食管早癌及癌前病变内镜黏膜下剥离术后食管狭窄危险因素分析

Analysis of the risk factors for postoperative complications of the ESD in esophageal carcinoma/precancerous lesions

[目的]探讨食管早癌及癌前病变行内镜黏膜下剥离术(ESD)后食管狭窄发生率及其相关的危险因素。[方法]回顾性分析行ESD的食管早癌及癌前病变132例患者的临床资料,分析可能引起术后食管狭窄的危险因素。[结果]132例行ESD治疗的食管早癌及癌前病变患者发生术后并发症29例,其中食管狭窄22例(16.7%),迟发型出血5例(3.8%),食管穿孔2例(1.5%)。将狭窄组(n=22)与非狭窄组(n=110)进行单因素分析比较显示病变纵向长度≥50mm、组织浸润深度为m2有统计学意义(P<0.05),选择性阶梯变量回归分析显示病变纵向长度≥50mm和组织浸润深度为m2是狭窄发生的危险因素。[结论]食管早癌及癌前病变ESD后影响管腔狭窄的危险因素是病变纵向长度≥50mm、组织浸润深度为m2。

[Objective]To investigate the incidence of complications after endoscopic submucosal dissection（ESD）in early esophageal cancer or precancerous lesion.[Methods]The clinical data of 132 patients with early esophageal cancer or precancerous lesion who underwent the ESD in our hospital from August2011 to April 2017 were retrospectively analyzed.Then the risk factors of postoperative esophageal stenosis were evaluated.[Results]In all the 132 patients,postoperative complications happened in twenty-nine cases,including stenosis in 22 cases,delayed bleeding in 5 cases,perforation in 2 cases.The single factor analysis showed that longitudinal length greater than or equal to 50 mm,tissue infiltration depth of more than m2 were statistically significant different between the stenosis group（n=22）and non stenosis group（n=110,P〈0.05）.Logistic regression analysis showed that the longitudinal length was greater than or equal to 50 mm and tissue infiltration depth of more than m2 were risk factors for stricture.[Conclusion]The risk factors which predict the lumen stricture are the longitudinal length of lesion≥50 mm and tissue infiltration depth of more than m2.