内镜超声引导下反向切开术治疗食管良性难治性狭窄的初步应用

目的 探讨内镜超声引导下反向切开术治疗食管良性难治性狭窄的疗效及安全性。 方法 回顾性分析2016年1月—2019年12月在南方医科大学顺德医院消化内镜中心行内镜超声引导下反向切开术治疗的17例食管良性难治性狭窄患者的临床资料，观察手术成功率、并发症、临床疗效等。 结果 17例患者均成功一次完成内镜下反向切开术，术后胃镜均能自由通过，操作时间（38.82±24.27）min。17例患者均无大出血、穿孔、感染等严重并发症发生。随访时间3~44个月，4例患者分别于术后3、12、18、26个月再次出现吞咽困难症状，复查胃镜示狭窄复发，余13例患者未出现再次狭窄。 结论 内镜超声引导下反向切开术治疗食管良性难治性狭窄安全、有效，值得进一步研究。

Application of endoscopic ultrasonography guided reverse dissection for refractory benign esophageal stricture

Objective To study the effect and safety of endoscopic ultrasonography guided reverse dissection for refractory benign esophageal stricture. Methods Seventeen patients with refractory benign esophageal stricture were selected for endoscopic ultrasonography guided reverse dissection in Shunde Hospital, Southern Medical University from January 2016 to December 2019. The clinical data including operation success rate, complications and clinical efficacy were analyzed. Results All 17 patients were successfully treated with endoscopic ultrasonography guided reverse dissection. The operating time was 38.82±24.27 minutes. No serious complications such as major bleeding, perforation, and infection were found during and after the operation. The follow-up time ranged from 3 to 44 months. Four patients had symptoms of dysphagia again at 3, 12, 18, and 26 months after operation, and re-examination of gastroscopy revealed recurrent esophageal stenosis. The rest of the patients did not re-stenosis until the last time of follow-up. Conclusion Endoscopic ultrasonography guided reverse dissection is a safe and effective treatment for refractory benign esophageal stricture.