内镜黏膜切除术治疗低位直肠侧向发育型肿瘤

Endoscopic mucosal resection of laterally spreading tumor of low rectum

目的探讨内镜黏膜切除术（EMR）治疗低位直肠侧向发育型肿瘤（LST）的价值。方法应用黏膜染色技术结合超声内镜在内镜下对8例低位直肠侧向发育型肿瘤进行EMR治疗。结果全部病例均一次完成。病变最大56mm×62mm，最小8mm×10mm，病理诊断绒毛状腺瘤并不典型增生Ⅰ-Ⅱ级3例，管状腺瘤伴Ⅱ级不典型增生3例，管状腺瘤并黏膜内癌2例，全部病人未出现出血、穿孔等并发症。随访0．5～2年，无复发。结论EMR治疗低位直肠侧向发育型肿瘤安全有效。

AIM To study the therapeutic efficacy of endoscopic mucosal resection or endoscopic piecemeal mucosal resection （EMR or EPMR）of laterally spreading tumor of low rectum. METHODS Eight patients with laterally spreading tumor of low rectum received EMR （n= 6） or EPMR （n= 2） under ultrasonic endoscope following mucosal staining, RESULTS All tumors （the largest 56mm ＊ 62mm） were resected successfully, Pathological examination revealed villous adenoma with dysplasia Ⅰ-Ⅱ in three, tubular adenoma with dysplasia II in three and tubular adenoma with intramucosal carcinoma in two patients, No operation - related complications and recurrance were recorded in 0.5 to 2 - year follow- up. CONCLUSION EMR or EPMR of laterally spreading turmor of low rectum under ultrasonic endoscope is effective and safe.