Wong Vivien Wai Yin, Goto Osamu, Gregersen Hans, Chiu Philip Wai Yan
Division of Upper GI and Metabolic Surgery, Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.
Curr Treat Options Gastroenterol. 2017 Dec;15(4):603-617. doi: 10.1007/s11938-017-0152-0.
Purpose of Review The study aimed to discuss novel endoscopic approaches to resection of submucosal lesions. Recent Findings Endoscopic resection by excavation, full-thickness resection, and submucosal tunneling are by now well-documented techniques for submucosal tumor resection. Combined approaches with laparoscopy such as several variations of laparoscopic endoscopic cooperation surgery (LECS) and non-exposed wall-inversion surgery (NEWS) are also possible now. Reports of these approaches show good results. However, lesion size is the main limitation to these approaches. Summary Endoscopic submucosal tumor resection can be effectively done endoscopically or by endoscopy combined with laparoscopy. These techniques allow localized resection of lesions at difficult locations such as in the gastroesophageal junction with limited influence on the normal anatomy. Variations in techniques are being practiced worldwide striving to achieve complete resection with minimal disturbance of function or contamination. The choice between approaches depends largely on the size and site of the lesion and expertise available.
综述目的 本研究旨在探讨切除黏膜下病变的新型内镜方法。
最新发现 目前，内镜下挖除术、全层切除术和黏膜下隧道切除术是用于切除黏膜下肿瘤的成熟技术。现在也可以采用与腹腔镜联合的方法，如腹腔镜内镜协作手术（LECS）的几种变体和非暴露壁翻转手术（NEWS）。这些方法的报告显示出良好的效果。然而，病变大小是这些方法的主要限制因素。
总结 内镜下黏膜下肿瘤切除术可以通过内镜或内镜联合腹腔镜有效地完成。这些技术能够在诸如胃食管交界处等困难部位对病变进行局部切除，对正常解剖结构的影响有限。世界各地都在实践技术的变体，力求在对功能影响最小或污染最少的情况下实现完整切除。方法的选择很大程度上取决于病变的大小和部位以及现有的专业技术水平。
