小探头超声内镜联合预切开粘膜切除术在直肠类癌治疗中的应用  

Application of Small Probe Endoscopic Ultrasonography Combined with Pre-cut-endoscopic Mucosal Resection in the Treatment of Rectal Carcinoid

作　　者：张思宇 Zhang Siyu(Gastroenterology Department,Zhengzhou Second People’s Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州市第二人民医院消化内科,河南郑州450000

出　　处：《黑龙江医学》2025年第4期435-438,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨小探头超声内镜(EUS)联合预切开粘膜切除术(Pre-cut-EMR)在直肠类癌治疗中的应用价值。方法:选取2019年9月-2023年8月郑州市第二人民医院内镜中心检查肠镜行EUS提示类癌的患者共27例作为研究对象,无周围及远处转移的患者行Pre-cut-EMR手术。结果:27例经小探头超声检查或病理化验考虑直肠类癌的患者经Pre-cut-EMR治疗病变均位于直肠,病灶直径分别为0.8~2.0 cm。Pre-cut-EMR手术时间(32.8±10.87) min,病灶整块切除率为96.2%,完整切除率为100%,术中穿孔0例,术中即刻出血共15例,术后出现迟发出血1例。术后随访3~12个月,无复发及转移。结论:EUS检查能够明确直肠类癌的浸润深度、直径,对治疗方法选择有较高的指导价值。对于直径<20 mm的直肠类癌,pre-cut-EMR是一种安全、有效的方法。Objective:To explore the application value of small probe endoscopic ultrasonography(EUS)combined with pre-cut-endoscopic mucosal resection(pre-cut-EMR)in the treatment of rectal carcinoids.Methods:Endoscopic ultrasonography with small probe was performed and biopsy was taken for patients with rectal submucosal swelling found by colonoscopy in the hospital from September 2019 to August 2023.Patients whose pathological results were considered as neuroendocrine tumor were evaluated.After EUS and CT examinations,patients without peripheral or distant metastasis were treated with pre-cut-EMR.Results:27 patients who were considered rectal carcinoid by small probe ultrasonography or pathological assay were treated with pre-cut-EMR.The lesions were all located in the rectum with a diameter of 0.8~2.0 cm.The pre-cut-EMR operation time was(32.8±10.87)minutes,the whole resection rate was 96.2%,and the complete resection rate was 100%.There were 0 cases of intraoperative perforation.There were 15 cases of immediate bleeding during the operation and 1 case of delayed bleeding after the operation.Postoperative follow-up was 3~12 months without recurrence or metastasis.Conclusion:EUS can clarify the depth and diameter of rectal carcinoid invasion,which has a high guiding value for the selection of treatment methods.Pre-cut-EMR is a safe,time-saving,and effective method for rectal neuroendocrine tumors<20 mm in diameter.

关 键 词：小探头超声内镜 预切开粘膜切除术 类癌 

分 类 号：R735.3[医药卫生—肿瘤]