标题：内镜黏膜下剥离术治疗消化道隆起性病变18例疗效分析

      作者：朱晓蕾，陈志坦
    （南京明基医院消化内科南京医科大学附属医院，江苏 南京 210019）

      卷次： 2012年23卷23期

      【摘要】 目的 探讨内镜黏膜下剥离术（ESD）治疗消化道隆起性病变（含早癌）的疗效和安全
性。方法 对 2008年 8月至 2012年 6月南京明基医院消化科内镜中心发现的 18例消化道隆起性病变行ESD
治疗。术前行超声内镜确认病灶的深度。结果 手术全部一次性切除成功。病变长径0.8~5 cm (平均1.63 cm)，
ESD手术时间 40~120 min（平均 75 min），术后 1例出血，2例穿孔，皆保守治疗后治愈。术后病理提示间质瘤 2
例，息肉2例，1例异位胰腺，7例上皮内瘤变，6例早癌。所有ESD切除病变全部送检病理确诊，基底和切缘未见
病变累及。术后随访，创面愈合，无病变残留和复发。结论 ESD治疗消化道隆起性病变安全有效，可以提供完
整的病理诊断学资料。ESD可用于治疗消化道早癌。

      【关键词】 内镜黏膜下剥离术；消化道隆起性病变；早癌

      【中图分类号】 R57 【文献标识码】 A 【文章编号】 1003—6350（2012）23—058—03<

br>Endoscopic submucosal dissection for gastrointestinal elevated lesions.
ZHU Xiao-lei, CHEN Zhi-tan. Department
of Gastroenterology, BenQ Medical Center, Nanjing Medicai University, Nanjing 210019, Jiangsu, CHINA

【Abstract】 Objective To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) for
gastrointestinal elevated lesions including early cancer. Methods Between August 2008 to October 2011, 18 cases of
gastrointestinal elevated lesions were managed by ESD after endoscopic ultrasonography examination. Results All
lesions were removed completely for only once. The lesions ranged from 0.8 cm to 5 cm with a mean size of 1.6 cm.
The mean ESD procedure time was 75 min ( ranged from 40 min to 120 min ). One case of delayed bleeding and two
cases of perforation occurred and had been cured after conservative treatment. Pathological examination showed 2 cas-
es of stromal tumors, 2 cases of polyps, one case of ectopic pancreas, seven cases of intraepithelial neoplasia, six cases
of early carcinoma. Histological evaluation showed that the tunica of the tumors was intact, and both the lateral and
basal margins of the specimens were free of tumor cells. Followed up for 2 and 6 months after operation, all the cases
·临床经验·doi:10.3969/j.issn.1003-6350.2012.23.025