摘要
Objective To explore the therapeutic effect and safety of endoscopic resection and laparoscopic surgical treatment for colorectal submucosal tumors under the guidance of ultrasound endoscopy.Methods The clinical data of 90 patients with colorectal submucosal tumors in Tengzhou Central People′s Hospital form January 2013 to January 2018 were retrospectively analyzed.Among them,60 patients underwent endoscopic resection ( hereinafter referred to as endoscopic resection group) and 30 patients underwent laparoscopic resection ( hereinafter referred to as laparoscopic resection group).The complete resection rate, average diameter of resected lesions, average operation time, average hospital stay, average intraoperative bleeding volume, incidence of complications and recurrence rate of colorectal submucosal tumors were compared between the two groups.Results The complete resection rate of endoscopic resection groups was 96.7%,The complete resection rate of laparoscopic surgical treatment groups was 96.6%,there was no statistical difference between the two groups( χ2＝0.16,P＝0.759).The average diameter of the lesion was larger in laparoscopic surgical treatment group (( 29.7 ± 5.3) mm) than that in endoscopic resection group((14.9±4.3) mm,P＝0.013).The operation time was shorter in endoscopic resection group ((32.1±6.1) min) than that in laparoscopic surgical treatment group((75.3±9.8) min,P＝0.007).There was statistically statistical difference in the intraoperative blood loss between endoscopic resection group ((13.2± 5.5) ml ) and laparoscopic surgical treatment group (( 28.3 ± 7.6) ml, P ＝ 0.009).The postoperative hospital stays was less in endoscopic resection group((3.1±1.4) d) than that in laparoscopic surgical treatment group((6.9±2.2) d,P＝0.007).The complicationgs rate in endoscopic resection group (3.33%) was significantly lower than that in laparoscopic surgical treatment group(13.3%),(χ2＝4.89,P＝0.021).The average hospitalization expenses of endoscopic resection group was significantly lower than that of the laparoscopic surgical treatment group(( 18 745± 6 281) vs(42 961± 10 423) yuan,P＝0.006) .There were no relapse and distant metastasis in two groups,followed up for 6 to 12 months.Conclusion Endoscopic resection and laparoscopic resection are both safe and effective methods for the treatment of rectal submucosal tumors.Endoscopic resection has less trauma,quicker recovery,shorter hospitalization time and lower hospitalization costs.
摘要
Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD)for colorectal SMTs. Methods In this retrospective study, 412 consecutive patients with colorectal SMTs who underwent ESD at Zhongshan Hospital of Fudan University from January 2008 to July 2014 were enrolled. Tumor histopathology,resection rate and complications were analyzed.Results Complete resection was achieved in 358(86.9%)lesions. Adverse events occurred in 13(3.2%)patients including bleeding and perforation. Multivariate analysis showed that the SMTs in the colon(OR=0.460,95%CI:0.232-0.911, P=0.014)and number of ESD procedures for colorectal SMTs(OR=0.421, 95% CI:0.211-0.837, P=0.026)were independent risk factors for non-complete resection.Moreover,SMTs in the colon(OR=0.253, 95%CI:0.067-0.957,P=0.043),tumors in the muscularis propria(OR=5.459,95%CI:1.162-25.638, P=0.032)and number of ESD procedures for colorectal SMTs(OR=0.198, 95% CI:0.058-0.674, P=0.010)were independent risk factors for adverse events. Conclusion ESD is safe and effective for resection of colorectal SMTs. Tumor location and the experience of endoscopists may influence the complete resection rate and the development of adverse events.