Zhao Zhi-Feng, Zhang Ning, Ma Shu-Ren, Yang Zhuo, Han Xiao, Zhao Yun-Feng, Gao Fei, Gong Zhao-Jie, Yang Lin
Department of Endoscopy, Shenyang North Hospital, Shenyang, Liaoning Province, China.
Surg Laparosc Endosc Percutan Tech. 2012 Jun;22(3):260-3. doi: 10.1097/SLE.0b013e3182512e0f.
To investigate the advantages and disadvantages of various endoscopic resection methods for rectal carcinoid tumors.
A retrospective analysis of 3 types of endoscopic resection techniques for rectal carcinoid tumors was performed. The surgical time and the complication rate were compared between 30 patients who underwent conventional endoscopic mucosal resection (EMR), cap-assisted endoscopic mucosal resection (EMR-C), or endoscopic submucosal dissection (ESD). All rectal carcinoid tumors were under 1 cm and were treated in our center between January 2002 and January 2008.
Ten patients underwent each surgical approach. All cases were pathologically diagnosed as rectal carcinoid tumors. One-time complete resection rates using the conventional EMR, EMR-C, and ESD were 80%, 100%, and 100%, respectively. The operation time ranged from 5 to 53 minutes for the conventional EMR group, from 4 to 7 minutes for the EMR-C group, and from 16 to 35 minutes for the ESD group. The average follow-up time for the 30 patients was 18.43 ± 9.76 months. There were no recurrent or metastatic cases.
Endoscopic resection for rectal carcinoid tumors below 1 cm was safe. Considering the clinical efficacy, surgical time, and intraoperative complication rate, EMR-C may be the best endoscopic excision method.
探讨直肠类癌肿瘤各种内镜切除方法的优缺点。
对直肠类癌肿瘤的3种内镜切除技术进行回顾性分析。比较30例行传统内镜黏膜切除术（EMR）、帽辅助内镜黏膜切除术（EMR-C）或内镜黏膜下剥离术（ESD）患者的手术时间和并发症发生率。所有直肠类癌肿瘤均小于1 cm，于2002年1月至2008年1月在本中心接受治疗。
每种手术方法各有10例患者接受。所有病例经病理诊断为直肠类癌肿瘤。传统EMR、EMR-C和ESD的一次性完全切除率分别为80%、100%和100%。传统EMR组手术时间为5至53分钟，EMR-C组为4至7分钟，ESD组为16至35分钟。30例患者的平均随访时间为18.43±9.76个月。无复发或转移病例。
内镜切除1 cm以下的直肠类癌肿瘤是安全的。综合临床疗效、手术时间和术中并发症发生率，EMR-C可能是最佳的内镜切除方法。
