Objective: To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for large sessile colorectal polyps. Methods: ESD was performed in 15 patients with diameter>2 cm sessile colorectal polyp detected by colonoscopy from July 2010 to May 2011 in the First Affiliated Hospital of Xiamen University. We analyzed the treatment method of ESD and its clinical results. Results: All the patients underwent ESD successfully. The ESD procedure time was 85.8 ± 25.26 min, the diameter of polyp was 3.29 ± 0.75cm. In our group, there were intra-operative bleeding in 3 cases and delayed bleeding in 1 case, all of the bleedings were successfully stopped with electro-coagulation,APC or metal clips. 1 case of perforation was healed completely by the e-mergency laparoscopic surgical perforation repair. 3 cases of pathology confirmed colorectal cancer,including 2 cases of invasive cancer which was underwent radical surgery .and 1 case of mucosal carcinoma in situ was to follow-up. 13 cases were followed up after ESD, the follow-up time was 5.77 ±2.20 months, and there were no residue and recurrence. Conclusion: ESD is an effective and safe invasive method for the treatment of large sessile colorectal polyps.%目的:探讨内镜黏膜下剥离术(ESD)治疗广基的结直肠息肉的疗效和安全性.方法:总结2010年7月-2011年5月厦门大学附属第一医院结肠镜检查发现的15例直径＞2 cm广基结直肠息肉ESD治疗的方法及临床效果.结果:15例患者均顺利完成内镜粘膜下剥离术,手术时间85.8±25.26 min,息肉直径3.29±0.75 Cmo术中出血3例,1例术后出现延迟性出血,均经电凝、氩离子血浆凝固或金属夹成功止血.穿孔1例,行腹腔镜下穿孔修补术治愈.癌变3例,2例残基部见有癌细胞,追加外科行根治性手术,1例黏膜原位癌予随访.术后随访13例,随访时间5.77±2.20月,无病变残留和复发病例.结论:ESD治疗广基结直肠息肉在临床上是安全可行的.
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