中国临床医学Issue(5)：643-646,4.
内镜黏膜下剥离术治疗上消化道病变的疗效分析：附30例报告
Efficacy Analysis of Endoscopic Submucosal Dissection for the Treatment of Upper Gastrointestinal Lesions:a Report of 30 Cases
王觅柱 1党彤 1孟宪梅 1徐美东2
作者信息
- 1. 内蒙古科技大学包头医学院第二附属医院消化科，内蒙古包头 014030
- 2. 复旦大学附属中山医院普外科，上海 200032
- 折叠
摘要
Abstract
Objective:To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of upper gastrointestinal lesions .Methods:IT knife and HOOK knife were applied in ESD for the treatment of 30 cases of upper gastrointestinal mucosal or submucosal lesions revealed by gastroscopy .The ESD procedure was conducted as follows .Firstly , 0 .9% sodium chloride solution was injected into the submucosa so as to elevate the mucosa on lesion .Secondly ,the mucosa around the lesion was pre‐cut .Thirdly ,the lesion was dissected completely from the surrounding connective tissue .Results:The diameters of the lesions ranged from 0 .8 to 4 .5 cm with mean of (2 .6 ± 1 .3) cm .As postoperative pathology confirmed , there was tumor residual on wound surface of 2 cases after ESD ,and they received extended resection .And the lesions of the other 28 cases were successfully resected by ESD .The success rate of complete dissection was 93 .3% (28/30) .The ESD procedure time (from fluid injection to complete dissection) ranged from 29 to 110 min ,with a mean of (48 ± 11 .2) min .The average amount of bleeding during operation was 45 mL and the bleeding was successfully stopped by electro‐coagulation ,argon plasma coagulation . One patient (aspirin was stopped 5 days before operation) suffered hemorrhage per‐diapedesin and recovered after conservative treatment .The bleeding rate of ESD was 3 .33% (1/30) .Perforation occurred in 3 cases during the ESD procedure ,and was closed with metallic endoclip .And no case was transferred to laparotomy .The perforation rate of ESD was 10 .0% (3/30) .After the operation ,16 cases were followed up .And the follow‐up period ranged from 3 to 6 months ,with a mean of (4 .5 ± 1 .2) months .The wound surfaces of 16 cases were healed ,and there was no residue or recurrence .Conclusions:The curative effect of ESD for the treatment of upper gastrointestinal lesions is reliable ,as it can not only wholly remove the large lesion ,but also provide with pathological proof .With ESD ,less pain ,faster rehabilitation ,and lower recurrent rate can be achieved for patients .关键词
内镜黏膜下剥离术/上消化道病变/黏膜下肿瘤Key words
Endoscopic submucosal dissection/Upper gastrointestinal lesion/Submucosal tumor分类
医药卫生引用本文复制引用
王觅柱,党彤,孟宪梅,徐美东..内镜黏膜下剥离术治疗上消化道病变的疗效分析：附30例报告[J].中国临床医学,2015,(5):643-646,4.
