Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of General Practice, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2018 Jul 14;24(26):2878-2885. doi: 10.3748/wjg.v24.i26.2878.
To evaluate the clinical outcomes of patients who underwent endoscopic submucosal tunnel dissection (ESTD) for esophageal squamous cell carcinoma (ESCC) and precancerous lesions.
ESTD was performed in 289 patients. The clinical outcomes of the patients and pathological features of the lesions were retrospectively reviewed.
A total of 311 lesions were included in the analysis. The en bloc rate, complete resection rate, and curative resection rate were 99.04%, 81.28%, and 78.46%, respectively. The ESTD procedure time was 102.4 ± 35.1 min, the mean hospitalization time was 10.3 ± 2.8 d, and the average expenditure was 3766.5 ± 846.5 dollars. The intraoperative bleeding rate was 6.43%, the postoperative bleeding rate was 1.61%, the perforation rate was 1.93%, and the postoperative infection rate was 9.65%. Esophageal stricture and positive margin were severe adverse events, with an incidence rate of 14.79% and 15.76%, respectively. No tumor recurrence occurred during the follow-up period.
ESTD for ESCC and precancerous lesions is feasible and relatively safe, but for large mucosal lesions, the rate of esophageal stricture and positive margin is high.
评估内镜黏膜下隧道剥离术（ESTD）治疗食管鳞状细胞癌（ESCC）及癌前病变患者的临床疗效。
对 289 例患者行 ESTD 治疗，回顾性分析患者的临床疗效及病变的病理特征。
共纳入 311 处病变，整块切除率、完全切除率及治愈性切除率分别为 99.04%、81.28%和 78.46%。ESTD 手术时间为 102.4±35.1 min，平均住院时间为 10.3±2.8 d，平均费用为 3766.5±846.5 美元。术中出血率为 6.43%，术后出血率为 1.61%，穿孔率为 1.93%，术后感染率为 9.65%。食管狭窄和切缘阳性为严重不良事件，发生率分别为 14.79%和 15.76%。随访期间无肿瘤复发。
ESTD 治疗 ESCC 及癌前病变是可行且相对安全的，但对于较大的黏膜病变，食管狭窄和切缘阳性的发生率较高。
