临床与病理杂志2025，Vol.45Issue(7)：817-823,7.DOI:10.11817/j.issn.2095-6959.2025.250012
早期上消化道肿瘤内镜黏膜下剥离术并发症
Complications following endoscopic submucosal dissection for early upper gastrointestinal tumors
摘要
Abstract
Objective:Endoscopic submucosal dissection(ESD)has gained broad acceptance among gastroenterologists for the treatment of early upper gastrointestinal tumors due to its high efficacy and low complication rate.This study aims to investigate the incidence and risk factors of postoperative complications following ESD for early upper gastrointestinal tumors. Methods:A total of 88 patients with early gastrointestinal tumors who underwent ESD at the Second People's Hospital of Wuhu City between January 2020 and December 2023 were retrospectively analyzed.Baseline clinical characteristics,lesion features(such as location,depth of invasion,and pathology),postoperative complications,and therapeutic outcomes were reviewed.Patients were grouped based on the presence or absence of postoperative complications,and their clinicopathological characteristics were compared.Multivariate logistic regression was performed to identify independent risk factors for complications after ESD. Results:The overall postoperative complication rate among the 88 patients was 21.59%.Univariate analysis showed that patients with early gastric cancer(P<0.01),lesions invading the deep submucosal(P<0.001),poor intraoperative lifting sign(P<0.001),postoperative pathology confirming carcinoma(P<0.01),and positive vertical margins(P<0.01)had a significantly higher incidence of ESD complications compared to those with early esophageal cancer,lesions confined to the mucosa or superficial submucosa,good lifting sign,high-grade intraepithelial neoplasia,or negative vertical margins,respectively.Multivariate logistic regression analysis identified lesion invasion depth as an independent risk factor for postoperative complications[odds ratio(OR)=5.369,P<0.05]. Conclusions:Tumor type,lesion invasion depth,intraoperative lifting condition,postoperative pathological type,and vertical margin status are significant factors affecting the occurrence of ESD complications for early upper gastrointestinal tumors,while lesion invasion depth is an independent risk factor.关键词
早期上消化道肿瘤/内镜黏膜下剥离术/并发症/临床疗效/预后Key words
early upper gastrointestinal tumors/endoscopic submucosal dissection/complications/clinical efficacy/prognosis引用本文复制引用
张文仙,李生,李宗先..早期上消化道肿瘤内镜黏膜下剥离术并发症[J].临床与病理杂志,2025,45(7):817-823,7.基金项目
芜湖市科技项目(2022yf69).This work was supported by the Wuhu City Science and Technology Project,China(2022yf69). （2022yf69）
