿瘤平均直径为(1.8±0.8)cm,恶性肿瘤85例(70.8%),癌前病变35例(29.2%),术后穿孔2例(1.7%),延迟出血5例(4.2%),下腹轻度疼痛13例(10.8%)。结论应用内镜下黏膜剥离术治疗早期直肠癌及癌前病变患者,效果良好,患者损伤小,病灶完整切除率较高,手术安全有效,值得推广。
Objective To examine the efficacy of endoscopic submucosal dissection surgery for early rectal cancer and precancerous lesions. Methods From June 2015 to December 2015,120 patients with early rectal carcinoma and precancerous lesions treated at Huangpu People＇s Hospital were selected as the research subject. Endoscopic submucosal dissection surgery was used to observe the operative condition,lesions and postoperative complications. Results All the patients completed endoscopic submucosal dissection surgery treatment,among which 2 patients transferred to open surgery because of negative submucosal injection and lifting sign and no celiac lymph node involvement was found. Mean operation time was（62. 5± 2. 8） min. Intraoperative blood loss was（120. 5 ± 3. 9） ml. Overall resection rate of lesion was 87. 5%.Histological curative resection rate was 97. 5%. Mean tumor diameter was（1. 8 ± 0. 8） cm. Malignant tumors occurred in 85 patients（70. 8%）. Precancerous lesions occurred in 35 patients（29. 2%）. Postoperative perforation occurred in 2 patients（1. 7%）. Delayed bleeding occurred in 5 patients（4. 2%）. Lower abdomen mild pain occurred in 13 patients（10. 8%）. Conclusion For patients with rectal cancer and precancerous lesions,early application of endoscopic submucosal dissection surgery was safe and has good efficacy and high complete resection rate with less damage and is worthy of clinical popularization.
出处
《中国肿瘤临床与康复》
2017年第6期715-717,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
中山市科技攻关计划项目(2016B1111)
关键词
内镜下黏膜剥离术
早期
直肠肿瘤
癌前病变
Endoscopic submucosal dissection
Early
Rectal neoplasms
Precancerous lesions
作者简介
雷浩强，男，主治医师，主要从事消化内科专业。
