内镜黏膜切除术及剥离术治疗大肠早癌及癌前病变分析  

Analysis of EMR and ESD in treatment of early colorectal cancer and precancerous lesion

作　　者：乔丽娟[1] 徐辉[1] 陈虹彬[1] 蒋明德[1] 汤善宏[1] 贺莉[1] 

机构地区：[1]成都军区总医院消化内科,成都610083

出　　处：《西南国防医药》2015年第3期278-280,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨内镜黏膜切除术(EMR)及黏膜下剥离术(ESD)治疗大肠早癌及癌前病变的价值。方法对38例结肠较大隆起病变(直径≥1 cm)进行活检,病检提示为管状腺瘤伴中重度异型增生的,再行EMR或ESD术,分析其疗效及安全性。结果所有38例早癌及癌前病变均成功切除送检,完整切除率为97.37%(37/38);病理结果:中度异型增生17例,重度异型增生11例,癌变10例(其中1例结合术后病检结果追加了外科手术治疗);术中明显出血者EMR 0例,ESD 1例,明显出血率为0.26%(1/38);38例均未发生穿孔,术后1、6、12个月复查,无一例复发。结论 EMR及ESD术切除大肠早癌及癌前病变安全、有效。Objective To explore the value of endoscopic mucosal resection （EMR） and endoscopic submucosal dissection （ESD） in the treatment of early colorectal cancer and precancerous lesion .Methods 38 cases with large protuberant lesions （d≥1 cm） received biopsy and EMR or ESD operation was performed in the patients suffered from tubular adenoma with severe dysplasia indicated by pathological examination .The efficacy and safety of the operation were analyzed .Results The protuberant lesions of the 38 patients with early colorectal cancer and precancerous lesion were resected successfully , and the resection rate reached to 97.37%（37/38）.Pathological examination results： moderate dysplasia in 17 cases, severe dysplasia in 11 cases, and cancer in 10 cases （ among them , an additional surgical operation based on the postoperative pathological results was performed in one case ）; significant intraoperative bleeding occurred in no case during EMR , but in one case during ESD , with a significant bleeding rate of 0.26% （1/38）;there was no perforation in 38 cases;during the postoperative reexamination in one month , six months, and twelve months after the operation, there was no recurrence of the disease .Conclusion EMR and ESD in treatment of early colorectal cancer and precancerous lesion are safe and effective .

关 键 词：大肠 早癌 癌前病变 黏膜切除术 黏膜下剥离术 疗效 安全性 

分 类 号：R735.34[医药卫生—肿瘤]