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首页> 外文期刊>Surgical Endoscopy >Clinical outcomes for patients with perforations during endoscopic submucosal dissection of laterally spreading tumors of the colorectum
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Clinical outcomes for patients with perforations during endoscopic submucosal dissection of laterally spreading tumors of the colorectum

机译：内镜大肠侧向扩散性肿瘤的内镜黏膜下剥离术中穿孔患者的临床结果

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Background: Endoscopic submucosal dissection (ESD) for colorectal neoplasms is not widely performed because of the high risk of perforation. Perforations are divided into macroperforations and microperforations. Currently, there is a limited amount of clinical data on the outcome of patients with these types of perforations during colonic ESD. The aim of this study was to investigate the clinical outcome of patients who sustained colon perforations during ESD. We also compared the clinical outcome of patients with microperforations and those with macroperforations. Methods: This study enrolled 101 patients with colorectal laterally spreading tumors (LST) who underwent ESD. We retrospectively reviewed their medical records, including patient demographic data and the clinical, endoscopic, and pathologic features. In the cases where perforation had occurred, the course of hospital treatment was analyzed. All ESD-related perforations were divided into macroperforations and microperforations. A macroperforation was defined as a gross perforation that occurred during an ESD procedure and a microperforation was defined by free air visible on X-rays after the procedure. Results: Of the 101 enrolled patients, 9 (8.9 %) developed perforations. The most common tumor morphology was nongranular-type LST (5 of 9 cases, 55.6 %) based on endoscopic examination. Five patients had microperforations and four had macroperforations. All macroperforations were closed primarily by endoclips during ESD. The endoscopic characteristics did not differ between the groups. However, the length of hospital stay and the mean duration of NPO and antibiotic treatments were longer for microperforation patients. All patients had conservative nonsurgical management such as fasting, intravenous antibiotics, and nasogastric tube drainage. Conclusions: The clinical complications for microperforation patients were worse than those for macroperforation patients. However, the clinical prognoses of patients with perforations that occur during colonic ESD are favorable.
机译：背景：由于穿孔的高风险，对大肠肿瘤的内镜黏膜下剥离术（ESD）并未广泛进行。穿孔分为大穿孔和微穿孔。当前，关于结肠ESD期间具有这些类型的穿孔的患者的结果的临床数据有限。这项研究的目的是调查在ESD期间持续发生结肠穿孔的患者的临床结局。我们还比较了微穿孔和大穿孔患者的临床结局。方法：本研究招募了接受ESD治疗的101例大肠侧向扩散性肿瘤（LST）患者。我们回顾性地回顾了他们的病历，包括患者的人口统计数据以及临床，内镜和病理特征。在发生穿孔的情况下，分析了医院治疗的过程。所有与ESD相关的孔眼均分为大孔眼和微孔眼。宏观穿孔的定义是在ESD程序中发生的总穿孔，而微观穿孔的定义是手术后X射线可见的自由空气。结果：在101名入组患者中，有9名（8.9％）出现了穿孔。根据内窥镜检查，最常见的肿瘤形态是非颗粒型LST（9例中有5例，占55.6％）。 5例有微穿孔，4例有大穿孔。在ESD期间，所有的大孔主要是通过内窥镜闭合的。两组之间的内镜特征没有差异。但是，微穿孔患者的住院时间，NPO和抗生素治疗的平均持续时间更长。所有患者均接受保守的非手术治疗，如禁食，静脉注射抗生素和鼻胃管引流。结论：微穿孔患者的临床并发症比大穿孔患者的严重。但是，在结肠ESD期间发生穿孔的患者的临床预后良好。

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