内镜治疗早期食管癌和癌前病变的现状与展望  

Current status and prospects of endoscopic treatment for early esophageal carcinoma and precancerous lesions

作　　者：徐美东 初元 XU Mei-dong;CHU Yuan(Center of Endoscopy,East Hospital,Tongji University School of Medicine,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院内镜中心

出　　处：《同济大学学报（医学版）》2019年第5期535-541,共7页Journal of Tongji University(Medical Science)

摘　　要：随着内镜诊疗技术的进步和临床经验及证据的积累,内镜治疗早期食管癌和癌前病变被证实有确切的疗效,已成为临床一线治疗方案。内镜治疗早期食管癌的方法主要包括内镜下黏膜切除术(endoscopic mucosal resection)、内镜黏膜下剥离术(endoscopic submucosal dissection)和射频消融术(radiofrequency ablation)等。针对不同具体病变选择适当的内镜治疗方式,对于提高疗效具有重要意义。目前,在术前评估、适应证选择及并发症防治上仍有尚待解决的问题,这制约了内镜治疗早期食管癌的发展和临床进一步推广。本文通过对内镜治疗早期食管癌和癌前病变的方法和疗效进行述评,阐明治疗过程中存在的问题,并根据现有临床资料提出对策与建议,为临床医师提供参考。With the advances of endoscopic diagnosis and treatment techniques and the accumulation of clinical experience and evidence,endoscopic treatment of early esophageal carcinoma and precancerous lesions has shown definite curative effect,and become the first-line treatment.Endoscopic treatment of early esophageal carcinoma includes endoscopic mucosal resection,endoscopic submucosal dissection and radiofrequency ablation.To improve the therapeutic effects it is important to choose appropriate endoscopic treatment for different lesions.Due to the problems of preoperative evaluation,indication selection and complication prevention,the development of endoscopic treatment of early esophageal carcinoma has been restricted.This review introduces methods and curative effects of endoscopic treatment for early esophageal carcinoma and precancerous lesions,describes the problems during the treatment process,and proposes countermeasures based on the existing clinical evidence to provide reference for clinicians.

关 键 词：内镜治疗 早期食管癌 术前评估 适应证 并发症 

分 类 号：R655.6[医药卫生—外科学]