内镜黏膜下剥离术治疗下咽部浅表癌的临床价值研究(含视频)

Clinical value of endoscopic submucosal dissection for superficial hypopharyngeal neoplasm(with video)

目的评价内镜黏膜下剥离术(ESD)用于治疗下咽部浅表癌的安全性及有效性。方法回顾性分析2015年9月至2018年3月在复旦大学附属中山医院内镜中心接受ESD治疗的9例下咽部浅表癌患者的临床病理资料。结果9例患者中男7例、女2例,平均年龄61.2岁(48~80岁)。切除病灶平均大小为16.3mm(5~27mm),平均手术时间为52.2min(30~90min)。9例患者术中及术后均未发生出血、穿孔、气肿、呼吸困难等并发症。平均住院天数4.6d(3~7d)。术后病理包括上皮内高级别瘤变1例,鳞状细胞癌8例;在8例鳞状细胞癌患者中,肿瘤组织浸润深度均未突破固有膜。1例水平切缘阳性,患者术后接受了区域放疗。平均随访时间10.2个月(3~29个月),所有患者未见复发或转移,未见食管入口狭窄。结论ESD是治疗下咽部浅表癌安全有效的方法,具有良好的临床应用价值。

ObjectiveTo evaluate the safety and efficacy of endoscopic submucosal dissection(ESD)for superficial hypopharyngeal neoplasm.MethodsClinicopathological data of 9 patients,who received ESD for superficial hypopharyngeal neoplasm in Zhongshan Hospital affiliated to Fudan University from September 2015 to March 2018,were retrospectively analyzed.ResultsNine patients including 7 males and 2 females with mean age of 61.2 years(48-80 years)were included.The mean diameter of lesions was 16.3 mm(5-27 mm),and the mean operation time was 52.2 min(30-90 min).No bleeding,perforation,emphysema or dyspnea during or after ESD occurred.The mean length of hospitalization was 4.6 days(3-7 days).Pathology indicated 1 high grade intraepithelial neoplasia and 8 squamous cell cancer,and all cases of squamous cell cancer were constrained within lamina propria.One patient had positive horizontal margin and received radiotherapy.No recurrence,metastasis or stenosis was found during 10.2 months(3-29 months)of follow-up.ConclusionESD is a safe and effective option for superficial hypopharyngeal neoplasm.