80 岁以上老年患者内镜黏膜下剥离术特点

目的分析80岁以上老年患者内镜黏膜下剥离术(ESD)的临床特点。方法回顾性分析陆军总医院消化内镜中心从2010年9月-2017年1月行ESD治疗的80岁以上患者资料,41例患者共行47次ESD。对病变部位、病理类型和并发症进行分析。结果所有患者顺利完成ESD术,食管病变3例,胃病变21例,结肠病变10例,直肠病变13例。术后病理学检查早癌及癌前病变34例,间质瘤2例,神经内分泌肿瘤1例,其他病理类型10例。1例贲门早癌患者追加腹腔镜下淋巴结清扫手术。术后并发症7例,4例为术后延迟出血,2例为术后谵妄,1例为肺部感染导致的发热。结论 80岁以上患者结肠ESD比例高,术后出血为最主要并发症。

Characteristic of endoscopic submucosal dissection in elderly patients aged more than or equal to 80 years

Objective To analyze the characteristic of endoscopic submucosal dissection (ESD) in elderly patients aged more than or equal to 80 years. Methods We retrospectively reviewed 41 patients aged more than or equal to 80 years with 47 lesions treated by ESD from September 2010 to January 2017. The diseased region, pathology and complications were evaluated. Results Of the 47 lesions, there have 3 esophageal lesions, 21 gastric lesions, 10 colonic lesions and 13 rectal lesions. For the pathology, there have 34 early cancer or precancerous lesion, 2 GIST, 1 neuroendocrine tumor and 10 other types of pathology. 1 cardia1 early cancer underwent additional laparoscopic lymphadenectomy. There have 7 complications, 4 post-ESD bleeding, 2 delirium and 1 pneumonia. Conclusion ESD for colorectal lesion is more frequently in elderly patients aged more than or equal to 80 years. Post-ESD bleeding is the main complication.