预切开内镜下黏膜切除术在治疗结直肠侧向发育性肿瘤中的临床效果

Effect of precutting endoscopic mucosal resection in treatment of colorectal laterally spreading tumors

目的探讨预切开内镜下黏膜切除术(Precutting-EMR)在治疗结直肠侧向发育性肿瘤(laterally spreading tumors,LSTs)中的临床效果。方法对32例直径在15～30 mm的结直肠LSTs患者中进行了Precutting-EMR治疗,观察整块切除率、完全切除率和并发症发生率。结果 32例患者中,整块切除者29例(90. 6%),病理证实为完全切除者28例(87. 5%)。对于21～30 mm的病灶,整块切除率和完全切除率分别为87. 0%、82. 6%。仅有1例(3. 1%)病灶发生迟发性出血,所有治疗均未发生术中穿孔。圈套器的正确使用是保证Precutting-EMR效果的关键。结论 Precutting-EMR技术降低了结直肠LSTs内镜下切除的技术难度,同时保证了内镜下治疗的效果,值得在中小型医院推广。

Objective To evaluate the effect of precutting endoscopic mucosal resection (Precutting-EMR) in treatment of colorectal laterally spreading tumors (LSTs). Methods Thirty-two colorectal LSTs with diameters from 15 mm to 30 mm were treated by Precutting-EMR. The en bloc resection rate, complete resection rate and the complication rate were observed . Results The en bloc resection rate was 90.6%(29/32) and the complete resection rate was 87.5%(28/32) for the 32 lesions. For lesions with diameters from 21 mm to 30 mm, the en bloc resection rate and complete resection rate were 87.0% and 82.6%, respectively. Only 1 case (3.1%) of delayed hemorrhage was seen. No perforation was seen during the procedures. Proper use of the snare was the key to a successful Precutting-EMR. Conclusion Precutting-EMR is a technique for treating colorectal LSTs easily and effectively, which is worth spreading in the middle or small medical centers.