超声内镜及内镜黏膜下剥离术对直肠类癌的诊疗价值

Endoscopic ultrasonography in the diagnosis and endoscopic submucosal dissection in treatment of rectal carcinoid tumors

摘要:

目的 探讨超声内镜（EUS）对直肠类癌治疗的指导价值，及内镜黏膜下剥离术（ESD）对直肠 类癌治疗的安全性及有效性。方法 对临床考虑直肠类癌的患者进行EUS 检查，根据EUS 结果选择适合的 治疗方案。结果 45 例术前病理确诊的类癌病例，42 例经ESD 治疗，2 例累及固有肌层及1 例浸透浆膜层并 伴有周围淋巴结转移者，经外科手术治疗。结论 EUS 能够明确直肠类癌的大小、浸润深度、有无周围淋巴 结肿大，对其治疗有较高的指导价值。对于小于20 mm 直肠类癌，ESD 是一种安全、有效的方法。

Abstract:

Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) in diagnosis and treatment of rectal carcinoid tumom, and the safety and efficacy of endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. Methods All the submucous tumor considered rectal carcinoid tumor received EUS examination and according to the result to select appropriate therapeutic regimen. Results All the 45 lesions were verified rectal carcinoid tumors by pathological examination. 42 patients received endoscopic submucosal dissection. Two tumors invaded into the muscularis propria and one tumor invaded beyond serosa and with lymph node metastasis received surgical strategy. Conclusion EUS can be used to determine surgical strategy for rectal carcinoid tumor for it provides precise information of the size, depth, border, muscularis propria or vessel infiltration of the tumor. For rectal carcinoid tumors smaller than 20 mm in diameter, ESD is safe and effective.