内镜下多环黏膜切除术治疗食管上皮内瘤变的安全性及实用性研究

Study on the safety and practicality in the treatment of esophageal intraepithelialneoplasia by Endoscopic Multi-Band Mucosectomy

目的研究内镜下多环黏膜切除术治疗食管上皮内瘤变的安全性及实用性。方法应用内镜下多环黏膜切除法治疗36例食管上皮内瘤变患者。术后第1、3、6、12月分别复查胃镜。结果 36例中单灶者31例,多灶者5例,共42处病灶,均一次顺利完成病灶切除,术中少量渗血者8例,内镜下处理后均出血停止,术中、术后无发生创面大出血、穿孔等并发症者。术前病检提示低级别上皮内瘤变22例,高级别上皮内瘤变14例;术后病检提示低级别上皮内瘤变20例,高级别上皮内瘤变13例,癌变3例。结论内镜下多环黏膜切除法简单易行,是治疗食管上皮内瘤变,尤其是针对多灶患者及病变面积较大者的安全有效方法。

Objective To study the safety and practicality of Endoscopic Multi-Band Mucosectomy for esophageal intraepithelial neoplasia（EMBM）. Methods 36 cases of esophageal intraepithelial neoplasia treated by EMBM and review by gastroscope at thefirst,3,6,12 months after the treatment. Result 31 cases of the 36 cases are single lesion,5 cases are muhifocal, all of 42 lesions were successfully excised. 8 cases capillary hemorrhage during the operation and sotpped bleeding by therapeutic endoscopy, no arterial hemorrhage, perforation and other complications happened during operation and after operation. Preoperative pathological examination showed 22 cases of Iow grade intraepithelial neoplasia, high grade intraepithelial neoplasia in 14 cases ; postoperative pathological examination showed 20 cases of Iow grade intraepithelial neoplasia, high grade intraepithelial neoplasia in 13 cases,3 cases of canceration. Conclusion EMBM is simple and practical,is a safe and effective method for the treatment of esophageal intraepithelial neoplasJa, especially for mulfifocal patient and who has a lesion with large area.