内镜黏膜下剥离术中8字环辅助牵引的效果及安全性初探

Application of 8-ring traction-assisted endoscopic submucosal dissection for gastric lesions

为了评价内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)中使用8字环辅助牵引的效果及安全性,2021年7月至2022年1月间,因胃部病变在南京大学医学院附属鼓楼医院行8字环辅助牵引下ESD治疗的总共13例病例(共15处病灶)纳入回顾性分析,结果显示13例均成功完成8字环辅助牵引下ESD,中位手术时间56min,单位时间切除面积(0.20±0.02)cm^(2)/min,病灶整块切除率93.3%(14/15),完全切除率80.0%(12/15),治愈性切除率80.0%(12/15),无术中及术后穿孔,无迟发性出血,无其他严重并发症及死亡病例。初步结果提示,8字环辅助牵引作为一种新型内牵引技术,操作简便,能够有效提高剥离效率,减少并发症发生,值得临床进一步研究和推广。

To evaluate the effectiveness and safety of 8-ring assisted traction in endoscopic submucosal dissection(ESD),a total of 13 patients with 15 gastric lesions who underwent 8-ring traction-assisted ESD in Nanjing Drum Tower Hospital from July 2021 to January 2022 were included in the retrospective cohort study.All patients successfully completed the operation.The median procedure time was 56 min,and the dissected area per unit time was 0.20±0.02 cm^(2)/min.The en bloc resection rate,the complete resection rate and the curative resection rate were 93.3%(14/15),80.0%(12/15)and 80.0%(12/15),respectively.There were no ESD-related complications,such as delayed bleeding or intraperative and postoperative perforation.No deaths occurred.As a novel internal traction technology,8-ring traction method is simple to operate,providing a good field of vision during ESD to improve the dissection efficiency and reduce complications,which is worthy of further clinical research and promotion.