内镜黏膜下剥离术治疗十二指肠隆起性病变的疗效评估

Efficacy of endoscopic submucosal dissection for duodenal prominent lesions

目的:评价内镜黏膜下剥离术(ESD)治疗十二指肠隆起性病变的疗效及安全性。方法:回顾性分析2014年8月至2019年12月本院ESD治疗的24例十二指肠隆起性病变的临床资料,分析患者的基线资料、病灶大小及病理特征、并发症发生情况及转归、术后随访情况等资料,评估ESD在十二指肠隆起性病变的安全性及有效性。结果:24例患者在全麻下行十二指肠隆起性病变ESD治疗,手术操作均顺利完成;24例患者中,男性13例,女性11例,平均年龄(47.8±14.0)岁;病变位于十二指肠球部13例,球降交界5例,降部6例;病灶直径1.5(0.7~5.0)cm。1例患者在术中发现创面小部分区域可见穿孔,共3例患者出现术后发热症状。平均术后住院天数(5.6±2.4)d,术后中位随访时间18(1~66)个月,随访期间无复发及狭窄等情况。结论:ESD是治疗十二指肠隆起性病变有效方法之一,可作为十二指肠隆起病变微创治疗的良好选择。

Objective:To assess the clinical value of endoscopic submucosal dissection(ESD)for duodenal prominent lesions.Methods:A total of 24 patients with duodenal prominent lesions underwent ESD from August 2014 to December 2019 in our hospital were retrospectively analyzed,and patients’baseline data,lesion size and pathological characteristics,complications and outcomes,and postoperative follow-up were analyzed to evaluate the safety and effectiveness of ESD in duodenal prominent lesions.Results:24 cases of duodenal protuberant lesions were treated with ESD under general anesthesia,including 13 male and 11 female patients.The mean age was 47.8±14.0 years.There were 13 lesions in duodenal bulb,6 lesions in descending part and 5 lesions in the junction of bulb and descending part,the diameter of the lesion was 1.5(0.7~5.0)cm.Intraoperative perforation occurred in 1 patient,and a total of 3 patients developed postoperative fever.The average postoperative hospital stay was 5.6±2.4 d.The median follow-up time was 18(1~66)m,and there was no recurrence or stenosis occurred during the follow-up period.Conclusion:ESD is effective for treatment of duodenal prominent lesions and can be used as a good choice for duodenal prominent lesions.