结直肠内镜下黏膜剥离术并发穿孔的研究进展

Research progress on perforation of colorectal endoscopic submucosal dissection complications

内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)因为其完整切除率高、复发率低、限制小、创伤小、恢复快等优点,已经成为被广泛应用于治疗结直肠早期肿瘤的一项内镜技术。但由于ESD的操作难度大、时间长,而结直肠壁薄、弯曲角度大、管腔狭窄且具有皱褶等原因,导致结直肠ESD的穿孔率相对较高。因此正确认识并掌握结直肠ESD并发穿孔的发生情况、危险因素、预防及处理措施,对结直肠ESD的顺利完成及临床推广至关重要。

Endoscopic submucosal dissection(ESD)has become a widely used endoscopic technique for the treatment of early colorectal tumors due to the advantages of high complete resection rate,low recurrence rate,small restriction,minimal trauma,and rapid recovery.However,because the difficult and long operation of ESD,as well as the thin colorectal wall,large bending angle,narrow lumen and folds,the perforation rate of colorectal ESD is relatively high.Therefore,proper understanding and knowledge of the occurrence,risk factors,prevention and management measures of colorectal ESD complicating perforation are essential for the successful completion and clinical promotion of colorectal ESD.