内镜黏膜下剥离术治疗上消化道黏膜下病变疗效及安全性

目的探讨内镜黏膜下剥离术（ESD）治疗上消化道黏膜下病变的疗效及安全性。方法消化内镜检查发现上消化道黏膜下病变,经超声内镜确定黏膜下病变的种类及层次,在内镜下行ESD共57例,切除全瘤组织行病理切片明确病变性质。结果所有57例黏膜下病变均成功切除。病理示间质瘤40例（70.1%）,囊肿2例（3.5%）,平滑肌瘤8例（14.0%）,胃黏膜下血管瘤1例（1.8%）,胃异位胰腺5例（8.8%）,胃早癌1例（1.8%）。超声内镜诊断与病理一致率达94.7%（54/57）。结论 ESD是治疗上消化道黏膜下病变较为安全及有效的方法。

Efficacy and safety of endoscopic submucosal dissection in treatment of submucosal lesions of upper digestive tract

Objective To explore the efficacy and safety of endoscopic submucosal dissection （ESD） in treatment of submueosal lesions of upper digestive tract. Methods According to the types and levels of the submucosal lesions found by endoscopic ultrasonography, total 57 patients with submueosal lesions in upper digestive tract were selected to receive ESD in order to determine clearly the nature of the lesions through resection of the entire tumor tissue for pathological section. Results The submucosal lesions in 57 cases were successfully reseeted. The pathological examination indicated interstitialoma in 40 cases （70. 1% ）, cyst in two cases （3.5 % ） , leiomyoma in eight cases （ 14.0% ） , gastric submueosal hemangioma in one case （ 1.8% ） , gastric ectopic pancreas in five cases （ 8. 8% ） , and early gastric cancer in one case （ 1. 8% ）. The consistent rate of endoscopic uhrasonography diagnosis to pathological diagnosis was 94.7% （54/57）. Conclusion ESD is a safe and effective way in treatment of submucosal lesions of upper digestive tract.