内镜黏膜切除术治疗食管早期癌和癌前病变16例报告

目的 探讨内镜黏膜切除术（EMR）治疗早期食管癌和癌前病变的价值.方法 应用透明帽法对16例食管早期癌和癌前病变行EMR治疗,应用氩离子凝固术治疗残留及复发病灶.术后第3、6及12个月进行内镜复查.结果 16例行EMR治疗的患者,共切除标本21块,完全切除14例（87.5%）,分块切除3例（18.7%）,不完全切除者2例（12.5%）.后者经再次碘染色确定残余病灶,应用氩离子凝固术处理.有3例（18.7%）术后有少许渗血,局部喷洒肾上腺素盐水及用钛夹封闭创面均止血成功,无一例发生食管穿孔及狭窄.术后平均随访时间为18个月,无复发.结论 EMR是治疗早期食管癌及癌前病变的安全有效的方法.

Endoscopic mucosal resection for early esophageal carcinomas and pre-malignant lesions

Objective To assess the clinical application of endoscopic mucosal resection（EMR） for early esophageal carcinomas and pre - malignant lesions. Methods Endoscopic esophageal mucosal resection in combination with transparent - cap technique were performed in 16 patients with early esophageal carcinomas and pre - malignant lesions, and the residual lesions were treated by argon plasma coagulation （APC）. All patients were endoscopically examined 3,6 and 12 months after the operation. Results A total of 21 esophageal mucosa lesions were resected from the 16 patients. Fourteen lesions （87.5%）were completely removed,3 cases（ 18.7% ） were piecemeal resected and 2 （ 12.5% ） partially excised. The residual lesions were located by iodine staining and then treated by APC. Three cases（ 18.7% ）had wound bleeding which was controlled successfully by local spraying of saline - epinephrine and using titanium clips. No esophageal perforation and stenosis occurred. The mean follow - up period was 18 months and no recurrence was found. Conclusion EMR is safe and effective in the treatment of early esophageal cancer and precancerous lesion.