Naveau S, Perrier C, Zourabichvili O, Brunie F, Poitrine A, Chaput J C
Service d'Hépato-Gastroentérologie, Hôpital Antoine-Béclère, Clamart.
Gastroenterol Clin Biol. 1988 Aug-Sep;12(8-9):604-9.
Fifty-eight patients, 23 men, 35 women (mean age 76 +/- 10 yrs), with colorectal villous adenomas underwent endoscopic neodymium Yag laser therapy. In 50 patients with interpretable results, tumor ablation was complete in 45 p. 100 of extensive adenomas involving at least two thirds of the circumference and extending longitudinally for at least 4 cm, in 92 p. 100 of intermediate adenomas between 1 and 4 cm in diameter and in 100 p. 100 of small adenomas with diameter less than or equal to 1 cm. These patients had a mean follow up of 72 weeks (range 13-182 wks). Twelve adenomatous tissue recurrences occurred in 9 patients. In 10 of these recurrences, laser ablation was effective. Age, sex, dysplasia grade, macroscopic appearance, or tumor location did not influence the results which were related to the size of the villous adenomas. Four complications occurred: a symptomatic stenosis, an asymptomatic stenosis, an ileocaecal fistula and a rectal fistula near a colorectal anastomosis.
58例患有大肠绒毛状腺瘤的患者（23例男性，35例女性，平均年龄76±10岁）接受了内镜钕钇铝石榴石激光治疗。在50例结果可解释的患者中，对于至少累及三分之二周长且纵向延伸至少4 cm的广泛性腺瘤，肿瘤完全消融率为45%；对于直径在1至4 cm之间的中等大小腺瘤，完全消融率为92%；对于直径小于或等于1 cm的小腺瘤，完全消融率为100%。这些患者的平均随访时间为72周（范围13 - 182周）。9例患者出现12次腺瘤组织复发。其中10次复发，激光消融有效。年龄、性别、发育异常程度、宏观表现或肿瘤位置均未影响与绒毛状腺瘤大小相关的结果。发生了4例并发症：1例有症状的狭窄、1例无症状的狭窄、1例回盲部瘘和1例结直肠吻合口附近的直肠瘘。
