CAJ | 학술논문

目的：探讨联合超声内镜（EUS）行内镜下切除〔内镜下黏膜切除术（ EMR）、内镜黏膜下剥离术（ESD）〕治疗消化道类癌的安全性与可靠性。方法对宜昌市中心人民医院消化内镜室2004年3月—2011年8月行常规检查时发现消化道黏膜面呈半球状隆起的患者18例，患者常规内镜检查考虑消化道类癌后均行 EUS 检查，对其中直径<1 cm 的行 EMR 治疗，直径1~2 cm 的行 ESD 治疗。结果18例患者 EUS 所见考虑肿瘤可能，未累及肌层，其中17例病灶深度判断正确。病灶部位为直肠11例，胃3例，食管2例，十二指肠球部2例；18例患者均成功完成内镜下切除治疗，17例切除完整，1例病变与肌层有粘连，转手术治疗。术后随访患者均未发现肿瘤复发及转移。结论联合 EUS 行内镜下切除治疗直径≤2 cm 且未累及肌层的消化道类癌安全可靠。
목적：탐토연합초성내경（EUS）행내경하절제〔내경하점막절제술（ EMR）、내경점막하박리술（ESD）〕치료소화도유암적안전성여가고성。방법대의창시중심인민의원소화내경실2004년3월—2011년8월행상규검사시발현소화도점막면정반구상륭기적환자18례，환자상규내경검사고필소화도유암후균행 EUS 검사，대기중직경<1 cm 적행 EMR 치료，직경1~2 cm 적행 ESD 치료。결과18례환자 EUS 소견고필종류가능，미루급기층，기중17례병조심도판단정학。병조부위위직장11례，위3례，식관2례，십이지장구부2례；18례환자균성공완성내경하절제치료，17례절제완정，1례병변여기층유점련，전수술치료。술후수방환자균미발현종류복발급전이。결론연합 EUS 행내경하절제치료직경≤2 cm 차미루급기층적소화도유암안전가고。
Objectjve To investigate the safety and reliability of endoscopic ultrasonography( EUS),endoscopic mucosa resection(EMR)and endoscopic submucosal dissection(ESD)for patients with gastrointestinal carcinoid. Methods A total of 18 patients confirmed with gastrointestinal carcinoid in Gastrointestinal Endoscopy Room of Yichang Central People′s Hospital from March 2004 to August 2011 were selected,and patients who showed hemispherical hump on the mucosa surface of the digestive tract were analyzed retrospectively. EUS was performed when the gastrointestinal carcinoid was suspected after endoscopy. EMR was performed when the diameter of the lesions were less than 1 cm,and ESD was performed when the diameter of the lesions were from 1 cm to 2 cm. Results Eighteen cases were suspected of carcinoid without muscular layer involvement, and 17 patients were diagnosed accurately in terms of the depth of lesion. The lesions were located in rectum(11 cases), stomach(3 cases),esophagus(2 cases)and duodenal bulb(2 cases). All the 18 cases were given endoscopic therapy successfully,with 17 cases having complete resection. One case was converted to surgery due to adhesion of lesion and muscularis. No recurrent carcinoid or metastasis occurred during the follow - up. Conclusjon The EUS examination and endoscopic resection is feasible and reliable for patients with gastrointestinal carcinoid less than 2 cm in diameter without muscular layer involvement.