使用内镜粘膜切除和跨门内镜显微手术切除大直肠多的一个分阶段方法:一个案例报告
Bhavna A Guduguntla1, Jared Yee2, Paul E Wise2
1Department of Medicine, Barnes-Jewish Hospital/Washington University in St. Louis, 660 S. Euclid Ave., MSC 8066-22-6602, St. Louis, MO 63110, United States.
Journal of surgical case reports
|February 20, 2025
概括
通过两阶段内镜和透过门的外科手术方法成功切除了一个大直肠多. 这种微创的,器官保存的方法可以避免为患有管状腺瘤的患者进行分泌切除术.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 大型直肠腺瘤多体构成手术挑战,通常需要广泛的手术.
- 在技术上可行的情况下,对于直肠息肉来说,器官储存干预措施是首选的.
研究的目的:
- 介绍一个成功分阶段切除大直肠多胞体的案例.
- 为了突出针对大直肠腺瘤的最少侵入性,器官保存方法.
主要方法:
- 一个60毫米的直肠管状腺瘤被分阶段治疗.
- 最初的切除涉及内镜粘膜切除 (EMR).
- 随后的切除使用过内显微手术 (TEMS) 来切除残留组织.
主要成果:
- 在EMR手术中,大直肠多胞体的70%被切除.
- TEMS成功切割了剩余的中央部分.
- 病理学证实了带有负边缘的管状腺瘤.
- 六个月的随访显示完全治愈,没有复发.
结论:
- 一个分阶段的EMR和TEMS方法对于大型直肠多瘤是有效的.
- 这种最少的侵入性策略允许器官保存.
- 大直肠腺瘤的成功切除可以在不进行前切除术的情况下实现.
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