对3例巴雷特食管患者的大增生性息肉进行内镜下黏膜切除术。
Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett's esophagus.
作者信息
De Ceglie Antonella, Lapertosa Gabriella, Blanchi Sabrina, Di Muzio Marcello, Picasso Massimo, Filiberti Rosangela, Scotto Francesco, Conio Massimo
机构信息
Corso Garibaldi 187, Sanremo (IM) 3 18038, Italy.
出版信息
World J Gastroenterol. 2006 Sep 21;12(35):5699-704. doi: 10.3748/wjg.v12.i35.5699.
AIM
To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophago-gastric junction (EGJ) associated with Barrett's esophagus (BE) with low-grade dysplasia (LGD), by endoscopic mucosal resection (EMR).
METHODS
Cap fitted EMR (EMR-C) was performed in 3 patients with hyperplastic-inflammatory polyps (HIPs) and BE.
RESULTS
The polyps were successfully removed in the 3 patients. In two patients, with short segment BE (SSBE) (<= 3 cm), the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm multiply 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous re-epithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR.
CONCLUSION
EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.
目的
报告内镜下黏膜切除术（EMR）治疗与伴有低级别异型增生（LGD）的巴雷特食管（BE）相关的食管及食管胃交界（EGJ）处大型增生性息肉。
方法
对3例增生性炎性息肉（HIP）合并BE患者实施带帽EMR（EMR-C）。
结果
3例患者息肉均成功切除。2例短节段BE（SSBE）（<= 3 cm）患者的化生组织被完全切除。1例息肉累及整个EGJ的患者实施了2 cm环周EMR。同时还对1例大小为1 cm×10 cm的BE相关息肉样异型增生病变进行了EMR-C。2例患者组织学评估发现BE存在LGD。未发生并发症。2例SSBE患者均实现了完全的新生鳞状上皮再上皮化。其余1例出现食管复发，经EMR成功再次治疗。
结论
EMR-C似乎是治疗良性食管黏膜病变的一种安全有效的方法，还能完全切除SSBE。
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