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距肛门10厘米以上的上段直肠或乙状结肠的小腺瘤可经内窥镜以活检钳钳除或用圈套器电灼割除。但位于上述部位、直径3厘米以上的大腺瘤,即使有蒂,一般经内窥镜切除也相当困难。因为:(1)圈套此类大腺瘤相当不易;(2)此类腺瘤的蒂均较粗大,内含较粗的小动脉,圈套器电灼割除时往往不易可靠地凝闭此类动脉,术后有发生大出血的危险;如为了充分地凝闭动脉而电灼过度时,则术后又可导致肠壁坏死而发生出血穿孔之虞。因此外科医
The small adenomas in the upper rectum or sigmoid colon above 10 cm from the anus can be removed by biopsy forceps or endoscopic electrocautery. However, if a large adenoma with a diameter of 3 cm or more is located in the above-mentioned site, even if there are pedicles, endoscopic resection is generally difficult. Because: (1) It is not easy to trap such large adenomas; (2) The pedicles of these adenomas are relatively thick and contain relatively thick small arteries. It is not easy to reliably occlude these arteries when the snare is electrocauterized. There is a risk of major bleeding after surgery; if excessive electrocautery is used to adequately constrict the arteries, the wall of the bowel may be necrotic and bleeding perforation may occur. Therefore, surgeons