内科理论与实践 ›› 2022, Vol. 17 ›› Issue (04): 289-294.doi: 10.16138/j.1673-6087.2022.04.004
李为光a, 孙蕴伟a, 孙菁a, 张本炎b, 王华枫b, 钱爱华a()
收稿日期:
2022-04-17
出版日期:
2022-07-18
发布日期:
2022-08-08
通讯作者:
钱爱华
E-mail:qianaihua1981@126.com
基金资助:
LI Weiguanga, SUN Yunweia, SUN Jinga, ZHANG Benyanb, WANG Huafengb, QIAN Aihuaa()
Received:
2022-04-17
Online:
2022-07-18
Published:
2022-08-08
Contact:
QIAN Aihua
E-mail:qianaihua1981@126.com
摘要:
目的: 比较无黏膜下注射的结扎装置辅助黏膜下组织切除术(endoscopic submucosal resection with ligation, ESMR-L)和内镜黏膜下剥离术 (endoscopic submucosal dissection, ESD)治疗直径≤1 cm的直肠神经内分泌肿瘤(neuroendocrine tumor, NET)的有效性及安全性。方法: 前瞻性研究2020年10月至2021年10月期间在上海交通大学医学院附属瑞金医院接受内镜治疗的42例直径≤1 cm直肠NET患者,随机化入无黏膜下注射的ESMR-L组和ESD组,分别治疗21个病灶,比较2种内镜治疗方法的平均手术时间、病灶切缘、组织学完整切除率以及肿瘤下缘与垂直切缘距离等临床病理学特点。结果: 无黏膜下注射ESMR-L组的手术时间明显短于ESD组[(10.10±1.37) min比(29.90±3.81) min,P<0.001];2组侧切缘及垂直切缘均为阴性,组织学完整切除率均为100%,差异无统计学意义(P>0.05);无黏膜下注射ESMR-L组的肿瘤下缘到垂直切缘的距离明显长于ESD组[(1 051.5±561.4) μm比(612.6±305.4) μm,P=0.038]。结论: 与ESD相比,无黏膜下注射ESMR-L能有效缩短手术时间,且具有同样的病变完整切除率,是直径≤1 cm的直肠 NET简单、安全且有效的治疗方法。
中图分类号:
李为光, 孙蕴伟, 孙菁, 张本炎, 王华枫, 钱爱华. 直径≤1 cm的直肠神经分泌肿瘤2种内镜治疗方法的比较[J]. 内科理论与实践, 2022, 17(04): 289-294.
LI Weiguang, SUN Yunwei, SUN Jing, ZHANG Benyan, WANG Huafeng, QIAN Aihua. Management of rectal neurosecretory tumors less than 1 cm in diameter: comparison of two endoscopic procedures[J]. Journal of Internal Medicine Concepts & Practice, 2022, 17(04): 289-294.
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