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目的探讨内镜下黏膜分片切除术(EPMR)治疗结肠巨大侧向发育型腺瘤性息肉的有效性及安全性。方法将确诊为结肠巨大侧向发育型腺瘤性息肉病人26例应用EPMR进行病变切除治疗,观察其疗效及并发症。结果所有治疗病人中有2例术中创面少量出血外无一例有迟发出血、肠穿孔、局限性腹膜炎等严重并发症发生;术后1个月复查肠镜1例发现创面残留,予以高频电凝切除术和氩离子凝固术(APC)电灼,术后3个月复查所有病例创面愈合良好,未再发现创面残留及复发现象。术后12个月复查电子肠镜未再发现原有创面复发。术后2年13例复查电子肠镜,有1例在原发病灶位置处出现复发。结论 EPMR作为内镜下黏膜切除术(EMR)的改良的手术方式,在结肠巨大腺瘤内镜下治疗中,是有效的,其并发症少,可操作性强,值得在内镜治疗工作中推广。
Objective To investigate the efficacy and safety of endoscopic mucosal biopsy (EPMR) in the treatment of giant lateral developmental adenomatous polyps in the colon. Methods Twenty-six patients diagnosed as giant lateral colon adenomatous polyposis were treated by EPMR and the curative effect and complications were observed. Results In all the patients treated, there were 2 cases of small wound hemorrhage without any bleeding, intestinal perforation, localized peritonitis and other serious complications; 1 case of colonoscopy was found 1 month after operation and the residual wounds were found, Electrocoagulation and argon plasma coagulation (APC) electrocautery, 3 months after the review of all cases of wound healing, did not find the residual wound and recurrence. 12 months after the review of electronic colonoscopy no longer found the original wound recurrence. After 2 years of 13 cases of electronic colonoscopy review, 1 case of recurrence in the location of the primary lesion. Conclusions EPMR, as an improved surgical method of endoscopic mucosal resection (EMR), is effective in endoscopic treatment of colorectal giant adenoma with less complications and maneuverability, which is worthwhile in the endoscopic treatment work Promotion.