内镜下不同治疗方法对大肠侧向发育型肿瘤的治疗价值的探讨

The therapeutic value of different endoscopic treatments for laterally spreading tumors

[目的]探讨内镜下不同治疗方法对大肠侧向发育型肿瘤(LST)的治疗价值。[方法]收集行内镜下治疗的78例LST患者的临床资料,采用内镜下黏膜切除术(EMR)治疗14例,内镜下分片黏膜切除术(EPMR)13例,预切开内镜下黏膜切除术(Pre-cut-EMR)24例,内镜黏膜下剥离术(ESD)27例;比较并分析各种治疗方法的平均操作时间、完整切除率、并发症发生率、复发率。[结果]EMR、EPMR、Pre-cut-EMR、ESD平均治疗时间分别为(23.9±7.9)min、(31.1±7.6)min、(24.7±6.5)min、(52.4±17.1)min,完整切除率均为100%,并发症发生率分别为0%、7.7%、0%、22.2%,EPMR治疗复发率为7.7%,其余治疗方法无复发病例。[结论]EMR、EPMR、Pre-cutEMR、ESD均为治疗LST安全有效的方法,且各有优势,故临床上可根据病灶具体情况、本医院内镜设备及内镜操作水平并结合患者意愿制定个体化的治疗方案。

[Objective]To investigate the therapeutic value of different endoscopic treatments for Laterally spreading tumors.[Methods]The clinical data of 78 patients with LST who underwent endoscopic treatment in our department of Digestive Endoscopy from January 2015 to December 2016 were collected and analyzed.The cases included 14 cases in EMR treatment group,13 cases in group EPMR,24 cases in group Pre-cut-EMR,and 27 cases in group ESD.The average operation time,complete resection rate,complication rate and recurrence rate were compared and analyzed.[Results]The average treatment time of EMR treatment group,EPMR group,Pre-cut-EMR and ESD group was(23.9±7.9)min,(31.1±7.6)min,(24.7±6.5)min,(52.4±17.1)min,respectively.The complete resection rate was 100%.The incidence of complications was 0%,7.7%,0%,22.2%,respectively.The recurrence rate in the EPMR treatment group was 7.7%.There was no recurrence in the other treatment groups.[Conclusion]EMR,EPMR,Pre-cutEMR and ESD are all safe and effective methods for the treatment of LST,and have their own advantages.Therefore,we can make an individualized treatment according to the specific condition of the lesion,the hospital endoscope equipment and the operating level of endoscopy and the wishes of the patients.