经内镜黏膜下隧道憩室间脊切开术治疗食管憩室的临床初探  

Submucosal tunneling endoscopic septum division for treatment of esophageal diverticulum:A pilot study

作　　者：孙萍胡[1] 丁小云[1] Ping-Hu Sun;Xiao-Yun Ding(Department of Digestive Medicine,Ningbo First Hospital,Ningbo 315000,Zhejiang Province,China)

机构地区：[1]宁波市第一医院消化内科,浙江省宁波市315000

出　　处：《世界华人消化杂志》2020年第19期959-963,共5页World Chinese Journal of Digestology

摘　　要：背景经内镜黏膜下隧道憩室间脊切开术(submucosal tunneling endoscopic septum division,STESD)为治疗食管憩室的新型内镜技术,但目前国内外对于该技术应用的研究开展得尚不多,其安全性及有效性需进一步评估.目的探讨STESD治疗食管憩室的可行性及安全性.方法回顾性分析我院2017-11/2019-01的3例STESD患者的临床资料、手术经过及手术疗效评估(使用改良Eckardt评分系统,包括吞咽困难、烧心、反流、体重减轻和胸骨后疼痛5项症状,每项评分0-3分,最高15分,最低0分,评分越高,症状越严重).结果全组2例Zenker憩室,1例膈上憩室;全组3例患者均顺利完成STESD,无术中及术后穿孔、出血等严重并发症的发生.3例患者术前症状评分分别为4分、7分和8分;术后评分为分别为0分、0分和2分.至随访截止日(随访时间>9 mo)症状未见加重及复发.结论STESD治疗食管憩室短期疗效好,安全性高.BACKGROUND Submucosal tunneling endoscopic septum division(STESD)is a new endoscopic technique for the treatment of esophageal diverticulum.However,there are few studies on the application of STESD,so its safety and feasibility need to be further evaluated.AIM To evaluate the feasibility and efficacy of STESD for esophageal diverticulum.METHODS Three patients who underwent STESD at Ningbo First Hospital from November 2017 to January 2019 were enrolled in this study,and the clinical data were analyzed retrospectively.The symptoms including dysphagia,heartburn,regurgitation,weight loss,and retrosternal pain were scored using a system modified according to Eckardt score,with the score of each symptom ranging from 0 to 3(maximum total score 15,minimum total score 0;the higher the score,the more severe the symptoms).RESULTS One patient had epiphrenic diverticulum,and two had Zenker’s diverticula.All the three patients underwent STESD successfully.No major adverse events such as perforation or bleeding were found in the perioperative period.The patients were followed for at least 9 mo,and the longest follow-up time was 23 mo.The preoperative symptom scores for the three patients were 4,7,and 8,and the postoperative scores declined to 0,0,and 2,respectively.No recurrence or aggravation of symptoms was observed.CONCLUSION STESD is efficient and safe to relieve symptomatic esophageal diverticulum in short term.

关 键 词：食管憩室 隧道内镜技术 内镜治疗 

分 类 号：R655.4[医药卫生—外科学]