消化道早癌内镜黏膜下剥离术术后迟发性出血研究进展

内镜黏膜下剥离术（endoscopic submucosal dissection, ESD）目前已广泛运用于临床中以治疗消化道早癌及癌前病变。该技术术后复发率低，病变位置及范围对其限制小，术后患者恢复快，目前属于消化内镜常规微创手术之一。但受制于各种因素的影响，可能会出现术中及术后出血、穿孔、电凝综合征及管腔狭窄等并发症。尤其是术后迟发性出血，因发病隐匿可能诱发心血管等产生严重后果的相关疾病，因此认识并掌握消化道早癌ESD术后迟发性出血的相关影响因素及防治措施对ESD的进一步发展至关重要，本文就最新防治进展做相关总结和述评。

Research Progress in Delayed Bleeding after Endoscopic Submucosal Dissection of Early-Stage Gastrointestinal Cancer

Endoscopic submucosal dissection (ESD) has been widely used in the clinical treatment of early-stage and precancerous lesions of the digestive tract. Compared with traditional open surgery, the procedure has a number of advantages, including low postprocedural recurrence rate, the location and scope of lesions not posing much restrictions on the procedure, and quick patients recovery afterwards. The procedure has hence become one of the minimally-invasive procedures commonly performed with gastrointestinal endoscope. However, due to the influence of various factors, complications such as intraoperative and postoperative bleeding, perforation, electrocoagulation syndrome and lumen stenosis may occur. Delayed postoperative bleeding, in particular, may induce cardiovascular and other related diseases due to the insidious nature of its onset, resulting in serious consequences. It is critically important for the further development of ESD that we should acquire thorough understanding and mastery of the relevant influencing factors and preventive measures of delayed bleeding after ESD of early-stage gastrointestinal cancer. We herein summarized and discussed the latest research findings in the preventative and treatment measures.