Endoskopska mukozna resekcija ravnih i sesilnih kolorektalnih adenoma: naše iskustvo sa dugotrajnim praćenjem

  • Saša Grgov Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
  • Predrag Dugalić Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ratko Tomašević Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Tomislav Tasić Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
DOI: https://doi.org/10.2298/1864
Ključne reči: adenoma||, ||adenom, colorectal neoplasms||, ||kolorektalne neoplazme, endoscopy, digestive system||, ||endoskopija, gastrointestinalna, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod/Cilj. Endoskopska mukozna resekcija (EMR) ili mukozektomija je  metoda uklanjanja ravnih i sesilnih lezija, tumora sa lateralnim širenjem i karcinoma kolona i rektuma ograničenih na mukozu i površni nivo submukoze. Cilj rada bio je da se izvrši procena efikasnosti i bezbednosti EMR u uklanjanju ravnih i sesilnih adenoma kolona i rektuma. Metode. Tokom perioda od 8 godina prospektivnom studijom obuhvaćeno je 140 bolesnika kod kojih je tehnikom „ubrizgaj i seci sa omčom“ metode EMR uklonjeno 187 kolorektalnih adenoma. Rezultati. Prosečna veličina mukozektomiranih adenoma iznosila je 13,6 mm (od 8 mm do 60 mm). Ukupno je bilo 48 ravnih (25,7%) i 139 sesilnih adenoma (74,3%) (p < 0,01). „En bloc” resekcijom uklonjeno je 173 (92,5%) kolorektalnih adenoma, dok je resekcijom deo po deo uklonjeno 14 (7,5%) adenoma. Kod svih bolesnika postignuto je potpuno uklanjanje kolorektalnih adenoma. Kod dva (1.4%) bolesnika uklonjen je po jedan adenom sa intramukoznim karcinomom. U prosečnom periodu praćenja od 21,2 ± 17,8 meseci, kod dva bolesnika (1,4%) je nakon EMR došlo do recidiva adenoma. Od komplikacija, krvarenje nakon EMR bilo je kod jednog bolesnika sa velikim adenomom rektuma (0,7%). Takođe, kod jednog (0.7%) bolesnika, nakon EMR adenoma cekuma došlo je do nastanka postkoagulacionog sindroma. Zaključak. Mukozektomija je efikasna, bezbedna i minimalno invazivna metoda uklanjanja ravnih i sesilnih adenoma kolona i rektuma, sa vrlo niskim procentom recidiva adenoma tokom dugotrajnog perioda praćenja.

Biografije autora

Saša Grgov, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
Sef odeljenja za gastroenterologiju i hepatologiju
Predrag Dugalić, Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Chiefe of Department of gastroenterology KBC Zemun, Clinical hospital of School of medicine University of Belgrade
Ratko Tomašević, Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
KBC Zemun, Department of gastroeterology, Clinical hospital of School of medicine University of Belgrade
Tomislav Tasić, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
General hospital Leskovac, Department of Gastroenterology and hepatology

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Objavljeno
2015/04/21
Broj časopisa
Vol. 71 Br. 1 (2014)
Rubrika
Originalni članak