内镜下黏膜剥离术在早期胃癌治疗中的应用进展

Application Progress of Endoscopic Submucosal Dissection in Treatment of Early Gastric Cancer

内镜下黏膜剥离术(ESD)作为早期胃癌(EGC)的治疗手段,由于具有创伤小、恢复时间短、痛苦小、费用相对低廉等优点,在具有适应证的EGC患者中得以广泛应用。另外,ESD由于保留了胃的解剖结构,对患者生活质量的影响较小。EGC的内镜下治疗手段包括内镜下黏膜切除术和ESD两种,但由于ESD更适用于较大病变的切除且切除后复发率低,在EGC的治疗方面占据重要地位。近年来,ESD取得了很大的发展,内镜下全层胃壁切除及联合腹腔镜治疗EGC的方式逐渐开展,不仅能根除病灶,而且能保存胃的解剖结构,减少术后并发症发生,提高患者生活质量。

Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer(EGC),which has the advantages of small trauma,short recovery time,light pain and relatively low cost,therefore has been widely used.Besides,ESD has less influence on the quality of life of the patients because it preserves the anatomy of the stomach.The surgery of EGC includes endoscopic mucosal resection and ESD,but ESD has played an important role in the treatments since it is more suitable for resection of larger lesions and has lower recurrence rate.In recent years,ESD technology has made great progress,endoscopic full-thickness resection and combination with laparoscopic surgery to treat EGC have been gradually developed,because it can not only eradicate lesions,but also save the anatomy of the stomach,reduce postoperative complications,and improve the quality of the patients′life.