自体皮片移植术预防食管环周早癌内镜黏膜下隧道剥离术后食管狭窄的临床研究

目的 评价自体皮片移植术预防食管环周早癌内镜黏膜下隧道剥离术（ESTD）后食管狭窄的安全性和有效性。方法 2018年1月至2018年3月，5例食管环周早癌患者于解放军总医院接受ESTD联合自体皮片移植术。术后通过内镜随访，观察皮片生长情况，有无食管狭窄及并发症发生情况。结果 5例患者均成功实施了食管环周早癌ESTD和自体皮片移植术。无食管穿孔、出血、创面感染和支架移位等并发症发生。平均移植皮片成活率为86.0%。4例患者术后平均随访9.5个月，未发生食管狭窄；1例患者术后发生食管狭窄并进行了球囊扩张，术后随访8个月内未再发生狭窄。结论 自体皮片移植术可能是预防食管环周早癌ESTD术后食管狭窄的一种安全且有效的方法。

Clinical value of autologous skin-grafting surgery to prevent esophageal stenosis after complete circular endoscopic submucosal tunnel dissection for early esophageal cancer

Objective To assess the efficacy and safety of autologous skin-grafting surgery (ASGS) in the prevention of esophageal stenosis after complete circular endoscopic submucosal tunnel dissection (ESTD) for early esophageal cancer. Methods Between January 2018 and March 2018, five patients with early esophageal cancer underwent complete circular ESTD and ASGS in Chinese PLA General Hospital. The skin graft survival situation, and occurrence of esophageal stenosis and complications were observed by endoscopy follow-up. Results Complete circular ESTD and ASGS were successfully performed in all 5 patients, and no complications including perforation, bleeding, wound infection and stent migration occurred. The mean skin graft survival rate was 86.0%. Four patients did not experience esophageal stenosis over a mean follow-up of 9.5 months. One patient experienced esophageal stenosis after operation, and underwent endoscopic balloon dilatation. No stenosis occurred in 8 months of follow-up. Conclusion ASGS is a safe and effective method to prevent esophageal stenosis after complete circular ESTD.