【摘要】 目的探讨内镜黏膜下剥离术(ESD)治疗早期消化道肿瘤病变的疗效、安全性和技术难度。方法应用ESD治疗消化道高级别上皮内瘤变和黏膜内癌病变31例。结果该组ESD操作时间35~250min。31例患者中30例完成切除病变,其中整块切除28例,分块切除2例。随访残留复发1例,再次ESD治疗无复发。术中较明显出血15例,内镜下止血成功。术后迟发出血1例,药物治疗治愈。1例胃窦病变术后出现胃潴留,保守治疗好转。1例术中贲门部穿孔,内镜下夹闭成功。结论对于消化道分化较好的黏膜内癌、高级别上皮内瘤变行ESD治疗是一种较理想治疗选择。更多还原

【Abstract】 【Objetive】To investigate the efficacy,safety and technical difficulty of endoscopic submucosal dissection for early neoplasia of the GI Tract.【Methods】The lesions of severe hyperplasia,high grade intraepithelial neoplasia and intramucosal carcinoma in the GI tract were treated by endoscopic submucosal dissection.【Results】 The procedure time of ESD ranged from 35 to 250 minutes.The procedure was finished successfully in 30 out of 31 cases,among them en bloc resection was achieved in 28 cases.One case reoccurred in one year follow-up,which was retreated successfully by ESD without recurrence.Manifest bleeding occurred in 15 cases during the procedures,which were managed endoscopically.Delayed bleeding occurred in one case,which was treated successfully by medicine.One case with the large lesion in gastric antrum was found to develop gastric retention in one month after ESD treatment and recovered in 4 months’ follow-up.Perforation occurred in one case,which was successfully managed by endoscopic clipping.【Conclusions】ESD is a good choice of treatment for the patients with the lesion of early neoplasia such as severe hyperplasia,high grade intraepithelial neoplasia and intramucosal carcinoma in the GI tract.更多还原