内镜黏膜下剥离术诊治食管早癌及癌前病变的临床价值

目的 探讨内镜黏膜下剥离术(ESD)诊治食管早癌(EEC)及癌前病变的临床价值.方法 选择安徽医科大学第二附属医院2017年3月至2019年6月经普通内镜检查及活检确诊为EEC及癌前病变的患者63例,回顾性分析患者的临床、病理及随访资料.患者术前常规行窄带成像放大内镜技术(NBI-ME)及超声内镜检查(EUS)明确病变...

The clinical value of endoscopic submucosal dissection in diagnosis and treatment of early esophageal cancer and precancerous lesions

Objective To investigate the clinical value of endoscopic submucosal dissection (ESD) in the diagnosis and treatment of early esophageal cancer (EEC) and precancerous lesions. Methods A total of 63 patients diagnosed with EEC and precancerous lesions by general endoscopy and biopsy in the Second Hospital of Anhui Medical University from March 2017 to June 2019 were selected, then the clinical, pathological and follow-up data of the patients were retrospectively analyzed. NBI-ME and EUS were routinely performed preoperatively to determine the range and depth of the lesions, and all patients were treated with ESD. The clinical features, ESD treatment effect, complications and pathological consistency before and after operation were observed. Results All patients in this group successfully completed ESD, the resection rate of whole block reached 100%;combined with postoperative pathological results, the complete and curative resection rates were both 92.06%. The consistency rate of preoperative and postoperative pathological diagnosis was 65.08%, and the low and high judgment rates were 28.57% and 6.35%, respectively, both of which were consistent (Kappa=0.221, P=0.010).All patients had no postoperative bleeding, perforation of the related complications, while only two cases (3.17%) experienced postoperative stenosis, one underwent endoscopic balloon expansion after treatment, and the other one case was mild stenos is without endoscopic intervention. All patients underwent routine gastroscopy for three months to one year after surgery, and one patient was followed up for recurrence one year after surgery. The second ESD treatment was successful, and no recurrence was observed for another one year after follow-up.No local residue or distant metastasis was found in all the patients. Conclusions The application of ESD in the diagnosis and treatment of EEC and precancerous lesions can safely and effectively remove the lesion completely at one time, and obtain the whole specimen, which can improve the positive rate of pathological diagnosis.