Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor

HU Hong-na; ZHANG Li-jiu; SONG Sha-sha

doi:10.16766/j.cnki.issn.1674-4152.001995

Volume 19 Issue 7

Jul. 2021

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Chinese Journal of General Practice > 2021 > 19(7): 1103-1106, 1195

HU Hong-na, ZHANG Li-jiu, SONG Sha-sha. Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor[J]. Chinese Journal of General Practice, 2021, 19(7): 1103-1106, 1195. doi: 10.16766/j.cnki.issn.1674-4152.001995

Citation:

HU Hong-na, ZHANG Li-jiu, SONG Sha-sha. Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor[J]. Chinese Journal of General Practice, 2021, 19(7): 1103-1106, 1195. doi: 10.16766/j.cnki.issn.1674-4152.001995

Citation:

PDF( 1538 KB)

Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor

doi: 10.16766/j.cnki.issn.1674-4152.001995

1.
Department of Gastroenterology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China

Funds:

1708085QH192

Received Date: 2020-11-18
Available Online: 2022-02-16

Abstract

Abstract

Objective To study the endoscopic pathological features and endoscopic treatment method of laterally spreading tumor (LST). Methods The clinic pathological data of 48 LST patients diagnosed and treated with endoscopy in the Second Affiliated Hospital of Anhui Medical University from January 2014 to December 2019 were retrospectively analyzed. According to the lesion site, the patients were divided into the rectal group (27 cases) and the colon group (21 cases), and their diameters, lesion subtypes and postoperative pathological Results were recorded respectively. Twenty-seven cases underwent endoscopic mucosal dissection (ESD), 19 cases underwent endoscopic mucosal resection (EMR/EPMR), and 2 cases underwent expected mucosal resection (pre-cut-off EMR). The residual rate, bleeding rate, perforation rate and recurrence rate of endoscopic treatment were observed. Results There was no significant difference in age and gender between the two groups (all P > 0.05). In the rectal group, the diameter of the lesions was (3.27±1.29) cm, and the nodules were mainly of mixed type, while in the colon group the diameter was (2.61±0.78) cm, and the main particles were all of the homogeneous type, with statistically significant differences (all P < 0.05). Compared with the colon group, the proportion of high-grade intraepithelial neoplasia and cancerization in the rectal group was significantly increased (P < 0.05). Rectal LST was mainly treated with ESD (74.1%), while colon LST was mainly treated with EMR/EPMR (61.9%). One case of colon LST was unable to receive effective complete resection with ESD due to excessive length of lesion length, and was transferred to surgical operation. The remaining 47 cases were all completely removed. Postoperative hemorrhage in 1 case (2.1%) was improved by endoscopic hemostasis therapy again. One patient recurred 4 years after operation and underwent complete endoscopic resection again. None of the patients in this group had residual or perforation complications. Conclusion Rectal LST lesions have a large range, mainly nodular mixed type, with relatively high malignant potential, mainly ESD therapy. Colonic LST is commonly treated with granular homogeneous type, and EMR/EPMR treatment is more common. Pre-cut-EMR treatment may be considered in some cases.
- Laterally spreading tumor,
- The endoscopic pathological features,
- Endoscopic diagnosis and treatment techniques

FullText(HTML)

References(20)

