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目的探讨内镜黏膜下剥离术(ESD)在胃肠道神经内分泌肿瘤(GI-NENs)治疗中的安全性和有效性。方法回顾性分析该院2011年1月-2015年12月52例经ESD治疗的GI-NENs患者临床资料,总结其内镜下形态,记录完整切除率,并发症发生率,病理特征以及随访结果。结果 52例患者中胃16例,结肠9例,直肠27例;大部分病灶为黏膜下隆起,少数为不典型的息肉样改变;所有病灶均一次性整块切除病变,其中G1 44例,G2 8例;完整切除率94.23%(49/52);2例直肠病灶侵犯固有肌层,追加外科手术;1例直肠穿孔,内镜下处理及保守治疗好转。全组病例未出现大出血,术后平均随访22.6个月,1例胃病灶发生局部复发,行第二次ESD治疗,未发现淋巴结和远处转移病例。结论严格把握内镜治疗适应证,ESD治疗GI-NENs是可行、安全、有效的。
Objective To investigate the safety and efficacy of endoscopic submucosal dissection (ESD) in the treatment of gastrointestinal neuroendocrine tumors (GI-NENs). Methods The clinical data of 52 patients with GI-NENs treated by ESD from January 2011 to December 2015 in our hospital were analyzed retrospectively. The morphology of endoscopic lesions was recorded. The complete resection rate, complication rate, pathological features and follow-up results were recorded . Results Among the 52 patients, there were 16 cases of stomach, 9 cases of colon and 27 cases of rectum. Most of the lesions were submucosal uplift and a few of them were atypical polypoid lesions. Among them, 44 lesions were G1, 8 cases; complete resection rate was 94.23% (49/52); 2 cases of rectal invaded the muscularis propria, additional surgery; 1 case of rectal perforation, endoscopic treatment and conservative treatment improved. No bleeding occurred in all the cases. After a mean follow-up of 22.6 months, one case of gastric lesion developed local recurrence and the second ESD treatment showed no lymph node or distant metastasis. Conclusion Strict grasp of indications for endoscopic treatment, GI-NENs ESD is feasible, safe and effective.