内镜下黏膜剥离联合钛铗缝合术在结直肠侧向发育型肿瘤治疗中的效果分析

Clinical Analysis of Endoscopic Mucosal Dissection Combined with Titanium Clip Suture in the Treatment of Laterally Spreading Tumor

目的:分析内镜下黏膜剥离联合钛铗缝合术在结直肠侧向发育型肿瘤(LST)治疗中的效果。方法:选取2020年1-10月收治的90例LST患者为研究对象,随机将患者分为对照A组、对照B组和试验组,分别给予外科手术、内镜黏膜切除术(EMR)、内镜下黏膜剥离术(ESD)联合钛铗缝合术进行治疗,分析三组患者手术情况、术中术后并发症及肿瘤复发率。结果:试验组和对照B组的操作时间均短于对照A组(P<0.05);试验组与对照B组的操作时间比较差异无统计学意义(P>0.05)。试验组的整块切除率、完整切除率均高于对照A组和对照B组(P<0.05);对照A组和对照B组的整块切除率、完整切除率比较差异无统计学意义(P>0.05)。三组术中穿孔、吻合口瘘发生率比较,差异无统计学意义(P>0.05);试验组术后出血发生率低于对照A组、对照B组(P<0.05)。三组肿瘤复发率比较,差异有统计学意义(P<0.05)。结论:ESD联合钛铗缝合术在LST治疗中的效果突出,可提升病灶整块、完整切除率和手术安全性。

Objective:To analyze the effect of endoscopic mucosal dissection combined with titanium clip suture in the treatment of laterally spreading tumor (LST).Method:A total of 90 patients with LST from January to October 2020 were randomly divided into the control group A,control group B and experimental group,and they were treated by surgery,endoscopic mucosal resection (EMR),endoscopic mucosal dissection (ESD) and titanium clip suture respectively.The operation situation,intraoperative and postoperative complications and tumor recurrence rate of the three groups were analyzed.Result:The operation time of experimental group and control group B was shorter than that of control group A (P<0.05).There was no significant difference in operation time between experimental group and control group B (P>0.05).The en bloc resection rate and complete resection rate of experimental group were higher than those of control group A and control group B (P<0.05).There was no significant difference in en bloc resection rate and complete resection rate of between control group A and control group B (P>0.05).There was no significant difference in the incidence of perforation and anastomotic leakage among the three groups (P>0.05).The incidence of postoperative bleeding in the experimental group was lower than that in the control group A and control group B (P<0.05).The difference of tumor recurrence rate among the three groups was statistically significant (P<0.05).Conclusion:ESD combined with titanium clip suture is effective in the treatment of LST,which can improve the en bloc resection rate,complete resection rate and surgical safety.