套扎法内镜下黏膜切除术在直肠神经内分泌肿瘤中的应用  

Application of endoscopic mucosal ligation resection in rectal neuroendocrine tumors

作　　者：陈功 孙超[1] 柴海娜[1] 吴莹莹[1] 王璐[1] 陈超伍[1] 汤东[2] 刘军[1] CHEN Gong;SUN Chao;CHAI Haina;WU Yingying;WANG Lu;CHEN Chaowu;TANG Dong;LIU Jun(Endoscopic Center,Northern Jiangsu People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225000;Department of Gastrointestinal Surgery,Northern Jiangsu People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225000)

机构地区：[1]江苏省苏北人民医院消化内镜中心,江苏扬州225000 [2]江苏省苏北人民医院胃肠外科,江苏扬州225000

出　　处：《实用临床医药杂志》2022年第18期21-25,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省青年医学重点人才依托项目(QNRC2016330);江苏省扬州市重点研发计划(社会发展)项目(YZ2018087)。

摘　　要：目的比较套扎法内镜下黏膜切除术(EMR-b)和内镜下黏膜剥离术(ESD)对直肠神经内分泌肿瘤(NENs)的治疗效果。方法回顾性分析56例接受ESD或EMR-b治疗的直肠NENs患者的资料,患者肿瘤直径均<10 mm且无淋巴系统转移。根据接受治疗的不同,将患者分为EMR-b组26例和ESD组30例。记录2组患者组织学完整切除率、并发症发生率和操作时间。结果56例患者的平均年龄为(51.05±11.31)岁。EMR-b组肿瘤直径为(7.12±2.76)mm,ESD组为(7.47±2.32)mm,2组肿瘤直径差异无统计学意义(P=0.599)。EMR-b组切除时间为(9.08±3.45)min,短于ESD组的(18.50±3.25)min,差异有统计学意义(P<0.001)。EMR-b组完整切除率为92.31%(24/26),ESD组为93.33%(28/30),2组完整切除率差异无统计学意义(P=1.000)。非完整切除患者随访期间无局部复发和远处转移。结论与ESD相比,EMR-b有相似的组织学完整切除率,但切除时间更短,操作更简单,EMR-b对于直径<10 mm、不超过黏膜下层的直肠NENs是一种良好的内镜下治疗方法。Objective To compare the efficacy of endoscopic mucosal resection using band ligation(EMR-b)and endoscopic mucosal dissection(ESD)in the treatment of rectal neuroendocrine tumors(NENs).Methods The data of 56 rectal NENs patients with rectal NENs<10 mm in diameters,without lymphatic metastasis treated by ESD or EMR-b were retrospectively analyzed.According to different treatments,the patients were divided into EMR-B group(26 cases)and ESD group(30 cases).The complete resection rate,incidence of complications,and length of procedures were compared between the two groups.Results The mean age was(51.05±11.31)years old of 56 cases.The tumor size of EMR-B group was(7.12±2.76)mm,and was(7.47±2.32)mm in the ESD group,and the between-group difference in tumor size showed no significant difference(P=0.599).The resection time in EMR-B group was(9.08±3.45)min,which was shorter than(18.50±3.25)min in the ESD group,and the difference was statistically significant(P<0.001).The complete resection rate of the EMR-B group was 92.31%(24/26),and was 93.33%(28/30)in the ESD group,and the difference was not statistically significant(P=1.000).In the cases of incomplete resection,there was neither local recurrence nor distant metastasis during the follow-up.Conclusion Compared with ESD,EMR-b has similar histological complete resection rate,but has shorter resection time and simpler operation.EMR-b may be a better choice for rectal NENs with diameter<10 mm and without invasion of submucosa.

关 键 词：套扎法内镜下黏膜切除术 内镜下黏膜剥离术 直肠 神经内分泌肿瘤 

分 类 号：R735.3[医药卫生—肿瘤] R61[医药卫生—临床医学]