Kim Yu Jin, Lee Sang Kil, Cheon Jae Hee, Kim Tae Ill, Lee Yong Chan, Kim Won Ho, Chung Jae Bock, Yi Seung Woo, Park Semi
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2008 Mar;51(3):174-80.
BACKGROUND/AIMS: Well differentiated rectal carcinoid tumors which are less than 1cm in diameter can be treated by endoscopic resection. We aimed to evaluate the efficacy of endoscopic resection in treating small sized rectal carcinoids.
Medical records of 30 rectal carcinoid cases treated by endoscopic resection in Yonsei University College of Medicine, Severance Hospital between January 1995 and March 2007 were reviewed retrospectively.
Mean age was 49.7 years and male to female ratio was 1:0.88. Mean size of tumor was 6.29+/-3.06 mm and 25 out of 30 patients (83.3%) had tumors of diameter less than 10 mm. Twenty-two out of 30 patients treated by conventional polypectomy, 6 by endoscopic mucosal resection using a transparent cap (EMR-C) and 2 by endoscopic submucosal dissection (ESD). Histological examination revealed that 9 patients had resection margin positive for tumor; 7 (31.8%) were in polypectomy group, 1 (16.7%) in EMR-C group, and 1 (50%) in ESD group (p=0.868). Five patients underwent transanal excision to remove residual tumor. No residual tumor was found in additionally resected tissue. Mean follow-up duration was 19. 3 months (range 0-122), and there were no recurrence.
Endoscopic resection is an effective method in the treatment of small rectal carcinoids. However, long-term outcome remains to be elucidated by a large scaled prospective study.
背景/目的:直径小于1cm的高分化直肠类癌肿瘤可通过内镜切除术进行治疗。我们旨在评估内镜切除术治疗小尺寸直肠类癌的疗效。
回顾性分析了1995年1月至2007年3月在延世大学医学院Severance医院接受内镜切除术治疗的30例直肠类癌病例的医疗记录。
平均年龄为49.7岁,男女比例为1:0.88。肿瘤平均大小为6.29±3.06mm,30例患者中有25例(83.3%)肿瘤直径小于10mm。30例患者中,22例行传统息肉切除术,6例行透明帽辅助内镜黏膜切除术(EMR-C),2例行内镜黏膜下剥离术(ESD)。组织学检查显示,9例患者的切除边缘肿瘤阳性;息肉切除术组7例(31.8%),EMR-C组1例(16.7%),ESD组1例(50%)(p = 0.868)。5例患者接受经肛门切除术以切除残留肿瘤。在额外切除的组织中未发现残留肿瘤。平均随访时间为19.3个月(范围0 - 122个月),无复发。
内镜切除术是治疗小直肠类癌的有效方法。然而,长期结果仍有待大规模前瞻性研究阐明。