内镜下多环黏膜套切术与内镜黏膜下切除术治疗结直肠黏膜下肿瘤疗效比较

Comparison of the effect of endoscopic multi - band mucosectomy and endoscopic mucosal resection for colorectal submucosal tumors

目的比较内镜下多环黏膜套切术（EMBM）与内镜黏膜下切除术（ESMR）治疗早期结直肠黏膜下肿瘤的效果及安全性。方法选择2012年1月至2014年6月在滕州市中心人民医院内镜中心行结肠镜检查发现手术治疗的结直肠黏膜下肿瘤患者加例的临床资料，依据治疗方法不同分为EMBM组22例（采用EMBM治疗）与ESMR组18例（采用ESMR治疗），比较两组结直肠黏膜下肿瘤病灶完全切除率、手术时间及并发症发生情况。结果EMBM组完全切除率95．45％，ESMR组完整切除率94．44％，两组差异无统计学意义（0=0．273，P〉0．05）；EMBM组手术时间（31．3±4．0）min，明显短于ESMR组的（47．2±4．5）rain（t=-15．194，P〈0．05）；EMBM组出血发生率为9．0％，明显低于ESMR组的33．3％（x。=3．952，P〈0．05）；两组术后直肠狭窄发生率差异无统计学意义（P〉0．05）；术后随访3-24个月，两组均无病灶局部复发。结论与ESMR比较，EMBM治疗结直肠黏膜下肿瘤患者安全、有效，并发症少。

Objective To compare the therapeutic effect and safety of endoscopic multi - band mucosetomy （EMBM） and endoscopic mucosal resection （ESMR） in the treatment of colorectal submucosal tumors. Methods From January 2012 to June 2014, the clinical data of 40 patients with colorectal submucosal tumors in Tengzhou Central People＇s Hospital were divided into EMBM group （22 cases） and ESMR group（ 18 cases） according to different treatment method. The complete resection rate, operation time and complications were compared between the two groups. Results The complete resection rate of the EMBM group was 95.45%, which of the ESMR group was 94. 44%, the difference between the two groups was not statistically significant （ X2 = 0. 273, P 〉 0.05 ）. The operation time was shorter in the EMBM group [ （ 31.3.5 ±4.0） min] than that in the ESMR group [ （47.2 ±4.5 ） min）, t = - 15. 194 ,P 〈0.05 ]. The incidence rate of hemorrhage in the EMBM group was 9.0% ,which was significantly lower than 33. 3% in the ESMR group （ X2 = 3. 952 ,P 〈 0.05 ）. There was no statistically significant difference between the two groups in the incidence of postoperative colorectal stricture （ P 〉 0.05 ）. All the patients were followed up for 3 24 months after operation,and no local recurrence occurred. Conclusion EMBM is safe and effective for colorectal submucosal tumors and the complications are less.