内镜黏膜切除术治疗低位直肠侧向发育型肿瘤随机对照研究

Randomized Controlled Trials of Endoscopic Mucosal Resection for the Treatment of Low Rectal Cancer

目的:探讨内镜黏膜切除术治疗低位直肠侧向发育型肿瘤的临床效果。方法:收集我院收治的低位直肠侧向发育型肿瘤患者40例,随机分为对照组和实验组,每组各20例,对照组患者给予常规内镜下粘膜切除术,实验组患者给予内镜反转黏膜切除术,治疗结束后,对所有患者的病变残留例数、手术时间以及住院时间、并发症发生情况、手术切除效果进行检测并比较。结果:与对照组患者相比,实验组患者复发率较低(P<0.05),手术时间以及住院时间、并发症发生率较低(P<0.05);两组患者切除效果相比较,实验组分次切除、肿瘤残留例数患者较少,完全切除患者例数较多(P<0.05),两组患者的整块切除例数无差异(P>0.05)。结论:内镜反转黏膜切除术对于低位直肠侧向发育型肿瘤患者的临床疗效优于常规内镜下粘膜切除术,对临床有指导意义。

Objective： To investigate the clinical effect of endoscopic mucosal resection in the treatment of low rectal lateral spreading tumors. Methods： 40 cases with low rectal lateral spreading tumor from our hospital were selected and randomly divided into the control group and the experiment group with 20 cases in each group, and the patients in the control group were received the conventional endoscopic mucosal resection, while the patients in the experiment group were given the retroflex endoscopic mucosal resection. After the end of treatment, the cases of residual lesion, operation time and hospitalization time, complications, and surgical resection effects were detected and compared. Results： Compared with the control group, the recrudescence rate was higher in experiment group （P 〈 0.05）, and the operation time and hospitalization time and the incidence of complications was lower in experiment group with statistical significance （P 〈 0.05）; and in comparison with the efficacy of resection, the cases of fractional resection and residual tumor was smaller in experiment group, and the number of complete resection was more （P 〈 0.05）, but there was no differences in the number of entire resection between two groups （P〉0.05）. Conclusions： The curative effect of endoscopic mucosal resection is superior to the conventional endoscopic mucosal resection in the treatment of low rectal lateral spreading tumor, which has a guiding significance for clinical practice.