[1]彭贵勇,武育卫,龙庆林,等.内镜黏膜下剥离术治疗食管肿瘤的临床价值[J].第三军医大学学报,2009,31(16):1527-1529.
 PENG Gui-yong,WU Yu-wei,LONG Qing-lin,et al.Clinical value of endoscopic submucosal dissection for esophageal tumors[J].J Third Mil Med Univ,2009,31(16):1527-1529.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
31卷
期数:
2009年第16期
页码:
1527-1529
栏目:
专题报道
出版日期:
2009-08-30

文章信息/Info

Title:
Clinical value of endoscopic submucosal dissection for esophageal tumors
作者:
彭贵勇武育卫龙庆林陈磊赵京晶周倩
第三军医大学西南医院全军消化病研究所
Author(s):
PENG Gui-yong WU Yu-wei LONG Qing-lin CHEN Lei ZHAO Jing-jing ZHOU Qian
Gastroenterology Research Institute, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
关键词:
食管早期癌黏膜下肿瘤内镜黏膜下剥离术
Keywords:
esophagus early cancer submucosal tumor endoscopic submucosal dissection
分类号:
R730.56;R735.1;R768.3
文献标志码:
A
摘要:
目的   探讨内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)在食管肿瘤治疗中的价值。   方法   利用染色内镜及超声内镜探测病变范围及侵犯深度,对位于黏膜层及黏膜肌层的早期癌、癌前病变、黏膜下肿瘤等病变行ESD治疗。于病灶边缘2 mm处用氩气刀标记切除范围,于病灶及周围黏膜下注射甘油果糖使病变与固有肌层相分离;沿标记线外侧切开病变周围黏膜;剥离病变下方黏膜下层组织,完整切除病变。   结果   21例病灶,最大直径均大于2 cm,病灶最大者直径5 cm。8例早期食管黏膜内癌,5例食管黏膜中、重度异型增生及8例食管平滑肌瘤经ESD一次性完全切除。ESD手术时间30~180 min,平均110 min;术中少量出血均经电凝止血;术后无迟发性出血发生;1例早期食管癌术中发生穿孔(4.76%),经内镜金属夹封闭、内科保守治疗后痊愈。术后随访1~12个月无复发。   结论   在超声内镜及色素内镜的指导下,采用内镜黏膜下剥离术治疗食管黏膜内癌、癌前病变及黏膜肌层的肿瘤,是一项安全有效的内镜治疗方法。
Abstract:
Objective   To investigate the value of endoscopic submucosal dissection (ESD) in treatment of esophageal tumors.   Methods   The properties, range and infiltrating depth of the neoplastic lesions in esophagus were detected by chromoendoscopy and endoscopic ultrasonography. The mucosal lesions including early cancers, submucosal tumors deriving from mucosa were removed by ESD: injecting fructose-glycerol fluid into the submucosa to elevate the lesion from the muscle layer, pre-cutting the surrounding mucosa of the lesion, and dissecting the connective tissue of the submucosa beneath the lesion.    Results   The diameter in all 21 lesions was larger than 2 cm, and the largest was as large as 5 cm. All the lesions, including 8 cases of early esophageal cancer, 5 cases of esophageal mucosa moderate and severe dysplasia, and 8 cases of esophageal leiomyoma, were removed by ESD radically. The time for ESD operation was 30-180 minutes (average time: 110 minutes). A small amount of intraoperative bleeding was stopped by electrocoagulation hemostasis. No delayed postoperative bleeding occurred. Perforation occurred in one patient of early esophageal cancer (4.76%), but was cured by endoscopic metal clip closure and medical conservative treatment. No recurrence was found during the follow-up for 1-12 months.   Conclusion   With the aid of chromoendoscopy and endoscopic ultrasonography, endoscopic submucosal dissection is a safe and effective endoscopic treatment method for esophageal mucosal cancers, precancerous lesions and submucosal tumors.

参考文献/References:

彭贵勇,武育卫,龙庆林,等.内镜黏膜下剥离术治疗食管肿瘤的临床价值[J]. 第三军医大学学报,2009,31(16):1527-1529.

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更新日期/Last Update: 2009-09-07