摘要
目的探讨口袋法内镜黏膜下剥离术(ESD)治疗早期结直肠癌及其癌前病变的临床疗效。方法收集2017年4月-2018年12月该院消化内科收治的23例早期结直肠癌及其癌前病变患者,通过口袋法ESD术治疗,记录临床相关数据,进行回顾性分析。结果切下的23例病变最长径1.8~4.5 cm;手术时间为25.0~140.0 min;无术中明显出血及迟发性出血病例;无术中和迟发性穿孔病例;整块切除率为100.0%;术后病理显示,腺瘤伴低级别上皮内瘤变14例,腺瘤伴高级别上皮内瘤变6例,腺瘤伴黏膜内癌2例,水平及垂直切缘均阴性,完全切除率95.7%(22/23),而1例术后病理示腺瘤伴高级别上皮内瘤变,局灶癌变伴黏膜下浸润,垂直切缘阳性,追加外科手术;随访时所有患者未见局部复发和远处转移,治愈性切除率为95.7%。结论口袋法ESD术治疗早期结直肠癌及其癌前病变安全且有效。
Objective To explore the clinical effect of endoscopic submucosal dissection(ESD)with pocketcreation method for early colorectal carcinoma and precancerous lesions.Methods ESD with pocket-creation method was applied to 23 patients with early colorectal carcinoma and precancerous lesions from April 2017 to December 2018.The clinical data were recorded and analyzed retrospectively.Results The longest diameter of the lesions was 1.8~4.5 cm;The operating time was 25.0~140.0 min;no intraoperative bleeding or delayed bleeding;no intraoperative or delayed perforation;the resection rate of the en block was 100.0%.Postoperative pathological evaluation showed that 14 cases of adenoma with low-grade intraepithelial neoplasia,6 cases of adenoma with highgrade intraepithelial neoplasia,2 cases of adenoma with intramucosal carcinoma,negative horizontal and vertical incision margins.The complete resection rate was 95.7%(22/23).1 case of adenoma with high-grade intraepithelial neoplasia,local carcinogenesis with submucosal infiltration,positive vertical incision margin,and additional surgery were performed.No local recurrence or distant metastasis was found in all follow-up patients,and the cure resection rate was 95.7%.Conclusion ESD with pocket-creation method is safe and effective in the treatment of for early colorectal carcinoma and precancerous lesions.
作者
沈波
王庆华
张林英
陈芳
梅娟
陈金珍
周静
Bo Shen;Qing-hua Wang;Lin-ying Zhang;Fang Chen;Juan Mei;Jin-zhen Chen;Jing Zhou(Department of Gastroenterology,Kunshan Hospital affiliated to Jiangsu University,Kunshan,Jiangsu 215300,China)
出处
《中国内镜杂志》
2020年第1期81-84,共4页
China Journal of Endoscopy
关键词
早期结直肠癌
口袋法
内镜黏膜下剥离术
手术操作时间
整块切除
early colorectal carcinoma
pocket-creation method
endoscopic submucosal dissection
operating time
en bloc resection
