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目的探讨内镜黏膜切除术(EMR)对肠道广基大息肉样病变的治疗价值。方法采用结肠镜下大肠黏膜切除术治疗135例共157个结直肠广基大息肉。病灶黏膜下注射肾上腺素生理盐水后,一次圈套整块切除或分次圈套切除病变,回收全部标本送病理检查,术后结肠镜随访。结果全部息肉EMR一次切除,除3个位于直肠黏膜下的病灶小于1 cm外,其余均大于1.5 cm,最大的13 cm×12 cm,无手术并发症。术后病理:腺瘤123个,其中有异型增生80个;黏膜内癌11个;增生性息肉20个;直肠类癌3个。随访中,有2例大于7 cm的直肠腺瘤分别于术后1个月及3个月复查时复发,均给予热活检钳完整钳除,病理分别为增生性息肉和绒毛状腺瘤,再复查6-12个月无复发。结论EMR是治疗大肠癌前病变及黏膜内癌安全、有效的方法。
Objective To investigate the value of endoscopic mucosal resection (EMR) in the treatment of extensive intestinal polyps disease. Methods Colonoscopic resection of colorectal mucosa was performed in 135 cases of 157 colorectal polyps. Submucosal injection of epinephrine saline lesion, a single block trap or sub-trap removal of lesions, all the specimens collected for pathological examination, colonoscopy after follow-up. Results All polypectomy EMR resection, except for 3 lesions in the rectal mucosa less than 1 cm, the rest were greater than 1.5 cm, the largest 13 cm × 12 cm, no surgical complications. Postoperative pathology: 123 adenomas, including dysplasia 80; mucosal carcinoma 11; proliferative polyps 20; rectal carcinoid three. During the follow-up, 2 cases of rectal adenomas larger than 7 cm had recurrences at 1 month and 3 months after operation, respectively, and were given a complete forceps biopsy forceps. The pathology was hyperplastic polyps and villous adenomas, respectively Review of 6-12 months without recurrence. Conclusion EMR is a safe and effective method for the treatment of precancerous lesions and intramucosal carcinoma in colorectal cancer.