内镜治疗直肠类癌的长期疗效

目的探讨内镜下治疗直肠类癌的长期疗效。方法总结分析2000年1月至2007年7月间采用内镜治疗的91例直肠类癌患者的临床资料。结果本组患者肿瘤病理结果均为典型类癌，均未突破黏膜下层，均未侵及周围淋巴结及血管。有80例（87．9％）患者获随访，随访时间6～96（32．5±24．1）个月。肿瘤直径小于1．0cm的65例患者，术后无1例复发；1．0-2．0cm的25例患者，术后有3例（12％）复发，复发时间分别为3个月、2年和6个月，其中1例再行Dixon术后3个月又出现肝脏转移（4％）：肿瘤直径大于2．0cm的1例患者术后未见复发。本组1、3、5年累计生存率分别为100％、98．0％和91．4％。结论肿瘤直径小于1cm、未侵犯肌层的直肠类癌患者内镜下治疗长期疗效较为理想。

Long-term efficacy of endoscopic excision of rectal carcinoids

OBJECTIVE: To evaluate the long-term efficacy of endoscopic excision for rectal carcinoids. METHODS: Clinical data of 91 patients with rectal carcinoids treated by endoscopic excision from 2000 to 2007 were analyzed retrospectively. RESULTS: The average size of the primary tumor was 0.8 cm(range 0.3 to 2.3 cm). All the tumors were localized within the submucosal layer showing typical histology without lymphatic or vessel infiltration. Follow-up was available for 80 patients with mean 32.5 months (range 6 to 96 months). There was no recurrence in 65 patients with tumor size < 1.0 cm. Recurrence occurred in 3 cases among 25 patients with tumor size from 1.0 to 2.0 cm, and 1 died of hepatic metastasis. The 1-, 3-, and 5-year survival rates of the patients were 100%, 98.0%, and 91.4% respectively. CONCLUSIONS: Tumor size and depth of invasion are two important prognostic factors of rectal carcinoids. Endoscopic excision is useful for rectal carcinoid patients with tumor size < 1.0 cm and located within the submucosal layer.