内镜下黏膜切除术治疗胃食管癌前病变35例临床分析

Clinical Analysis of 35 Cases with Endoscopic Mucosal Resection for the Treatment of Gastric Precancerous Lesion of Esophagus

目的探讨内镜下黏膜切除术治疗胃食管癌前病变的临床疗效。方法选择2008年3月至2011年2月我院收治的内镜下黏膜切除术患者35例,术后均经病理检查诊断为异型增生。回顾性分析其临床资料,对比手术前后病理结果,并对术后并发症和复发情况进行观察和处理。结果 35例患者共切除病变42处,其中首次完全切除40处,占95.24%。术后经病理检查诊断为轻度异型增生7处,中度异型增生16处,重度异型增生19处。手术前后病理结果相符者37处。术后发生出血10例,经对症处理后均痊愈或好转,未发生一例食管狭窄、穿孔等严重并发症。术后随访半年,1例患者发现食管新发病灶1处,经再次手术治疗后痊愈。结论内镜下黏膜切除术是治疗胃食管癌前病变的有效方法之一,对术前活体组织病理检查为异型增生的病变均应及时进行内镜下黏膜切除术治疗。

Objective Study the clinical effect of endoscopic mucosal resection for the treatment of gastric precancerous lesions.Methods Choose 35 cases from Mar.2008 to Feb.2011 in our hospital,postoperative were confirmed by pathological examination in the diagnosis of dysplasia.Retrospective analys the clinical data.Results 35 cases with total resection of the lesion of 42,of which the first was completely excised 40 （95.24%）.After pathological examination 7 mild dysplasia,16 moderate dysplasia,19 severe dysplasia.Operation and pathology results in 37.Bleeding occurred in 10 cases,without a case of esophageal stricture,perforation and other serious complications.Follow--up 6 months,1 cases with esophageal lesions found new,given second operation.Conclusion Endoscopic mucosal resection is a effective methed.Preoperative donor tissue for histologic examination dysplasia lesions were timely endoscopic mucosal resection for the treatment.