结直肠侧向发育型肿瘤的诊治分析（附17 例报告）

Diagnosis and treatment of 17 laterally spreading tumors

摘要:

：目的 探讨结直肠侧向发育型肿瘤（LST）内镜下的形态特征、腺管开口形态（pit pattern）分 型与病理学类型的关系，为治疗方式的选择提供依据，并探讨内镜下治疗的价值。方法 回顾性分析该院 2015 年1 月-2016 年12 月常规内镜检查发现的17 例LST 病例，首先行染色放大内镜检查，并进行pit pattern 分型，对所有LST 均采用内镜黏膜下剥离术（ESD）或外科手术治疗，术后病理回顾分析。结果 17 例病例 中15 例行ESD，2 例行外科手术，均治疗成功，无穿孔、出血等并发症。术后3 个月～ 2 年内镜复查无复发。 结论 术前的pit pattern 分型能为治疗方式提供依据；ESD 治疗结直肠LST 疗效好，复发率低，安全性较好。

Abstract:

Objective To investigate the relationship between the morphological features, pit pattern classification and pathological types of colorectal laterally spreading tumor (LST). To provide a basis for the selection of treatment modalities, and to explore the value of endoscopic treatment. Methods Retrospective analysis of 17 cases of LST from January 2015 to December 2016 detected by conventional endoscopy. 17 cases of LST first underwent dyeing magnifying endoscopy and pit pattern typing. Endoscopic submucosal dissection (ESD) or surgical treatment was performed in all patients with LST. Postoperative pathologic findings were analyzed retrospectively. Results Of the 17 cases, ESD was performed in 15 patients, and other 2 patients underwent surgical treatment. All of the 17 cases were treated successfully without complications such as bleeding or perforation. No recurrence was found under endoscopy in the 3-month to 2-year postoperative review. Conclusion The preoperative pit pattern classification can provide the basis for treatment. ESD has good curative effect, low recurrence rate and good safety in the treatment of colorectal LST.