内镜黏膜下剥离术治疗胃早期癌及癌前病变

基础医学与临床 ›› 2014, Vol. 34 ›› Issue (9): 1231-1234.

内镜黏膜下剥离术治疗胃早期癌及癌前病变

汤姗¹,王晓伟¹,安贺娟¹,张健²,何玉琦¹,金鹏²,盛剑秋²

1. 北京军区总医院
2. 北京军区总医院消化内科

收稿日期:2014-07-01 修回日期:2014-07-08 出版日期:2014-09-05 发布日期:2014-09-02
通讯作者: 盛剑秋 E-mail:Lina20120712@163.com
基金资助:
军队保健专项科研课题

ESD Treatment on Early Gastric Cancer and Pre-cancerous Lesions

Received:2014-07-01 Revised:2014-07-08 Online:2014-09-05 Published:2014-09-02

摘要/Abstract

摘要： 目的评价内镜下黏膜下剥离术（ESD）治疗胃黏膜内或轻度黏膜下癌的有效性和安全性。方法收集2012年6月至2013年6月北京军区总医院消化内镜中心通过ESD的方法治疗的33例胃早期癌和癌前病变患者的临床病理资料。收集的资料包括患者年龄、性别、肿瘤大小、肿瘤位置、大体形态、病理、非抬起征、操作时间和并发症等。结果病灶整块切除率为97%（32/33），完整切除率为93.9%（31/33）。手术中穿孔的发生率为3.03%（1/33），出血的发生率为18.2%（6/33），无术后迟发性穿孔及出血。肿瘤位置（P＜0.05）及大体形态（P＜0.05）是影响胃ESD并发症发生的相关因素。肿瘤大小（P＜0.05）、位置（P＜0.05）和非抬起征（P＜0.05）是影响手术时间的相关因素。结论 ESD治疗早期胃癌，整块切除率和完整切除率高，具有很好的有效性和安全性。

关键词: 内镜黏膜下剥离术, 胃早期癌, 并发症, 安全性

Abstract: Objective To assess the efficacy and safety of endoscopic submueosal dissection (ESD) for early gastric cancer (EGC). Methods Retrospectively analysis 33 patients with early gastric cancer treated by ESD in Digestive Endoscopy Center of Beijing Military General Hospital from June 2012 to June 2013. Data collected including age, gender, tumor size, tumor location, macroscopic type, histology, nonlifting sign, procedure time and complications. Results The enbloc resection rate was 97% (32/33) and the R0 resection rate was 93.9% (31/33). The rate of immediate perforation was 3.03% (1/33), bleeding was 18.2% (6/33), no postoperative bleeding and delayed perforation was recorded. Tumor location (P＜0.05) and macroscopic type (P＜0.05) were associated with complications. Tumor size (P＜0.05), tumor location (P＜0.05) and nonlifting sign (P＜0.05) were associated with operative time. Conclusion ESD is an applicable method for early gastric cancer with high rate of en bloc resection and complete resection.

Key words: Endoscopic submucosal dissection, Early Gastric Cancer, complication, safety

汤姗王晓伟安贺娟张健何玉琦金鹏盛剑秋. 内镜黏膜下剥离术治疗胃早期癌及癌前病变[J]. 基础医学与临床, 2014, 34(9): 1231-1234.

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