内镜黏膜下剥离术治疗消化道病灶56例疗效分析

Effectiveness analysis of endoscopic submucosal dissection on 56 cases of gastrointestinal lesions

目的探讨内镜黏膜下剥离术（ESD）治疗消化道病灶的疗效和安全性。方法内镜检查发现的消化道病灶病例患者为入选对象,术前行染色内镜和超声内镜检查,确定病变范围和深度,常规行术前评估,观察手术时间、手术成功率及并发症发生率,并进行术后随访。结果 2008年12月~2009年6月我院共实施ESD手术56例进入观察,切除标本平均直径（2.56±0.69）cm,平均手术操作时间（70.24±28.35）min;手术完整剥离成功率94.6%,术中穿孔发生率5.4%,迟发性穿孔率3.6%。1例发生迟发型出血,行手术治疗。术后随访率92.9%,随访患者中6个月内切面愈合率91.3%,12个月内切面愈合率达100%。结论 ESD治疗消化道病灶病变局部的复发率低,并发症少。

Objective To assess the effectiveness and safety of the technique of endoscopic submucosal dissection（ESD） on gastrointestinal lesions.Methods The patients with gastrointestinal lesions detected by endoscopy were enrolled.Chromoendoscopy and endoscopic ultrasonography were applied to confirm the extent and depth of the lesions.All the patients were practiced routine preoperative evaluation.The operation time,the En bloc resection rates and complications were detected.All cases post-ESD were followed up.Results A total of 56 cases were enrolled from December 2008 to June 2009.The max diameter of resection samples was（2.56±0.6） cm.The operation time was（70.24±28.35）min.The En bloc resection rate was 94.6%.The intraoperative perforation rate was 5.4% and the tardive perforation rate was 3.6%.One patient received emergency surgery because of uncontrolled delayed hemorrhage.The post-ESD followed-up rate was 92.9%.The cross section healing rates were 91.3% in 6 months and 100% in 12 months.Conclusion ESD on gastrointestinal lesions results in less relapse rate and complication rate.