内镜下黏膜消融术治疗食管黏膜高级别上皮内瘤变临床分析

Clinical analysis of endoscopic mucosal ablation in esophageal mucosa high grade intraepithelial neoplasia

目的探讨内镜下黏膜消融术(endoscopic mucosal ablation,EMA)治疗食管黏膜高级别上皮内瘤变(high grade intraepithelial neoplasia,HIN)的疗效和安全性。方法收集扬州市第一人民医院2010年7月-2012年6月经内镜检查发现的食管黏膜患者32例作为入选对象,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。结果平均手术操作时间(21.6±2.8)min;手术成功率100%,术中及术后均无出血、穿孔发生。术后2例患者病理证实癌变,转为外科手术及放疗。术后随访率93.75%,随访患者中6个月内切面愈合率100%。结论 EMA治疗食管黏膜HIN安全性及有效性高,并发症少。

Objective To investigate the efficacy and safety of endoscopic mucosal ablation （EMA） treating esophageal mucosa high grade intraepithelial neoplasia （HIN）.Methods Thirty-two patients with esophageal mucosa HIN in Yangzhou First People＇s Hospital from Jul.2010 to Jun.2012 were enrolled,and endoscopic staining and endoscopic ultrasonography examination were adopted before operation to make certain the sphere and depth of the neoplasia.Routine preoperative assessment was done,and EMA successful rate,incidence of complications were all carefully recorded.Following-up was also done.Results The average operation time was （21.6 ± 2.8） min.All operations were successfully done and no operation related bleeding or perforation happened.Two patients were later proved to be malignancy by pathology,and the patients were subsequently transferred to the department of general surgery.Following up rate was 93.75％,the wound of EMA of all patients were recoverd 6 months after the operation.Conclusion Both the efficacy and safety of EMA in the treatment of esophageal mucosa HIN are high,and the complication rate is low.