Clinical evaluation of pre-cut-endoscopic mucosal resection in treatment of colorectal lateral spreading tumor
10.3969/j.issn.1007-1989.2016.08.022
- VernacularTitle:预切开内镜黏膜切除术诊治结肠侧向发育型肿瘤的临床疗效评价
- Author:
Yan JIN
;
Lei GONG
;
Xuejun TANG
;
Xiaobin PENG
;
Chunxiao TAN
;
Xiaoyun WANG
;
Ping HUA
;
Yuanmei REN
;
Pinghong ZHOU
- Keywords:
colorectal;
laterally spreading tumor;
pre-cut-endoscopic mucosa resection
- From:
China Journal of Endoscopy
2016;22(8):94-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of pre-cut-endoscopic mucosa resection of colorectal laterally spreading tumor. Methods 65 patients with LST were enrolled from January 2014 to February 2014. LST was detected by chromoendoscopy and NBI combined with magnifying endoscopy technique. The size, site, morphological features, were observed and the histopathological features of the specimen of LST was analyzed. All the 65 LSTs were resect by pre-cut-EMR. The clinical results including enbloc resection rate, all bloc resection rate, procedure time, complication and recurrence rates were retrospectively evaluated. Results All the 65 LSTs lesions ranged from 2.0 cm to 5.0 cm, with a mean diameter of (2.4 ± 1.7) cm. The site of 65 LSTs was in rectum 28 (43.1 %), 11 LSTs in sigmoid colon (16.9 %), 6 LSTs in descending colon (9.2 %), 2 LSTs in splenic flexure of colon (3.1 %), 9 LSTs in transverse colon (13.8 %), 4 LSTs in Hepatic flexure of colon (6.2 %), 2 LSTs in ascending colon(3.1 %), and 3 LSTs in cecum (4.6 %). Morphology of 23 LSTs were homogeneous granular type (35.4 %), 27 LSTs were mixed non-granular type (41.5 %), 13 LSTs were flat elevated type (20.0 %), and 2 LSTs were pseudo-depressed type (3.1 %). The histopathological diagnoses of LST included 12 tubular adenoma (18.5 %), 19 villous-tubular adenoma (29.2 %), 26 villous adenoma (40.0 %), 7 advanced intraepithelial tumor (10.7 %), 1 intramucosal carcinoma (1.5 %). Enbloc resection was achieved in 65 patients (100.0 %) with a mean operation time of (18.0 ± 11.7) min. 5 cases were bleeding during the operation (7.7 %), 1 case was bleeding 7 days after operation (1.5 %), no perforation was happened. 65 patients were followed up for 3 ~ 12 months, and no local recurrence was found. Conclusion Pre-cut-endoscopic mucosal resection an effective and safe therapy for colorectal LST larger than 2.0 cm.
