圈套器牵引法在早期食管癌及癌前病变内镜黏膜下剥离术中的应用  

Application of Snare Traction in Endoscopic Submucosal Dissection for Early Esophageal Carcinoma and Precancerous Lesions

作　　者：葛存锦[1] 仝巧云[1] 郑世华[1] 周明东[1] Ge Cunjin;Tong Qiaoyun;Zheng Shihua;Zhou Mingdong(Department of Gastroenterology,Yichang Central People’s Hospital,The First College of Clinical Medical Science,China Three Gorges University&Institute of Digestive Diseases,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]消化内科&三峡大学消化疾病研究所,湖北宜昌443003

出　　处：《巴楚医学》2022年第4期29-32,共4页Bachu Medical Journal

基　　金：湖北省自然科学基金项目(No:2019CFB313)。

摘　　要：目的:探讨圈套器牵引法在早期食管癌及癌前病变内镜黏膜下剥离术(ESD)中的安全性及有效性。方法:回顾性分析我院消化内镜中心2017年1月~2020年5月进行的54例圈套器牵引食管ESD(圈套器牵引组)和54例非圈套器牵引食管ESD(对照组)的临床资料,对患者相关变量、黏膜下剥离时间、并发症、肌层损伤等进行总结分析。结果:两组患者均无穿孔、迟发性出血和迟发性穿孔发生,在ESD手术过程中出血次数相当(均P>0.05)。与对照组相比,圈套器牵引组患者肌层损伤发生率更低、且黏膜下剥离时间更短,差异均具有统计学意义(均P<0.05)。结论:圈套器牵引在早期食管癌及癌前病变ESD术中是安全有效的,可以缩短黏膜下剥离时间,减少剥离过程中的肌层损伤。Objective:To evaluate the effectiveness and safety of snare traction method for endoscopic submucosal dissection(ESD)in early esophageal carcinoma and precancerous lesions.Methods:A total of 54 snare traction esophageal ESD(the snare traction group)and 54 non-traction ESD(the control group)cases from January 2017 to May 2020 were retrospectively reviewed.The patient related variables,submucosal dissection time,complications,muscle layer injury and so on were analyzed.Results:There was no perforation,delayed bleeding and delayed perforation occurred in any of the patients,and the bleeding times during ESD procedures were comparable between the two groups(all P>0.05).The incidence of muscle layer injury was lower,and the submucosal dissection time was significant shorter in the snare traction group than those in the control group(both P<0.05).Conclusion:The snare traction is safe and effective in ESD surgery for early esophageal cancer and precancerous lesions,which could reduce the muscle layer injury during ESD and shorten the submucosal dissection time.

关 键 词：内镜黏膜下剥离 圈套器牵引 黏膜下剥离时间 肌层损伤 

分 类 号：R571[医药卫生—消化系统]