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术前活检途径对早期胃癌患者内镜下黏膜下剥离术的影响。

Effect of route of preoperative biopsy on endoscopic submucosal dissection for patients with early gastric cancer.

作者信息

Jiang Hui, Tu Hui-Ming, Qiao Qiao, Xu Ke-Bin, Li Jie, Qi Xiao-Wei, Ge Xiao-Song

机构信息

Department of General Surgery, Jiangsu University Hospital, Wuxi, Jiangsu, China E-mail : thmercpthmercp @163.com.

出版信息

Asian Pac J Cancer Prev. 2014;15(20):8917-21. doi: 10.7314/apjcp.2014.15.20.8917.

Abstract

OBJECTIVE

To observe and compare the effects of multi-patch biopsy under conventional white light imaging endoscopy (C-WLI) and precise targeted biopsy under magnifying narrow-band imaging endoscopy (M-NBI) on the endoscopic submucosal dissection (ESD) of early gastric cancers and intraepithelial neoplasias.

METHODS

According to the way of selecting biopsy specimens, patients were divided into C-WLI and M-NBI groups, 20 cases. The ESD operations of the 2 groups were compared quantitively.

RESULTS

The mean frequency of biopsy in M-NBI group was (1.00±0.00), obviously lower than in the C-WLI group (4.78±1.02) (P<0.01).The average total number of selected biopsy specimens was also fewer (1.45±0.12 and 7.82±2.22, respectively, P<0.01). There was no significant difference in the time of determining excision extension, marking time and the time of specimen excision of 2 groups during the ESD (P>0.05), whereas submucosal injection time, mucosal dissection time, stopping bleeding time, wound processing time in the M-NBI group were significantly shorter than in the C-WLI group (P<0.01).

CONCLUSION

Precise targeted biopsy under M-NBI can obviously shorten the time of ESD operation, with small quantity of tissues but high pathological positive rate.

摘要

目的

观察并比较常规白光成像内镜(C-WLI)下多部位活检与放大窄带成像内镜(M-NBI)下精准靶向活检对早期胃癌及上皮内瘤变行内镜黏膜下剥离术(ESD)的效果。

方法

根据活检标本选取方式将患者分为C-WLI组和M-NBI组,每组20例。对两组的ESD手术进行定量比较。

结果

M-NBI组平均活检次数为(1.00±0.00),明显低于C-WLI组(4.78±1.02)(P<0.01)。所选活检标本的平均总数也较少(分别为1.45±0.12和7.82±2.22,P<0.01)。两组在ESD过程中确定切除范围时间、标记时间及标本切除时间差异无统计学意义(P>0.05),而M-NBI组黏膜下注射时间、黏膜剥离时间、止血时间、创面处理时间均明显短于C-WLI组(P<0.01)。

结论

M-NBI下精准靶向活检可明显缩短ESD手术时间,取材少但病理阳性率高。

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