内镜下黏膜剥离术治疗消化道病变的临床研究

目的 证明内镜下黏膜剥离术（ESD）治疗消化道病变的临床意义.方法 选取行ESD治疗患者112例,术前经消化道超声内镜检查定位提示病变尚未侵及肌层后行ESD.结果 112例中96例完整剥离并切除病变组织,术后病理显示基底部和切缘未见病变组织且被膜完整,完整切除率85.7％（96/112）.术中未出现难以控制的大出血,也未出现钛夹无法夹闭消化道穿孔、腹腔感染、皮下气肿等情况.对于12例早期癌症的患者进行术后1年的随访,未出现残留和复发现象.结论 ESD对于消化道病变是一种安全、有效、痛苦小、可以将病变组织一次性完整切除的手术.

Clinical study of endoscopic mucosal dissection treating digestive tract diseases

Objective To demonstrate the clinical significance of endoscopic mucosal dissection （ESD） in the treatment of digestive tract diseases.Methods A total of 112 patients with ESD treatment were selected.Preoperative localization endoscopy gastrointestinal ultrasound showed the lesion had not yet invaded muscular layer by ESD.Results Ninety-six cases had complete stripping and removal of lesions,postoperative pathology showed basal and margin had no lesions and membrane was intact integrity,complete resection rate was 85.7％（96/112）.Surgery did not appear to uncontrollable bleeding without titanium clip,also not be clipped digestive tract perforation,abdominal infection,subcutaneous emphysema etc.There was no uncontrollable bleeding,digestive tract perforation that couldn＇t be clipped by titanium clip,abdominal infection,subcutaneous emphysema etc in surgery.For 1 year in 12 patients with early stage cancer of postoperative follow-up,no residual and recurrence.Conclusion ESD is a safe,effective,less painful,can be a one-time operation lesions complete resection for gastrointestinal lesions.