直肠类癌的诊断和治疗(附38例报告)

Endoscopic Diagnosis and Treatment of Rectal Carcinoid(38 Cases Report)

目的 :探索直肠类癌的诊断和治疗。方法 :经大肠镜下电灼切除直肠类癌。经肠镜查出直肠类癌 38例 ,其中 32例 <1cm的直肠类癌经内镜电灼切除 ,4例直径在 1.5cm者行局部扩大切除术 ,2例直径 >2cm者行根治性手术。结果 :32例经内镜电灼切除术后经 6个月～ 2 0年随访无 1例复发 ,4例局部扩大手术 ,术后 3～ 8年至今无复发 ,直径 >2cm者 ,术后 3年 1例出现肝转移 ,另 1例发现直肠类癌时已有肝转移灶。结论 :直肠类癌应早期诊断早期治疗 ,对于 <1cm类癌可采用内镜下电灼切除 ,该项技术是一种简单安全有效的治疗方法。

Objective: To discuss the diagnosis and treatment for rectal carcinoid. Methods: Electroexcision under endoscopy is a new technique for diagnosis and treatment of rectal carcinoid. Total of 38 cases with rectal carcinoid, examined and diagnosed by colonoscopy, 32 cases(diameter smaller than 1cm) were electroexised under colonscopy, 4cases(diameter 1.5cm) were electroexised under colonscopy, 4cases(diameter 1.5cm) were operated with enlarged region. Resuls: 32 cases with colonoscopic electroexcision showed no recurrence after 6 months to 20 years follow-up. 4 cases with regional excision had no recurrence 3 to 8 years till now. As for 2 cases with diameter larger than 2cm, one had liver metastases 3 years later, another already had liver metastasis when examined. Conculsion: Rectal carcinoid should be diagnosed and treated early and can be electroexcised under colonoscopy with diameter smaller than 1cm. This technique is a simple, safe and effective for early rectal carcinoid.