Clinical Study Of Endoscopic Mucosal Resection For Treatment Of Digestive Tract Neoplastic Lesions

Objective To evaluate the curative effect of endoscopic mucosal resection (EMR) in therapy of digestive tract neoplastic lesions.Methods From June 2009 to October 2010,one hundred and seventy five patients with digestive tract neoplastic lesions referred for EMR. One hundred and seventy five cases with digestive tract neoplastic lesions included four esophageal leiomyomas, one stomach leiomyoma, eight gastric stromal tumors and four gastric ectopic pancreas diagnosed by ultrasound endoscopy, seven gastric polyps, five gastric uplift type lesions, two early colorectal cancer, two colorectal LSTs(lateral spreading tumors) and one hundred and fifty-one large intestinal polyps. Intraoperative and postoperative complications and treatment were recorded, and the resection specimens were detected by pathological method.Results One hundred and seventy five patients with three hundred and six digestive tract neoplastic lesions were completely resected by EMR or EPMR(Endoscopic Piecemeal Mucosal Resection).Diameter of the lesions ranged from 0.4cm to 6cm. One hundred and seventy cases included total of two hundred and ninety-nine lesions which diameter of the lesions ranged from 0.4cm to 3cm were completely resected by EMR, five cases which diameter of the lesions ranged from 0.5cm to 2cm were completely resected by Cap-EMR.Five cases included total of seven lesions which diameter of the lesions ranged from 3cm to 6cm were completely resected by EPMR. Eighteen cases with minor bleeding were treated by using 8% norepinephrine,blood enzymes and titanium folder. One patient with delayed postendoscopic hemorrhage was treated by using endoscopic injection and titanium folder. There was no gastrointestinal perforation, narrows and localized peritonitis. sixty patients were kept endoscopic follow-up from 1 to 10 months after EMR or EPMR, the lesions which were resected by EMR were not relapsed. No dilated bowel scar stricture or other long-term complications happened. There was no gastrointestinal keloids narrow or other complications.Conclusion EMR is a safe and effective treatment for digestive tract neoplastic lesions, which may provide its complete pathological materials.