Reshamwala Preeti A, Darwin Peter E
Division of Gastroenterology and Hepatology, University of Maryland Medical Center, Baltimore, Maryland, USA.
Curr Opin Gastroenterol. 2006 Sep;22(5):541-5. doi: 10.1097/01.mog.0000239870.04457.80.
Endoscopic mucosal resection for early gastric cancer is a widely accepted and practiced technique in countries such as Japan and China where the prevalence of gastric cancer is significantly higher than in the US. This review discusses standard endoscopic mucosal resection methods, as well as newly developed techniques. Data are reviewed in terms of complete resection rates and disease-free survival so as to allow endoscopists to determine which treatment options are best for their patients.
Within the past few years, new endoscopic mucosal resection and submucosal dissection techniques have been developed. These techniques may allow for the treatment of lesions that are not suitable for endoscopic treatment, especially in high-risk patients.
As gastroenterologists and surgeons in the West become more familiar and experienced with the techniques of endoscopic mucosal resection and submucosal dissection, patients will benefit from these minimally invasive therapeutic techniques. Although controlled studies are needed, in the future these methods may also be used to treat other early malignant conditions of the gastrointestinal tract.
对于早期胃癌,内镜黏膜切除术在胃癌患病率显著高于美国的日本和中国等国家是一种广泛接受且应用的技术。本综述讨论标准内镜黏膜切除方法以及新开发的技术。从完全切除率和无病生存率方面对数据进行回顾,以便内镜医师确定哪种治疗方案最适合其患者。
在过去几年中,已开发出新的内镜黏膜切除和黏膜下剥离技术。这些技术可能允许治疗不适合内镜治疗的病变,尤其是在高危患者中。
随着西方的胃肠病学家和外科医生对内镜黏膜切除和黏膜下剥离技术更加熟悉且经验丰富,患者将从这些微创治疗技术中受益。尽管需要对照研究,但未来这些方法也可能用于治疗胃肠道的其他早期恶性疾病。