内镜黏膜下剥离术治疗胃肿瘤的并发症及处理进展  

Advances in Complications of Endoscopic Submucosal Dissection for Treatment of Gastric Tumor and Related Management

作　　者：陈嘉希 李学良[1] CHAN Kahei;LI Xueliang(Department of Gastroenterology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院消化科,南京210029

出　　处：《医学综述》2020年第23期4719-4723,共5页Medical Recapitulate

摘　　要：内镜黏膜下剥离术(ESD)是一种相对较新的内镜下切除方法,即使是在大面积或溃疡性病变难以用传统内镜下黏膜切除术(EMR)切除的患者中也能整块切除。与EMR相比,ESD的适应证更广,并提高了完全切除率,减少病灶残留,复发率低,然而ESD需要更长的手术时间和更高的专业技术水平,随着适应证的扩大,ESD过程中出现并发症的情况较EMR复杂。因此,内镜医师不仅要了解并发症的危险因素和发生率,还要了解如何有效地治疗此类并发症。未来,内镜治疗技术应朝着简单、安全、操作便捷的方向发展,以使ESD并发症得到有效处理。Endoscopic submucosal dissection(ESD)is a relatively new method of endoscopic resection.It can realize the whole resection even in patients with large area or ulcerative lesions that are difficult to be removed by traditional endoscopic mucosal resection(EMR).Compared with EMR,ESD has wider indications,higher complete resection rate,less residual lesions and lower recurrence rate.However,ESD requires longer operation time and higher level of technical expertise.With the expansion of indications,the risk and situation of complications are more complex than EMR.Endoscopists should not only understand the risk factors and incidence of complications,but also understand how to effectively treat the complications.In the future,endoscopic treatment technology should be developed in the direction of simple,safe and convenient operation,so as to effectively deal with ESD complications.

关 键 词：胃肿瘤 内镜黏膜下剥离术 穿孔 出血 并发症 

分 类 号：R735.2[医药卫生—肿瘤]