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首页> 外文期刊>Surgical Endoscopy >Clinical outcomes of endoscopic resection for colorectal laterally spreading tumors with advanced histology
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Clinical outcomes of endoscopic resection for colorectal laterally spreading tumors with advanced histology

机译：具有晚期组织学结直肠横向扩散肿瘤内镜切除的临床结果

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BackgroundColorectal laterally spreading tumors (LSTs) are large, flat neoplasms that are usually treated using different endoscopic techniques based on their morphology, size, and histology. The aim of this study was to evaluate the clinical outcomes of LSTs with advanced histology treated by endoscopic resection.MethodsA total of 246 LSTs with advanced histology [i.e., high-grade dysplasia (HGD) and adenocarcinoma (AC)] treated by endoscopic resection [i.e., endoscopic mucosal resection (EMR), EMR-precutting (EMR-P), and endoscopic submucosal dissection (ESD)] were enrolled. Clinicopathological characteristics were collected by review of patient's medical records.ResultsThe en bloc resection and R0 resection rates were 75.6% and 85.0%, respectively. The bleeding and perforation rates were 10.2% and 2.4%, respectively. The frequency of cancerous pit pattern and bleeding was significantly higher in LSTs with AC than in LSTs with HGD. The R0 resection rate in LSTs with HGD was significantly higher than that in LSTs with AC. The frequency of cancerous pit patterns in LST cases with submucosal AC was significantly higher than those with intramucosal AC. The mean size of the LSTs was significantly larger in ESD group than in EMR or EMR-P groups. The frequencies of nodular mixed subtype, cancerous pit patterns, and en bloc resection rates were significantly higher in the ESD group than in the EMR or EMR-P groups. However, the frequency of perforation was significantly higher in EMR-P group than in EMR or ESD groups.ConclusionsThese results indicate that ESD is a more acceptable treatment approach for resection of colorectal LSTs of larger size, with nodular mixed subtype, having a cancerous pit pattern or AC, using either en bloc or curative resection methods, compared to EMR or EMR-P procedures.
机译：BackgroundColorectal横向扩展的肿瘤（LSTS）是通常使用基于它们的形态，大小，和组织学不同内窥镜技术处理的大而平的肿瘤。本研究的目的是评价通过内窥镜resection.MethodsA总共246个LSTS具有先进的组织学[即，高度异型增生（HGD）和腺癌（AC）]通过内​​窥镜切除治疗处理的具有先进组织学LSTS的临床结果[即，内窥镜粘膜切除术（EMR），EMR-预切割（EMR-P），和内窥镜黏膜下层剥离术（ESD）]的患者。临床特点是由患者的医疗records.ResultsThe整块切除和R0切除率的审核收集率分别为75.6％和85.0％。该出血和穿孔率分别为10.2％和2.4％。癌变坑洞图案和出血的发生率在AC LSTS比与HGD LSTS显著较高。与HGD LSTS的R0切除率明显高于同AC LSTS显著较高。在LST例黏膜癌变AC坑模式的频率明显高于与粘膜内AC显著较高。所述LSTS的平均尺寸在ESD组比EMR或EMR-P基团显著大。结节混合亚型，癌坑模式，和整块切除率的频率分别为所述ESD组中比在EMR或EMR-P基团显著更高。然而，穿孔的频率在EMR-P组较EMR或ESD groups.ConclusionsThese结果显著较高表明，ESD是用于切除较大尺寸的结LSTS，结节性混合亚型的更可接受的治疗方法，具有癌坑图案或AC，使用任一整块或根治性切除的方法，相对于EMR或EMR-P程序。

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