目的

了解内镜下黏膜剥离术（ESD）治疗腔内突出型结直肠肿瘤与大肠侧向发育型肿瘤的临床效果，并分析影响ESD完整性切除率的危险因素。

方法

前瞻性选取2022年1月至2024年1月行ESD治疗的≥20mm侧向发育型结直肠肿瘤患者50例（A组），及≥20mm腔内突出型结直肠肿瘤患者50例（B组）作为研究对象。采用SPSS 25.0软件对数据进行统计学分析。计量资料以（）表示，采用独立样本t检验； 计数资料以［例（%）］表示，运用χ²检验或Fisher确切概率法进行比较；采用多因素Logistic回归分析ESD不完整切除的影响因素。P<0.05为差异具有统计学意义。

结果

两组患者的纤维化分型、ESD手术时间、整块切除率及ESD相关并发症差异无统计学意义（P>0.05）；A组患者完整切除率及治愈性切除率较B组患者高（P<0.05）；单因素结果显示，结直肠肿瘤ESD完整性切除率与患者肿瘤病变形态及纤维化分型显著相关（P<0.05）；Logistic回归分析结果显示腔内突出型肿瘤、F2型纤维化是结直肠肿瘤ESD发生非完整性切除的独立危险因素（P<0.05）。

结论

ESD治疗腔内突出型结直肠肿瘤的临床效果较好，腔内突出型肿瘤和F2型纤维化是造成结直肠肿瘤非完整性切除的危险因素。

Objective

To understand the clinical efficacy of endoscopic submucosal dissection(ESD) in the treatment of intraluminal protruding colorectal tumors and laterally spreading tumors of the large intestine, and to analyze the risk factors affecting the complete resection rate of ESD.

Methods

Prospectively,50 patients with laterally spreading colorectal tumors with a diameter of ≥ 20 mm (group A) and 50 patients with intraluminal protruding colorectal tumors with a diameter of ≥ 20 mm (group B) who underwent ESD treatment from January 2022 to January 2024 were selected as the research subjects. The SPSS 25.0 software was used for statistical analysis of the data. Measurement data were expressed as () and analyzed by independent sample t test; Enumeration data were expressed as［ cases (%)］and compared by χ² test or Fisher’s exact probability method; Multivariate Logistic regression analysis was used to analyze the influencing factors of incomplete ESD resection. P<0.05 was considered to indicate a statistically significant difference.

Results

There were no statistically significant differences in the fibrosis classification, ESD operation time, en bloc resection rate, and ESD-related complications between the two groups of patients (P>0.05); The complete resection rate and curative resection rate of patients in group A were higher than those in group B (P<0.05);The results of univariate analysis showed that the complete resection rate of ESD for colorectal tumors was significantly correlated with the morphological characteristics of the tumor lesions and the fibrosis classification of the patients (P<0.05); The results of Logistic regression analysis showed that intraluminal protruding tumors and F2-type fibrosis were independent risk factors for incomplete ESD resection of colorectal tumors (P<0.05).

Conclusion

ESD has a good clinical efficacy in the treatment of intraluminal protruding colorectal tumors.Intraluminal protruding tumors and F2-type fibrosis are risk factors for incomplete resection of colorectal tumors.