Volume 19 Issue 7
Jul.  2021
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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
shu

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
  •   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.

     

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