Take Iri, Shi Qiang, Qi Zhi-Peng, Cai Shi-Lun, Yao Li-Qing, Zhou Ping-Hong, Zhong Yun-Shi
Iri Take, Qiang Shi, Zhi-Peng Qi, Shi-Lun Cai, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong, Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2015 Dec 28;21(48):13542-7. doi: 10.3748/wjg.v21.i48.13542.
To determine the feasibility and effectiveness of endoscopic resection for the treatment of colorectal granular cell tumors (GCTs).
This was a retrospective study performed at a single institution. From January 2008 to April 2015, we examined a total of 11 lesions in 11 patients who were treated by an endoscopic procedure for colorectal GCTs in the Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai, China. Either endoscopic mucosal resection or endoscopic submucosal dissection (ESD) was performed by three surgeons with expertise in endoscopic treatment. The pre- and post-operative condition and follow-up of these patients were evaluated by colonoscopy and endoscopic ultrasonography (EUS).
Of these 11 lesions, 2 were located in the cecum, 3 were in the ileocecal junction, 5 were in the ascending colon, and 1 was in the rectum. The median maximum diameter of the tumors was 0.81 cm (range 0.4-1.2 cm). The en bloc rate was 100%, and the complete resection rate was 90.9% (10/11). Post-operative pathology in one patient showed a tumor at the cauterization margin. However, during ESD, this lesion was removed en bloc, and no tumor tissue was seen in the wound. No perforations or delayed perforations were observed and emergency surgery was not required for complications. All patients were followed up to May 2015, and none had recurrence, metastasis, or complaints of discomfort.
Endoscopic treatment performed by endoscopists with sufficient experience appears to be feasible and effective for colorectal GCTs.
确定内镜切除治疗大肠颗粒细胞瘤(GCTs)的可行性和有效性。
这是一项在单一机构进行的回顾性研究。2008年1月至2015年4月,我们对复旦大学附属中山医院内镜中心11例接受大肠GCTs内镜治疗的患者的11个病变进行了检查。由三名具有内镜治疗专业知识的外科医生进行内镜黏膜切除术或内镜黏膜下剥离术(ESD)。通过结肠镜检查和内镜超声检查(EUS)评估这些患者的术前和术后情况以及随访情况。
在这11个病变中,2个位于盲肠,3个位于回盲部,5个位于升结肠,1个位于直肠。肿瘤的最大直径中位数为0.81 cm(范围0.4 - 1.2 cm)。整块切除率为100%,完整切除率为90.9%(10/11)。一名患者的术后病理显示烧灼边缘有肿瘤。然而,在ESD过程中,该病变被整块切除,伤口处未见肿瘤组织。未观察到穿孔或延迟穿孔,也无需因并发症进行急诊手术。所有患者随访至2015年5月,均无复发、转移或不适主诉。
由经验丰富的内镜医师进行内镜治疗对于大肠GCTs似乎是可行且有效的。