References

[1]	冯轶, 牛应林, 李鹏, 等. 结直肠侧向发育型肿瘤的内镜表现及病理特点研究[J]. 中国内镜杂志, 2019, 25(1): 79-84. doi: 10.3969/j.issn.1007-1989.2019.01.016
[2]	高志强, 张学松, 宋毓飞, 等. 结直肠侧向发育型肿瘤的诊治分析(附17例报告)[J]. 中国内镜杂志, 2017, 23(9): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201709020.htm
[3]	徐威, 姚平, 胡学军, 等. 内镜黏膜下剥离术治疗直肠侧向发育型肿瘤的疗效分析[J]. 中国临床医学, 2015, 22(3): 356-359. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX201503024.htm
[4]	张菊嫦, 王学青, 李爱民, 等. 结直肠侧向发育型肿瘤的临床病理特征和治疗方法的发展趋势分析[J]. 中华消化杂志, 2017, 37(2): 88-93. doi: 10.3760/cma.j.issn.0254-1432.2017.02.004
[5]	OKA S, TANAKA S, SAITO Y, et al. Local recurrence after endoscopic resection for large colorectal neoplasia: A multicenter prospective study in Japan[J]. Am J Gastroenterol, 2015, 110(5): 697-707. doi: 10.1038/ajg.2015.96
[6]	林良兜, 卢杰夫, 李超芹. 大肠侧向发育型肿瘤的诊断与内镜治疗进展[J]. 微创医学, 2016, 11(3): 356-359. https://www.cnki.com.cn/Article/CJFDTOTAL-WCYX201603018.htm
[7]	王华秀, 练晶晶, 陈世耀, 等. 内镜黏膜下剥离术治疗巨大结直肠侧向发育型肿瘤的临床研究[J]. 中国内镜杂志, 2017, 23(7): 80-84. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201707017.htm
[8]	曾玉婷, 孙克文, 陈建平, 等. 内镜治疗结直肠侧向发育型肿瘤64例临床观察[J]. 国际消化病杂志, 2017, 37(3): 198-200. doi: 10.3969/j.issn.1673-534X.2017.03.017
[9]	贾婷婷, 夏满奎, 郭慧敏, 等. 内镜黏膜下剥离术治疗巨大直肠侧向发育型肿瘤的临床研究[J]. 中华消化内镜杂志, 2018, 35(7): 510-513. doi: 10.3760/cma.j.issn.1007-5232.2018.07.012
[10]	JEON H H, LEE H S, YOUN Y H, et al. Learning curve analysis of colorectal endoscopic submucosal dissection(ESD) for laterally spreading tumors by endoscopists experienced in gastric ESD[J]. Surg Endosc, 2016, 30(6): 2422-2430. doi: 10.1007/s00464-015-4493-2
[11]	徐玫丽, 吴杰, 汪春莲, 等. 直肠和结肠来源的侧向发育型肿瘤的临床病理特征的差异[J]. 中南大学学报(医学版), 2018, 43(2): 192-197. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYD201802018.htm
[12]	SHIGITA K, OKA S, TANAKA S, et al. Clinical significance and validity of the subclassification for colorectal laterally spreading tumor granular type[J]. J Gastroenterol Hepatol, 2016, 31(5): 973-979. doi: 10.1111/jgh.13238
[13]	中华医学会消化内镜学分会. 中国早期结直肠癌筛查及内镜诊治指南(2014, 北京)[J]. 中华医学杂志, 2015, 95(28): 2235-2252. doi: 10.3760/cma.j.issn.0376-2491.2015.28.002
[14]	BAE J H, YANG D H, LEE J Y, et al. Clinical outcomes of endoscopic submucosal dissection for large colorectal neoplasms: A comparison of protruding and laterally spreading tumors[J]. Surg Endosc, 2016, 30(4): 1619-1628. doi: 10.1007/s00464-015-4392-6
[15]	BRIEDIGKEIT A, SULTANIE O, SIDO B, et al. Endoscopic mucosal resection of colorectal adenomas>20 mm: Risk factors for recurrence[J]. World J Gastrointest Endosc, 2016, 8(5): 276-281. doi: 10.4253/wjge.v8.i5.276
[16]	NISHIZAWA T, YAHAGI N. Endoscopic mucosal resection and endoscopic submucosal dissection: Technique and new directions[J]. Curr Opin Gastroenterol, 2017, 33(5): 315-319. doi: 10.1097/MOG.0000000000000388
[17]	廖斐, 刘玉兰, 沈磊, 等. 内镜黏膜下剥离术治疗直径大于20 mm的结直肠侧向发育型肿瘤的临床研究[J]. 临床内科杂志, 2016, 33(4): 239-242. doi: 10.3969/j.issn.1001-9057.2016.04.005
[18]	ACQUISTAPACE F, MATERNINI F, SNIDER L, et al. Endoscopic treatment of superficial colorectal neoplasms. Retrospective analysis of a single center technique and results[J]. G Chir, 2015, 36(6): 247-250. http://www.giornalechirurgia.it/common/php/portiere.php?ID=79a764ef59ea9187db81a3ec6324c854
[19]	AREZZO A, PASSERA R, MARCHESE N, et al. Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions[J]. United European Gastroenterol J, 2016, 4(1): 18-29. doi: 10.1177/2050640615585470
[20]	金燕, 龚镭, 唐学军, 等. 预切开内镜黏膜切除术诊治结肠侧向发育型肿瘤的临床疗效评价[J]. 中国内镜杂志, 2016, 22(8): 94-98. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201608023.htm

