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[目的]探讨超声内镜(EUS)结合内镜黏膜下剥离术(ESD)治疗直肠类癌的效果及价值。[方法]对EUS检查发现来源于黏膜下层、无固有肌层受累、无淋巴结转移、直径≤1.5cm、考虑为直肠类癌的21例直肠黏膜隆起病灶行ESD治疗。ESD后6个月、12个月及24个月行EUS随访。[结果]21例均成功完成ESD,瘤体完整剥离,基底及边缘无残留;术中均无穿孔,术后创面少量出血5例,经内科治疗后痊愈;术后病检确诊为类癌,随访6~24个月,无一例病变残留和复发。[结论]EUS结合ESD治疗直径≤1.5cm、未侵犯固有肌层的直肠类癌安全有效,可避免不必要的外科手术。
[Objective] To investigate the effect and value of endoscopic submucosal dissection (EUS) combined with endoscopic submucosal dissection (ESD) in the treatment of rectal carcinoids. [Methods] 21 cases of rectal mucosal uplift lesions considered as rectal carcinoid tumors were treated with ESD in EUS examination, which originated from the submucosa, had no muscularis propria, no lymph node metastasis, and diameter ≤1.5cm. EUS follow-up was performed 6 months, 12 months and 24 months after ESD. [Results] All 21 cases were successfully completed ESD, the tumor completely stripped, no residual basal and margin; no perforation during surgery, 5 cases of postoperative wound bleeding, cured after medical treatment; postoperative pathological diagnosis of carcinoid, All patients were followed up for 6-24 months without any residual disease and recurrence. [Conclusion] EUS combined with ESD is safe and effective in the treatment of rectal carcinoid tumors less than 1.5cm in diameter and noninvasive muscularis propria, which can avoid unnecessary surgery.