小于7毫米的胃黏膜癌采用传统内镜黏膜切除术治疗的效果与内镜黏膜下剥离术相同。
Gastric mucosal cancer smaller than 7mm can be treated with conventional endoscopic mucosal resection as effectively as with endoscopic submucosal dissection.
作者信息
Watanabe Tatsuyuki, Kume Keiichiro, Taip Mayumi, Shibata Michihiko, Kubo Hiroaki, Ejiri Yutaka, Otsuki Makoto
机构信息
Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan.
出版信息
Hepatogastroenterology. 2010 May-Jun;57(99-100):668-73.
BACKGROUND/AIMS: Recently, endoscopic submucosal dissection (ESD) has been accepted for the treatment of gastrointestinal mucosal neoplasms because of the higher en bloc resection rate. However, ESD is technically more difficult, requires a longer procedure time and has more frequent complications compared with conventional endoscopic mucosal resection (EMR). We evaluated retrospectively the clinical outcomes of ESD compared with EMR to determine the size of the lesion for choosing EMR rather than ESD.
METHODOLOGY
Three hundred and sixty-five lesions of early gastric cancer were treated endoscopically (146 by EMR and 219 by ESD). We compared en bloc resection, residual tumor and recurrence-free rates between EMR and ESD.
RESULTS
En bloc resection rate was significantly higher with ESD (88.5%) than EMR (45.2%). With regard to lesions < or = 7mm in size, en bloc resection, residual tumor and recurrence-free rates did not differ.
CONCLUSIONS
Gastric mucosal cancer < or = 7mm can be treated with EMR as effectively as with ESD.
背景/目的：近来，内镜黏膜下剥离术（ESD）因其整块切除率更高，已被用于治疗胃肠道黏膜肿瘤。然而，与传统内镜黏膜切除术（EMR）相比，ESD技术难度更大，手术时间更长，并发症更常见。我们回顾性评估了ESD与EMR的临床结果，以确定选择EMR而非ESD的病变大小。
方法
对365例早期胃癌病变进行了内镜治疗（146例采用EMR，219例采用ESD）。我们比较了EMR和ESD之间的整块切除、残留肿瘤和无复发生存率。
结果
ESD的整块切除率（88.5%）显著高于EMR（45.2%）。对于大小≤7mm的病变，整块切除、残留肿瘤和无复发生存率没有差异。
结论
直径≤7mm的胃黏膜癌采用EMR治疗与ESD同样有效。
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