胃镜黏膜下剥离术治疗胃食管连接部黏膜病变30例临床分析

发布时间：2018-02-05 03:27

本文关键词： 黏膜病变胃食管连接部胃镜黏膜下剥离术胃镜检查　出处：《中华实用诊断与治疗杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨胃镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗胃食管连接部黏膜病变的疗效及安全性。方法回顾性分析30例胃食管连接部黏膜病变患者临床资料,分析病变特点及ESD治疗切除率和手术时间,随访观察术后并发症和复发情况。结果患者胃食管连接部黏膜病变直径(30±15)mm,ESD治疗完整切除率为100%,手术时间(45±16)min;术后1例有少量胃管内出血,未发生穿孔等并发症;组织病理确诊黏膜慢性炎症8例,萎缩性胃炎3例,增生性息肉6例,低级别上皮内瘤变9例,高级别上皮内瘤变3例,腺癌1例;平均随访18个月,无复发。结论 ESD治疗胃食管连接部黏膜病变的完整切除率高,安全。
[Abstract]:Objective to investigate endoscopic submucosal dissection in submucosal dissection. Methods the clinical data of 30 patients with gastroesophageal junction mucosal lesions were retrospectively analyzed. The characteristics of the lesions, the resection rate and the operation time of ESD were analyzed, and the postoperative complications and recurrence were observed. Results the diameter of mucosal lesions in the gastroesophageal junction was 30 卤15mm. The complete resection rate of ESD was 100 and the operation time was 45 卤16 minutes. There was a small amount of intragastric hemorrhage in 1 case, and no complications such as perforation occurred. 8 cases of chronic inflammation of mucosa, 3 cases of atrophic gastritis, 6 cases of proliferative polyps, 9 cases of low grade intraepithelial neoplasia, 3 cases of high grade intraepithelial neoplasia and 1 case of adenocarcinoma were confirmed by histopathology. Conclusion the complete resection rate of ESD for gastroesophageal junction mucosal lesions is high and safe.
【作者单位】：江阴市中医院内镜中心;复旦大学附属中山医院内镜中心;
【基金】：国家自然科学基金(81370588)
【分类号】：R655.4
【正文快照】： 胃食管连接部是鳞状上皮及柱状上皮交汇处,为食管与胃结合部位,管腔狭窄且为锐性转角,其特殊的解剖结构可增加术后并发症发生率[1]。胃食管连接部病变临床多采用开腹或腹腔镜手术,但术后可引起胃食管反流等。随着胃镜技术发展,临床对病变局限于上皮内、且无淋巴结转移的癌前病

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