关键词: 直肠较大腺瘤, 传统手术； 内镜黏膜下剥离术, 术式

Abstract: Objective To explore the titer ratio of local resection through anus and endoscopic submucosal dissection(ESD) for the treatment of large adenoma of lower rectum,so as to provide a reference for the rational choice of operation.
Methods From November 2012 to November 2019,96 patients with large low rectal adenoma were divided into two groups according to two surgical methods,48 cases in the observation group were treated with traditional transanal local resection,and 48 cases in the control group were treated with endoscopic submucosal dissection(ESD).The operation efficacy,anal pain,hospitalization expenses and consumables ratio of the two groups were compared.
Results There was no significant difference between the two groups in complete resection rate,whole block resection rate,postoperative complication rate and local recurrence rate(P>0.05).The VAS scores of postoperative anal pain at 2h, 8h and 12h in the local anal resection group were higher than those in the ESD group, and the difference was statistically significant(P<0.05);the cost of hospitalization and the ratio of consumables in the local anal resection group were significantly lower than that in the ESD group(P<0.05).
Conclusion In the treatment of low rectal adenoma,the best operation should be selected according to the patient's condition,the level of hospital medical technology and the patient's economic situation.
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Key words: large rectal adenoma, traditional surgery, endoscopic submucosal dissection, operation method