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目的 评价内镜粘膜切除术治疗消化道浅表肿瘤病变的效果 ,并对其适应症、并发症和操作方法等问题进行讨论。方法 选择符合内镜粘膜切除术适应症的 92例患者 ,应用辅助吸引帽切除术和 /或注射高渗肾上腺素盐水圈套切除术 ,切除了1 0 1处病变。对手术发生的并发症进行观察和处理 ,以及手术前后病理诊断进行对照研究 ,并随访了部分患者的无癌生存率。结果 92例患者 ,EMR切除病变 1 0 1处 ,完全切除率达 89%。术后病理诊断腺癌 1 6例 ,类癌 3例 ,重度异型增生 1 3例 ,低度异型增生 3例 ,腺瘤 4 7例 ,其他良性病变 1 9例。并发症主要是出血 ,2 2例占 2 1 .8% ,均经处理而痊愈 ,无 1例发生穿孔等严重并发症。腺癌完全切除患者无癌生存时间平均 2 7个月。结论 内镜粘膜切除术是治疗早期胃肠道癌和癌前病变的微创介入治疗方法 ,对大多数患者能达到完全切除 ,其效果好、易操作、较安全 ,值得临床推广和深入研究
Objective To evaluate the efficacy of endoscopic mucosal resection in the treatment of gastrointestinal superficial lesions and to discuss its indications, complications and operation methods. Methods Ninety-two patients who were eligible for endoscopic mucosal resection were treated with salpingectomy and / or hypertonic epinephrine salvage. One hundred and one lesions were removed. The complication of surgery was observed and treated, as well as the control study of pathological diagnosis before and after surgery, and some patients were followed up for cancer-free survival. Results 92 patients, EMR excision lesion 1 0 1, the complete resection rate of 89%. Postoperative pathological diagnosis of adenocarcinoma in 16 cases, carcinoid in 3 cases, severe dysplasia in 13 cases, 3 cases of low dysplasia, adenoma 47 cases, other benign lesions in 19 cases. Complications were mainly bleeding, 2 2 cases accounted for 21.8%, were treated and healed, no one case of serious complications such as perforation. Complete resection of adenocarcinoma patients with cancer-free survival time of an average of 2 7 months. Conclusions Endoscopic mucosal resection is a minimally invasive interventional treatment for early gastrointestinal cancer and precancerous lesions. It can achieve complete resection in most patients, and its effect is good, easy to operate, safer, worthy of clinical promotion and further study