目的 探讨内镜黏膜切除术治疗结直肠局灶性隆起性病变的有效性、安全性、疗效及影响原位复发的危险因素。方法 对2009年1月至2014年12月在上海交通大学医学院附属同仁医院内窥镜室就诊的450例共626处结直肠单发或多发隆起性病灶患者进...目的 探讨内镜黏膜切除术治疗结直肠局灶性隆起性病变的有效性、安全性、疗效及影响原位复发的危险因素。方法 对2009年1月至2014年12月在上海交通大学医学院附属同仁医院内窥镜室就诊的450例共626处结直肠单发或多发隆起性病灶患者进行内镜黏膜切除术,统计病理结果 及并发症情况,并结肠镜随访了180例患者术后6~36个月。观察术后病灶原位复发情况。结果 450例患者中,病灶大小：Φ≤1.0 cm 278枚,1.0〈Φ≤2.0 cm 280枚,2.0 cm〈Φ≤3.0 cm 52枚,Φ〉3.0 cm 16枚。病灶病理类型：结肠癌7例,低级别上皮内瘤变314例,高级别上皮内瘤变43例,单纯腺瘤23例,非腺瘤性息肉44例,间质来源肿瘤及其他19例。病灶均经EMR完整切除。11例患者出现包括出血、穿孔等手术发症。180例随访患者经6~36个月内镜随访,出现病灶原位复发39例（8.67%）,其中12个月内复发32例（32/39,82.05%）,Logistic回归分析示病灶个数及结直肠肿瘤手术史为原位复发的危险因素（P〈0.05）。结论 EMR是治疗结直肠隆起性病变安全、简便、有效的方法 ;对于存在高危因素患者应术后6个月内复查结肠镜。展开更多
Objective To investigate the diagnostic value of miniprobe ultrasonography (MPS) in the protruding lesions of esophagus. Methods Sixty-two patients with protruding lesions of esophagus were examined with MPS. Results ...Objective To investigate the diagnostic value of miniprobe ultrasonography (MPS) in the protruding lesions of esophagus. Methods Sixty-two patients with protruding lesions of esophagus were examined with MPS. Results The MPS examination showed diseases of esophageal polyp, inflammatory protruding, esophageal leiomyoma, esophageal leiomyosarcoma, esophageal venous aneurysm, esophageal lipoma, esophageal cyst, esophageal carcinoma, and extra esophageal compression including aorta compression, lung tumor compression and spina compression. Fourteen patients were verified by surgical operations and pathological examinations, resulting in 92.86% (13/14) diagnosis accuracy rate. Forty-eight cases had results of gastroscope examination consistent with that of MPS. Twelve cases had results of CT and MRI examination consistent with that of MPS. Follow-up was completed on 22 patients. Conclusion Besides imaging the esophageal layer, MPS can precisely locate the histological layer of the esophageal protruding lesions and predict their characters. This indicates its value in the diagnosis and differential diagnosis of the protruding lesions of esophagus. Furthermore, the miniature probe used in MPS examination can pass the structured esophagus, enabling wider application of the examination.展开更多
文摘目的 探讨内镜黏膜切除术治疗结直肠局灶性隆起性病变的有效性、安全性、疗效及影响原位复发的危险因素。方法 对2009年1月至2014年12月在上海交通大学医学院附属同仁医院内窥镜室就诊的450例共626处结直肠单发或多发隆起性病灶患者进行内镜黏膜切除术,统计病理结果 及并发症情况,并结肠镜随访了180例患者术后6~36个月。观察术后病灶原位复发情况。结果 450例患者中,病灶大小：Φ≤1.0 cm 278枚,1.0〈Φ≤2.0 cm 280枚,2.0 cm〈Φ≤3.0 cm 52枚,Φ〉3.0 cm 16枚。病灶病理类型：结肠癌7例,低级别上皮内瘤变314例,高级别上皮内瘤变43例,单纯腺瘤23例,非腺瘤性息肉44例,间质来源肿瘤及其他19例。病灶均经EMR完整切除。11例患者出现包括出血、穿孔等手术发症。180例随访患者经6~36个月内镜随访,出现病灶原位复发39例（8.67%）,其中12个月内复发32例（32/39,82.05%）,Logistic回归分析示病灶个数及结直肠肿瘤手术史为原位复发的危险因素（P〈0.05）。结论 EMR是治疗结直肠隆起性病变安全、简便、有效的方法 ;对于存在高危因素患者应术后6个月内复查结肠镜。
文摘Objective To investigate the diagnostic value of miniprobe ultrasonography (MPS) in the protruding lesions of esophagus. Methods Sixty-two patients with protruding lesions of esophagus were examined with MPS. Results The MPS examination showed diseases of esophageal polyp, inflammatory protruding, esophageal leiomyoma, esophageal leiomyosarcoma, esophageal venous aneurysm, esophageal lipoma, esophageal cyst, esophageal carcinoma, and extra esophageal compression including aorta compression, lung tumor compression and spina compression. Fourteen patients were verified by surgical operations and pathological examinations, resulting in 92.86% (13/14) diagnosis accuracy rate. Forty-eight cases had results of gastroscope examination consistent with that of MPS. Twelve cases had results of CT and MRI examination consistent with that of MPS. Follow-up was completed on 22 patients. Conclusion Besides imaging the esophageal layer, MPS can precisely locate the histological layer of the esophageal protruding lesions and predict their characters. This indicates its value in the diagnosis and differential diagnosis of the protruding lesions of esophagus. Furthermore, the miniature probe used in MPS examination can pass the structured esophagus, enabling wider application of the examination.
