内镜下放射状切开治疗上消化道良性狭窄的临床初探

Efficacy of endoscopic radial incision(ERI) for benign stricture of upper digestive system

目的评价内镜下放射状切开(ERI)治疗上消化道良性狭窄的安全性及有效性。方法将食管、胃良性狭窄患者(包括吻合口狭窄、内镜下黏膜剥离术后狭窄及腐蚀性狭窄)纳入该试验中,记录其狭窄程度、病变长度和瘢痕厚度等,内镜下对狭窄病变进行ERI,必要时辅助球囊扩张,并记录术后症状改善情况、并发症及患者预后。结果一共7例入组该试验,均成功行ERI治疗,其中4例联合球囊扩张,术后所有患者吞咽困难均明显改善,有1例术后少量出血,经保守治疗后缓解。在长期随访过程中,大多数患者经过1或2次ERI后可达到长期缓解。结论 ERI治疗上消化道良性狭窄是安全有效的,可以延长管腔通畅时间,值得临床推广。

Objective To evaluate the safety and efficacy of endoscopic radial incision（ERI） for benign stricture of upper digestive system. Methods Patients with benign esophageal or gastric stricture（including anastomotic stricture,stricture after ESD and caustic stricture） were enrolled in this study. The stage of stricture, length of the lesion and the thickness of the scar were recorded. ERI（maybe associated with balloon dilatation） were performed. Post-operative symptoms, complications and follow-up were also recorded. Results 7 patients were enrolled and all received ERI, and 4 additional balloon dilatation were done. Dysphagia in all patients relieved. 1 case with hemorrhage occurred and relieved with conservative treatment. Majority of the patients got long-term remission after 1 ~2 times of ERI. Conclusion ERI is safe and effective for benign stricture of upper digestive system. It may prolong the dysphagia-free period, worth clinical promotion.