内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的临床分析

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摘要目的研究并探讨内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的临床效果。方法选取我院2015年1月～2017年1月收治的50例大肠侧向发育型肿瘤患者作为研究对象，按照计算机随机数字分组法，将患者分为两组，每组各25例。对照组实施内镜下黏膜切除术，观察组实施内镜黏膜下剥离术，比较两组患者的手术时间、术中出血量、整块切除率、完整切除率、转外科手术概率、并发症发生率、复发率。结果观察组患者的手术时间长于对照组，差异有统计学意义（P＜0.05）；观察组的术中出血量与对照组比较，差异无统计学意义（P＞0.05）。观察组的整块切除率、完整切除率均高于对照组，差异有统计学意义（P＜0.05）。在内镜治疗时，观察组转外科手术的概率为8%，对照组为4%，两组比较，差异无统计学意义（P＞0.05）。手术后，观察组的并发症总发生率为12%，对照组为4%，两组比较，差异无统计学意义（P＞0.05）。术后随访3～12个月，观察组的肿瘤局部复发率为4%，低于对照组的24%，差异有统计学意义（P＜0.05）。结论内镜黏膜下剥离术治疗大肠侧向发育型肿瘤具有显著的效果，不仅有较高的整块切除率、完整切除率，还可有效减少术后肿瘤局部的复发。

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关键词 ：大肠侧向发育型肿瘤, 内镜黏膜下剥离术, 内镜下黏膜切除术

Abstract：Objective To study and explore the clinical effect of endoscopic submucosal dissection in the treatment of laterally spreading tumor of large intestine.Methods From January 2015 to January 2017,50 patients with laterally spreading tumor of the large intestine treated in our hospital were selected as the subjects,according to the computer random grouping method,the patients were divided into two groups,25 cases in each group.The control group received endoscopic mucosal resection,the observation group received endoscopic submucosal dissection.The operation time,intraoperative bleeding,en bloc resection rate,complete resection rate surgical operation,probability,complication rate,recurrence rate were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,the difference was statistically significant(P＜0.05).There was no significant difference in the amount of bleeding between the observation group and the control group(P＞0.05).The overall resection rate and complete resection rate of the observation group were higher than those of the control group,the differences were statistically significant(P＜0.05).In the endoscopic treatment,the probability of surgery in the observation group was 8%,and the control group was 4%,there was no significant difference between the two groups(P＞0.05).After operation,the total incidence of complications in the observation group was 12%,and the control group was 4%,there was no significant difference between the two groups(P＞0.05).After a follow-up of 3 to 12 months,the local recurrence rate of the observation group was 4%,which was lower than that of the control group(24%)(P＜0.05).Conclusion Endoscopic submucosal dissection has a significant effect in the treatment of laterally spreading tumors of the colon,which not only has high en bloc resection rate,complete resection rate,but also can effectively reduce the local recurrence of tumor.

Key words： Colorectal laterally spreading tumor Endoscopic submucosal dissection Endoscopic mucosal resection

基金资助:广东省河源市科技局科研项目（河科发[2017]65-98）

作者简介: 陈维超（1971-），男，本科，主治医师

引用本文:

陈维超;谢志练;徐春香. 内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的临床分析[J]. 中国当代医药, 2018, 25(10): 31-33转40.
CHEN Wei-chao;XIE Zhi-lian;XU Chun-xiang. Endoscopic submucosal dissection in the treatment of laterally spreading tumors of large intestine. 中国当代医药, 2018, 25(10): 31-33转40.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I10/31

[3]	胡忠卓，李捷.应用电子结肠镜联合腹腔镜治疗结直肠巨大侧向发育型肿瘤的临床疗效分析[J].四川医学，2015，36（7）：1038-1039.
[4]	苏虹，刘明，陈进忠，等.内镜下黏膜切除术和内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的疗效分析[J].中华消化内镜杂志，2014，31（1）：46-48.
[5]	王华秀，练晶晶，陈世耀，等.内镜黏膜下剥离术治疗巨大结直肠侧向发育型肿瘤的临床研究[J].中国内镜杂志，2017，23（7）：80-84.
[6]	植中敬，陈慕维，吕建广，等.注射法内镜下黏膜剥离切除法治疗结直肠侧向发育型肿瘤的临床效果[J].中国当代医药，2017，24（5）：43-47.
[7]	闫振坤，李颖，张金萍，等.大肠侧向发育型肿瘤患者疾病特征及内镜诊断和治疗价值[J].中国老年学杂志，2014，34（17）：4983-4985.
[8]	廖斐，刘玉兰，沈磊，等.内镜黏膜下剥离术治疗直径大于20 mm的结直肠侧向发育型肿瘤的临床研究[J].临床内科杂志，2016，33（4）：239-242.
[9]	何东凌.内镜黏膜切除术治疗结直肠侧向发育型肿瘤的临床疗效[J].中国老年学杂志，2015，35（15）：4293-4294.
[11]	张菊嫦，王学青，李爱民，等.结直肠侧向发育型肿瘤的临床病理特征和治疗方法的发展趋势分析[J].中华消化杂志，2017，37（2）：88-93.
[1]	Tanabe S，Ishido K，Higuchi K，et al.Long-term outcomes of endoscopic submucosal dissection for early gastric cancer：a retrospective comparison with conventional endoscopic resection in a single center[J].Gastric cancer，2014，17（1）：130-134.
[2]	Wen J，Yang Y，Liu Q，et al.Preventing stricture formation by covered esophageal stent placement after endoscopic submucosal dissection for early esophageal cancer[J].Dig Dis Sci，2014，59（3）：658-663.
[10]	Yeo DM，Chung DJ，Cheung DY，et al.Temporal evolution of multidetector CT findings after endoscopic submucosal dissection in patients with early gastric cancer：Correlation with endoscopy[J].Eur J Radiol，2014，83（6）：880-885.
[12]	张艳飞，丁士刚.大肠侧向发育型肿瘤的诊断及内镜治疗进展[J].中国微创外科杂志，2017，17（12）：1117-1120.
[13]	金燕，龚镭，唐学军，等.预切开内镜黏膜切除术诊治结肠侧向发育型肿瘤的临床疗效评价[J].中国内镜杂志，2016，22（8）：94-98.
[14]	黄勤，叶丽萍，毛鑫礼，等.内镜黏膜下剥离术在结直肠侧向发育型肿瘤中的应用[J].中华消化内镜杂志，2015，32（7）：480-482.
[15]	朱大磊，何玉善，肖宝星，等.内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的体会[J].临床消化病杂志，2016，28（2）：115-117.
[16]	彭学，樊超强，于劲，等.大肠侧向发育型肿瘤的内镜下分型与术后病理的相关性分析[J].第三军医大学学报，2014，36（24）：2489-2491.
[17]	Saito Y，Yamada M，So E，et al.Colorectal endoscopic submucosaldissection：Technicaladvantagescomparedtoendoscopic mucosal resection and minimally invasive surgery[J].Dig Endosc，2014，26（Suppl.1）：52-61.
[18]	杨小乔，梁彪，黎程，等.简化内镜下黏膜下层剥离术治疗大肠侧向发育型肿瘤的效果[J].广东医学，2015，36（15）：2386-2388.
[19]	王艳，孙红英，曾燕，等.内镜黏膜下层剥离术治疗大肠侧向发育性肿瘤[J].实用医药杂志，2014，31（12）：1096-1097.
[20]	Lian JJ，Ma LL，Hu JW，et al.Endoscopic balloon dilatation for benign esophageal stricture after endoscopic submucosal dissection for early esophageal neoplasms[J].J Dig Dis，2014，15（5）：224-229.