摘要
目的:总结内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)在上消化道病变治疗中的应用体会.方法:回顾分析2012-05/2013-05在我院经ESD的52例患者资料,评价ESD在上消化道病变治疗的安全性、有效性.结果:52例患者中食管病变4例、胃部病变48例,所有病变均经病理检查表明病灶完整切除,切缘及基底部无病变残留.其中黏膜病变40例(术后病理示食管乳头状瘤2例,贲门增生性息肉9例、腺瘤3例,胃窦原位癌2例、高级别上皮内瘤变3例、低级别上皮内瘤变5例、腺瘤9例、增生性息肉5例、肠上皮化生2例);黏膜下肿瘤12例(术后病理示食管平滑肌瘤1例、食管间质瘤1例、胃间质瘤2例、胃脂肪瘤1例,胃异位胰腺7例).无并发大出血病例;术中穿孔2例,均于保守治疗后治愈.结论:以ESD方法治疗上消化道病变,不仅能完整切除病变,同时可获得完整、准确的病理资料,值得推广应用.
AIM： To discuss the clinical value of endoscopic submucosal dissection （ESD） for treating upper gastrointestinal lesions. METHODS： A total of 52 patients who underwent ESD between May 2012 and May 2013 were retrospectively analyzed to assess the feasibility, safety and efficacy of ESD for treating upper gastrointestinal lesions. RESULTS： Among 52 patients, 4 had esophageal lesions, 48 had gastric lesions. Postoperative pathology revealed that 40 were mucosal lesions, including esophageal papilloma （n = 2）,cardiac hyperplastic polyps （n = 9）, cardiac adenoma （n = 3）, early gastric cancer （n = 2）, high grade intraepithelial neoplasia （n = 3）, low grade intraepithelial neoplasia （n = 5）, gastric antral adenomatous polyps （n = 9）, hyperplastic polyps （n = 5）, and intestinal metaplasia （n = 2）; and 12 were submucosal lesions, including esophageal leiomyoma （n = 1）, esophageal gastrointesti- nal stromal tumor （n = 1）, gastric heterotopic pancreas （n = 7）, gastric body gastrointestinal stromal tumor （n = 2）, and lipoma （n = 1）. All the lesions were completely resected and were confirmed by pathologic examination. No severe bleeding occurred. Perforation occurred in two cases but was safely managed by conservative treatment. CONCLUSION： ESD is a safe, effective and recommendable treatment for upper gastrointestinal lesions. It can not only resect the lesions completely, but also provide accurate pathologic information.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第5期730-734,共5页
World Chinese Journal of Digestology
关键词
胃
食管
内镜下黏膜剥离术
Esophagus
Stomach
Endoscopic submucosal dissection
