内镜黏膜下剥离术治疗大面积食管早期癌的随访分析  

A follow-up survey of endoscopic submucosal dissection for widespread early esophageal superficial neoplasms

作　　者：毛艳会 文黎明[1] 李林艳[1] 杨亚玲 Yan-hui Mao;Li-ming Wen;Lin-yan Li;Ya-ling Yang(Department of Gastroenterology,the 404th Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川绵阳四〇四医院消化内科

出　　处：《中国内镜杂志》2020年第2期43-47,共5页China Journal of Endoscopy

摘　　要：目的探讨内镜黏膜下剥离术(ESD)治疗大面积(剥离范围超过1/2周)食管早期癌的临床疗效及预后。方法回顾性分析2015年1月1日-2019年1月1日在该院治疗的55例病灶范围超过1/2周的食管早期癌患者资料。根据剥离面积不同,分为A组(1/2<术后黏膜缺损<3/4周组)42例,B组(3/4≤术后黏膜缺损≤全周组)13例。对比两组疗效、并发症及随访情况。结果随访周期3~48个月,A组狭窄率7.1%(3/42),B组都有不同程度的狭窄(100.0%)。两组在性别构成和病理类型方面差异无统计学意义(P>0.05),在狭窄发生率和狭窄程度方面差异有统计学意义(P<0.05)。结论ESD能安全有效地治疗大面积食管早期癌,但术后需规律随访。ESD术后黏膜缺损范围在1/2~3/4者术后狭窄发生率较低,术后梗阻程度与病变位置有关,食管上段的狭窄程度较重。Objective To evaluate the efficacy and analyze the prognosis of endoscopic submucosal dissection for widespread early esophageal superficial neoplasms.Methods Retrospective analysis was performed on the clinical data of 55 patients with widespread early esophageal superficial neoplasms and precancerous lesions in January 2015 to 2019.According to the peeling area,divided into 2 groups,group A(1/2<postoperative mucosal defect<3/4 weeks group)(n=42),group B(3/4 postoperative mucosal defect whole week group)(n=13).The efficacy,complications and follow-up of the two groups were compared.Results The follow-up period is 3 to 48 months,the stenosis rate of group A is 7.1%(3/42)and group B(100.0%)showed different degrees of stenosis.There were no statistically significant differences between the two groups in gender and pathological types(P>0.05),but there were statistically significant differences in stenosis incidence and stenosis degree(P<0.05).Conclusion ESD is safely and effectively for large area of early esophageal cancer,but regular follow-up is required postoperration.The incidence of postoperative stenosis was lower in patients with ESD defect ranging from 1/2 to 3/4,the degree of postoperative obstruction was related to the lesion location,and the degree of stenosis in upper esophageal was more serious.

关 键 词：食管早期癌 内镜黏膜下剥离术(ESD) 大面积 狭窄 疗效 

分 类 号：R735.1[医药卫生—肿瘤]