摘要
目的分析早期食管癌患者内镜黏膜下剥离术后发生食管狭窄的影响因素。方法收集90例早期食管癌行内镜黏膜下剥离术患者的病历资料,统计术后食管狭窄的发生情况,早期食管癌患者内镜黏膜下剥离术后食管狭窄发生的影响因素采用多因素Logistic回归分析。结果90例患者均顺利完成内镜黏膜下剥离术,其中15例患者术后出现食管狭窄,发生率为16.67%(15/90)。单因素分析结果显示,食管狭窄与未狭窄患者固有肌层受损情况、病变长度、病变范围、组织浸润深度、术中应用止血夹数目、临床分期、食管上皮乳头内毛细血管袢(IPCL)分型比较,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,固有肌层受损、病变长度﹥3 cm、病变范围﹥50%环周、组织浸润深度为m_(3)~sm_(2)、术中应用止血夹数目﹥5均是早期食管癌患者内镜黏膜下剥离术后发生食管狭窄的独立危险因素(P﹤0.01)。结论固有肌层受损、病变长度﹥3 cm、病变范围﹥50%环周、组织浸润深度为m_(3)~sm_(2)、术中应用止血夹数目﹥5均是早期食管癌患者内镜黏膜下剥离术后发生食管狭窄的危险因素,临床应实时监测上述因素并积极预防,从而改善早期食管癌患者的预后。
Objective To analyze the influencing factors on esophageal stenosis after endoscopic submucosal dissection in early esophageal cancer.Method A total of 90 patients with early esophageal cancer were selected who were treated with endoscopic submucosal dissection.The influencing factors of esophageal stenosis in early esophageal cancer patients after endoscopic submucosal dissection were analyzed by multivariate Logistic regression analysis.Result A total of 90 patients were successfully treated with endoscopic submucosal dissection,15 had esophageal stenosis after operation,with incidence of 16.67%(15/90).Univariate analysis showed that there were statistically significant differences in the damage of musculi propria,lesion length,lesion scope,tissue infiltration depth,number of hemostatic clips used during surgery,clinical stage,and intrapapillary capillary loop(IPCL)classification between patients with and without esophageal stenosis(P<0.05).Multivariate Logistic regression showed that damage of musculi propria,lesion length>3 cm,lesion scope>50%circumference,tissue infiltration depth of m_(3)-sm_(2) and intraoperative hemostatic clips>5 were independent risk factors for esophageal stenosis in patients with early esophageal cancer after endoscopic submucosal dissection(P<0.01).Conclusion The damage of musculi propria,lesion length>3 cm,lesion scope>50%circumference,tissue infiltration depth of m_(3)-sm_(2) and intraoperative hemostatic clips>5 are risk factors for esophageal stenosis in patients with early esophageal cancer after endoscopic submucosal dissection,which should be monitored and actively prevented to improve the prognosis of patients with early esophageal cancer.
作者
杜学芳
张利利
马尚超
张彩凤
张超群
姬娟娟
DU Xuefang;ZHANG Lili;MA Shangchao;ZHANG Caifeng;ZHANG Chaoqun;JI Juanjuan(First Ward,Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,He’nan,China;Department of Intensive Care Medicine,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,He’nan,China)
出处
《癌症进展》
2023年第24期2735-2737,2756,共4页
Oncology Progress
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210531)
2020年度新乡医学院第一附属医院青年培育基金项目(QN-2020-B03)。
关键词
早期食管癌
内镜黏膜下剥离术
食管狭窄
影响因素
early esophageal cancer
endoscopic submucosal dissection
esophageal stenosis
influencing factor
