ESD联合EMR和ESD治疗结直肠病变疗效比较  

Comparison of Efficacy of ESD Assisted EMR Versus ESD in the Treatment of Colorectal Lesions

作　　者：王小瑞[1] 王觅柱[2] 张永立[1] 王丽娟[1] 王晓荣[1] 梁玉寰[1] 郝慧菁[1] 张艳[1] WANG Xiaorui;WANG Mizhu;ZHANG Yongli;WANG Lijuan;WANG Xiaorong;LIANG Yuhuan;HAO Huijing;ZHANG Yan(Department of Digestive Diseases,The Fourth Hospital of Baotou,Inner Mongolia,Baotou Inner Mongolia 014030,China;Department of Digestive Diseases,The Second Affiliated Hospital of Baotou Medical College(Inner Mongolia Institute of Digestive Diseases),Baotou Inner Mongolia 014030,China)

机构地区：[1]内蒙古自治区包头市第四医院消化内科,内蒙古包头014030 [2]包头医学院第二附属医院消化内科(内蒙古消化病研究所),内蒙古包头014030

出　　处：《中国继续医学教育》2019年第34期135-138,共4页China Continuing Medical Education

基　　金：包头市医药卫生科技计划项目（WSJJ2015036）

摘　　要：目的对比EMR联合ESD和单独ESD治疗结直肠早癌、黏膜及黏膜下肿瘤的疗效及应用价值。方法将本院2015年1月-2016年9月肠镜发现的结直肠早癌、结直肠黏膜及黏膜下肿瘤患者,根据治疗方法的不同,共分为ESD联合EMR治疗组30例及单独ESD治疗组30例,比较两种内镜治疗方法的手术耗时、整块切除率、并发症(术中、术后出血及穿孔)发生率及局部残留复发率等。结果 ESD联合EMR组手术时间(29.33±6.73)min短于单独ESD组(45.93±6.86)min,两组手术时间有显著性差异(P <0.05);两组的整块切除率分别为83.3%、93.3%,无显著性差异(P> 0.05),两组并发症发生率分别为,13.3%、23.3%,其中术中出血率分别为10.0%、13.3%,术中穿孔发生率分别为0.0%、6.7%,两组并发症无显著性(P> 0.05)。结论 ESD联合EMR和单独ESD治疗结直肠早癌、黏膜及黏膜下肿瘤疗效及并发症发生率相当,但两组手术耗时统计有显著差异(P <0.05)。ESD联合EMR可以简化操作,在治疗结直肠早癌、结直肠黏膜及黏膜下肿瘤能明显缩短手术时间,可做为ESD初学者的入门技术。Objective To compare the efficacy and application value of ESD assisted EMR versus ESD in the treatment of early colorectal cancer, colorectal mucosa and submucosal tumors. Methods In our hospital From January 2015 to September 2016, the patients with early colorectal cancer, colorectal mucosa and submucosal tumors were divided into two groups: ESD assisted EMR group 30 cases and ESD group 30 cases according to the different treatment methods. We compared mean operation time rate of the overall resection rate, complications(intraoperative, postoperative bleeding and perforation) and local residual recurrence rate between ESD assisted EMR group and ESD group. Results The operation time of ESD assisted EMR group(29.33±6.73)min was shorter than that of ESD group(45.93±6.86)min, and there was significant difference between the two groups(P < 0.05). The whole resection rate of the two groups was 83.3% and 93.3%, respectively, with no significant difference(P > 0.05). The incidence of complications in the two groups was 13.3% and 23.3%, respectively, among which the intraoperative bleeding rate was 10% and 13.3%, and the incidence of intraoperative perforation was 0% and 6.7%, respectively, and there was no significant difference between the two groups(P > 0.05). Conclusion ESD assisted EMR and ESD in the treatment of colorectal cancer, mucosal and submucosal tumors and the incidence of complications are similar, but there was significant difference in operation time between the two groups(P < 0.05).ESD assisted EMR can simplify the operation in the treatment of early colorectal cancer, Colorectal mucosa and submucosal tumors can significantly shorten the operation time, can be used as an entry-level technique for ESD beginners.

关 键 词：内镜黏膜切除术 内镜黏膜下剥离联合圈套切除术 内镜黏膜下剥离术 结直肠 早癌 黏膜及黏膜下肿瘤 

分 类 号：R459[医药卫生—治疗学]