全周内镜下黏膜剥离术治疗长段巴雷特腺癌：1例报告
Treatment of long-segment Barrett's adenocarcinoma by complete circular endoscopic submucosal dissection: a case report.
作者信息
Kaneko Miki, Mitoro Akira, Yoshida Motoyuki, Sawai Masayoshi, Okura Yasushi, Furukawa Masanori, Namisaki Tadashi, Moriya Kei, Akahane Takemi, Kawaratani Hideto, Kitade Mitsuteru, Kaji Kousuke, Takaya Hiroaki, Sawada Yasuhiko, Seki Kenichiro, Sato Shinya, Fujii Tomomi, Yamao Junichi, Obayashi Chiho, Yoshiji Hitoshi
机构信息
Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
出版信息
BMC Gastroenterol. 2018 Jan 19;18(1):16. doi: 10.1186/s12876-018-0743-9.
BACKGROUND
We present the first description of en bloc endoscopic submucosal dissection (ESD) for total circumferential Barrett's adenocarcinoma, predominantly of the long-segment Barrett's esophagus (LSBE), with a 2-year follow-up and management strategies for esophageal stricture prevention.
CASE PRESENTATION
A 59-year-old man was diagnosed with LSBE and Barrett's adenocarcinoma by esophagogastroduodenoscopy (EGD). A 55-mm-long circumferential tumor was completely resected by ESD. Histopathology revealed a well-differentiated adenocarcinoma within the LSBE superficial muscularis mucosa. For post-ESD stricture prevention, the patient underwent an endoscopic triamcinolone injection administration, oral prednisolone administration, and preemptive endoscopic balloon dilatation. Two years later, there is no evidence of esophageal stricture or recurrence.
CONCLUSIONS
ESD appears to be a safe, effective option for total circumferential Barrett's adenocarcinoma in LSBE.
背景
我们首次描述了用于全周性巴雷特腺癌（主要为长段巴雷特食管[LSBE]）的整块内镜下黏膜剥离术（ESD），并进行了2年随访以及预防食管狭窄的管理策略。
病例介绍
一名59岁男性经食管胃十二指肠镜检查（EGD）诊断为LSBE和巴雷特腺癌。通过ESD完整切除了一个55毫米长的周缘性肿瘤。组织病理学显示LSBE黏膜肌浅层内为高分化腺癌。为预防ESD术后狭窄，患者接受了内镜下曲安奈德注射、口服泼尼松龙以及预防性内镜下球囊扩张。两年后，没有食管狭窄或复发的迹象。
结论
ESD似乎是治疗LSBE中全周性巴雷特腺癌的一种安全、有效的选择。
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