超声内镜辅助内镜黏膜下剥离术治疗早期食管癌及癌前病变的效果观察

Efficacy of endoscopic ultrasound-assisted endoscopic submucosal dissection on early esophageal cancer and precancerous lesions

目的:探讨超声内镜辅助内镜黏膜下剥离术(ESD)治疗早期食管癌及癌前病变的效果。方法:抽取焦作市第二人民医院2018年12月至2020年7月经ESD治疗的早期食管癌及癌前病变患者86例,根据是否选择超声内镜辅助分为超声内镜辅助ESD组(48例)和常规ESD组(38例)。比较两组患者的一次性完整切除率,ESD时间,术后住院时间,术中出血、穿孔及术后并发症发生率。结果:超声内镜辅助ESD组患者病灶均一次性完整切除,一次性完整切除率(100.00%,48/48)高于常规ESD组(84.21%,32/38),P<0.05。超声内镜辅助ESD组ESD时间为(28.31±3.92)min,少于常规ESD组的(41.02±5.43)min(P<0.05);且两组术后住院时间比较差异未见统计学意义(P>0.05)。超声内镜辅助ESD组患者术中出血率、术中穿孔率和术后食管狭窄率(4.17%,2/48;0.00%,0/48;2.08%,1/48)均低于常规ESD组(18.42%,7/38;10.53%,4/38;13.16%,5/38),P均<0.05。结论:超声内镜辅助ESD治疗早期食管癌及癌前病变能准确定位病灶黏膜深度及病灶切除范围,一次性完整切除率高,手术时间短,术中出血、穿孔及术后并发症的发生率低,安全性高。

Objective To investigate the efficacy of endoscopic ultrasound-assisted endoscopic submucosal dissection for early esophageal cancer and precancerous lesions.Methods A total of 86 patients with early esophageal cancer and precancerous lesions of the esophagus treated by ESD in the Second People’s Hospital of Jiaozuo from December 2018 to July 2020 were enrolled.According to the application of endoscopy assisted by ultrasound,they were divided into endoscopic ultrasound-assisted ESD group(48 cases)and conventional ESD group(38 cases).The one-time complete resection rate,ESD time and postoperative hospital stay,intraoperative bleeding,perforation and postoperative complications were compared between the two groups.Results The lesions in the endoscopic ultrasound-assisted ESD group were completely resected once,and the first-attempt success rate(100.00%,48/48)was higher than that of the conventional ESD group(84.21%,32/38),P<0.05.The ESD time of the endoscopic ultrasound-assisted ESD group was(28.31±3.92)min,shorter than the(41.02±5.43)min of the conventional ESD group(P<0.05).And there was no significant difference in postoperative hospital stay between the two groups(P>0.05).The intraoperative bleeding rate,intraoperative perforation rate and postoperative esophageal stenosis rate in the endoscopic ultrasound-assisted ESD group were 4.17%(2/48),0.00%(0/48)and 2.08%(1/48),respectively,lower than the 18.42%(7/38),10.53%(4/38)and 13.16%(5/38)in the conventional ESD group(all P<0.05).Conclusions Endoscopic ultrasound-assisted ESD in the treatment of early esophageal cancer and precancerous lesions can accurately locate the depth of the lesion mucosal and the extent of the lesion resection.And it has high first-attempt success rate,short operation time,less incidence of intraoperative bleeding,perforation and postoperative complications,with high safety is high.