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首页> 外文期刊>Endoscopy International Open >Endoscopic submucosal dissection of malignant non-pedunculated colorectal lesions
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Endoscopic submucosal dissection of malignant non-pedunculated colorectal lesions

机译：内镜下黏膜下剥离术对未切除的大肠恶性病变的影响

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Background and study aims Endoscopic submucosal dissection (ESD) is an established method for en bloc resection of large non-pedunculated colorectal lesions in Asia but dissemination of ESD in Western countries is limited. The aim of this study was to evaluate the role of ESD in the management of malignant non-pedunculated colorectal lesions in a European center. Patients and methods Among 255 patients undergoing colorectal ESD between 2014 and 2016, 29 cases were identified as submucosal invasive cancers and included in this study. The main outcomes were en bloc, R0 and curative resection as well as procedural time, complications and recurrence. Results Median tumor size was 40?mm (range 20?–?70?mm). Thirteen cancers were located in the colon and 16 were located in the rectum. Procedural time was 89 minutes (range 18?–?594 minutes). Complete resection was achieved in 28 cases, en bloc and R0 resection rates were 83?% and 69 %, respectively. Curative resection rate was 38?%. One case had a perforation in the sigmoid colon requiring emergency surgery. No significant bleeding occurred. Six patients underwent additional surgery after ESD, one of whom had residual tumor. One recurrence was detected in 20 patients that were followed-up endoscopically, median follow-up time was 13 months (range 2?–?30 months). Conclusion ESD seems to be a safe and effective method for treating non-pedunculated malignant colorectal lesions after careful patient selection and proper endoscopic training.
机译：背景和研究目的内镜黏膜下剥离术（ESD）是一种用于在亚洲整体切除大的无蒂大肠病变的行之有效的方法，但是ESD在西方国家的传播受到限制。这项研究的目的是评估ESD在欧洲中心对恶性非带蒂大肠癌病变管理中的作用。患者和方法在2014年至2016年间接受结肠直肠ESD治疗的255例患者中，有29例被确定为粘膜下浸润性癌症，并纳入本研究。主要结局为整体，R0和根治性切除以及手术时间，并发症和复发。结果中位肿瘤大小为40？mm（范围20？–？70？mm）。结肠中有13种癌症，直肠中有16种癌症。程序时间为89分钟（范围18？–？594分钟）。完全切除28例，整块和R0切除率分别为83％和69％。治愈率38％。 1例乙状结肠穿孔需要紧急手术。无明显出血发生。 ESD后有6例患者接受了额外的手术，其中1例残留肿瘤。经内镜随访的20例患者中发现1例复发，中位随访时间为13个月（范围2？–？30个月）。结论经过仔细的患者选择和适当的内镜训练，ESD似乎是一种安全，有效的治疗未切除的恶性大肠病变的方法。

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