河北医科大学学报

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低位直肠神经内分泌肿瘤手术方式选择的回顾性临床对照分析研究

  

  1. 1.河北省唐山市人民医院胃肠外科,河北 唐山 063000;2.北京大学人民医院胃肠外科, 北京 100044
  • 出版日期:2018-05-25 发布日期:2018-05-30
  • 作者简介:李青科(1981-),男,河北邢台人,河北省唐山市人民医院主治医师,医学博士研究生,从事胃肠外科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20171279)

A retrospective clinical comparative analysis study on the surgical method of low rectal neuroendocrine tumors#br#

  1. 1.Department of Gastrointestinal Surgery, Tangshan People′s Hospital, Hebei Province, Tangshan
    063000, China; 2.Department of Gastrointestinal Surgery, Beijing University
    People′s Hospital, Beijing 100044, China
  • Online:2018-05-25 Published:2018-05-30

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗对比观察内镜黏膜下层剥离术(endoscopic submucosal dissection,ESD)与经肛门内镜微创手术(transanal endoscopic microsurgery,TEM)用于低位直肠神经内分泌肿瘤的治疗效果及安全性。
〖HTH〗方法〖HTSS〗〖KG*2〗选择低位直肠神经内分泌肿瘤(距肛缘≤7 cm)患者89例(肿瘤分级G1和G2),根据病情需要分别给予ESD或TEM黏膜下手术切除治疗,其中35例患者采用ESD治疗,54例患者接受TEM治疗;观察2组术中出血量、手术时间、平均住院时间以及随访5年内2组肿瘤完全切除、穿孔和术后复发情况。
〖HTH〗结果〖HTSS〗〖KG*2〗TEM组术中出血量少于ESD组,TEM组手术时间和平均住院时间少于ESD组,差异有统计学意义(P<005);2组肿瘤完全切除、穿孔和术后复发率差异无统计学意义(P>005)。
〖HTH〗结论〖HTSS〗〖KG*2〗TEM治疗低位直肠神经内分泌肿瘤具有良好效果,术中出血量少,手术时间和平均住院时间短,值得临床推广。

关键词: 结直肠肿瘤, 内镜黏膜下剥离术, 经肛门内镜微创手术

Abstract: [Abstract] Objective〖HTSS〗〓To observe and compare the efficacy and safety of the endoscopic submucosal dissection(ESD) and transanal endoscopic microsurgery(TEM) in the treatment of lower rectal neuroendocrine tumors.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eightynine patients(grades G1 and G2) with lowgrade rectal neuroendocrine tumors(≤7 cm from the anus) were included in this study. Thirtyfive patients were treated with ESD and fiftyfour patients were treated with TEM. The operative time, intraoperative blood loss, average hospital stay were compared, And complete resection rate, perforation, and postoperative recurrence rate were followed up for 5 years after operation.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The intraoperative blood loss of the patients in the TEM group was less than that in ESD group(P<005). The operative time and the hospital stay of the patients in the TEM group were shorter than those in ESD group(P<005). There was no difference in complete resection rate, perforation, and postoperative recurrence rate between the two groups(P>005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Compared with TEM has the advantages of less intraoperative blood loss, shorter operative time, and shorter hospital stay,and is worthy of clinical promotion.

Key words: colorectal neoplasms, endoscopic submucosal dissection, transanal endoscopic microsurgery