阑尾口息肉的临床特征及内镜下超级微创治疗效果

Clinical characteristics of appendix orifice polyps and the effect endoscopic super minimally invasive treatment

分析阑尾口息肉的临床特征及内镜下超级微创治疗效果。回顾性分析2022年1月1日至2023年12月31日期间在北京大学第一医院以及解放军总医院第一医学中心消化内科切除阑尾口息肉患者临床资料。分析患者的年龄、性别等一般情况,阑尾口息肉分型,内镜下治疗方式,术后病理以及术后并发症情况。共纳入47例患者,男28例,女19例,年龄35~86(61±12)岁。阑尾口息肉分为4型,0、1、2、3型分别为14、15、12和6例。内镜下形态为颗粒型侧向发育型肿瘤22例。治疗方案中行内镜下黏膜剥离术37例。术后放置阑尾支架1例。息肉病理类型:腺瘤15例,高级别上皮内瘤变10例,黏膜内癌4例,黏膜下癌5例,炎性息肉1例,无蒂锯齿状病变12例。治疗结局中治愈性切除44例。术后无出血、穿孔、急性阑尾炎等并发症。阑尾口息肉病理多为癌前病变,内镜下超级微创切除的方案是安全、有效的。

To analyze the clinical characteristics of appendiceal orifice polyps and the effect of endoscopic super minimally invasive treatment.A retrospective analysis was conducted on the general situation(age and sex),the classification of appendiceal orifice polyps,the treatment method under endoscope,postoperative pathology and postoperative complications in patients who underwent resection of appendiceal orifice polyps at the Peking University First Hospital and the First Medical Center of the PLA General Hospital from January 1,2022,to December 31,2023.A total of 47 patients were included,consisting of 28 males and 19 females,with 35-86(61±12)years.Appendiceal orifice polyps were classified into four types:type 0(14 cases),type 1(15 cases),type 2(12 cases),and type 3(6 cases).Among the endoscopic morphologies,22 cases were granular laterally spreading tumors.Endoscopic mucosal dissection was performed in 37 cases.Postoperative appendiceal stent placement was performed in 1 case.The pathological types of polyps included adenoma in 15 cases,high-grade intraepithelial neoplasia in 10 cases,intramucosal carcinoma in 4 cases,submucosal carcinoma in 5 cases,inflammatory polyps in 1 cases,and sessile serrated lesion in 12 cases.Curative resection was performed in 44 cases.There were no postoperative complications such as bleeding,perforation,or acute appendicitis.The pathology of appendiceal polyps is mostly precancerous lesions,and the treatment scheme of endoscopic super minimally invasive resection is both safe and effective.