Aubert A, Méduri B, Fritsch J, Aimé F, Baglin A C, Barbagelata B
Département d'Endoscopie digestive, Centre médico-chirurgical Foch, Suresnes.
Presse Med. 1992 Dec 5;21(42):2046-9.
Endoscopic snare resection prior to Nd:YAG laser photocoagulation was used to treat benign colorectal villous adenoma. One hundred and thirty four patients were included in the study: 72 with surgical contraindications, 61 for whom surgical resection appeared to be too drastic and 1 who refused surgery. Treatment sessions were repeated every fifteen days until total tumour destruction was achieved. A carcinoma was detected in biopsy specimens obtained during endoscopic treatment of seven patients. Eight patients were lost to follow up. Treatment results could be analysed in 119 patients. A successful treatment was achieved in 108 patients. Tumour destruction was complete in 85.4 percent of the cases with lesions of at least 4 cm in diameter and in 94.3 percent of the cases with smaller lesions. During the average 101 weeks follow up period, 15.7 percent of the patients with total tumour destruction had recurrence. The risk of recurrence was correlated with the number of initial treatment sessions and previous surgical treatment. It would appear that endoscopic resection prior to Nd:YAG laser photocoagulation is a safe and effective method for the destruction of colorectal villous adenomas.
在钕钇铝石榴石激光光凝治疗之前，采用内镜圈套切除术治疗良性大肠绒毛状腺瘤。134例患者纳入本研究：72例有手术禁忌证，61例患者似乎不宜进行手术切除，1例拒绝手术。每15天重复治疗一次，直至肿瘤完全破坏。7例患者在内镜治疗期间获得的活检标本中检测到癌。8例患者失访。119例患者的治疗结果可进行分析。108例患者治疗成功。直径至少4 cm的病变中，85.4%的病例肿瘤完全破坏；较小病变的病例中，94.3%肿瘤完全破坏。在平均101周的随访期内，肿瘤完全破坏的患者中有15.7%复发。复发风险与初始治疗次数和既往手术治疗有关。看来，在钕钇铝石榴石激光光凝治疗之前进行内镜切除是一种安全有效的大肠绒毛状腺瘤破坏方法。
