早期直肠癌内镜下黏膜剥离术与经肛门内镜微创手术的临床效果对比

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摘要目的探讨内镜黏膜下剥离术（ESD）与经肛门镜微创手术（TEM）对早期结直肠肿瘤的微创治疗效果。方法选取2010年5月—2016年5月河北省唐山市人民医院收治的结直肠肿瘤（uTis-uT1）患者211例，根据手术方式分为ESD组（98例）和TEM组（113例）。比较两种手术方式的手术时间、住院时间，术中出血、肿瘤完整切除、肿瘤残留及复发例数；比较两组术后出血、穿孔、梗阻、狭窄等并发症的发生情况。结果 ESD组手术时间、住院时间短于TEM组，差异有高度统计学意义（P < 0.01）；两组术中出血、瘤完整切除率、肿瘤残留率及复发率比较，差异无统计学意义（P ＞ 0.05）。两组并发症发生率比较，差异无统计学意义（P ＞ 0.05）。结论 ESD与TEM对于治疗早期直肠癌均安全有效，但ESD的手术时间及住院事件明显缩短。

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	李青科1 何立芳2 梁磊1 韩龙才1 马国明1 刘远廷1▲ 王志武3

关键词 ：早期直肠癌, 内镜黏膜下剥离术, 经肛门镜微创手术, 治疗

Abstract：Objective To investigate the efficacy of endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) in the treatment of early colorectal tumors. Methods A total of 211 patients with early rectal cancer (uTis-uT1) who treated in Tangshan People′s Hospital of Hebei Province from May 2010 to May 2016 were selected. They were divided into ESD group (98 cases) and TEM group (113 cases). The operative time, hospital stay, intraoperative bleeding, complete tumor resection, tumor residual and recurrence were compared between the two methods. Postoperative complications such as hemorrhage, perforation, obstruction and stenosis occurred were compared between the two groups. Results The operation time and hospital stay in ESD group were shorter than those in TEM group, and the differences were statistically significants (P < 0.01); and there were no significant differences in intraoperative bleeding, complete tumor resection rate, tumor residual rate and recurrence rate (P ＞ 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion Both ESD and TEM are safe and effective in the treatment of early rectal cancer, but the operation time and hospital stay in ESD are significantly shortened.

Key words： Early rectal cancer Endoscopic submucosal dissection Transanal endoscopic microsurgery Treatment

基金资助:河北省医学科学研究重点课题（20171279）；
国家自然科学基金资助项目（81603475）。

通讯作者: ▲通讯作者

引用本文:

李青科1 何立芳2 梁磊1 韩龙才1 马国明1 刘远廷1▲ 王志武3. 早期直肠癌内镜下黏膜剥离术与经肛门内镜微创手术的临床效果对比[J]. 中国医药导报, 2020, 17(31): 118-121.
LI Qingke1 HE Lifang2 LIANG Lei1 HAN Longcai1 MA Guoming1 LIU Yuanting1▲ WANG Zhiwu3. Comparison of clinical effects between endoscopic submucosal dissection and transanal endoscopic microsurgery for early rectal cancer. 中国医药导报, 2020, 17(31): 118-121.

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