内镜黏膜下切除早期胃癌后并发迟发性胃穿孔的临床特点

The clinical characteristics of delayed gastric perforation after endoscopic submucosal dissection

目前,内镜黏膜下切除术(endoscopic submucosal dissection,ESD)已经成为无淋巴结转移风险的早期胃癌的标准治疗方法。ESD虽然具有显著的优点,但它依然可以引起一些并发症。ESD术后并发迟发性胃穿孔是其中一类较为罕见的并发症,然而,一旦该并发症发生,患者的症状通常较重,大多需要紧急处理。当前,世界上关于该并发症的研究不多,而且主要存在两方面问题。其一,在研究对象方面,由于该并发症较为罕见,故研究对象数目较少,而且研究对象基本都是日本人,种族来源较窄;其二,在研究结果方面,不同的研究所得出的数据及结论之间有相互矛盾之处。为解决这两方面的问题,应当对该并发症进行进一步的研究。为使更多的研究人员关注该并发症,推动关于该并发症的调查研究,获得更为可靠的数据及结果,从而促进该并发症在临床的预防、治疗及恢复,以减少患者的病痛,本文总结了一些该并发症相关的研究,对ESD术后并发迟发性胃穿孔的发生原因、临床表现、治疗方法、预后及预防等临床特点进行综述。

Endoscopic submucosal dissection(ESD)is a standard treatment for early gastric cancer with a negligible risk of lymph node metastasis.Delayed gastric perforation after ESD is a rare complication.However,once this complication occurs,the symptoms are usually severe and most patients should be treated emergently.Until now,related researches have two main problems.For one thing,the sample size and source are limited;for another,the results of these researches varied widely.In order to prompt more scientists to pay attention to this complication,to do further researches on it and to acquire more reliable results,which can promote the better management,prevention and recovery of this complication,thus minimize the pain for the patients,we summarized some related researches and introduced the clinical characteristics such as reasons,clinical manifestations,management,prognosis and prevention of this complication.