内镜黏膜下剥离术联合铥激光治疗：一种治疗胃上皮性肿瘤新方法的初步结果。
Endoscopic submucosal dissection using a thulium laser: preliminary results of a new method for treatment of gastric epithelial neoplasia.
机构信息
Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.
出版信息
Endoscopy. 2013 Sep;45(9):725-8. doi: 10.1055/s-0033-1344215. Epub 2013 Jul 24.
BACKGROUND AND STUDY AIM
This study aimed to evaluate the feasibility of a novel laser system for endoscopic submucosal dissection (ESD) of gastric epithelial neoplasia.
PATIENTS AND METHODS
A total of 10 patients underwent ESD by a single expert endoscopist. A thulium 2-μm wavelength laser system was used for ESD procedures. Instead of using endoscopy knives, a 550-μm flexible silica fiber was inserted through the working channel of the endoscope.
RESULTS
In all patients, ESD was completed using only the thulium laser, without the need for endoscopy knives. The median total procedure time was 49 minutes (range 35 - 203). In 8 /10 patients (80 %), no active bleeding was observed during ESD. The final pathologic mapping revealed low-grade dysplasia (n = 4), differentiated adenocarcinoma (n = 5), and signet ring cell carcinoma (n = 1). Curative resection was achieved in 9 /10 patients (90 %). There were no significant complications, such as delayed bleeding or perforation.
CONCLUSIONS
The thulium laser system was feasible in ESD of gastric epithelial neoplasia.
背景和研究目的
本研究旨在评估一种新型激光系统用于内镜黏膜下剥离术（ESD）治疗胃上皮肿瘤的可行性。
患者和方法
总共 10 名患者由一位经验丰富的内镜专家进行 ESD。采用铥 2μm 波长激光系统进行 ESD 操作。与使用内镜刀不同，一根 550μm 柔软的二氧化硅纤维通过内镜的工作通道插入。
结果
所有患者均仅使用铥激光完成 ESD，无需使用内镜刀。中位总手术时间为 49 分钟（范围 35-203 分钟）。在 8/10 名患者（80%）中，ESD 过程中未观察到明显出血。最终病理显示低级别上皮内瘤变（n=4）、分化型腺癌（n=5）和印戒细胞癌（n=1）。9/10 名患者（90%）达到了根治性切除。无明显并发症，如延迟性出血或穿孔。
结论
铥激光系统可用于胃上皮肿瘤的 ESD。
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