大肠粘膜内癌内镜局部治疗的探讨  

Investigation of endoscopic local treatment for colorectal intramucosal carcinoma

作　　者：李洋[1] 周洪伟[1] 常正[1] 

机构地区：[1]重庆医科大学附属第二医院普通外科,重庆400010

出　　处：《重庆医科大学学报》2007年第2期178-181,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨大肠粘膜内癌内镜下局部治疗的近期和远期效果。方法:对近5年发现的42例大肠粘膜内癌采用活检钳咬除、肛镜下枪式套扎器套扎、圈套高频电切一种或几种方法相互结合进行局部治疗,术后1月～3年用电子结肠镜复查。结果:(1)18例用活检钳全部摘除,3例枪式套扎器套扎,16例圈套高频电切,5例采用多种方法相互结合。(2)有5例同时合并另一进展期癌肿,除1例拒绝手术,1例病期太晚失去手术时机,3例作了扩大根治切除;其余37例中,有7例追加外科手术治疗,切除的肠标本上未发现癌残留。(3)33例(其中未追加手术30例)随访1月～5年,未发现癌复发。(4)随访病例中,14例癌伴多发性腺瘤在术后1～3年新生腺瘤发生率57.1%(8/14);而单发早期癌同期新生腺瘤发生率15.8%(3/19)。结论:只要病例选择合适,大肠粘膜内癌经内镜局部切除是可以达到治愈的,而且安全和微创。Objective：To investigate the effects of endoscopic local treatment for colorectal intramucosal carcinoma.Methods：42 patients with colorectal intramucosal carcinoma were treated with endoscopic local through one or few methods such as biopsy forceps resection,looping ligature and high frequency electric coagulation etc.in past five years.Results： （1）18 cases received biopsy forceps resection,3 cases received looping ligature,16cases received high frequency electric coagulatio resection,5 cases received many kinds of methods.（2）3 cases of 5 cases with advanced carcinoma were operated enlarge radical surgery except 1 cases who refused operation and 1 cases who losted operation opportunity.In the rest 37 cases,7cases were operated surgery, malignant remnants were no founded in theses colon specimens.（3）The following-up 33cases （30 cases without surgery）failed to show recurrent cancer for 1 month to 5 years.（4）In the following-up cases,the incidence of neogenesis adenoma was 57.1% in cancer with pilosity adenoma and was 15.8% in early cancer without adenoma during 1 year to 3 years after operation. Conclnsions：h can achieve to healing,security and minimum invasive treatment for endoscopic local resection to colorectal intramucosal carcinoma as long as it is suitable to select case.

关 键 词：大肠 粘膜内癌 内镜治疗 

分 类 号：R735.34[医药卫生—肿瘤]