ESD与EMR治疗结直肠侧向发育型肿瘤的随机对照研究

Randomized Controlled Study of ESD and EMR in the Treatment of Lateral Colorectal Tumors

目的 探讨内镜下黏膜剥离术(ESD)与内镜下黏膜切除术(EMR)治疗结直肠侧向发育型肿瘤患者的临床效果.方法 选取2017年3月至2019年3月滨海县人民医院接受内镜治疗结直肠侧向发育型肿瘤的患者48例,按照随机数表法分为对照组和观察组,各24例.对照组采用EMR治疗,观察组采用ESD治疗,观察2组的手术时间、术中出血量、住院时间、整块切除率、完整切除率,肿瘤局部复发率.结果 观察组手术时间及住院时间均显著短于对照组(P<0.05).观察组整块切除率91.66%、完整切除率88.50%均显著高于对照组(45.83%、41.66%,P<0.05).对照组患者经EMR治疗后复发率25.00%(6/24),观察组患者经ESD治疗后复发率4.16% (1/24),观察组显著低于对照组(P<0.05).结论 结直肠侧向发育型肿瘤患者予以ESD治疗,可取得较好治疗效果,缩短手术时间,降低患者不适感,提高整块切除率、完整切除率,缩短住院时间,降低治疗肿瘤局部复发,提高预后,故应用推广.

Objective A randomized controlled study of ESD and EMR in the treatment of lateral colorectal tumors.Methods A total of 48 patients who received endoscopic treatment for lateral colorectal tumors in the People's Hospital of Binhai County from March 2017 to March 2019 were selected and divided into a control group and an observation group according to a random number table,with 24 cases each.The control group was treated with endoscopic mucosal resection(EMR),the observation group was treated with endoscopic mucosal dissection(ESD),and the operation time,intraoperative blood loss,hospital stay,monolithic resection rate,and complete resection were observed in the two groups Rate,local tumor recurrence rate.Results The operation time and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).The overall resection rate of 91.66%and complete resection rate of 88.50%in the observation group were significantly higher than those in the control group by(45.83%and 41.66%,P<0.05).The recurrence rate of patients in the control group after EMR treatment was 25.00%(6/24),and the recurrence rate of patients in the observation group after treatment with ESD was 4.16%(1/24).Conclusion ESD treatment for patients with lateral colorectal tumors can achieve better treatment results,shorten the operation time,reduce patient discomfort,improve the overall resection rate,complete resection rate,shorten the hospital stay,reduce local tumor recurrence,and improve the prognosis.So the application promotion.