【摘要】 目的探讨内镜黏膜剥离术(ESD)在早期食管癌及癌前病变治疗中的应用价值与意义。方法选取2007年1月至2010年1月57例行内镜检查取活检经病理学确诊的早期食管癌及癌前病变并行ESD治疗的患者,进行内镜下黏膜剥离术,对照术前与术后的病理结果,并对手术并发症、治疗效果及预后进行观察。结果 57例行ESD治疗的早期食管癌及癌前病变患者,术后病理学诊断黏膜内癌12例(21.1%),原位癌22例(38.6%),重度不典型增生18例(31.6%),中度不典型增生5例(8.8%)。术前术后病理学诊断符合率为87.6%,其中有10例不相符的患者为术前活检病理级别低于术后病理级别。结论对于病理学活检、染色内镜及超声内镜确诊为直径<30mm无肿瘤转移的早期食管癌及中重度异型增生患者进行内镜下黏膜切除术效果良好。黏膜下剥离术是这类早期食管癌及癌前病变治疗的有效方法,且创伤小,能有效提高患者术后生活质量,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the application value and clinical significance of endoscopic submucosal dissection in the treatment of early esophageal cancer and precancerous lesion.Methods From January 2007 to January 2010,57 patients with early esophageal cancer or esophageal precancerous lesion were treated using ESD.Data of these 57 patients were analyzed retrospectively,including the histological findings before and after ESD,and the related complications.ResultsEndoscopic submucosal dissection was fulfilled in 57 cases.Post-ESD histopathologic evaluation revealed 12 cases(21.1%)of carcinoma in mucosal,22 cases of carcinoma in situ(38.6%),18 cases(31.6%)of severe dysplasia and 5 cases(8.8%)moderately dysplasia.Consistent diagnosis rate before and after the operation is 87.6%.There was no perforation,hemorrhage and transmural injury and other complications,intraoperative bleeding stop timely.Conclusions Mucosectomy is of value in the endoscopic treatment of early carcinoma of esophagus,carcinoma in situ,and severe dysplasia patients.All these cases should be treated endoscopic submucosal dissection.更多还原