摘要
目的探讨内镜黏膜下剥离术（ESD）治疗直肠神经内分泌肿瘤的疗效及安全性。方法以2006年1月至2016年1月于北京大学第一医院确诊为直肠神经内分泌肿瘤且接受ESD治疗的58例患者为研究对象，回顾性研究患者内镜特征、临床表现、病理分析、RO切除率及随访结果。结果58例直肠神经内分泌肿瘤病变最大直径3．0～18．0mm，平均7．6mm。ESD整块切除率为100．O％，RO切除率94．8％（55／58），1例患者出现术后出血。病变直径〉15mm者RO切除率降低（P〈0．05）。术后平均随访时间3．2年（1．2-11．2年），无局部复发病例，1例（1．7％）G2级直肠神经内分泌肿瘤伴淋巴管内瘤栓患者出现肝脏转移。结论肿瘤直径〈15mm的直肠神经内分泌肿瘤患者选择ESD治疗安全有效。直肠神经内分泌肿瘤患者需长期随访观察，对肿瘤分级高、存在淋巴管浸润的患者应积极评估远处转移风险。
Objective To investigate the efficiency and safety of endoscopic submucosal dissection （ESD） for rectal neuroendocrine neoplasm （NEN）. Methods A retrospective analysis was performed on data collected from 58 consecutive patients with rectal NEN, who underwent endoscopic ultrasonography and followed by ESD from January 2006 to January 2016 at Peking University First Hospital. Patients＇ endoscopic and pathological features, clinical manifestations, RO resection rate and follow-up results were studied. Results En bloc resection was achieved for all of the 58 lesions with a mean diameter of 7.6 mm （ range 3.0-18.0 ram）. The complete resection rate was 94. 8% （55/58）. One patient showed postoperative bleeding. The diameter of lesion more than 15 mm increased the risk of non-R0 resection （P〈0. 05）. During the mean follow-up of 3.2 years （ range 1.2-11.2 years） , all patients remained free from local recurrence. However, distant metastasis was detected in 1 NEN G2 patient with lymphatic invasion （ 1.7% ）. Conclusion ESD is effective for treatment of rectal NEN with diameter less than 15 mm and causes less complications. Tumor features and stage determine the risk of distant metastasis, so long-term follow-up is essential.
出处
《中华消化内镜杂志》
CSCD
北大核心
2018年第1期27-31,共5页
Chinese Journal of Digestive Endoscopy
关键词
神经内分泌瘤
直肠
内镜黏膜下剥离术
治疗
有效性
安全性
Neuroendocrine tumors, rectum
Endoscopic submucosal dissection
Therapy
Efficiency
Safety