Relative Articles

[1]	CHEN Chaobo, QIAN Shu, ZHAO Jingwei, HENG Wei, QIAN Jixian, ZHOU Chengpei. Advances in endoscopic translaminar approach for lumbar interbody fusion[J]. Chinese Journal of General Practice, 2024, 22(11): 1924-1928. doi: 10.16766/j.cnki.issn.1674-4152.003766
[2]	WANG Changyang, CI Jun, GUAN Hua. Predictive value of eustachian tube function for endoscopic intra tympanic injection in patients with sudden sensorineural deafness[J]. Chinese Journal of General Practice, 2023, 21(8): 1322-1325. doi: 10.16766/j.cnki.issn.1674-4152.003113
[3]	JIANG Zhen, ZHENG Yufeng, LIU Xiaomin, ZHANG Lamei. Endoscopic mucosal resection and submucosal dissection for clinical treatment of non-ampullary duodenal lesions[J]. Chinese Journal of General Practice, 2023, 21(5): 769-772. doi: 10.16766/j.cnki.issn.1674-4152.002979
[4]	YIN Kaihong, CHENG Yinmeng, ZHANG Tao, KE Xiquan, XU Feng, ZHAO Changdong. Clinical study of endoscopic rubber ring ligation combined with foam sclerosing agent injection in the treatment of internal hemorrhoids of grade Ⅱ to Ⅲ mixed hemorrhoids[J]. Chinese Journal of General Practice, 2023, 21(12): 2027-2030. doi: 10.16766/j.cnki.issn.1674-4152.003282
[5]	HAN Kang, TAN Shusen, ZHANG Zheng, ZHANG Hongxia, MI Na, SONG Ruoxian. Clinical analysis of targeted broken ligamentum flavum method of unilateral biportal endoscopy in the treatment of lumbar spinal stenosis[J]. Chinese Journal of General Practice, 2023, 21(4): 560-564. doi: 10.16766/j.cnki.issn.1674-4152.002930
[6]	WU Yanyan, KE Xiquan, MA Zhenzeng, DENG Min, WANG Meng. Analysis of the efficacy of endoscopic submucosal dissection for early gastric cancer and precancerous lesions[J]. Chinese Journal of General Practice, 2023, 21(10): 1657-1660. doi: 10.16766/j.cnki.issn.1674-4152.003193
[7]	WANG Jinhang, GUO Yuanyuan, SUN Wei, GAO Wuyue, LIU Jianmin, LIU Beibei. Effect analysis of laparoscopic partial nephrectomy combined with modified renal artery perfusion in the treatment of complex renal tumors[J]. Chinese Journal of General Practice, 2023, 21(9): 1461-1465. doi: 10.16766/j.cnki.issn.1674-4152.003146
[8]	LI Meng-yi, GONG Bei-lei, LI Wei, SHEN Yuan-bing, WU Jing, XU Yuan-yuan, ZHANG Ya-ting, CHEN Yu-qing. Treatment of severe benign central airway stenosis with laser under bronchoscope[J]. Chinese Journal of General Practice, 2022, 20(6): 923-926. doi: 10.16766/j.cnki.issn.1674-4152.002488
[9]	ZHA Zheng-wei, GAN Hui-zhong, PENG Qiong, KONG De-run. Diagnostic value of endoscopic ultrasonography for submucosal tumors of digestive tract[J]. Chinese Journal of General Practice, 2022, 20(2): 290-293. doi: 10.16766/j.cnki.issn.1674-4152.002335
[10]	DING Zhao-ran, JIANG Cheng-yi, WANG Wei, QIANG Hua-long, CHENG Zhong-qiang, ZHAN Xiao-dong. Analysis of clinical efficacy of tympanic membrane repair surgery under otoscope under wet ear stage[J]. Chinese Journal of General Practice, 2021, 19(2): 212-216. doi: 10.16766/j.cnki.issn.1674-4152.001770
