内镜黏膜下剥离术治疗消化道早期癌及癌前病变的疗效

Endoscopic Submucosal Dissection for Early Gastrointestinal Cancers and Precancerous Lesions

目的探讨内镜黏膜下剥离术（endoscopic submucosal dissection,ESD）治疗消化道早期癌和癌前病变的临床疗效及安全性。方法对58例消化道早期癌和癌前病变患者均采用ESD治疗,术后进行随访。结果 58例患者中,病灶位于食管16例,胃27例,结肠15例。手术时间30-180 min,平均42.5 min。整块切除率为96.6%（56/58）,完整切除率为94.8%（55/58）,治愈性切除率为91.4%（53/58）。ESD术中出血1例（1.7%）,迟发性出血1例（1.7%）,术中穿孔4例（6.9%）,术后复发率为3.4%（2/58）。结论 ESD治疗消化道早期癌及癌前病变具有较好的疗效,并发症少,复发率低,是一种安全、有效的内镜下微创治疗新技术。

Objective To explore the therapeutic efficacy and safety of endoscopic submucosal dissection（ESD）in the treatment of early gastrointestinal cancers and precancerous lesions.Methods Fifty-eight patients with early gastrointestinal cancers and precancerous lesions were treated with ESD and followed up after treatment.Results Among the 58 patients,lesions were located in esophagus in 16,in stomach in 27,and in colon in 15.The operation time was 30-180minutes（average 42.5minutes）.The rates of en bloc resection,complete resection and curative resection were 96.6%（56/58）,94.8%（55/58）and 91.4%（53/58）,respectively.Intraoperative bleeding occurred in 1of the 58patients（1.7%）,delayed bleeding in 1（1.7%）,and intraoperative perforation in 4（6.9%）.The incidence of postoperative recurrence was 3.4%（2/58）.Conclusion As a safe and effective endoscopic minimally invasive technique,ESD is associated with few complications and low recurrence rate in the treatment of early gastrointestinal cancers and precancerous lesions.