消化道早癌内镜黏膜下剥离术的质量控制

Quality control of endoscopic submucosal dissection for early gastrointestinal cancer

内镜黏膜下剥离(endoscopic submucosal dissection,ESD)最开始是在1999年由日本小野裕之教授等提出的治疗消化道早期肿瘤的内镜下切除方法,近年来在全世界范围内得到了广泛的普及。尽管ESD是一种很好的治疗选择,但对适应证或可治愈性评估的错误判断可能会导致对患者不利的结果,这表明ESD的质量控制相关问题需要给予高度的重视。所以本文从术前诊断及适应证的把握、术中切除要点、术后可治愈性评估及随访监测等三大方面提出相关的质量管控要点。

Endoscopic submucosal dissection(ESD)was first proposed by Professor Hiroyuki Ono et al.in 1999 as an endoscopic resection method for the treatment of early gastrointestinal tumors,which has been popularized worldwide in recent years.Although ESD is an excellent treatment option,misjudgment of indications or curability assessment may lead to adverse outcomes for patients.This indicates that issues related to quality control of ESD need to be given proper attention.Therefore,we propose relevant quality management points from three aspects:preoperative diagnosis and indications;key points of intraoperative resection;and postoperative curability evaluation and follow-up monitoring.