右半结肠巨大侧向发育型肿瘤内镜黏膜下剥离术中选择不同麻醉方式的效果评价

Evaluation of the effect of different anesthesia methods in endoscopic submucosal dissection of right hemicolon laterally spreading tumors with diameters>3 cm

目的分析不同麻醉方式下,内镜黏膜下剥离术(ESD)治疗右半结肠巨大侧向发育型肿瘤的疗效和安全性。方法回顾性统计本中心从2017年7月至2021年10月治疗的166例右半结肠巨大侧向发育肿瘤(LST)接受ESD治疗的患者,探讨分析不同麻醉方式、术后并发症情况、围手术期处理等。结果气管插管全麻下ESD治疗右半结肠LST较静脉麻醉手术效率更高,术后切缘阳性率、完整切除率、治愈性切除率、术后并发症发生率方面差异均无统计学意义。结论静脉麻醉和气管插管两种麻醉方式,对右半结肠巨大侧向发育型肿瘤的ESD治疗,在短期疗效和安全性方面差异无统计学意义,但气管插管麻醉方式能使ESD治疗效率更高。

Objective To analyze the efficacy and safety of endoscopic submucosal dissection(ESD)in the treatment of LST with diameters>3 cm in the right hemicolon under different anesthesia methods.Methods 166 patients with right half colon lateral tumor(LST)with diameters>3 cm who received ESD treatment from July 2017 to October 2021 were retrospectively analyzed,and different anesthesia methods,postoperative complications and perioperative management were analyzed.Results ESD under tracheal intubation and general anesthesia was more effective than intravenous anesthesia in the treatment of right colon LST with diameters>3 cm.There were no significant differences in the positive rate of resection margin,enbloc resection rate,curative resection rate and postoperative complication rate.Conclusion There is no significant difference in short-term efficacy and safety between intravenous anesthesia and endotracheal intubation for endoscopic submucosal dissection of right half colon lateral tumor with diameters>3 cm,but endotracheal intubation can make ESD treatment more efficient.