透视引导下经Fustar可调弯鞘钳夹活检诊断食管梗阻性病变

Fluoroscopy-guided Fustar adjustable bent sheath clamp biopsy for diagnosing obstructive esophageal diseases

目的观察透视引导下经Fustar可调弯鞘钳夹活检诊断食管梗阻性病变的可行性和有效性。方法回顾性分析29例无法完成内镜下活检的食管或食管-胃连接部梗阻病变患者,均于局部麻醉下接受实时透视引导下经10F Fustar可调弯鞘病变区钳夹活检,记录技术成功率、手术时间及辐射剂量,观察并发症。结果29例均成功完成钳夹活检,技术成功率100%(29/29),平均用时(29.81±10.05)min,平均辐射剂量(127.14±100.36)mGy;未出现食管穿孔、大出血等严重并发症。活检初步诊断22例(22/29,75.86%)为阳性,其中2例接受外科手术,术后病理结果与活检诊断一致;7例(7/29,24.14%)为阴性,对其中2例于3个月后再次进行钳夹活检,结果显示为阳性。结论经Fustar可调弯鞘钳夹活检用于诊断食管梗阻性病变简便易行,可作为内镜下钳夹活检的替代或补充。

Objective To observe the feasibility and effectiveness of fluoroscopy-guided Fustar adjustable bent sheath clamp biopsy for diagnosing obstructive esophageal diseases.Methods Totally 29 patients with esophageal or esophagogastric junction obstruction who failed to complete endoscopic biopsy were retrospectively analyzed.Real-time fluoroscopy-guided clamp biopsy of lesion areas were performed through 10F Fustar adjustable bent sheath under local anesthesia.The technical success rate,operation time,radiation dose were recorded,and the complications were evaluated.Results Clamp biopsy of lesion areas were successfully performed in all 29 cases,with technical success rate of 100%(29/29),the average operation time of(29.81±10.05)min and the average radiation dose of(127.14±100.36)mGy.No serious complication such as esophageal perforation nor massive bleeding occurred.After biopsy,22 cases(22/29,75.86%)were preliminarily diagnosed as positive,among them 2 cases underwent surgical operation,and the postoperative pathological results were consistent with biopsy.Negative biopsy results were found in 7 cases(7/29,24.14%),among them 2 cases underwent clamp biopsy again 3 months later which showed positive results.Conclusion Fustar adjustable bent sheath clamp biopsy was feasible and effective for diagnosing obstructive esophageal diseases,which could be regarded as the substitution and supplementation of endoscopic clamp biopsy.