论文部分内容阅读
目的探讨内镜下黏膜切除治疗结肠巨大腺瘤的经验。方法采用粘膜注射、圈套器高频电切法治疗结肠巨大腺瘤40例。结果 40例结肠巨大腺瘤直径2～8cm,直肠13例,乙状结肠14例,降结肠9例,横结肠4例;均为单发,对有蒂的18例及亚蒂的6例直接由圈套器切除,其余16例广基腺瘤分别行黏膜切除和粘膜分块切除。40例巨大腺瘤均切除顺利,7例术中出血经保守治疗成功止血,无穿孔、管腔狭窄等并发症。术后病理结果40例均为腺瘤性息肉,其中管状腺瘤6例,绒毛状腺瘤6例,绒毛状管状腺瘤8例。40例中有8例为腺瘤重度不典型增生、原位癌或黏膜内癌。所有病例术后随访均未发现复发。结论内镜下黏膜切除结肠巨大腺瘤是一种安全有效的治疗方法。
Objective To investigate the experience of endoscopic mucosal resection in treatment of colorectal giant adenoma. Methods Forty cases of colonic giant adenoma were treated with mucosal injection and high-frequency electrosurgical excision of snare. Results The diameter of colorectal adenomas was 2 ~ 8cm in 40 cases, 13 cases in rectum, 14 cases in sigmoid colon, 9 cases in descending colon and 4 cases in transverse colon. All of them were solitary, and 18 cases of pedicle and 6 cases of pedicle were directly managed by snare Excision, the remaining 16 cases of radical adenomas were mucosal resection and mucosal resection. Forty cases of giant adenoma were successfully resected, and seven cases of intraoperative bleeding were successfully treated by conservative treatment to stop bleeding without complications such as perforation and stenosis. Postoperative pathological findings of 40 cases were adenomatous polyps, including 6 cases of tubular adenoma, villous adenoma in 6 cases, villous tubular adenoma in 8 cases. Among the 40 cases, 8 were adenosquamous dysplasia, carcinoma in situ or mucosal carcinoma. All patients were followed up were found no recurrence. Conclusion Endoscopic mucosal resection of giant colon adenoma is a safe and effective treatment.