江西医药
江西醫藥
강서의약
JIANGXI MEDICAL JOURNAL
2014年
8期
668-670
,共3页
方军%杨力%向阳%赵赛菊
方軍%楊力%嚮暘%趙賽菊
방군%양력%향양%조새국
内镜黏膜下剥离术%消化道良性肿瘤
內鏡黏膜下剝離術%消化道良性腫瘤
내경점막하박리술%소화도량성종류
Endoscopic submucosal dissection%Gastrointestinal benign tumor
目的:探讨内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)在治疗消化道良性肿瘤中的应用价值。方法收集近2年电子胃肠镜发现的30例胃与大肠黏膜及黏膜下良性肿瘤,内镜超声检查和(或)病理活检进一步明确病灶大小、位置及性质。 ESD操作步骤:黏膜下注射液体以抬高病灶,接着预切开病灶周围黏膜,之后使用Hook刀或IT刀沿病灶黏膜下层完整剥离病灶。结果30例患者均顺利完成ESD治疗,病变直径1.0-3.5cm,平均2.3cm,ESD手术时间30-175min,平均73 min,ESD治疗过程中创面均有少量出血,均经电凝或金属钛夹止血,无术后延迟出血发生,穿孔发生率为6.7%(1/15),术后随访1-8个月,未见肿瘤残留或复发。结论 ESD作为一种内镜微创治疗,能实现较大病灶的完全剥离,为临床提供完整的病理学资料,也为消化道黏膜及黏膜下良性肿瘤的治疗开辟了新的治疗途径。
目的:探討內鏡黏膜下剝離術(endoscopic submucosal dissection,ESD)在治療消化道良性腫瘤中的應用價值。方法收集近2年電子胃腸鏡髮現的30例胃與大腸黏膜及黏膜下良性腫瘤,內鏡超聲檢查和(或)病理活檢進一步明確病竈大小、位置及性質。 ESD操作步驟:黏膜下註射液體以抬高病竈,接著預切開病竈週圍黏膜,之後使用Hook刀或IT刀沿病竈黏膜下層完整剝離病竈。結果30例患者均順利完成ESD治療,病變直徑1.0-3.5cm,平均2.3cm,ESD手術時間30-175min,平均73 min,ESD治療過程中創麵均有少量齣血,均經電凝或金屬鈦夾止血,無術後延遲齣血髮生,穿孔髮生率為6.7%(1/15),術後隨訪1-8箇月,未見腫瘤殘留或複髮。結論 ESD作為一種內鏡微創治療,能實現較大病竈的完全剝離,為臨床提供完整的病理學資料,也為消化道黏膜及黏膜下良性腫瘤的治療開闢瞭新的治療途徑。
목적:탐토내경점막하박리술(endoscopic submucosal dissection,ESD)재치료소화도량성종류중적응용개치。방법수집근2년전자위장경발현적30례위여대장점막급점막하량성종류,내경초성검사화(혹)병리활검진일보명학병조대소、위치급성질。 ESD조작보취:점막하주사액체이태고병조,접착예절개병조주위점막,지후사용Hook도혹IT도연병조점막하층완정박리병조。결과30례환자균순리완성ESD치료,병변직경1.0-3.5cm,평균2.3cm,ESD수술시간30-175min,평균73 min,ESD치료과정중창면균유소량출혈,균경전응혹금속태협지혈,무술후연지출혈발생,천공발생솔위6.7%(1/15),술후수방1-8개월,미견종류잔류혹복발。결론 ESD작위일충내경미창치료,능실현교대병조적완전박리,위림상제공완정적병이학자료,야위소화도점막급점막하량성종류적치료개벽료신적치료도경。
Objective To assess the clinical effects of endoscopic submucosal dissection (ESD) for gastrointestinal benign tu-mors. Methods 30 patients with gastrointestinal mucosal or submucosal benign tumors were enrolled,endoscopic ultrasonography and/or biopsy were applied to confirm the size,location and nature of lesions,the procedures of ESD was as follows;normal saline was injected into the submucosa to elevate the lesion,and the mucosa around the lesion were pre-cut,then dissecting the submu-cosal tissue and resecting the lesion completely with a hook knife or IT knife. Results ESD were successfully performed in 30 pa-tients,the lesions size ranged form 1.0 to 3.5cm (mean 2.3cm) and the operation time was 30 to 175min (mean 73min),mild bleed-ing occurred in all cases,which was stoped by electric coagulation or endoclip,no delayed bleeding occurred,the perforation rate of ESD was 6.7%(1/15),the patients were followed up for 1 to 8 months,no tumor residue or recurrence was observed. Conclusion ESD is a novel endoscopic procedure to resect gastrointestinal mucosal or submucosal benign tumors ,which makes it possible to resect whole large lesion and provide precise pathological information.