Clinical study of endoscopic resection and laparoscopic surgical treatment for colorectal submucosal tumors
10.3760/cma.j.issn.1008?6315.2019.05.008
- VernacularTitle:内镜下切除术与腹腔镜下切除术对结直肠黏膜下肿瘤的治疗效果及安全性对比研究
- Author:
Shuhui LI
1
;
Shuguang ZHU
Author Information
1. 山东省滕州市中心人民医院消化内一科 277500
- Keywords:
Colorectal submucosal tumors;
Endoscopic resection;
Laparoscopic resection
- From:Clinical Medicine of China
2019;35(5):417-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the therapeutic effect and safety of endoscopic resection and laparoscopic surgical treatment for colorectal submucosal tumors under the guidance of ultrasound endoscopy.Methods The clinical data of 90 patients with colorectal submucosal tumors in Tengzhou Central People′s Hospital form January 2013 to January 2018 were retrospectively analyzed.Among them,60 patients underwent endoscopic resection ( hereinafter referred to as endoscopic resection group) and 30 patients underwent laparoscopic resection ( hereinafter referred to as laparoscopic resection group).The complete resection rate, average diameter of resected lesions, average operation time, average hospital stay, average intraoperative bleeding volume, incidence of complications and recurrence rate of colorectal submucosal tumors were compared between the two groups.Results The complete resection rate of endoscopic resection groups was 96.7%,The complete resection rate of laparoscopic surgical treatment groups was 96.6%,there was no statistical difference between the two groups( χ2=0.16,P=0.759).The average diameter of the lesion was larger in laparoscopic surgical treatment group (( 29.7 ± 5.3) mm) than that in endoscopic resection group((14.9±4.3) mm,P=0.013).The operation time was shorter in endoscopic resection group ((32.1±6.1) min) than that in laparoscopic surgical treatment group((75.3±9.8) min,P=0.007).There was statistically statistical difference in the intraoperative blood loss between endoscopic resection group ((13.2± 5.5) ml ) and laparoscopic surgical treatment group (( 28.3 ± 7.6) ml, P = 0.009).The postoperative hospital stays was less in endoscopic resection group((3.1±1.4) d) than that in laparoscopic surgical treatment group((6.9±2.2) d,P=0.007).The complicationgs rate in endoscopic resection group (3.33%) was significantly lower than that in laparoscopic surgical treatment group(13.3%),(χ2=4.89,P=0.021).The average hospitalization expenses of endoscopic resection group was significantly lower than that of the laparoscopic surgical treatment group(( 18 745± 6 281) vs(42 961± 10 423) yuan,P=0.006) .There were no relapse and distant metastasis in two groups,followed up for 6 to 12 months.Conclusion Endoscopic resection and laparoscopic resection are both safe and effective methods for the treatment of rectal submucosal tumors.Endoscopic resection has less trauma,quicker recovery,shorter hospitalization time and lower hospitalization costs.