Hua Xu Li, Jun Li Liang, Wen Zhou Chuan, Lin Ji Ying, Ye Tian, Liang Li Xue
Xu Li Hua, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing (210029), China.
Li Liang Jun, Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an (223300), China.
Pak J Med Sci. 2016 May-Jun;32(3):617-21. doi: 10.12669/pjms.323.9743.
Complications are important determining factors for safety of endoscopic submucosal dissection (ESD). ESD of large lesions is associated with increased procedural time. This study investigated whether double-channel gastroscope could be used to reduce procedural time in gastric antrum ESD.
A retrospective cohort study of 46 patients with one gastric antrum lesion resected by ESD was conducted between January 2013 and December 2015. The diameter of a lesion was from 2cm to 4cm in 46 patients. EUS before ESD was used to evaluate the submucosal vascular structure and the location of lesion in gastric wall. Forty six lesions had ESD with either the ordinary gastroscope (OS group) (n=24) or the double-channel gastroscope (DC group) (n=22).
The mean procedural time was significantly lower in the DC group than in the OS group (49.1 minutes vs. 20.5 minutes, p=0.04). There were no significant differences in submucosal injection frequency, specimen size, en bloc resection rate and perforation rate between the two endoscopic groups. There was no recurrence in any case during the follow-up period.
Our data suggest that ESD utilizing double-channel gastroscope may provide a better platform for quicker ESD with equal safety.
并发症是内镜黏膜下剥离术（ESD）安全性的重要决定因素。大病变的ESD与手术时间延长有关。本研究探讨双通道胃镜是否可用于缩短胃窦ESD的手术时间。
对2013年1月至2015年12月期间46例行胃窦病变ESD切除的患者进行回顾性队列研究。46例患者病变直径为2cm至4cm。ESD前采用超声内镜评估黏膜下血管结构及病变在胃壁的位置。46个病变分别采用普通胃镜（OS组）（n = 24）或双通道胃镜（DC组）（n = 22）进行ESD。
DC组的平均手术时间显著低于OS组（49.1分钟对20.5分钟，p = 0.04）。两组内镜治疗在黏膜下注射频率、标本大小、整块切除率和穿孔率方面无显著差异。随访期间无一例复发。
我们的数据表明，使用双通道胃镜进行ESD可能为在同等安全性下更快地进行ESD提供更好的平台。
