内镜下纵行切开联合博来霉素局部注射治疗复杂性 食管良性狭窄的初步临床观察

本研究对2018年8月—2019年11月间在空军特色医学中心接受内镜下纵行切开联合博来霉素局部注射治疗的7例复杂性食管良性狭窄患者进行了回顾性观察。7例患者术前食管狭窄长度4～14 cm，狭窄段食管最小直径0.2～0.4 cm，行内镜下纵行切开联合博来霉素局部注射治疗，均技术成功。随访5～14个月，无不良事件发生。5例出现狭窄复发及不同程度吞咽困难，首次内镜下治疗结束至食管狭窄复发需再次内镜下治疗的间隔时间为30～120 d。5例复发者中，4例经2次、1例经4次治疗后食管保持通畅。截至随访期末，7例患者吞咽困难症状分级为0～1分。初步小样本经验表明，内镜下纵行切开联合博来霉素局部注射治疗复杂性食管良性狭窄安全、有效。

Preliminary clinical observation on endoscopic longitudinal incision combined with bleomycin therapy as a treatment for complex benign esophageal strictures

Data of 7 patients with complex benign esophageal strictures (CBESs) who underwent endoscopic longitudinal incision combined with local injection of bleomycin were retrospectively reviewed at Air Force Medical Center from August 2018 to November 2019.The length of preoperative esophageal stenosis was 4-14 cm and the minimum diameter of esophageal stenosis was 0.2-0.4 cm in 7 cases. The procedure was successful for all 7 patients.No adverse events occurred during 5-14 months of follow-up period.Restenosis and dysphagia occurred in 5 cases.The interval between the first endoscopic treatment and the recurrence of esophageal stenosis was 30-120 days.Among the 5 cases of recurrence, 4 cases remained unobstructed after 2 treatments and 1 case remained unobstructed after 4 treatments. The dysphagia scores of 7 patients were graded from 0 to 1 by the end of follow-up. Endoscopic longitudinal incision combined with bleomycin therapy in treatment of CBESs is safe and effective.