Chirinos Vega J A, Vargas G, Alcántara C, Zapata J
Departamento de Gastroenterología, Clínica Angloamericana, Lima, Perú.
Servicio Gastroenterología, Hospital Nacional Arzobispo Loayza, Lima, Perú.
Rev Gastroenterol Mex (Engl Ed). 2018 Oct-Dec;83(4):393-399. doi: 10.1016/j.rgmx.2017.10.001. Epub 2018 Feb 9.
The aim of the present study was to evaluate the feasibility of endoscopic submucosal dissection (ESD) and determine the clinical and pathologic characteristics of early gastric cancers and premalignant lesions treated with that technique at the Hospital Nacional of the Department of Health and a private clinic in Lima, Peru.
A descriptive study of all pre-malignant and malignant gastric lesions treated with ESD at the Gastroenterology Service of the Hospital Arzobispo Loayza and the Clínica Angloamericana was conducted within the time frame of January 2012 and January 2017.
A total of 13 lesions were resected through ESD: 8 adenocarcinomas (61.53%), 3 adenomas with high-grade dysplasia (23%), and 2 adenomas with low-grade dysplasia (15.38%). Twelve lesions (92.3%) were located in the lower third of the stomach. Slightly elevated lesions (Paris classification IIa) (4 lesions, 30.76%) and mixed slightly elevated lesions with a depressed component (IIa+IIc) (4 lesions, 30.76%) predominated. The mean size of the resected specimens was 35mm. Complete resection of all lesions was achieved in 11 cases (84.6%) and en bloc resection was carried out in 11 cases (84.6%). Resection was curative in 6 cases (75%), from the total of 8 resected adenocarcinomas. One case of perforation was the only complication reported (7.6%) and it was surgically resolved.
The feasibility and efficacy of ESD for the treatment of early gastric cancer was demonstrated at two healthcare centers in Lima, Peru. The complication rate was similar to that reported in the international medical literature.
本研究旨在评估内镜黏膜下剥离术（ESD）的可行性，并确定在秘鲁利马的国家卫生部医院和一家私人诊所中，采用该技术治疗的早期胃癌及癌前病变的临床和病理特征。
对2012年1月至2017年1月期间在洛亚萨大主教医院胃肠病科和英裔美国人诊所接受ESD治疗的所有胃癌前病变和恶性病变进行描述性研究。
共通过ESD切除13个病变：8例腺癌（61.53%）、3例高级别异型增生腺瘤（23%）和2例低级别异型增生腺瘤（15.38%）。12个病变（92.3%）位于胃的下三分之一处。略隆起病变（巴黎分类IIa）（4个病变，30.76%）和伴有凹陷成分的略隆起混合病变（IIa+IIc）（4个病变，30.76%）占主导。切除标本的平均大小为35mm。11例（84.6%）实现了所有病变的完整切除，11例（84.6%）进行了整块切除。在8例切除的腺癌中，6例（75%）的切除为根治性。报告的唯一并发症为1例穿孔（7.6%），通过手术解决。
在秘鲁利马的两个医疗中心证实了ESD治疗早期胃癌的可行性和有效性。并发症发生率与国际医学文献报道的相似。
