内镜黏膜下剥离术治疗大面积食管早期癌的随访分析

A follow-up survey of endoscopic submucosal dissection for widespread early esophageal superficial neoplasms

摘要:

摘要：目的??探讨内镜黏膜下剥离术（ESD）治疗大面积（剥离范围超过1/2周）食管早期癌的临床疗效及预后。方法?回顾性分析2015年1月1日－2019年1月1日在该院治疗的55例病灶范围超过1/2周的食管早期癌患者资料。根据剥离面积不同，分为A组（1/2<术后黏膜缺损<3/4周组）42例，B组（3/4≤术后黏膜缺损≤全周组）13例。对比两组疗效、并发症及随访情况。结果?随访周期3～48个月，A组狭窄率7.1%（3/42），B组都有不同程度的狭窄（100.0%）。两组在性别构成和病理类型方面差异无统计学意义（P >0.05），在狭窄发生率和狭窄程度方面差异有统计学意义（P <0.05）。结论?ESD能安全有效地治疗大面积食管早期癌，但术后需规律随访。ESD术后黏膜缺损范围在1/2～3/4者术后狭窄发生率较低，术后梗阻程度与病变位置有关，食管上段的狭窄程度较重。

Abstract:

Abstract: Objective?To evaluate the efficacy and analyze the prognosis of endoscopic submucosal dissection for widespread early esophageal superficial neoplasms.?Methods?Retrospective analysis was performed on the clinical data of 55 patients with widespread early esophageal superficial neoplasms and precancerous lesions in January 2015 to 2019. According to the peeling area, divided into 2 groups, group A (1/2 0.05), but there were statistically significant differences in stenosis incidence and stenosis degree (P < 0.05).?Conclusion?ESD is safely and effectively for large area of early esophageal cancer, but regular follow-up is required postoperration. The incidence of postoperative stenosis was lower in patients with ESD defect ranging from 1/2 to 3/4, the degree of postoperative obstruction was related to the lesion location, and the degree of stenosis in upper esophageal was more serious.