Feng Xiuxue, Linghu Enqiang, Chai Ningli, Lu Zhongsheng, Wang Xiangdong, Tang Ping, Meng Jiangyun, Du Hong, Wang Hongbin
Department of Gastroenterology, Chinese PLA General Hospital, Beijing 100853, China.
Gastroenterol Res Pract. 2018 Mar 6;2018:1419369. doi: 10.1155/2018/1419369. eCollection 2018.
To evaluate the efficacy and safety of endoscopic submucosal tunnel dissection (ESTD) for resection of large superficial gastric lesions (SGLs).
The clinicopathological records of patients performed with ESTD or endoscopic submucosal dissection (ESD) for SGLs between January 2012 and January 2014 were retrospectively reviewed. 7 cases undergoing ESTD were enrolled to form the ESTD group. The cases were individually matched at a 1 : 1 ratio to other patients performed with ESD according to lesion location, ulcer or scar findings, resected specimen area, operation time and operators, and the matched cases constituting the ESD group. The treatment outcomes were compared between the two groups.
The mean specimen size was 46 mm. 10 lesions were located in the cardia and 4 lesions in the lesser curvature of the lower gastric body. En bloc resection was achieved for all lesions. The mean ESTD resection time was 69 minutes as against 87.7 minutes for the ESD ( = 0.01). The mean resection speed was faster for ESTD than for ESD (18.86 mm/min versus 13.76 mm/min, = 0.03). There were no significant differences regarding the safety and curability during the endoscopic follow-up (mean 27 months).
ESTD is effective and safe for the removal of SGLs and appears to be an optimal option for patients with large SGLs at suitable sites.
评估内镜黏膜下隧道剥离术（ESTD）切除大型浅表性胃病变（SGLs）的疗效和安全性。
回顾性分析2012年1月至2014年1月期间接受ESTD或内镜黏膜下剥离术（ESD）治疗SGLs患者的临床病理记录。纳入7例行ESTD的患者组成ESTD组。根据病变位置、溃疡或瘢痕表现、切除标本面积、手术时间和手术者，将病例按1:1比例与其他行ESD的患者进行个体匹配，匹配病例组成ESD组。比较两组的治疗效果。
标本平均大小为46mm。10处病变位于贲门，4处病变位于胃体下部小弯侧。所有病变均实现整块切除。ESTD平均切除时间为69分钟，而ESD为87.7分钟（P = 0.01）。ESTD的平均切除速度比ESD快（18.86mm/min对13.76mm/min，P = 0.03）。在内镜随访期间（平均27个月），安全性和治愈率方面无显著差异。
ESTD切除SGLs有效且安全，对于合适部位的大型SGLs患者似乎是一个最佳选择。
