内镜食道静脉瘤套扎器治疗直肠神经内分泌肿瘤的疗效分析

Analysis of the efficiency of endoscopic esophagus variceal ligation in treatment of rectal neuroendocrine neoplasms

目的评估超声内镜结合内镜食道静脉瘤套扎器行内镜下圈套器法黏膜切除术(EMR-L)治疗直肠神经内分泌肿瘤(NENs)的临床有效性、安全性以及技术的可行性。方法回顾性分析北京世纪坛医院消化内科2015年11月-2017年11月收治的13例直肠NENs患者临床资料,治疗前均行超声内镜检查,后进行EMR-L切除病变。观察患者内镜表现、EMR-L操作过程及其并发症、病理结果,术后定期结肠镜随访。结果 13例患者顺利完成EMR-L切除病变,耗时10 min 36 s^52 min 21 s,平均(21.9±10.6)min。1例患者发生急性出血,予药物喷洒及钛夹封闭创面治疗后出血停止。无急性或迟发性直肠出血、穿孔等并发症。结论应用内镜食道静脉瘤套扎器行EMR-L可有效、安全的切除小于1.0 cm的直肠NENs,同时治疗费用较食管静脉曲张连环套扎器少,有很好的临床应用价值。

Objective To research the efficiency and safety of endoscopic mucosal resection with ligator device(EMR-L)on rectal neuroendocrine neoplasms.Methods A retrospective analysis to the clinical data of 13 patients with rectal neuroendocrine tumors from November 2015 to November 2017.All patients underwent endoscopic ultrasonography before treatment,and then accepted EMR-L resection.The endoscopic characteristics,the process and the complications of the operation,pathology results were observed,follow-up colonoscopies were made regularly.Results All lesions were resected by EMR-L successfully.The time consuming was in a range of 10 min 36 s^52 min 21s(the average was 21.9±10.6 min).The complication of acute bleeding occurred in only 1 case,the bleeding could be controlled with both drugs and titanium clips.There is no complications such as acute or delayed rectal bleeding and perforation.Conclusion Endoscopic esophageal variceal ligation for EMR-L can remove rectal neuroendocrine neoplasms of which the diameter is less than 1cm effectively and safely.Meanwhile,the cost of this treatment is less than that of the esophagus varicose polycyclic ligation device,and it has good clinical application value.