【摘要】 目的评价胃镜下钬激光气化切除术在早期食管癌治疗中的应用价值。方法对7例早期食管癌患者(男性3例,女性4例,年龄56～76岁,平均66岁)进行胃镜下钬激光气化切除治疗。全部患者均经胃镜病理和超声胃镜检查证实。其中食管上段癌4例,中段1例,下段2例。高分化鳞癌4例,高分化腺癌2例,局灶癌变1例。胃镜下分型为表浅隆起型(Ⅱa型)3例和表浅平坦型(Ⅱb型)4例。超声胃镜(EUS)检查示病灶均局限于黏膜层。6例患者因合并其他重要脏器功能障碍无法行外科手术,1例患者因拒绝外科手术,而行胃镜下钬激光气化切除治疗。术后1～3个月胃镜复查,病理活检了解治疗效果,随后进行胃镜随访。结果所有病灶均气化切除成功,未发生任何术中及术后并发症。术后1～3个月全部患者均复查胃镜,病理活检均未发现病灶残留。胃镜随访38～56个月,均未发现肿瘤复发。结论胃镜下钬激光气化切除术治疗食管早期癌安全有效。更多还原

【Abstract】 Objective:To evaluate endoscopic holmium:YAG laser ablation in the treatment of early esophageal cancer.Methods:Seven patients(mean age 66yr) with histologically proven early esophageal cancer were treated with endoscopic ablation using holmiu:YAG laser.All nidi of the patients were detected by endoscopic ultrasonography(EUS) and were confirmed in the mucosal layer,including 4 cases of well differentiated squamous cell cancer,2 cases of well differentiated adenocarcinoma and 1 case of high grade dysplasia associated with focal canceration.Endoscopic appearances were of Ⅱa and Ⅱb types.Endoscopy were performed 1~3 months after the treatment and biopsy were made to evaluate the effect of the therapy.Long time endoscopic follow-up was maintained.Results:Complete eradication of the nidi was achieved in all the patients without any operative or delayed complications.At endoscopy,there was no residual cancer.No recurrence was found during a follow-up of 38~56 months.Conclusions:Endoscopic holmium:YAG laser ablation of early esophageal cancer is an effective,convenient and safe method in selected patients.更多还原