单中心回顾性分析食管早期癌内镜黏膜下剥离术

Clinical experience of endoscopic submucosal dissection for early esophageal cancer in a medical center in China

目的分析内镜黏膜下剥离术(ESD)切除食管早癌治疗效果、并发症、复发率和操作时间等,探讨其有效性及安全性。方法 2012年6月至2014年3月内镜下ESD切除病理明确诊断的食管早癌49例,患者平均年龄62.1±8.9岁,平均操作时间为60.4±43.2 min,统计切除率及并发症发生情况。结果病灶整块切除率为94.3%,完整切除率为90.1%,穿孔率7.8%。术后环周狭窄率6.1%,无迟发性穿孔。肿瘤环食管管腔的范围(P<0.05)与并发症发生具有相关因素,食管肿瘤环周病变的大小(P<0.01)以及病理分型(P<0.05)为影响ESD操作时间的相关因素。结论 ESD治疗食管早期癌,整块切除率和完整切除率高,具有创伤小、住院时间短、恢复快、费用低及较高安全性等优点,是治疗早期食管癌的较好选择。

Objective To evaluate the outcomes of endoscopic submucosal dissection（ESD） of early esophageal cancer and evaluate the efficacy and safety of ESD. Methods From June 2012 to March 2014, 49 cases of endoscopic resected esophageal age procedure was 90.1%. superficial neoplasia were evaluated. The mean age of the patients was 62. 1 ± 8. 9 years. The avertime was 60. 4 ±43.2 minutes. Results The enbloc resection rate was 94. 3% and the R0 resection rate The rate of immediate perforation was 7. 8%, no postoperative bl eeding and delayed perforation was re- corded. The rate of esophageal stenosis was 6. 1%. Extent of circumferential esophageal involvement （P 〈 0. 05 ） was associated with complications. Extent of circumferential esophageal involvement （P 〈 0. 01 ） and pathological type （P 〈 0. 05） were associated with a short procedure time. Conclusions ESD is an applicable method for Early esophageal Cancer with high rate of en bloc resection and complete resection, and it is effective and safty.