常规内镜黏膜下剥离术与经内镜黏膜下隧道剥离术治疗食管大面积黏膜病变的疗效及安全性

Efficacy and safety of conventional endoscopic submucosal dissection and endoscopic submucosal tunnel dissection in the treatment of large esophageal mucosal lesions

目的分析常规内镜黏膜下剥离术与经内镜黏膜下隧道剥离术(ESTD)治疗食管大面积黏膜病变的疗效及安全性。方法选取我院2015年5月~2017年12月收治的49例食管癌患者按随机数字表法分为两组,对照组24例,给予常规内镜黏膜下剥离术;观察组25例,给予经内镜黏膜下隧道剥离术。术后比较两组手术效果及并发症发生情况。结果观察组的病灶切除率高于对照组,手术时间、出血量、胃肠功能恢复时间、并发症发生率均低于对照组(P<0.05)。结论 ESTD能完整切除食管大面积病变,减少出血量,降低手术时间,有效防止并发症发生,值得临床推广。

Objective To analyze the efficacy and safety of conventional endoscopic submucosal dissection and endoscopic submucosal tunnel dissection in the treatment of large esophageal mucosal lesions. Methods 49 patients with esophageal cancer were treated in our hospital from May 2015 to Dec 2017.The random digital table was divided into 2 groups.24 cases in the control group were treated with conventional endoscopic submucosal dissection,and 25 cases in the observation group were treated by endoscopic submucosal tunnel dissection.The operative effects and complications of the two groups were compared after the operation. Results The resection rate in the observation group was higher than that in the control group.The operative time,bleeding volume,gastrointestinal function recovery time and complications were better than those in the control group （ P 〈0.05）. Conclusion ESTD can completely remove the large area of esophageal lesions,reduce the amount of bleeding and operation time,effectively prevent complications,and is worthy of clinical promotion.