Zhongshan Hospital, Fudan University, Shanghai, China.
Endoscopy. 2013 Sep;45(9):770-3. doi: 10.1055/s-0033-1344225. Epub 2013 Jul 29.
Endoscopic resection of colonic submucosal tumors (SMTs) is challenging and carries a high risk of perforation. In this prospective pilot study we aimed to evaluate the feasibility, safety, and efficacy of endoscopic full-thickness resection of colonic SMTs. The study enrolled 19 consecutive patients with colonic SMTs 3 cm in size or smaller. In 18 of the 19 patients full-thickness resection was carried out endoscopically with the entire tumor capsule intact. In 16 of these18 patients, full-thickness resection was carried out and the colonic wall defect closed all endoscopically; in the other 2 patients, laparoscopic closure was needed. Two cases of local peritonitis were managed with conservative treatment. No deaths occurred within 30 days, and no recurrence was detected after a median of 18 months' follow-up. Endoscopic full-thickness resection is a novel method enabling resection of colonic SMTs. The colonic wall mucosal defect can be closed endoscopically in the majority of cases. It appears to be a safe and effective endoscopic technique for managing these tumors, which traditionally are managed by colonic resection.
经内镜结肠黏膜下肿瘤（SMT）全层切除术的探索性前瞻性研究
经内镜结肠黏膜下肿瘤（SMT）全层切除术具有挑战性，穿孔风险高。本前瞻性研究旨在评估内镜下结肠 SMT 全层切除术的可行性、安全性和疗效。研究纳入 19 例大小为 3cm 或以下的结肠 SMT 患者。19 例患者中，18 例完整内镜下全层切除术，其中 16 例完全内镜下闭合结肠壁缺损，2 例需要腹腔镜下闭合。2 例局部腹膜炎患者经保守治疗后治愈。30 天内无死亡病例，中位随访 18 个月后无复发。内镜下全层切除术是一种新的结肠 SMT 切除术方法，大多数情况下可通过内镜闭合结肠壁黏膜缺损。对于传统上需要结肠切除的这类肿瘤，该技术似乎是一种安全有效的内镜治疗方法。
