内镜黏膜下剥离术后并发幽门狭窄临床处理策略的研究进展

Research progress in the clinical management strategies of pyloric stenosis after endoscopic submucosal dissection

内镜黏膜下剥离术(endoscopic submucosal dissetion,ESD)切除幽门病变达到或超过其环周3/4是ESD后并发狭窄的危险因素,ESD后同时局部注射激素、胃切开经口内镜肌切开术及系统口服激素可以预防狭窄的发生。ESD后狭窄可通过胃出口梗阻评分系统选择不同的治疗方式,包括内镜下球囊扩张术、激素局部注射及口服激素、瘢痕对侧内镜下黏膜切开术等,规范操作可避免并发症发生。对于幽门ESD后顽固性幽门狭窄可能需要多种方式组合治疗,严重影响患者的生活质量。因此,本文概述了目前ESD后并发幽门狭窄临床特征、防治策略的研究进展,以期为临床提供更多的选择和参考。

Endoscopic submucosal dissetion(ESD)resection of pyloric lesions in excess of 3/4 of the peripheral period is a risk factor for post-ESD stenosis,and meanwhile,local hormone injection,gastrotomy and endoscopic myotomy through mouth and systemic oral hormone treatment after ESD can prevent stenosis.Different treatment modalities for post-ESD stenosis can be selected through the gastric outlet obstruction scoring system,including endoscopic balloon dilatation,local hormone injection and oral hormone injection,and endoscopic mucotomy on the opposite side of scar,etc.Standard operation can avoid complications.Intractable pyloric stenosis after pyloric ESD may require a combination of treatment,seriously affecting the quality of life of patients.Therefore,this articel summarized the current research progress on the clinical characteristics and prevention strategies of pyloric stenosis complicated by ESD,in order to provide more options and references for the clinic.