内镜下高频电刀联合尼龙绳切除大肠有蒂大息肉42例临床分析

Clinical analysis on 42 cases of the resection of pedunculated colorectal polyps using high-frequency electric coagulation nylon thread ligation by endoscope

目的探讨内镜下高频电刀联合尼龙绳切除大肠有蒂大息肉的价值。方法回顾性分析2009年7月～2014年7月收治的42例大肠有蒂大息肉患者的临床资料。结果 42例患者在内镜下高频电刀联合尼龙绳共切除49枚息肉,成功率100%,术中及术后无一例患者发生肠出血、肠穿孔等并发症,也无一例患者发生息肉切除尼龙绳结扎脱落现象。49枚息肉术后病理检验,管状腺瘤11枚,绒毛状腺瘤14枚,混合性息肉18枚,幼年息肉6枚,其中12枚腺瘤伴轻至重度不典型增生,1枚绒毛状腺瘤局部癌变,因癌变局限于切除息肉内,为高分化腺癌,内镜下已完整切除,切缘未累及,未进一步手术治疗。术后1～6个月后复查结肠镜见息肉切除处均修复正常,之后1年复查结肠镜未见异常。结论内镜下高频电刀联合尼龙绳切除大肠有蒂大息肉是一种安全、有效、经济的方法。

Objective To explore the clinical value of high-frequency electric coagulation resection combined with nylon thread ligation under endoscope（Hfecrntle） for the treatment of pedunculated colorectal polyps（PCP）. Methods The clinical data of 42 PCP patients were analyzed retrospectively from July 2009 to July 2014. Results The 49 PCPs recovered successfully from the 42 patients by HFECRNTLE. The healing rate was 100%. No complications such as bleeding, intestinal perforation, or abscission of endoloop and epinephrine were observed in the period of resection or postoperative. The 49 PCPs were 11 tubular adenomas, 14 villous adenomas, 18 mixed polyps and 6 juvenile polyps,confirmed with postoperative pathology inspection;12 cases were adenoma with mild and high degree atypical hyperplasia, 1 case was villus adenoma with malignant change, in which the carcinogenesis was well-differentiated adenocarcinoma with no additional operation. 1-6 months later, all patients were followed-up with coloscope that the resection areahad been repaired completely. There was no abnormal condition for the colonoscopy examination after one year.Conclusion Hfecrntle is a safe, effective and economic method for the treatment of colorectal polyps.