消化道类癌三种内镜治疗方法的比较  

Comparison of three endoscopic treatments for gastrointestinal carcinoid

作　　者：周巧直[1] 俞力[1] 牛应林[1] 吕富靖[1] 李鹏[1] 冀明[1] 王拥军[1] 张澍田[1] 

机构地区：[1]首都医科大学附属北京友谊医院消化内科首都医科大学消化病学系北京市消化疾病中心国家消化系统疾病临床医学研究中心,北京100050

出　　处：《中华腔镜外科杂志（电子版）》2016年第1期11-14,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的比较普通圈套器电切、内镜黏膜切除术（EMR）和内镜黏膜下剥离术（ESD）治疗消化道类癌的有效性和安全性。方法回顾性分析2006年1月至2015年6月病理符合消化道类癌患者的临床资料,比较普通圈套器电切治疗（普通圈套器电切组,12例）、内镜黏膜切除术治疗（EMR组,47例）和内镜黏膜下剥离术治疗（ESD组,39例）的组织学完全切除率、并发症,以及术后随访6-36个月观察其疗效。结果内镜治疗消化道类癌的组织学完全切除率为78.57%（77/98）。普通圈套器电切组的组织完全切除率为66.67%（8/12）,EMR组为82.98%（39/47）,ESD组为76.92%（30/39）,差异均无统计学意义（P=0.463）。仅1例ESD治疗后发生穿孔,其他患者未出现并发症。所有患者随访6-36个月,均未复发。结论内镜治疗对病变未超过黏膜下层的小的消化道类癌是一种安全有效的方法。Objective To compare the efficacy and safety of snare resection,endoscopic mucosal resection（ EMR） and endoscopic submucosal dissection（ ESD） for the treatment of gastrointestinal carcinoid.Methods We retrospectively analyzed the clinical data of 98 cases of pathologically confirmed gastrointestinal carcinoid from Jan. 2006 to Jun. 20l5. The clinical effect of snare resection（ n = 12）,EMR（ n = 47） and ESD（ n = 39） for the treatment of gastrointestinal carcinoid was compared in terms of histologically complete resection rate,complications,and endoscopy follow-up for 6-36 months. Results The rate of histologically complete resection was 78. 57%（ 77 /98）; the rate of histologically complete resection in snare resection group was 66. 67%（ 8 /12）,EMR group was 82. 98%（ 39 /47）,ESD group was76. 92%（ 30 /39）,there is no significant difference in those three groups（ P = 0. 463）. Only l case had gastrointestinal perforation after ESD and no complication occurred in other patients. A total of 98 cases were followed up for 6-36 months and no recurrence was found. Conclusions Three endoscopic treatments are useful and safe methods for treatment of small gastrointestinal carcinoid which does not cross submucosal layer.

关 键 词：类癌 消化道 内镜黏膜下剥离术 内镜黏膜切除术 圈套器电切 

分 类 号：R735[医药卫生—肿瘤]