gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1986Research ArticleОБМЕН ОПЫТОМEXCHANG OF EXPERIENCEЭндоскопическая резекция слизистой оболочки при неполиповидных образованиях толстой кишкиEndoscopic resection of a mucosa at non-polypoid lesions of the large intestineАгаповМ. Ю.AgapovM. Yu.ТаранН. А.TaranN. A.РыжковЕ. Ф.RyzhkovYe. F.БарсуковА. С.BarsukovA. S.2008250820081847781Copyright © Агапов М.Ю., Таран Н.А., Рыжков Е.Ф., Барсуков А.С., 20082008Агапов М.Ю., Таран Н.А., Рыжков Е.Ф., Барсуков А.С.Agapov M.Y., Taran N.A., Ryzhkov Y.F., Barsukov A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1986

Цель исследования. Проведена ретроспективная оценка результатов эндоскопических резекций слизистой оболочки по поводу неполиповидных образований толстой кишки с учетом гистологической картины, техники удаления, осложнений и рецидивов.Материал и методы. Удалено 76 неполиповидных образований у 58 пациентов. Всем предварительно выполнена тотальная колоноскопия аппаратами EC450 HL5 («Fujinon», Япония) или CF­230I («Olympus», Япония) с подготовкой фортрансом (макрогол) компании «Ipsen» (Франция). Резекция включала следующие этапы: прицельную хромоскопию 0,5% раствором индигокармина, подслизистое введение жидкости (раствор адреналина 1:10 000) иглой NM­220L («Olympus», Япония), удаление петлей SD­16U­1 или SD­17U­1 («Olympus», Япония).Результаты. Большинство образований – 45 (59,2%) – были типа 0-­IIa, локализовались в правых отделах толстой кишки и представляли собой аденомы. Из 15 опухолей с 0­-IIс компонентом в 9 случаях выявлена дисплазия и в 3 – аденокарцинома. При отсутствии компонента 0-­IIc (61 опухоль) дисплазия наблюдалась в 14 и аденокарцинома в одном случае. Удаление единым блоком выполнено в 67 (88,2%) случаях, несколькими фрагментами – в 9 (11,8%). Все, кроме 2 опухолей, удаленных по частям, были размером более 20 мм.Выводы. Эндоскопическая резекция слизистой оболочки с патологическим образованием является безопасным и эффективным методом лечения неполиповидных неоплазий толстой кишки и методом выбора при их размерах до 20 мм. Присутствие участка 0-­IIс достоверно связано с наличием дисплазии или аденокарциномы.

Aim of investigation

Aim of investigation. Retrospective evaluation of endoscopic resection of the large intestine mucosa for non-polypoid lesions was carried out with account for histological pattern, technique of resection, complications and relapses.

Stuff and methods

Stuff and methods. 76 non-polypoid lesions in 58 patients were removed. All patients previously underwent total colonoscopy by EC450 HL5 («Fujinon», Japan) or CF-230I («Olympus», Japan) endoscopes with preparation by fortrans (macrogoal), «Ipsen» company (France). Resection included following stages: guided chromoscopy by 0,5% indigo carmine solution, submucosal injection of fluid (1:10 000 epinephrine solution) by NM-220L needle («Olympus», Japan), erasion by SD-16U-1 or SD-17U-1 loop («Olympus», Japan).

Results

Results. The majority of lesions – 45 (59,2%) were adenomas of 0-IIa type and were localized in right-sided regions of large intestine. Of 15 neoplasms with 0-IIс component in 9 cases dysplasia and in 3 – adenocarcinoma were revealed. At the absence of 0-IIc component (61 tumor) dysplasia was observed in 14 cases and adenocarcinoma – in one case. E n-block erasion was done in 67 (88,2%) cases, resection by several fragments – in 9 cases (11,8 %). All, but 2 tumors that have been removed in parts, were over 20 mm in size.

Conclusions

Conclusions. Endoscopic resection of the large intestine mucosa with pathological lesion is a safe and effective method for non-polypoid neoplasms treatment and is a method of choice for lesions less than 20 mm in size. Presence of 0-IIс focus significantly correlates to the presence of dysplasia or adenocarcinoma.

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The authors declare that there are no conflicts of interest present.