摘要
目的西方国家直肠类癌是第3位的消化道类癌;而在我国,直肠类癌发病居胃肠道类癌的首位。对于直径<10mm的直肠类癌而言,是可以选择内镜下治疗的。本文对微小直肠类癌不同内镜下治疗方式的安全性及有效性进行比较。方法应用CNKI、Medline和PubMed期刊全文数据库检索系统,以"直肠类癌,内镜,治疗"等为关键词,检索2003-1-2015-12的文献,共检索到英文文献184篇,中文文献48篇。纳入标准:(1)内镜下治疗直肠类癌的效果;(2)内镜下治疗直肠类癌的安全性。排除标准:(1)研究目的不是内镜治疗的效果或安全性;(2)其他直肠肿瘤的内镜治疗。根据纳入标准,纳入分析34篇文献。结果传统的息肉切除术或者内镜下黏膜切除术(endoscopic mucosal resection,EMR)治疗直肠类癌操作简单,但是这两种方法都很难达到完整的组织学切除。透明帽辅助法内镜下黏膜切除术(capassisted EMR,EMR-C)、套扎器法内镜黏膜下切除术(endoscopic submucosal resection with ligating device,ESMR-L)和内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)显示出相似的有效性和安全性。EMR-C和经肛内镜微创手术(transanal endoscopic microsurgery,TEM)能够用作传统息肉切除或EMR没有完整切除后的补救治疗。结论不同内镜下治疗方式各有利弊,操作者的技术熟练程度在内镜治疗过程中发挥着重要作用,各治疗方式之间的疗效和长期预后的比较还需要大样本研究去评估。
OBJECTIVE Rectal carcinoid is the No. 3 of gastrointestinal carcinoid in Western countries, however in China, it is the No. 1. For the rectal carcinoid whose diameter 〈10 mm, it is possible to select endoscopic treatment. This study was to compare the safety and efficacy of each endoscopic treatment methods of rectal carcinoid. METHODS By CNK1/Medline and PubMed retrieval system, with ＂rectal neuroendocrine tumor, endoscopy, treatment＂ as the key words, 184 papers of literature in English and 48 in Chinese were retrieved from 2003-1 to 2015-12. The selection stand- ards for the data：The safety of endoscopic treatment of rectal carcinoid~ the efficacy of endoscopic treatment of rectal car cinoid. Exclusion criteria：The objective is not to endoscopic treatment effects or safety; the endoscopic treatment of other rectal cancer. Acording to the above standards, 34 were finally analyzed. RESULTS Conventional polypectomy or endo- scopic mucosal resection （EMR） are easily operating, but difficult to achieve histologically complete resection, cap-assis- ted EMR （EMR-C）, endoscopic submucosal resection with ligating device （ESMR-L） and endoscopic submucosal dissec- tion （ESD） showed similar efficacy and safety. EMR-C and transanal endoscopic microsurgery （TEM） can be used as a remedy treatments after incomplete resection by traditional polypectomy or EMR. CONCLUSIONS Each endoscopic treatment methods has its own advantages and disadvantages. Technical proficiency of the operator plays an important role in the endoscopic treatment. Large-scale investigations are required to compare the efficacy and long-term prognosis between them.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第10期694-698,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省自然科学基金(ZR2013HL045)
山东省医科院科技计划面上项目(2014-24)
关键词
直肠肿瘤
内镜
治疗
综述文献
rectal neoplasms
endoscopy
trearment
review literature
