透明帽法内镜黏膜切除术与多环黏膜套扎切除术治疗早期食管癌及癌前病变的比较研究

目的比较透明帽法内镜下黏膜切除术（EMR—Cap）与多环黏膜套扎切除术（MBM）治疗早期食管癌及癌前病变的疗效和安全性。方法回顾性分析2008年12月至2009年12月间在中国医学科学院肿瘤医院内镜科接受EMR—CaP治疗的30例（EMR—Cap组）及2010年1月至2011年1月间接受MBM治疗的32例（MBM组）早期食管癌及癌前病变患者的临床资料，比较两种技术的疗效、安全性及费用。结果EMR，Cap组平均病变切除时间和治疗总时间分别为26rain和43min．明显长于MBM组的10min和32min（P=0．036，P=0．038）。切除病变总厚度和黏膜下切除深度两组差异无统计学意义（均P〉0．05）。EMR—Cap组平均治疗费用为（5466±354）元，明显高于MBM组的（4014±368）元（P=0．008）。EMR—Cap组出现术后狭窄1例，MBM组出现术中穿孔1例。术后随访17～42个月，无一例局部复发，EMR—Cap组m现1例淋巴结转移。结论EMR—Cap和MBM均是治疗早期食管癌和癌前病变微创、安全和有效的手段。在保证相同治疗效果的前提下，与EMR—Cap相比，MBM具有操作简单、治疗时间短、治疗成本低的优点，适宜广泛推广和开展。

Comparative study of endoscopic musoucal resection with transparent cap and endoscopic multi- band mucosectomy for early esophageal cancer and precancerous lesion

Objective To evaluate the efficacy and safety of endoscopic musoucal resection with transparent cap （EMR-Cap） and endoscopic multi-band mucosectomy （MBM） in the treatment of early esophageal cancer and precancerous lesion. Methods A retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared. Results In EMR-Cap group, the median resection time was 26 （10-56） rain and median procedure time was 43 （22-81） rain, significantly longer than those in MBM group [10 （7-18） min and 32 （28-45） min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions （P〉0.05）. In EMR-Cap group, the median cost was significantly higher than that of MBM group [（5466±354） vs. （4014±368） RMB, P=0.008）]. Conclusions EMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.