单中心回顾性分析食管早期癌内镜黏膜下剥离术

基础医学与临床 ›› 2014, Vol. 34 ›› Issue (9): 1241-1244.

单中心回顾性分析食管早期癌内镜黏膜下剥离术

陶玉荣,余东亮,谢惠,张健,汤姗,何玉琦,盛剑秋

北京军区总医院

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:mmroll@126.com
基金资助:
军队保健专项科研课题

Clinical Experience of Endoscopic Submucosal Dissection for Early Esophageal Cancer in a Medical Center in China

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

摘要/Abstract

摘要： 目的分析内镜黏膜下剥离术（ESD）切除食管早癌治疗效果、并发症、复发率和操作时间等，探讨其有效性及安全性。方法2012年6月至2014年3月内镜下ESD切除病理明确诊断的食管早癌49例，患者平均年龄62.1±8.9岁，平均操作时间为60.4±43.2min，统计切除率及并发症发证情况。结果病灶整块切除率为94.3%，完整切除率为90.1%，穿孔率7.8%。术后环周狭窄率6.1%，无迟发性穿孔。肿瘤环食管管腔的范围（P<0.05）与并发症发生具有相关因素，食管肿瘤环周病变的大小（P<0.01）以及病理分型（P<0.05）为影响ESD操作时间的相关因素。结论ESD治疗食管早癌，整块切除率和完整切除率高，具有创伤小、住院时间短、恢复快、费用低及较高安全性等优点，是治疗早期食管癌的较好选择。

关键词: 食管早癌, 内镜粘膜下剥离术, 安全性

Abstract: Objective To observe the outcomes of endoscopic submucosal dissection(ESD) of early esophageal cancer and evaluate the efficacy and safety of ESD. Methods From June 2012 to March 2014, 49 cases of endoscopic resected esophageal superficial neoplasia were included. The mean age of the patients was 62.1±8.9 years. The average procedure time was 60.4±43.2 minutes.Results The enbloc resection rate was 94.3%and the R0 resection rate was 90.1%. The rate of immediate perforation was 7.8%, no postoperative bleeding and delayed perforation was recorded. The rate of esophageal stenosis was 6.1%. Extent of circumferential esophageal involvement (P<0.05) was associated with complications. Extent of circumferential esophageal involvement (P<0.01) and pathological type （P<0.05） were associated with a short procedure time. Conclusion ESD is an applicable method for Early esophageal Cancer with high rate of en bloc resection and complete resection, and it is effective and safety.

Key words: Early Esophageal Cancer, endoscopic submucosal resection(ESD), safty

陶玉荣余东亮谢惠张健汤姗何玉琦盛剑秋. 单中心回顾性分析食管早期癌内镜黏膜下剥离术 [J]. 基础医学与临床, 2014, 34(9): 1241-1244.

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