内镜粘膜下剥离术治疗老年直肠类癌的价值评估  

Value Evaluation of Endoscopic Submucosal Dissection for Senium Rectal Carcinoid Tumors

作　　者：李瑞光[1] 李顺 

机构地区：[1]新疆医科大学附属肿瘤医院内镜中心,乌鲁木齐830011

出　　处：《新疆医学》2017年第10期1098-1100,共3页Xinjiang Medical Journal

摘　　要：目的探讨内镜粘膜下剥离术(endoscopi submucosal dissection,ESD)治疗老年直肠类癌的安全性与可靠性。方法2007年2月-2012年2月对直径≤20 mm的35例老年直肠类癌行ESD治疗。粘膜下注射肾上腺素生理盐水抬高病灶,使病灶与肌层分离;预切开瘤体周围粘膜;剥离瘤体下方粘膜下层结缔组织,完整切除瘤体。结果对35例直径≤20 mm老年直肠类癌行ESD治疗,均完整切除瘤体。术中穿孔1例,出血2例,经内科保守治疗后痊愈。切除标本基底及边缘均无肿瘤组织残留。35例随访1~5年,均无复发及转移。结论对老年患者类癌的治疗,ESD是一种安全可靠和微创的内镜治疗手段,可避免不必要的手术。Objective To discuss the safety and reliability of endoscopic submucosal dissection（ESD）for senium rectal carcinoid tumors. Methods Between February 2007 and February 2012,35 senium patients with rectal carcinoid tumors showed a tumor smaller than 20 mm in diameter, and underwent ESD after the examination.After marking the surrounding mucosa of the phyma, we injected a mixture into the submucosa to elevate the phyma from the muscle layer; and then the surrounding mucosa of the phyma were precut to dissect the connective tissue of the submucosa beneath the phyma, and then removed the tumor completely. Results The tumors smaller than 20 mm were all removed completely with ESD. Intraoperative perforation occurred in one patient, and postoperative hemorrhage was detected in two. No residual tumor tissues were detected after the operation. The 35 patients were followed up for 1 to 5 years, none of them had recurrence or metastasis. Conclusions ESD is a safe, effective and minimally invasive therapy in the senium rectal carcinoid tumors.

关 键 词：内镜粘膜下剥离术 老年 直肠类癌 

分 类 号：R574.63[医药卫生—消化系统]