内镜黏膜下剥离术治疗>2cm结肠侧向发育型肿瘤的预后

Prognosis of Endoscopic Submucosal Dissection in the Treatment of Laterally Developing Colon Tumors of>2cm

目的:探讨分析内镜黏膜下剥离术(ESD)治疗>2 cm结肠侧向发育型肿瘤的预后。方法:回顾2018年1月-2019年10月本院收治的>2 cm结肠侧向发育型肿瘤患者81例患者的临床资料,根据手术方式的不同分为两组,采用ESD治疗的患者(ESD组)45例,采用内镜黏膜下切除术(EMR)治疗的患者(EMR组)36例,分析对比两组手术情况与预后。结果:ESD组手术时间长于EMR组,住院时间短于EMR组,差异有统计学意义(P<0.05);两组术中出血量比较,差异无统计学意义(P>0.05);ESD组整块切除率与完整切除率均高于EMR组,局部复发率低于EMR组,差异有统计学意义(P<0.05);ESD组出现3例迟发性出血、1例穿孔,并发症发生率为8.89%,EMR组出现1例迟发性出血、1例吻合口瘘,并发症发生率为5.56%,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:相比EMR,ESD切除>2 cm结肠侧向发育型肿瘤病灶更彻底,住院时间更短,复发率更低,预后相对更好。

Objective:To investigate the prognosis of endoscopic submucosal dissection(ESD)in the treatment of laterally developing colon tumor of>2 cm.Method:Clinical data of 81 patients with laterally developing colon tumor of diameter>2 cm admitted to our hospital from January 2018 to October 2019 were reviewed.According to different surgical methods,they were divided into two groups,45 cases were treated with ESD(ESD group),and 36 cases were treated with endoscopic mucosal resection(EMR group).The surgical situation and prognosis of the two groups were analyzed and compared.Result:The operation time of ESD group was longer than that of EMR group,the hospitalization time was shorter than that of EMR group,the differences were statistically significant(P<0.05);there was no significant difference in intraoperative blood loss between the two groups(P>0.05);the whole resection rate and complete resection rate of ESD were higher than those of EMR group,and the local recurrence rate was lower than that of EMR group,the differences were statistically significant(P<0.05);there were 3 cases of delayed bleeding and 1 case of perforation in ESD group,the incidence of complications was 8.89%;there were 1 case of delayed bleeding and 1 case of anastomotic leakage in ESD group,the incidence of complications was 5.56%,there was no significant difference between the two groups(P>0.05).Conclusion:Compared with EMR,ESD has the advantages of more complete resection,shorter hospital stay,lower recurrence rate and better prognosis in the treatment of laterally developing colon tumor of>2 cm.