摘要
[目的]回顾性分析不同亚型结直肠侧向发育型肿瘤(LSTs)患者经内镜下内镜黏膜切除术(EMR)和内镜黏膜下剥离术(ESD)治疗的疗效。[方法]选取我院消化科收治的92例结直肠LSTs患者进行研究,其中采用EMR治疗患者38例(EMR组),ESD治疗患者54例(ESD组),观察2种治疗方法分别对LSTs 4种亚型治疗情况。[结果]EMR组、ESD组患者在性别、分型、病变部位及病变大小、病理类型方面比较,差异无统计学意义;EMR、ESD治疗颗粒均一型(LST-G-H)组手术操作时间均较短,与结节混合型(LST-G-NM)、假凹陷型(LST-NG-PD)组比较差异有统计学意义(P<0.05),扁平隆起型(LST-NG-F)组操作时间短于LST-NG-PD组(P<0.05);EMR治疗LST-G-H组整块切除率、完全切除率较高为71.43%、57.14%,LST-NG-PD组较低为42.86%、28.57%;ESD治疗LST-G-H、LST-NG-F、LST-NG-PD组整块切除率为100.00%,LST-G-H、LST-NG-F组完全切除率为100.00%,而LST-NG-PD完全切除率较低;EMR治疗后,LST-NG-PD出现1例术中穿孔,LST-G-NM出现1例出血,LST-G-NM、LST-NG-PD复发率较高,达31.58%和42.86%;ESD治疗后,LST-NG-PD穿孔率、出血率、复发率都较高均为25.00%,ESD治疗组手术操作时间、整块切除率、完全切除率均高于EMR治疗组(P<0.05),而术后复发率低于EMR治疗组(P<0.05)。[结论]EMR、ESD治疗LST-G-H操作时间均短,EMR治疗术后并发症少,复发率高,ESD治疗术后并发症多,复发率低,临床应根据不同分型选择合适的治疗方法。
[Objective]To retrospectively analyze the efficacy of endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in the treatment of different subtypes of colorectal cancer laterally spreading tumors(LSTs).[Methods]170 cases of colorectal LSTs were selected and studied,among them 78 cases were treated with EMR(EMR group)and 92 cases were treated with ESD(ESD group),the therapeutic effects of two treatments on four subtypes of LSTs were observed.[Results]There was no significant difference in sex,type,lesion location and size,pathological type between EMR group and ESD group.The operation time of EMR and ESD was shorter in LST-G-H group,and was significant difference with than that in LST-G-NM group and LST-NG-PD group(P<0.05),the operation time of the LST-NG-F group was shorter than that of the LST-NG-PD group(P<0.05);the overall resection rate and complete resection rate of EMR in the treatment of LST-G-H group 71.43%and 57.14%were high,while those of LST-NG-PD group 42.86%and 28.57%were low;the total resection rate of ESD in LST-G-H,LST-NG-F,LST-NG-PD was 100.00%,the complete resection rate of group LST-G-H and LST-NG-F was 100.00%,the complete resection rate of LST-NG-PD was low,after EMR treatment,1 cases of perforation occurred in LST-NG-PD,and 1 cases of bleeding occurred in LST-G-NM,the recurrence rate of LST-G-NM and LST-NG-PD reached 31.58%and 42.86%respectively,after ESD treatment,the perforation rate,bleeding rate and the recurrence rate of LST-NG-PD were both 25.00%;the operation time,otal resection rate and complete resection rate of ESD group were higher than those of EMR group(P<0.05),but the recurrence rate was lower than that of EMR group(P<0.05).[Conclusion]The operation time of EMR and ESD for LST-G-H is short,EMR has fewer complications and higher recurrence rate,ESD has many complications and low recurrence rate,it is very necessary to choose suitable treatment methods according to different classification.
作者
张月晓
张肖丽
李炳庆
于洋
付欣姿
刘璐
陈健
ZHANG Yue-xiao;ZHANG Xiao-li;LI Bing-qing;YU Yang;FU Xin-zi;LIU Lu;CHEN Jian(Department of Gastroenterology,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)
出处
《中国中西医结合消化杂志》
CAS
2019年第6期415-419,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
承德市科技支撑项目(No:201801A042)
关键词
内镜黏膜切除术
内镜黏膜下剥离术
结直肠
侧向发育型肿瘤
不同亚型
endoscopic mucosal resection
endoscopic submucosal dissection
colorectal cancer
laterally spreading tumors
different subtypes
