中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2013年
5期
496-498
,共3页
内镜黏膜剥离术%上消化道息肉样病变%治疗效果
內鏡黏膜剝離術%上消化道息肉樣病變%治療效果
내경점막박리술%상소화도식육양병변%치료효과
Endoscopic submucosal dissection%protrusion lesion of upper gastrointestinal tract%curative ef-fect
目的：探讨内镜下黏膜剥离术( ESD)治疗上消化道广基息肉、黏膜下肿瘤的疗效和安全性。方法：对内镜发现的58例上消化道隆起性病变进行超声内镜检查（25例病变位于黏膜层，16例位于黏膜肌层，17例位于黏膜下层），应用HOOK刀及IT刀行内镜下黏膜剥离术治疗。黏膜下注射生理盐水抬高病变，使病变与肌层分离，预切开病变周围黏膜，剥离病变下方黏膜下层结缔组织，完整切除病变。结果：58例患者均成功完成ESD治疗，病变大小0.4~3.4 cm（平均1.5 cm），手术时间15~95 min (平均40 min)，无出血、穿孔等并发症。所有ESD剥离病变包膜完整，基底和切缘未见病变累及。结论：ESD治疗上消化道广基息肉、黏膜下肿瘤安全、有效，可以完整切除病变，提供完整的病理诊断资料。
目的：探討內鏡下黏膜剝離術( ESD)治療上消化道廣基息肉、黏膜下腫瘤的療效和安全性。方法：對內鏡髮現的58例上消化道隆起性病變進行超聲內鏡檢查（25例病變位于黏膜層，16例位于黏膜肌層，17例位于黏膜下層），應用HOOK刀及IT刀行內鏡下黏膜剝離術治療。黏膜下註射生理鹽水抬高病變，使病變與肌層分離，預切開病變週圍黏膜，剝離病變下方黏膜下層結締組織，完整切除病變。結果：58例患者均成功完成ESD治療，病變大小0.4~3.4 cm（平均1.5 cm），手術時間15~95 min (平均40 min)，無齣血、穿孔等併髮癥。所有ESD剝離病變包膜完整，基底和切緣未見病變纍及。結論：ESD治療上消化道廣基息肉、黏膜下腫瘤安全、有效，可以完整切除病變，提供完整的病理診斷資料。
목적：탐토내경하점막박리술( ESD)치료상소화도엄기식육、점막하종류적료효화안전성。방법：대내경발현적58례상소화도륭기성병변진행초성내경검사（25례병변위우점막층，16례위우점막기층，17례위우점막하층），응용HOOK도급IT도행내경하점막박리술치료。점막하주사생리염수태고병변，사병변여기층분리，예절개병변주위점막，박리병변하방점막하층결체조직，완정절제병변。결과：58례환자균성공완성ESD치료，병변대소0.4~3.4 cm（평균1.5 cm），수술시간15~95 min (평균40 min)，무출혈、천공등병발증。소유ESD박리병변포막완정，기저화절연미견병변루급。결론：ESD치료상소화도엄기식육、점막하종류안전、유효，가이완정절제병변，제공완정적병리진단자료。
Objective To assess the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for flat polyp and submucosal tumor (SMT) of the gastrointestinal tract. Methods Total 58 patients with muco-sal tumor of the gastrointestinal tract diagnosed by endoscopy were examined using endoscopic ultrasonography (EUS). Among the cases, 25 lesions were within the submucosa, 16 lesions were within the submucosa muscula-ris and 17 in the submucosa propria. The cases were managed by ESD with a HOOK and IT knife. After injec-tion of physiological saline solution into the submucosal layer to separate the lesion from the muscle layer, the mucosa surrounding the lesion was pre-cut, and the connective tissue of the submucosa beneath the lesion was dissected. Then, the lesion was resected completely. Results All lesions were successfully resected with ESD. The resected lesions sized 0.4~3.4 cm in diameter (mean,1.5 cm) . The mean ESD procedure time was 40 min (ranged from 15 to 95 min). None of the patients showed delayed bleeding after ESD. Histological evaluation showed that the tunica of the tumors was intact, and both the lateral and basal margins of the specimens were free of tumor cells. Conclusion ESD is an efficacious and safe procedure for the treatment of SMT of the gas-trointestinal tract. It is possible to completely resect submucosal lesions and provide sufficient pathologi- cal information.
