内镜黏膜下剥离术治疗食管高级别上皮内瘤变的临床价值

Clinical Value of Endoscopic Submucosal Dissection in the Treatment of Esophageal High-grade Intraepithelial Neoplasia

目的:探讨内镜黏膜下剥离术(ESD)治疗食管高级别上皮内瘤变的临床价值。方法:以48例食管高级别上皮内瘤变患者为对象,就诊于某院的2017年2月~2018年3月期间,患者均给予内镜黏膜下剥离术(ESD)治疗,观察患者手术情况、瘤体大小及部位,并对其病理性质进行确诊,观察术后患者并发症发生率。结果:48例患者均一次顺利完成手术,取出瘤体的大小直径为20~40mm的概率明显高于≤20mm、40~50mm瘤体的概率(P<0.05);瘤体病变组织多分布在食道的中段,明显高于其他段位(P<0.05);大部分患者都发生了癌变;常见并发症为患者少量出血,或食管良性狭窄,未见明显穿孔患者。结论:食管高级别上皮内瘤变采用内镜黏膜下剥离术进行诊治,创伤小,操作安全,并发症少,具有积极的推广价值。

Objective:To investigate the clinical value of endoscopic submucosal dissection(ESD)in the treatment of esophageal high-grade intraepithelial neoplasia.Methods:From February 2017 to March 2018,48 patients with esophageal high-grade intraepithelial neoplasia were treated with endoscopic submucosal dissection(ESD).The surgical condition,tumor size and location were observed,and the pathological characteristics were confirmed.The incidence of complications was observed.Results:All the 48 patients successfully completed the operation at one time.The probability of removing tumor size and diameter of 20~40 mm tumors was significantly higher than that of<20 mm and 40~50 mm tumors(P<0.05).Most of the tumors were distributed in the middle part of the esophagus,which was significantly higher than that of other parts(P<0.05).Most of the patients had canceration.The common complications were a small amount of bleeding or benign esophageal stenosis without obvious perforation.Conclusion:Endoscopic submucosal dissection in the diagnosis and treatment of esophageal high-grade intraepithelial neoplasia has the advantages of minimal trauma,safe operation,fewer complications,which has positive popularization value.