Maunoury V, Collet R, Cochelard D, Brunetaud J M, Cortot A, Paris J C
Centre Multidisciplinaire de Traitement par Laser, Hôpital C.-Huriez, Lille.
Ann Chir. 1990;44(1):24-9.
Endoscopic laser treatment is reported in 313 patients with benign rectosigmoid villous adenomas. Total tumor destruction was achieved in 92% of them, without any major complications. The circumferential extension of the tumor base was the only factor affecting this result. During the average 37-month follow-up period of the patients with total tumor destruction, 14% had a tumor recurrence. The recurrence rate after initial treatment was higher a) in patients treated for a recurrence after a previous non laser treatment, b) when the initial histology was low-grade dysplasia and c) when the tumor was located in the lower or middle rectum. Because treatment is long and difficult with a high cancer rate, laser treatment for patients with a circumferential villous adenoma should be limited to nonsurgical candidates. In the other cases, laser is well adapted to old and fragile patients, when transanal resection seems difficult or in case of recurrence after a previous non-laser treatment.
据报道，313例乙状结肠直肠良性绒毛状腺瘤患者接受了内镜激光治疗。其中92%的患者实现了肿瘤完全切除，且无任何严重并发症。肿瘤基底的周向扩展是影响这一结果的唯一因素。在肿瘤完全切除的患者平均37个月的随访期内，14%的患者出现肿瘤复发。初次治疗后的复发率较高的情况为：a) 接受过非激光治疗后复发的患者；b) 初始组织学为低级别发育异常的患者；c) 肿瘤位于直肠中下段的患者。由于治疗时间长且困难，癌症发生率高，对于环状绒毛状腺瘤患者，激光治疗应仅限于不适合手术的患者。在其他情况下，激光治疗适用于年老体弱的患者、经肛门切除术似乎困难的患者或先前非激光治疗后复发的患者。
