早期直肠癌内镜下黏膜剥离术与经肛门内镜微创手术的临床效果对比  

Comparison of clinical effects between endoscopic submucosal dissection and transanal endoscopic microsurgery for early rectal cancer

作　　者：李青科[1] 何立芳 梁磊[1] 韩龙才[1] 马国明[1] 刘远廷[1] 王志武[3] LI Qingke;HE Lifang;LIANG Lei;HAN Longcai;MA Guoming;LIU Yuanting;WANG Zhiwu(Department of Gastrointestinal Surgery,Tangshan People′s Hospital,Hebei Province,Tangshan063000,China;Department of Nephrology,Tangshan People′s Hospital,Hebei Province,Tangshan063000,China;the First Department of Chemoradiotherapy,Tangshan People′s Hospital,Hebei Province,Tangshan063000,China)

机构地区：[1]河北省唐山市人民医院胃肠外科,河北唐山063000 [2]河北省唐山市人民医院肾内科,河北唐山063000 [3]河北省唐山市人民医院放化疗一科,河北唐山063000

出　　处：《中国医药导报》2020年第31期118-121,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题(20171279);国家自然科学基金资助项目(81603475)。

摘　　要：目的探讨内镜黏膜下剥离术(ESD)与经肛门镜微创手术(TEM)对早期结直肠肿瘤的微创治疗效果。方法选取2010年5月—2016年5月河北省唐山市人民医院收治的结直肠肿瘤(uTis-uT1)患者211例,根据手术方式分为ESD组(98例)和TEM组(113例)。比较两种手术方式的手术时间、住院时间,术中出血、肿瘤完整切除、肿瘤残留及复发例数;比较两组术后出血、穿孔、梗阻、狭窄等并发症的发生情况。结果ESD组手术时间、住院时间短于TEM组,差异有高度统计学意义(P<0.01);两组术中出血、瘤完整切除率、肿瘤残留率及复发率比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论ESD与TEM对于治疗早期直肠癌均安全有效,但ESD的手术时间及住院事件明显缩短。Objective To investigate the efficacy of endoscopic submucosal dissection(ESD)and transanal endoscopic microsurgery(TEM)in the treatment of early colorectal tumors.Methods A total of 211 patients with early rectal cancer(uTis-uT1)who treated in Tangshan People′s Hospital of Hebei Province from May 2010 to May 2016 were selected.They were divided into ESD group(98 cases)and TEM group(113 cases).The operative time,hospital stay,intraoperative bleeding,complete tumor resection,tumor residual and recurrence were compared between the two methods.Postoperative complications such as hemorrhage,perforation,obstruction and stenosis occurred were compared between the two groups.Results The operation time and hospital stay in ESD group were shorter than those in TEM group,and the differences were statistically significants(P<0.01);and there were no significant differences in intraoperative bleeding,complete tumor resection rate,tumor residual rate and recurrence rate(P>0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Both ESD and TEM are safe and effective in the treatment of early rectal cancer,but the operation time and hospital stay in ESD are significantly shortened.

关 键 词：早期直肠癌 内镜黏膜下剥离术 经肛门镜微创手术 治疗 

分 类 号：R735.34[医药卫生—肿瘤]