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目的探讨内镜下黏膜剥离术在早期直肠癌和癌前病变治疗中的应用效果。方法选取2015年6月至2016年12月间中山市黄圃人民医院收治的120例早期直肠癌及癌前病变患者为研究对象,采用内镜下黏膜剥离术治疗,观察患者手术情况、病灶情况及术后并发证。结果患者均完成内镜下黏膜剥离手术,其中2例因黏膜下注射抬举征阴性而中转开腹手术治疗,未见腹腔淋巴受侵犯。手术平均用时为(62.5±2.8)min,术中平均出血量为(120.5±3.9)ml,一次性病灶整块切除率为87.5%,组织学治愈性切除率为97.5%。肿瘤平均直径为(1.8±0.8)cm,恶性肿瘤85例(70.8%),癌前病变35例(29.2%),术后穿孔2例(1.7%),延迟出血5例(4.2%),下腹轻度疼痛13例(10.8%)。结论应用内镜下黏膜剥离术治疗早期直肠癌及癌前病变患者,效果良好,患者损伤小,病灶完整切除率较高,手术安全有效,值得推广。
Objective To investigate the application of endoscopic mucosal dissection in the treatment of early rectal cancer and precancerous lesions. Methods From June 2015 to December 2016, 120 patients with early stage colorectal cancer and precancerous lesions who were treated in Zhongshan Huangpu People’s Hospital were enrolled in this study. The endoscopic mucosal dissection was used to observe the operation and lesion status And postoperative card. Results All patients underwent endoscopic mucosal dissection. Two of them underwent laparoscopic surgery due to submucosal injection and no laparoscopic lymphatic invasion. The average operation time was (62.5 ± 2.8) min. The mean intraoperative blood loss was (120.5 ± 3.9) ml. The rate of one-off resection was 87.5%. The histological resection rate was 97.5%. The mean diameter of tumor was (1.8 ± 0.8) cm. There were 85 cases (70.8%) with malignant tumor, 35 cases (29.2%) with precancerous lesions, 2 cases with postoperative perforation (1.7%), 5 cases with delayed bleeding (4.2% Mild pain in 13 cases (10.8%). Conclusion Endoscopic mucosal dissection for early rectal cancer and precancerous lesions in patients with good results, patients with small damage, complete resection of the lesion rate is high, safe and effective surgery, it is worth promoting.