Zhi Fachao, Jiang Bo, Liu Side, Zhou Dan, Wan Tian mo, Pan Deshou, Wang Lihui, Zhou Dianyuan
Institute of Gastrointestinal of PLA, Nanfang Hospital, First Military Medical University. Guangzhou, 510515, China.
Zhonghua Yi Xue Za Zhi. 2002 Feb 10;82(3):180-1.
To observe the relationship between the pit patterns and pathology and compare the curative effect for colon flat lesion between endoscopic mucosa resection (EMR) and fulguration with high frequency current (FHFC).
They were divided to two groups. There were 37 cases for FHFC in group A, and 34 cases for EMR in Group B. The two groups were comparabal. Examining patients suffering with colon flat lesions with magnifying endoscope and observing the pit patterns of mucosa after staining with indicarmine.
The pit patterns of inflammatory or hyperplastic lesions were mainly pit II, adenoma pit III and pit IV, and carcinomatous lesions pit IV and pit V. The worse the differentiation degree of lesions was, the higher the pit patterns were. There were no difference (P > 0.05) between group A and B in complication and quantity, classification and distribution of lesions. No canceration was detected in 21 cases with adenoma in group A, while 4 cases of canceration (all were adenocacinoma) was found in 20 cases whith adenoma in group B. There was significance in canceration between two groups (P < 0.05).
The worse the differentiation degree of lesions was, the higher pit patterns were. EMR and FHFC share the same validity and security when treating the flat lesions, but by EMR, doctors could judge whether the lesions were resected completely, once the remained lesions were found, they could be resected immediately again lesion in case of omission of canceration.
观察结肠扁平病变的凹陷形态与病理之间的关系,并比较内镜下黏膜切除术(EMR)与高频电凝切除术(FHFC)治疗结肠扁平病变的疗效。
将患者分为两组。A组采用高频电凝切除术37例,B组采用内镜下黏膜切除术34例。两组具有可比性。用放大内镜检查结肠扁平病变患者,靛胭脂染色后观察黏膜的凹陷形态。
炎症或增生性病变的凹陷形态主要为Ⅱ型凹陷,腺瘤为Ⅲ型和Ⅳ型凹陷,癌性病变为Ⅳ型和Ⅴ型凹陷。病变分化程度越差,凹陷形态越高。A组和B组在并发症、病变数量、分类及分布方面无差异(P>0.05)。A组21例腺瘤患者未发现癌变,而B组20例腺瘤患者中有4例癌变(均为腺癌)。两组在癌变方面有显著性差异(P<0.05)。
病变分化程度越差,凹陷形态越高。内镜下黏膜切除术和高频电凝切除术在治疗扁平病变时有效性和安全性相当,但内镜下黏膜切除术可判断病变是否完全切除,一旦发现残留病变可立即再次切除以防遗漏癌变。