CAJ | 학술논문

目的探讨内镜下黏膜切除术(EMR)治疗早期食管癌及癌前病变的临床价值.方法分析2006年1月至2012年2月福建省立医院消化内镜中心90例行食管EMR治疗早期食管癌及癌前病变的临床资料,评价EMR手术的安全性及疗效.结果 90例中食管上段(距门齿15～23 cm)病变16例,食管中段病变(距门齿23 ～ 32 cm)52例,食管下段病变(距门齿32～ 40 cm)22例；病灶平均直径为(2.05±3.12) cm.所有病变均顺利完成EMR.切除标本大小为(3.55±2.71)cm.手术时间为(18 ～ 125) min,出血量为(10 ～70) ml,病灶整块切除率为24.4％(22/90).术中出血4例(4.4％),术后迟发性出血2例(2.2％),无1例食管穿孔发生；术后食管狭窄3例(3.3％),均予保守治疗好转.90例均接受随访,随访时间(4 ～60)个月,术后5年内病变复发5例,总复发率为5.6％ (5/90),无癌复发死亡病例.结论 EMR治疗早期食管癌及癌前病变具有安全性和有效性.
목적 탐토내경하점막절제술(EMR)치료조기식관암급암전병변적림상개치.방법 분석2006년1월지2012년2월복건성립의원소화내경중심90례행식관EMR치료조기식관암급암전병변적림상자료,평개EMR수술적안전성급료효.결과 90례중식관상단(거문치15～23 cm)병변16례,식관중단병변(거문치23 ～ 32 cm)52례,식관하단병변(거문치32～ 40 cm)22례；병조평균직경위(2.05±3.12) cm.소유병변균순리완성EMR.절제표본대소위(3.55±2.71)cm.수술시간위(18 ～ 125) min,출혈량위(10 ～70) ml,병조정괴절제솔위24.4％(22/90).술중출혈4례(4.4％),술후지발성출혈2례(2.2％),무1례식관천공발생；술후식관협착3례(3.3％),균여보수치료호전.90례균접수수방,수방시간(4 ～60)개월,술후5년내병변복발5례,총복발솔위5.6％ (5/90),무암복발사망병례.결론 EMR치료조기식관암급암전병변구유안전성화유효성.
Objective To assess the clinical value of endoscopic mucosal resection (EMR) treating early'esophageal cancer or precancerous lesions.Methods Ninety cases of early esophageal cancer and precancerous lesions were treated with EMR from Jan.2006 to Feb.2012 in Digestive Endoscopy Centre,Fujian Provincial Hospital.The data were analyzed retrospectively.Results Of 90 cases,the lesions were were located in the upper esophagus ( 15-23 cm from incisor) in 16 cases,in the middle esophagus (23-32 cm from incisor) in 52,and in the lower esophagus (32-40 cm from incisor) in 22 cases.Mean diameter of the lesions was (2.05 ± 3.12) cm.All cases received EMR successfully.Mean diameter of the resected specimens was (3.55 ± 2.71 ) cm.The median operating time was ( 18-125 ) min,median blood loss was (10-70) ml,and En-bloc resection rate was 24.4％ (22/90).The main complications of EMR included bleeding during the operation in 4 cases (4.4％ ),delayed bleeding in 2 cases ( 2.2％ ),and esophagostenosis in 3 cases (3.3％).There was no esophageal perforation.All were treated successfully with conservative treatment.Ninety cases were followed up with a mean period of (4-60) months.Local recurrence was detected in 5 cases (5.6％),and there was no death due to recurrence.Conclusion EMR was an effective,safe,and minimal invasive treatment for the early esophageal cancer and precancerous lesions