内镜黏膜下剥离术对早期胃癌及癌前病变治疗价值的临床研究  

Clinical research on ESD treatment early gastric cancer and pre-cancerous lesions

作　　者：郝晋雍[1,2] 黄晓俊[1,2] 王祥[1,2] 樊红[1,2] 金安琴[1,2] 王伟[1,2] 

机构地区：[1]兰州大学第二医院消化科 [2]兰州大学消化肿瘤研究所,甘肃兰州730030

出　　处：《中国内镜杂志》2012年第12期1245-1250,共6页China Journal of Endoscopy

基　　金：甘肃省自然科学研究基金项目(No.2009GS03093)

摘　　要：目的探讨内镜黏膜下剥离术(ESD)技术治疗早期胃癌及癌前病变的疗效及临床价值。方法收集2007年11月～2010年12月兰州大学第二医院消化科应用ESD术治疗47例早期胃癌及癌前病变患者。并进行随访及内镜复查。结果 ESD平均时间84.72min,剥离病变平均直径2.76cm。术中5例患者出血量较大,术中穿孔患者1例。术后迟发型出血患者1例,术后穿孔患者1例。术后病检证实早期胃癌患者34例,重度不典型增生患者7例,中度不典型增生患者6例。病理活检准确率为95.7%。随访患者中早期胃癌复发1例,外科组术后44例患者复查内镜未发现复发患者。结论 ESD是治疗早期胃癌及癌前病变的安全、有效的内镜下治疗新技术。【Objective】To evaluate the clinical value of ESD treatment for early gastric cancer and pre-cancerous lesions.【Methods】47 patients underwent endoscopic submucosal dissection (ESD) for early gastric cancer and precancerosis at Lanzhou University Second Hospital between November 2007 and December 2010 were recruited. 34 cases of early gastric cancer were followed up by regular clinic and endoscopy post endoscopic submucosal dissection. 【Results】The average operation time of ESD was 84.72 min, and the average diameter of peel lesions was 2.76cm. During the operations, 5 cases bled heavily, 1 case had gastric perforation .1 case had delayed bleeding, 1 case had postoperative perforation. Postoperative pathological confirmed 34 cases were early gastric cancer, 7 cases were severe dysplasia, and 6 cases were moderate dysplasia. The accuracy rate of biopsy was 95.7%. In follow-up period, there was 1 case found local recurrence, there was no local recurrence in surgical group.【Conclusion】ESD is a safety and effective method for early gastric cancer and pre-cancerous lesions.

关 键 词：早期胃癌 癌前病变 内镜黏膜下剥离术(ESD) 

分 类 号：R735.2[医药卫生—肿瘤]