内镜黏膜下剥离术对食管胃黏膜下病变的诊疗价值

目的探讨内镜黏膜下剥离术对食管胃黏膜下病变的安全性及临床疗效。方法将2008年1月至2011年12月我院同期收治的43例经超声内镜确诊为食管胃黏膜下病变的患者随机分为内镜黏膜下剥离术(ESD)组(n=20)和内镜黏膜下切除术(EMR)组(n=23)进行手术,对比分析两组的临床资料。结果 ESD组与EMR组在性别、年龄、肿瘤部位和肿瘤大小之间差异无统计学意义(P>0.05)。ESD组术后发生出血1例(2.0%);EMR组术后发生并发症3例(6.25%),其中出血2例,穿孔1例。两组比较其差异具有统计学意义(P<0.05)。ESD组无切缘阳性者,EMR组术后切缘阳性者有2例(4.17%)(P<0.05)。ESD组患者均无复发,EMR组术后仅1例复发(2.08%)(P<0.01)。结论 ESD创伤性小;安全性高;切除病灶

Clinical value of Endoscopic submueosal dissection for esophagogastric mucosal lesions

Objective lo explore the feaslble, satety ana clinical elIect oI rne enaoscopic suomucosal dissecnon for esophagogastric mucosal lesions. Methods A total of ninety-eight cases admitted from January 2008 to June 2010. All of the patients were diagnosised as esophagogastric mucosal lesions by the endoscopic ultrasonography. They were divided into two endoscopic submucosal dissection（ESD） group（n=50） and endoscopy mucosal resection（EMR） group（n =48） and the clinical data was analysed respectively. Results There was no significant difference between two groups in the gender,age tumor location and tumor size（P〉0.05）. One case in ESD group had a complication of postoperative bleeding , and there were three people had complications in EMR group, which were two cases of postoperative bleeding and one case of perforation,there was a significant difference between the two group in the complication （P〈0.05）. This study suggested that the positive margins rate in ESD group was zero,which is lower than that of EMR group（P〈0.05）. There was a significant difference between the two groups in the recrudescence rate（P〈0.05）. Conclusion ESD is safe,feasible and minimally invasion,which can complete removal of the lesion and receive a good treatment results . ESD is worthy of clinical application.