本文選題：圈套器　切入點(diǎn)：結(jié)直腸息肉　出處：《中國內(nèi)鏡雜志》2017年02期

【摘要】：目的探討改良的圈套器行內(nèi)鏡黏膜下剝離術(shù)(ESD)切除結(jié)直腸息肉及黏膜下腫瘤的安全性、有效性。方法回顧性研究2014年12月-2016年5月利用改良的圈套器完成ESD切除結(jié)直腸息肉、神經(jīng)內(nèi)分泌腫瘤(NETs)和間質(zhì)瘤患者的臨床資料,探討改良的圈套器進(jìn)行ESD術(shù)治療結(jié)直腸病變的安全性、有效性、治療時(shí)間和并發(fā)癥等,并與HOOK刀完成ESD術(shù)進(jìn)行比較。結(jié)果共20例病例24處入選并完成ESD術(shù),其中16例病例共20處病灶均順利完成改良的圈套器行ESD術(shù)(實(shí)驗(yàn)組),4例病灶采用傳統(tǒng)HOOK刀完成ESD術(shù)(對(duì)照組)。兩組手術(shù)成功率均為100.0%,病灶整塊切除率100.0%(24/24);實(shí)驗(yàn)組息肉長徑為1.2~4.0 cm,平均長徑(2.4±0.9)cm,對(duì)照組息肉長徑為1.5~3.0 cm,平均長徑(2.2±0.6)cm;實(shí)驗(yàn)組手術(shù)時(shí)間為45.0~120.0 min,平均時(shí)間(83.3±23.9)min,對(duì)照組手術(shù)時(shí)間45.0~80.0 min,平均時(shí)間(66.2±15.4)min,與對(duì)照組比較,實(shí)驗(yàn)組耗時(shí)長,差異具有統(tǒng)計(jì)學(xué)意義(P=0.038)。術(shù)后病理:結(jié)直腸腺瘤15例(其中3例腺瘤伴局部腺體高級(jí)別上皮內(nèi)瘤變),增生性息肉1例,高級(jí)別上皮內(nèi)瘤變1例,NETs 2例共4處病灶,間質(zhì)瘤1例,兩組中除1例來源于固有肌層間質(zhì)瘤全層切除術(shù)以外,無1例出現(xiàn)出血、穿孔、感染等并發(fā)癥,無1例術(shù)中、術(shù)后轉(zhuǎn)外科治療。結(jié)論改良的單圈套器能夠安全、有效地完成ESD術(shù)切除巨大結(jié)直腸息肉及黏膜下腫瘤,拓展了圈套器在內(nèi)鏡切除術(shù)中的使用方法及適應(yīng)證,但需要更長時(shí)間來完成手術(shù)。
[Abstract]:Objective to investigate the safety and efficacy of endoscopic submucosal dissection (ESD) for the resection of colorectal polyps and submucosal tumors with modified trap. Methods ESD was used to remove colorectal polyps from December 2014 to May 2016. The clinical data of patients with neuroendocrine neoplasms (NETs) and stromal tumors were studied to investigate the safety, efficacy, treatment time and complications of ESD for colorectal lesions. The results were compared with that of ESD performed by HOOK knife. Results A total of 20 cases with 24 cases were selected and completed ESD operation. In 16 cases, 20 lesions were successfully performed with ESD. (in the experimental group, 4 cases underwent ESD with traditional HOOK knife (control group). The success rate of operation in both groups was 100.00.The resection rate of the whole lesion was 100.024 / 24; the experimental group was treated with ESD. The mean length of meat was 1.2cm., the average length was 2.4 鹵0.9cm, the average length of polyp was 1.5 鹵3.0 cm, the mean length of polyp was 2.2 鹵0.6cm, the operative time was 45.0 min (120.0 min), the average time was 83.3 鹵23.9min, and the control group was 45.0 min (66.2 鹵15.4min), compared with the control group, the operation time of the control group was 45.0 鹵23.9min, the mean time of the control group was 66.2 鹵15.4min, and the operation time of the control group was 66.2 鹵15.4min. There were 15 cases of colorectal adenoma (3 cases of adenoma with local high grade intraepithelial neoplasia, 1 case of proliferative polyp, 1 case of high grade intraepithelial neoplasia) and 2 cases of high grade neoplasia of NETs. There was 1 case of stromal tumor in both groups, except one case originated from the total excision of muscular stromal tumor of the propria, no case had complications such as hemorrhage, perforation and infection, and no case was transferred to surgery after operation. Conclusion the modified single trap device is safe. ESD is effective in the removal of large colorectal polyps and submucosal tumors, which extends the use and indications of the snare in endoscopic resection, but it takes longer to complete the operation.
【作者單位】： 安徽醫(yī)科大學(xué)第二附屬醫(yī)院消化內(nèi)科;
【基金】：安徽省自然科學(xué)基金(No:1408085MH178)
【分類號(hào)】：R735.34

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 方海明;楊姣;李芳群;程啟閏;章禮久;;不同病理類型結(jié)直腸息肉中5-LOX與PlGF的表達(dá)及意義[J];安徽醫(yī)科大學(xué)學(xué)報(bào);2014年11期

2 田書信;鄭勇;陳世耀;黎永軍;劉芳;阮開學(xué);尚國臣;陶林;陳衛(wèi)剛;;內(nèi)鏡黏膜下剝離術(shù)治療直腸神經(jīng)內(nèi)分泌腫瘤的臨床價(jià)值[J];中華消化內(nèi)鏡雜志;2014年08期

3 蘇俊;吳會(huì)超;劉菲菲;魏建國;付俊國;;內(nèi)鏡下高頻電切術(shù)治療不同類型大腸息肉的安全性及可行性分析[J];中國內(nèi)鏡雜志;2014年07期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王瑜;;內(nèi)窺鏡下206例大腸息肉電切治療效果分析[J];中國醫(yī)療器械信息;2017年12期

2 江毓妮;陳欽明;余練;陳海彬;;內(nèi)鏡下胃腸道息肉高頻電切術(shù)中預(yù)先放置金屬鈦夾的效果分析[J];中國醫(yī)藥科學(xué);2017年07期

3 方海明;王業(yè)流;李s，

本文編號(hào)：1678849