摘要
目的:探究经内镜黏膜下剥离术(ESD)治疗的早期结直肠癌患者非治愈性切除的高危因素.方法:回顾性分析2021年1月—2024年1月苏州市第九人民医院收治的102例早期结直肠癌患者的临床资料.根据是否为非治愈性切除将患者分为发生组(n=29)与未发生组(n=73),收集两组年龄、性别、肿瘤形态、肿瘤直径、肿瘤位置、病理类型、浸润深度、术中出血量、术中穿孔、瘢痕部位病变情况.开展logistic回归分析,获得影响经ESD治疗的早期结直肠癌患者非治愈性切除的高危因素.结果:102例患者中有29例为非治愈性切除,发生率为28.43％.两组肿瘤形态、肿瘤直径、浸润深度、术中出血量、术中穿孔、瘢痕部位病变比较,差异均有统计学意义(P<0.05).多因素分析显示,溃疡型[OR=4.831,95％CI(1.908,12.230)]、肿瘤直径≥40 mm[OR=3.648,95％CI(1.475,9.023)]、浸润黏膜下层[OR=4.130,95％CI(1.661,10.273)]、术中出血量≥10 mL[OR=4.336,95％CI(1.775,10.768)]、术中穿孔[OR=7.762,95％CI(2.161,27.881)]、瘢痕部位病变[OR=2.852,95％CI(1.157,7.029)]为非治愈性切除的高危因素(P<0.05).结论:早期结直肠癌患者经ESD治疗后的非治愈性切除与肿瘤形态、肿瘤直径、浸润深度、术中出血量、术中穿孔、瘢痕部位病变关系密切.
Abstract
Objective:To explore the high risk factors of non-curative resection in patients with early colorectal cancer treated with endoscopic submucosal dissection (ESD).Method:The clinical data of 102 patients with early colorectal cancer admitted to Suzhou Ninth People's Hospital from January 2021 to January 2024 were retrospectively analyzed.Patients were divided into occurrence group (n=29) and non-occurrence group (n=73) according to whether non-curative resection was performed.Age,gender,tumor morphology,tumor diameter,tumor location,pathological type,infiltration depth,intraoperative bleeding volume,intraoperative perforation and scar lesions of the two groups were collected.logistic regression analysis was performed to determine the high risk factors for non-curative resection in early patients with early colorectal cancer treated with ESD.Result:Among 102 patients,29 were non-curative resection,the incidence rate of 28.43％.There were significant differences in tumor morphology,tumor diameter,infiltration depth,intraoperative bleeding volume,intraoperative perforation and scar lesions between the two groups (P<0.05).Multivariate analysis showed that ulcerative[OR=4.831,95％CI (1.908,12.230)],tumor diameter ≥40 mm[OR=3.648,95％CI (1.475,9.023)],infiltration of submucosa[OR=4.130,95％CI (1.661,10.273)],intraoperative bleeding volume ≥10 mL[OR=4.336,95％CI (1.775,10.768)],intraoperative perforation[OR=7.762,95％CI (2.161,27.881)],scar lesions[OR=2.852,95％CI (1.157,7.029)]were high risk factors for non-curable resection (P<0.05).Conclusion:Non-curative resection of early colorectal cancer patients after ESD treatment is closely related to tumor morphology,tumor diameter,infiltration depth,intraoperative bleeding volume,intraoperative perforation and scar lesions.
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