Abstract:

Research on application of transanal tube drainage for prevention of complication in colorectal mucosal lesions after ESD        LI Bing，ZHOU Ping-hong，YAO Li-qing，et al. Endoscopy Center and Endoscopy Research Institute，Zhongshan Hospital，Fudan University，Shanghai 200032，China
Corresponding author：ZHONG Yun-shi，E-mail：zhongyunshifd@126.com
Abstract    Objective    To evaluate transanal tube for prevention of complications in colorectal mucosal lesions after endoscopic submucosal dissection (ESD). Methods    The clinical data of 61 patients with colorectal mucosal lesions undergoing ESD from January to December 2016 in Endoscopy Center，Zhongshan Hospital，Fudan University were reviewed retrospectively. The incidence rate of complications after ESD within one month was analyzed. Results    A total of 21 of all lesions were located at right-half colon, 9 at left-half colon and 31 at rectum. The mean diameter of the lesions was 3.3?2.3 (0.8-12.0) cm. There were not intraoperative complications including serious bleeding and perforation. Delayed bleeding on the eighth post-ESD day was detected in 1 (1.6%) patient who was cured by transfusion. Three (4.9%) patients suffered post-ESD electrocoagulation syndrome and perforation did not present in all patients. Conclusion    The application of transanal tube drainage in colorectal mucosal lesions after ESD is a kind of convenient and safe preventive measure with lower incidences of complications. However, surgeons should do more research to know whether transanal tube need to be placed routinely after ESD or not.

Key words: endoscopic submucosal dissection, transanal tube drainage, colorectal, mucosal lesion

摘要：

目的    探讨结直肠黏膜病变行内镜黏膜下剥离术（ESD）后留置肛管减压对于预防术后并发症发生的临床价值。方法    回顾性分析2016年1-12月复旦大学附属中山医院内镜中心行ESD治疗结直肠黏膜病变且术后放置肛管引流减压的61例病人的临床资料，观察术后1个月内并发症发生情况。结果    病变位于右半结肠21例，左半结肠9例，直肠31例。病变直径0.8～12.0（3.3±2.3）cm。ESD术中无大量出血和穿孔等并发症发生。术后1例（1.6%）病人发生迟发性出血，经输血补液对症治疗后缓解；术后3例（4.9%）病人发生电凝综合征；无术后穿孔发生。结论    结直肠黏膜病变ESD术后应用肛管减压引流是一种简单安全的术后并发症预防措施，但是否需要常规放置仍须进一步研究。

关键词: 内镜黏膜下剥离术, 肛管引流, 结直肠, 黏膜病变