80 岁以上老年患者内镜黏膜下剥离术特点

Characteristic of endoscopic submucosal dissection in elderly patients aged more than or equal to 80 years

摘要:

目的 分析80 岁以上老年患者内镜黏膜下剥离术（ESD）的临床特点。方法 回顾性分析陆 军总医院消化内镜中心从2010 年9 月-2017 年1 月行ESD 治疗的80 岁以上患者资料，41 例患者共行47 次 ESD。对病变部位、病理类型和并发症进行分析。结果 所有患者顺利完成ESD 术，食管病变3 例，胃病变 21 例，结肠病变10 例，直肠病变13 例。术后病理学检查早癌及癌前病变34 例，间质瘤2 例，神经内分泌肿 瘤1 例，其他病理类型10 例。1 例贲门早癌患者追加腹腔镜下淋巴结清扫手术。术后并发症7 例，4 例为术 后延迟出血，2 例为术后谵妄，1 例为肺部感染导致的发热。结论 80 岁以上患者结肠ESD 比例高，术后出血 为最主要并发症。

Abstract:

Objective To analyze the characteristic of endoscopic submucosal dissection (ESD) in elderly patients aged more than or equal to 80 years. Methods We retrospectively reviewed 41 patients aged more than or equal to 80 years with 47 lesions treated by ESD from September 2010 to January 2017. The diseased region, pathology and complications were evaluated. Results Of the 47 lesions, there have 3 esophageal lesions, 21 gastric lesions, 10 colonic lesions and 13 rectal lesions. For the pathology, there have 34 early cancer or precancerous lesion, 2 GIST, 1 neuroendocrine tumor and 10 other types of pathology. 1 cardia1 early cancer underwent additional laparoscopic lymphadenectomy. There have 7 complications, 4 post-ESD bleeding, 2 delirium and 1 pneumonia. Conclusion ESD for colorectal lesion is more frequently in elderly patients aged more than or equal to 80 years. Post-ESD bleeding is the main complication.