Seewald S, Ang T L, Gotoda T, Soehendra N
Center of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland.
Endoscopy. 2008 Dec;40(12):1016-20. doi: 10.1055/s-0028-1103401. Epub 2008 Dec 8.
Barrett's esophagus with high grade intraepithelial neoplasia is associated with disease progression at rates of greater than 10% per year. Endoscopic resection is a lower risk alternative to surgery for the management of high grade intraepithelial neoplasia and intramucosal cancer. Two endoscopic approaches have been used, namely localized resection of the lesion and total endoscopic resection of all Barrett's mucosa. The latter strategy removes all at-risk mucosa. Currently it is performed mainly using piecemeal endoscopic mucosal resection techniques. In recent years endoscopic submucosal dissection has been attempted to obtain en bloc resection. This review will describe the techniques of total endoscopic resection, and summarize the key published data.
伴有高级别上皮内瘤变的巴雷特食管每年疾病进展率超过10%。对于高级别上皮内瘤变和黏膜内癌的治疗，内镜下切除是一种比手术风险更低的选择。已经使用了两种内镜治疗方法，即病变的局部切除和所有巴雷特黏膜的全内镜切除。后一种策略可切除所有有风险的黏膜。目前主要采用内镜下黏膜分片切除术进行全内镜切除。近年来，已尝试使用内镜下黏膜下剥离术进行整块切除。本综述将描述全内镜切除技术，并总结已发表的关键数据。