[11]	CHENG Jian-an, XI Qing-ming, TONG Bu-sheng. The clinical value of Eustachian tube exploration in tympanoplasty under otoendoscopy[J]. Chinese Journal of General Practice, 2021, 19(3): 365-367,378. doi: 10.16766/j.cnki.issn.1674-4152.001811
[12]	YANG Zhao-yun, ZHANG Wei-ping, KONG De-run. Nursing exploration of patients with esophageal and gastric varices treated by endoscopy[J]. Chinese Journal of General Practice, 2020, 18(10): 1766-1769. doi: 10.16766/j.cnki.issn.1674-4152.001614
[13]	CHEN Yan, WANG Wen-zhong, MA Shi-yin. The clinical analysis of the treatment of refractory nasal hemorrhage by bipolar electrocoagulation under nasal endoscope[J]. Chinese Journal of General Practice, 2018, 16(8): 1286-1289. doi: 10.16766/j.cnki.issn.1674-4152.000353
[14]	HUANG Jun, ZHENG Hai-lun, WANG Qi-zhi, WANG Qiang-wu, WANG Jian-chao, DENG Min. Clinical analysis of endoscopic treatment of 291 cases of submucosal tumors in digestive tract by miniprobe endoscopic ultrasonography[J]. Chinese Journal of General Practice, 2017, 15(12): 2038-2041. doi: 10.16766/j.cnki.issn.1674-4152.2017.12.010
[15]	ZHAO Fu-guang, ZHOU Juan-di, CHEN Jie, SHI Yi-jun, CAI Yuan-jie, XIE Shang-nao. Clinicopathological characteristics of primary malignant neoplasms of the appendix[J]. Chinese Journal of General Practice, 2017, 15(4): 593-596. doi: 10.16766/j.cnki.issn.1674-4152.2017.04.015
[17]	HE Xiaoyong. Clinical effects of less invasive stabilization systems assisted with arthroscopy for tibial plateau fracture[J]. Chinese Journal of General Practice, 2017, 15(7): 1169-1171. doi: 10.16766/j.cnki.issn.1674-4152.2017.07.023
[18]	CHEN Wei, HUANG Hui-feng, XIA Tai-jun, XU Yong-fei, CAO Chun-yu, MEI Li-hong. Retrospective analysis of 62 cases of early precancerous lesions by diagnostic and therapeutic gastrointestinal endoscopies[J]. Chinese Journal of General Practice, 2017, 15(11): 1888-1890. doi: 10.16766/j.cnki.issn.1674-4152.2017.11.020
[19]	TONG Min-feng, LIU Ji-hong, ZHANG Wei, YUAN Jian-lie. Therapeutic analysis of neuroendoscopic transcortical fenestration of septum pellucidum in treatment of intraventricular hemorrhage[J]. Chinese Journal of General Practice, 2016, 14(3): 362-364. doi: 10.16766/j.cnki.issn.1674-4152.2016.03.007
[20]	ZHOU Lei, ZHANG Xu, CAO Hai-long. Placement of endoscopic spiral nasal jejunal nutrition tube in patients with acute pancreatitis[J]. Chinese Journal of General Practice, 2016, 14(8): 1305-1307. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.019

Supplements(0)

Cited By

Cited by

Periodical cited type(2)

1.	沈璐，叶小峰，王晶，潘丹烨. SMSA评分对结肠侧向发育型肿瘤内镜黏膜下剥离术术后相关并发症的预测价值研究. 海军医学杂志. 2023(03): 260-264 .
2.	马鸣扬，王洁玮，李鹏. 细胞内镜评估结直肠病变的研究进展. 首都医科大学学报. 2022(02): 221-226 .

Other cited types(0)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2) / Tables(1)

Get Citation

PDF

XML

Article Metrics

Article views (273) PDF downloads(2)

Clinical study on endoscopic diagnosis and treatment of laterally spreading tumor

doi: 10.16766/j.cnki.issn.1674-4152.001995