多环黏膜套扎切除术与内镜黏膜下剥离术治疗食管胃交界部病变的对比研究

Comparative study of multiband mucosectomy and endoscopic submucosal dissection for early cancer and precancerous lesions of the esophagogastric junction

目的比较多环黏膜套扎切除术(MBM)与内镜黏膜下剥离术(ESD)治疗食管胃交界部(EGJ)早癌及癌前病变的疗效和安全性。方法回顾性分析2013年1月-2014年12月在扬州市第一人民医院接受ESD治疗的27例及MBM治疗的25例EGJ早癌及癌前病变患者的资料,比较两种技术的疗效及安全性。结果 ESD组平均手术操作时间为(54.8±13.5)min,明显长于MBM组的平均手术操作时间(46.2±9.7)min,两组比较,差异有统计学意义(P=0.012)。ESD组手术成功率96.3%,穿孔发生率3.7%;MBM组手术成功率100%,穿孔发生率4.0%,两组比较,差异均无统计学意义(P>0.05)。随访中两组均无复发病例。结论 MBM可安全有效治疗EGJ早癌及癌前病变,与ESD比较具有安全、操作简便、治疗时间短的优点。

Objective To compare the efficacy and safety of muhi-band mucosectomy （MBM） and endoscopic sub- mucosal dissection （ESD） for early cancer and precancerous lesions of the esophagogastric junction （EGJ）. Methods A retrospective analysis was performed to review 27 ESD and 25 MBM of early cancer and precancerous lesions of EGJ from Jan. 2013 to Dec. 2014 in Yangzhou NO. 1 People＇ s Hospital. The efficacy and safety were compared between two groups. Results In ESD group, the median resection time was （54.8 ± 13.5） rain, significantly longer than those in MBM group （46.2 ±9.7） rain （P =0. 012）. In ESD group, the surgical success rate and perforation rate were 96.3% and 3.7% , respectively. In MBM group, the surgical success rate and perforation rate were 100% and 4.0% , respec- tively, there was no significant difference between two groups（P 〉 0.05）. No recurrent case was found during follow-up in two groups. Conclusion MBM is effective and safe in the treatment of early cancer and precancerous lesions of EGJ. Compared with the ESD, MBM is simple with shorter treatment time.