早期食管癌及其癌前病变食管黏膜切除术  

Minimal Invasive Treatment of Early Esophageal Cancer and its Precancerous Lesion:Endoscopic Mucosal Resecti

作　　者：张蕾[1] 郝长清[2] 赵德利[3] 周瑞雪[3] 纪鹏[3] 张晓华[1] 贺舜[1] 张月明[1] 于桂香[1] 鞠凤环[1] 程荣荣[1] 荀华英[1] 王贵齐[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院内镜科 [2]河南省林州市肿瘤医院 [3]山东省肥城市人民医院

出　　处：《中国消化内镜》2007年第1期4-6,共3页Digestive Disease and Endoscopy

摘　　要：目的探讨透明帽法食管黏膜切除术治疗早期食管癌及食管鳞状上皮重度不典型增生的意义。方法应用透明帽法对53例早期食管癌和74例食管鳞状上皮重度不典型增生行食管黏膜切除。应用氩离子凝固术(APC)治疗残留及复发病灶。术后第1、4及12个月进行内镜复查。结果(1)在内镜下应用透明帽法共对127例患者进行局部黏膜切除,共切除病灶150块。切除标本每块大小平均为(2.7±4.3)mm×(18.0±3.40)mm。(2)本组术后5例出血,其中1例动脉出血,4例渗血。应用内镜压迫、肾上腺素盐水注射及氩离子凝固术治疗均成功止血;127例无一例食管穿孔发生;术后4例发生狭窄,术后一个月应用水囊扩张,每一个月扩张一次,连续扩张3～4次,狭窄均缓解,进食无明显不适感。(3)96例(75.6%)患者的食管黏膜病变被完全切除,其余病例有不同程度的残留,应用氩离子凝固术治疗残留病变。术后4个月内镜复查,病理证实3例早期癌,2例重度不典型增生局部复发。随访时间52.2个月,无明显不适感。结论应用透明帽法食管黏膜切除术可简便、安全、有效地治愈早期食管癌及癌前病变,有较好的应用前景。Objective:To explore the effect of endoscopic esophageal mucosal resection using transparent cap-fitted endoscope to treat early esophageal cancer and severe dysplasia,precancerous lesion of esophageal cancer.Methods:Endoscopic esophageal mucosal resection were performed with transparent-cap technique on 53 cases of early esophageal cancer and 74 cases of severe hyperplasia,and the residual lesions were treated by argon plasma coagulation(APC).All patients were followed up by endoscopic examination one mont...

关 键 词：食管肿瘤 内镜下黏膜切除术 氩离子凝固术 

分 类 号：R735.1[医药卫生—肿瘤]