内镜下黏膜切除术治疗早期食管癌及癌前病变  

Clinical observation of endoscopic mucosal resection treating early esophageal cancer and precancerous

作　　者：梁玮[1] 钟世顺[1] 邓万银[1] 王丽珍[1] 高丽影[1] 张咩仔[1] 何利平[1] 李伟华[2] 

机构地区：[1]福建医科大学省立临床医学院内镜中心,福州350001 [2]福建医科大学省立临床医学院肿瘤外科,福州350001

出　　处：《中华实验外科杂志》2012年第8期1616-1618,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨内镜下黏膜切除术（EMR）治疗早期食管癌及癌前病变的临床价值。方法分析2006年1月至2012年2月福建省立医院消化内镜中心90例行食管EMR治疗早期食管癌及癌前病变的临床资料，评价EMR手术的安全性及疗效。结果90例中食管上段（距门齿15—23cm）病变16例，食管中段病变（距门齿23～32cm）52例，食管下段病变（距门齿32～40cm）22例；病灶平均直径为（2．05±3．12）cm。所有病变均顺利完成EMR。切除标本大小为（3．55±2．71）CITI。手术时间为（18—125）min，出血量为（10-70）ml，病灶整块切除率为24．4％（22／90）。术中出血4例（4．4％），术后迟发性出血2例（2．2％），无1例食管穿孑L发生；术后食管狭窄3例（3．3％），均予保守治疗好转。90例均接受随访，随访时间（4～60）个月，术后5年内病变复发5例，总复发率为5．6％（5／90），无癌复发死亡病例。结论EMR治疗早期食管癌及癌前病变具有安全性和有效性。Objective To assess the clinical value of endoscopic mucosal resection （EMR） trea- ting early esophageal cancer or precancerous lesions. Methods Ninety cases of early esophageal cancer and precancerous lesions were treated with EMR from Jan. 2006 to Feb. 2012 in Digestive Endoscopy Cen- tre, Fujian Provincial Hospital. The data were analyzed retrospectively. Results Of 90 cases, the lesions were were located in the upper esophagus （ 15-23 cm from incisor） in 16 cases, in the middle esophagus （23-32 cm from incisor） in 52, and in the lower esophagus （32-40 cm from incisor） in 22 cases. Mean diameter of the lesions was （2.05 ±3. 12） era. All cases received EMR successfully. Mean diameter of the reseeted specimens was （3.55 ±2. 71 ） cm. The median operating time was （18-125） rain, median blood loss was （10-70） ml, and En-bloe resection rate was 24.4% （22/90）. The main complications of EMR included bleeding during the operation in 4 cases （4.4%） , delayed bleeding in 2 cases （2.2%） , and esophagustenosis in 3 cases （3.3%）. There was no esophageal perforation. All were treated successfully with conservative treatment. Ninety cases were followed up with a mean period of （4-60） months. Local re- currence was detected in 5 cases （5.6%）, and there was no death due to recurrence. Conclusion EMR was an effective, safe, and minimal invasive treatment for the early esophageal cancer and precancerous lesions.

关 键 词：内镜下黏膜切除术 食管癌 癌前病变 

分 类 号：R735.1[医药卫生—肿瘤]