早期食管胃结合部腺癌内镜下治疗

Endoscopic treatment of early adenocarcinoma of the esophagogastric junction

内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)作为一种治疗早期胃癌新技术,同样适用于治疗食管胃结合部(esophagogastric junction,EGJ)的浅表癌。ESD治疗食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)及EGJ处癌前病变,与外科剖腹手术及内镜黏膜切除术(endoscopic mucosal resection,EMR)等内镜治疗方法相比,具有明显优势。但ESD治疗EGJ处病变,手术难度较高,手术时间更长,手术并发症发生率更高,对操作者的技术要求较高。

Endoscopic submucosal dissection is the newly developed technique for treating superficial cancer in esophagogastric junction （EGJ） as well as early gastric cancer. For the treatment of adenocarcinoma of the esophagogastric junction （AEG）and precancerosis in EGJ, endoscopicsubmucosal dissection （ESD） has obvious advantages compared with laparotomy and endoscopic mucosal resection （EMR）. But for the lesions in EGJ, ESD is difficult with long operation time and high complication incidence, which should be performed only by the skilled surgeons.