内镜下治疗消化道早癌及癌前病变效果

Study on the Effect of Endoscopic Treatment for Early Digestive Cancer and Precancerous Lesions

目的 探究消化道早癌及癌前病变经内镜下治疗的方式及效果.方法 将泰州市人民医院消化内科2011年2月至2013年2月收治的25例消化道癌变患者作为研究对象,采用内镜下黏膜剥脱术（ESD）与内镜下黏膜切除术（EMR）治疗,对治疗效果及其并发症情况进行观察分析.结果 25例患者病变部分全部被切除,其中采用EMR切除病灶总计10例、采用ESD分片切除总计3例、采用ESD完整切除病灶总计12例.EMR手术时间33～56（40.3±4.8） min,ESD手术时间47～ 150（80.3±9.1） min.术后病理结果显示,4例胃息肉、5例胃早癌、6例直肠侧向发育性肿瘤、10例结肠息肉.25例患者经过EMR与ESD治疗后,一次切除率为96.00％ （24/25）,出血率为12.00％ （3/25）,穿孔率为8.00％（2/25）,出血患者与穿孔患者给予积极的处理皆效果良好.25例患者皆进行6～12个月随访,随访复发率为0％.结论 对于消化道早癌及癌前病变患者,采用ESD与EMR治疗能取得比较良好的效果,复发率较低,而且对于病理评估也有积极的意义.

Objective To explore the effect of endoscopic therapy for early digestive cancer and precancerous lesions.Methods A total of 25 cases of patients with digestive tract cancer admitted in Taizhou People＇s Hospital from Feb.2011 to Feb.2013 were given endoscopic mucosal stripping（ESD） and endoscopic mucosal resection（EMR） treatment,the treatment effect and complications were observed and analyzed.Results Lesions of all the cases were removed,including 10 cases by EMR,and 3 cases by ESD slicing,the other 12 cases by ESD complete excision.Operation time of EMR was 33-56 minutes,with an average of （40.3 ± 4.8） min,operation time of ESD was 47-150 minutes,with an average of （80.3 ± 9.1） rmin.The postoperative pathological results showed there were 4 cases of gastric polyp,5 cases of gastric cancer,6 cases of early rectal laterally spreading tumor,and 10 cases of colon polyps.The one-time resectability rate of all the 25 cases after EMR and ESD treatmentwas 96.00％ （24/25）,bleeding rate was 12.00％ （3/25）,perforation rate was 8.00％ （2/25）,and active treatment were given to the patients with bleeding and perforation with good effect.During the 6-12 months follow-up,the recurrence rate of all the cases was 0％ （0/25）.Conclusion ESD and EMR treatment has good effect on patients with early digestive cancer and precancerous lesions,with low recurrence rate,and also has positive significance in pathological evaluation.