内镜下黏膜剥离术相关辅助牵引技术研究进展

Research progress of endoscopic submucosal dissection with traction

内镜下黏膜剥离术已成为广为接受的胃肠道早癌微创外科术式，限于其学习曲线陡峭性，大规模的临床应用尚需时日。为此，一些简化手术进程的内镜下黏膜剥离术相关辅助牵引技术应势而生，包括金属夹丝线联合牵引技术、金属夹弹力圈联合牵引技术、S-O金属夹牵引技术、磁力锚牵引技术、钳牵引技术和机器人牵引技术等，可改善手术视野．增加手术安全性并提高工作效率。本文就当前出现的各种相关牵引技术的优、劣势进行综述。以期为临床抉择提供参考。

Endoscopic submucosal dissection （ESD） is a widely accepted treatment for early gastrointestinal cancer. However, the steep learning curve of standard ESD procedures makes it less widely applied in clinical practice. Therefore, various traction devices and techniques have been applied previously to facilitate ESD, such as clip-with-line method, Spring-assisted method, S-O clip method, magnetic anchor method, and robot-assisted method. These methods create a clear field of vision and allow dissections to be performed more quickly and safely. In this article, we will discuss various techniques for achieving tractions during ESD on clinical decision, and their advantages and disadvantages.