早期结直肠癌的诊断方法与微创治疗

Diagnosis and minimally invasive treatment of early colorectal carcinoma

目的探讨早期结直肠癌的诊断方法及微创治疗的可行性。方法对30例疑诊结直肠癌的患者进行普通肠镜和特殊肠镜(放大肠镜和超声肠镜)检查,选择适宜的病例进行微创治疗。结果30例患者术前经特殊肠镜检查均确诊为早期结直肠癌,与术后病理诊断符合率100%;病变浸润深度超声肠镜与病理检查符合率为91.3%。本组结直肠癌大体形态分类以亚有蒂型居多(53.3%);腺体开口以ⅢL加Ⅴ为主(50.0%)。微创手术治疗16例(53.3%),开腹手术14例。随访12～67个月,除1例盲肠癌患者术后第8天并发急性肺栓塞死亡外,余29例均无复发。结论术前应用放大肠镜或超声肠镜检查对早期结直肠癌诊断率高;选择适宜的病例进行微创治疗是可行的。

Objective To explore the diagnostic methods of early colorectal carcinoma and the feasibility of minimally invasive treatment. Methods Colonoscope and special colonoscope(magnification colonoscope and ultrasound colonoscope) were performed for the patients with suspected colorectal carcinoma. Early cases were detected and suitable cases were selected to undergo minimally invasive treatment. Results Thirty cases were diagnosed as early colorectal carcinoma. Compared with postoperative pathology,the accuracy for early colorectal carcinoma was 100%. The accuracy of ultrasound colonoscope for invasion depth was 91%(21/23). The most common macroscopic and microscopic types were Isp (16/30) and ⅢL+Ⅴ(15/30). Sixteen cases(53%) underwent minimally invasive treatment,and no recurrence was found after follow up from 12 to 67 months. Conclusions The diagnostic accuracy of magnification and ultrasound colonoscope for early colorectal carcinoma is high. It is feasible to perform minimally invasive operation for some suitable cases.