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目的回顾性分析内镜黏膜剥离术(endoscopic submucosal dissection,ESD)对大肠侧向发育型肿瘤(lateralspreading tumor,LST)的治疗结果。方法回顾性分析2009年5月至2012年3月间我科收治的41例LST患者行ESD治疗的手术操作时间、切除病灶直径、整切率、术中术后并发症、复发率及治愈率。结果 41例LST行ESD治疗,手术操作时间:10～115(63.2±24.3)min,病灶直径:1.2～12(4.0±2.7)cm,整切38例(38/41,92.3%),术中穿孔1例(1/41,2.4%),术后穿孔1例(1/41,2.4%),术后出血2例(2/41,4.8%),术后直肠狭窄1例(1/41,2.4%)。随访时间1～34(12.0±9.7)个月,残余灶1例,复发2例(2/41,4.9%),治愈40例(40/41,97.6%)。结论 ESD治疗LST的操作时间短、整切率高、复发率低。
Objective To retrospectively analyze the treatment outcome of lateralspreading tumor (LST) by endoscopic submucosal dissection (ESD). Methods Retrospective analysis of 41 cases of LST patients treated in our department from May 2009 to March 2012 retrospectively analyzed the operation time, diameter of lesion, rate of resection, postoperative complications, recurrence rate and cure rate . Results Totally 41 patients underwent LST for ESD. The operative time ranged from 10 to 115 (63.2 ± 24.3) min. The diameter of the lesion ranged from 1.2 to 12 (4.0 ± 2.7) cm and 38 (41/92, 1 case (1 / 41,2.4%) was perforation, 1 case (1 / 41,2.4%) was perforation after operation, 2 cases (2 / 41,4.8%) postoperative bleeding, 1 case postoperative rectal stenosis , 2.4%). The follow-up time ranged from 1 to 34 (12.0 ± 9.7) months. One patient had residual disease and 2 patients (2/41, 4.9%) had recurrence. Forty patients (40/41, 97.6%) were cured. Conclusion The operation time of ESD in treating LST is short, the rate of complete cut is high and the recurrence rate is low.