Yokota T, Sugihara K, Yoshida S
Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
Dis Colon Rectum. 1994 Nov;37(11):1108-11. doi: 10.1007/BF02049812.
Endoscopic mucosal resection, which is a new option for endoscopic polypectomy of colorectal polyps without stalks, was evaluated on its usefulness in polypectomy.
Three hundred thirty-seven lesions, which were removed by endoscopic mucosal resection between January 1990 and January 1993, were studied. The endoscopic configuration of neoplastic lesions were classified into four types: flat, sessile, large sessile with distinct lobulations, and semipedunculated.
The 337 lesions included 243 adenomas, 30 mucosal cancers, 13 submucosal cancers, 3 carcinoids, 43 hyperplastic polyps, and 5 inflammatory polyps. Of the 286 neoplastic lesions, excluding 3 carcinoids, 137 were flat, 81 were sessile, 18 were large sessile, and 50 were semipedunculated. The 137 flat lesions consisted of 125 adenomas, 10 mucosal cancers, and 2 submucosal cancers. The rate of complete removal was related to their size and configuration and was 87 percent in flat neoplastic lesions. Lesion diameters of greater than 20 mm and the large sessile-type configurations were factors that were associated with incomplete removal. Two (0.7 percent) cases were complicated by perforations, and one (0.4 percent) case was complicated by bleeding.
Endoscopic mucosal resection is an useful option for complete removal of colorectal nonpolypoid adenomas and cancers.
内镜黏膜切除术是大肠无蒂息肉内镜下息肉切除术的一种新选择，本研究评估其在息肉切除术中的实用性。
对1990年1月至1993年1月间通过内镜黏膜切除术切除的337个病变进行研究。肿瘤性病变的内镜形态分为四种类型：扁平型、广基型、具有明显分叶的大广基型和亚蒂型。
337个病变包括243个腺瘤、30个黏膜癌、13个黏膜下癌、3个类癌、43个增生性息肉和5个炎性息肉。在286个肿瘤性病变中，排除3个类癌后，137个为扁平型，81个为广基型，18个为大广基型，50个为亚蒂型。137个扁平病变包括125个腺瘤、10个黏膜癌和2个黏膜下癌。完整切除率与病变大小和形态有关，扁平肿瘤性病变的完整切除率为87%。病变直径大于2cm和大广基型形态是与切除不完全相关的因素。2例（0.7%）发生穿孔并发症，1例（0.4%）发生出血并发症。
内镜黏膜切除术是完整切除大肠非息肉样腺瘤和癌的一种有效选择。
