早期大肠类癌的超声内镜诊断及微创治疗  

Endoscopic ultrasonography in diagnosis and endoscopicaly minimally invasive treatment of early colorectal carcinoid

作　　者：武育卫[1] 何双丽 师雷峰 胡文华[1] 徐美珍[1] 王仰坤[1] 

机构地区：[1]解放军150医院消化内科,河南洛阳471031

出　　处：《实用医药杂志》2017年第2期133-135,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨超声内镜诊断大肠类癌的临床价值,以及内镜微创治疗早期大肠类癌的临床疗效。方法经普通结肠镜检查发现黏膜下肿瘤,然后经内镜超声检查确诊类癌,对起源于黏膜固有层和黏膜下层类癌患者29例行内镜微创治疗,直径≤1.0 cm行内镜下黏膜切除术(EMR),直径>1.0 cm行内镜黏膜下剥离术(ESD),术后标本行病理检查。结果 29例均完全切除,病变直径0.6~1.8 cm,19例行EMR术治疗,10例行ESD术治疗。2例ESD术中创面出血,经热活检钳电凝止血成功,无穿孔。术后病理检查均显示为类癌。术后3个月结肠镜复查随访,所有患者创面形成瘢痕,无残留和复发。结论超声内镜辅助下,内镜下EMR和ESD治疗起源于黏膜固有层和黏膜下层的早期大肠类癌是安全、有效的。Objective To evaluate the diagnostic value of endoscopic ultrasonography（EUS） and to explore the efficacy of endoscopicaly minimally invasive treatment of the colorectal carcinoid. Methods Submucosal tumors were found by colonoscopy,and the early colorectal carcinoid were diagnosed by endoscopic ultrasonography;The 29 patients whose neoplasms were from mucoderm and submucosa accepted endoscopic minimal invasive therapy. Endoscopic mucosal resection （EMR） was applied to remove submucosal tumors with diameters less than 1.0era,and endoscopic submucosal dissection（ESD） was applied to remove submucosal tumors bigger than 1.0 cm. Specimen were examined by pathology after treatment. Results In the 29 cases neoplasm sized 0.6-1.8 cm of diameter were completely resected,in 19 eases were resected with EMR,in 10 cases were resected with ESD;two patients had bleeding from wound-surface during operation that was stopped by electrocoagulation hemostasis. No perforation were found in any cases. Postoperative pathologic exam. revealed earcinoid. After 3 months-follow up,endoscopy showed that the scars formed in all patients,and no residue or recurrence. Conclusion With the aid of EUS,EMR and ESD are safe and effective for early colorectal earcinoid from mueoderm and submucosa.

关 键 词：早期大肠类癌 超声内镜 内镜下黏膜切除术 内镜黏膜下剥离术 

分 类 号：R735.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]