目的 分析结直肠黏膜下肿瘤(SMTs)内镜特征,探讨其治疗策略。方法 回顾性分析2018-01至2022-12武警广东总队医院经肠镜切除且经病理及免疫组化明确诊断的SMTs患者50例的临床资料。所有患者于术后3个月、6个月及1年后随诊复查肠镜。逐个分析患者临床症状、黏膜下肿瘤在结直肠的分布及内镜特征、总结病理结果。结果 50例中,脂肪瘤22例,神经内分泌肿瘤8例,间质瘤20例。脂肪瘤和间质瘤分布以结肠多见 ,神经内分泌肿瘤以直肠最多见且腹泻发生率最高。结直肠肿物通过内镜黏膜下剥离术(ESD)切除40例,经内镜下黏膜切除术(EMR)10例。患者术后均未发生感染、迟发出血、肠穿孔。随访6～20个月,患者均无复发与转移。结论 SMTs在肠镜及超声内镜下呈现不同的特征。超声内镜对黏膜下肿瘤的鉴别诊断有指导作用,且为内镜下微创手术提供安全、高效的策略。
Abstract
Objective To analyze the endoscopic features of colorectal submucosal tumors(SMTs) and to explore the treatment strategies. Methods A total of 50 patients with SMTs who underwent endoscopic resection and were diagnosed by pathology and immunohistochemistry at Guangdong Provincial Corps Hospital of Chinese People’s Armed Police Forces from January 2018 to December 2022 were selected. All the patients were followed up and reexamined by colonoscopy three, six and twelve months after operation. Clinical symptoms, distribution of submucosal lesions in the colorectum, and endoscopic features of the patients were analyzed one by one, and the pathological results were summarized. Results Among the 50 cases, there were 22 cases of lipoma,8 cases of neuroendocrine tumors, and 20 cases of stromal tumors . Lipomas and stromal tumors were more commonly distributed in the colon, while neuroendocrine tumors were more common in the rectum and had the highest incidence of diarrhea. Forty cases of colorectal tumors were resected by endoscopic submucosal dissection (ESD), and 10 cases were resected by endoscopic mucosal resection (EMR). None of the patients had infection, delayed bleeding, or intestinal perforation after the operation. During the postoperative follow-up period of 6 to 20 months, there was no recurrence or metastasis in the patients. Conclusions SMTs present different features under endoscopic ultrasonography (EUS). EUS has an important guiding role on the differential diagnosis of SMTs and provides a safe and efficient strategy for endoscopic minimally invasive surgery.
关键词
结直肠 /
黏膜下肿瘤 /
组织病理学 /
内镜特征 /
治疗策略
Key words
colorectum /
submucosal tumor /
histopathology /
endoscopic feature /
treatment strategy
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