直肠类癌的内镜超声诊断价值和经肛门内镜微创切除的疗效分析  

Endoscopic Ultrasonography and Transanal Endoscopic Microsurgery in the Diagnosis and Treatment of Rectal Carcinoid

作　　者：吴国举[1] 赵刚[1] 周新平[1] 黄美雄[1] 肖刚[1] 余涛[1] 

机构地区：[1]卫生部北京医院普外科,北京100730

出　　处：《医学临床研究》2013年第4期689-691,694,共4页Journal of Clinical Research

摘　　要：【目的】研究内镜超声（endoscopic ultrasonography，EUS）对直肠类癌的诊断价值；探讨经肛门内镜微创切除（transanalendoscopicmicrosurgery，TEM）直肠类癌的疗效。【方法】应用EUS探头对48例电子结肠镜发现的直肠黏膜隆起性病灶进行超声检查；对诊断为直肠类癌的病例行TEM治疗；比较EUS诊断和病理检查结果；观察TEM的安全性及疗效。【结果】经EUs检查，诊断直肠类癌18例，16例得到病理证实，EUS诊断准确率88．9％（16／18）；TEM术后均未发生并发症，随访2～50个月未发现肿瘤局部复发。【结论】EUS可以明确直肠类癌的肠壁来源、大小、内部回声性质、边界及有无固有肌层和周围血管浸润，对直肠类癌的诊断有临床意义；TEM为治疗直肠类癌提供了一种微创、安全、有效的手术方式。[Objective]To study the value of endoscopic ultrasonography（EUS） in the diagnosis of rectal carci- hold, and to explore the efficacy of transana[ endoscopic microsurgery（TEM）. [Methods] EUS was performed in 48 patients with mucosal protrusion lesions by colonoscopy. Patients diagnosed as rectal carcinoid underwent TEM. The diagnostic results of EUS were compared with pathological findings. The safe and effectiveness of TEM were ob- served. [Results] Eighteen patient were diagnosed as rectal carcinoid by EUS. Sixteen patients were confirmed by pathological examination, and the diagnosis accuracy rate of EUS was 88.9o//00 （16/18）. There were no complications after TEM. The follow-up for 2~50 months showed no local tumor recurrence. [Conclusion] EUS can identify the origin of intestinal wall, size, internal echo property, border, muscularis propria and peripheral vessel infiltration of rectal carcinoid, so it is of significance in the diagnosis of rectal carcinoid. TEM is a safe and effective minimally inva- sive surgical technique for the treatment of rectal carcinoid.

关 键 词：直肠肿瘤 超声检查 直肠肿瘤 外科学 

分 类 号：R735.37[医药卫生—肿瘤]